Monica Hauger Carlsen

• Rinde, Ludvig Balteskard; Hopstock, Laila Arnesdatter; Lundblad, Marie Wasmuth; Rinde, Nikoline Balteskard; Brobak, Karl Marius & Norvik, Jon Viljar Porserud [Show all 13 contributors for this article] (2026). Higher habitual protein intake is not linked to decline of iohexol-measured GFR in adults ≥40 years. Clinical Kidney Journal (CKJ). ISSN 2048-8505. 19(8), p. 1–10. doi: 10.1093/ckj/sfag235. Full text in Research Archive
• Husøy, Trine; Andreassen, Monica; Bernhard, Annette; Bruzell, Ellen Merete; Carlsen, Monica Hauger & Denison, Eva Marie-Louise [Show all 13 contributors for this article] (2026). Risk assessment of nitrate, nitrite and N-nitrosamines in food – Part 2. VKM Report. 2026(5), p. 1–186. Full text in Research Archive Show summary

  Nitrate and nitrite occur naturally in food, especially in vegetables, but are also used as food additives (E 249–252) in certain products to inhibit bacterial growth. Nitrate is permitted for use, for example, in some types of cheese, meat, and fish, while nitrite is permitted in certain processed meat products. Both nitrate and nitrite may also occur as contaminants, including in drinking water. Nitrate can be converted to nitrite, and nitrite can react with naturally occurring amines to form nitrosamines, several of which are carcinogenic. Conversion of nitrate and nitrite can occur both in food and in the body (endogenous formation). VKM has assessed whether nitrate, nitrite, and nitrosamines exposure may pose a health risk to the Norwegian population. The assessment includes ten nitrosamines that have been detected in food and classified as carcinogenic. VKM estimated both the dietary intake of these substances and the contributing exposure from the formation of nitrite and nitrosamines in the body. Exposure estimates are based on national dietary surveys and data on the occurrence of these substances in food. VKM used three intake levels: typical (median), average, and high intake (95th percentile). A typical intake reflects what is common in the population, while a high intake represents the top 5% of consumers. Storage and processing can influence the conversion of nitrate to nitrite and nitrite to nitrosamines in food. Since most available occurrence data were from raw foods, VKM developed a model to estimate concentrations in ready-to-eat foods. The purpose was to provide a more realistic estimate of exposure than from estimates based on raw foods alone. To estimate the total exposure to nitrite and nitrosamines, both from food and endogenous formation, VKM further developed mathematical models for endogenous formation. Since nitrate is converted to nitrite, which is responsible for the critical health effect, and this conversion was included in the total nitrite exposure, VKM did not perform a separate risk characterisation for nitrate. VKM compared exposure levels with reference values established by the European Food Safety Authority (EFSA): • For nitrite, EFSA has set an acceptable daily intake (ADI) of 0.07 mg/kg body weight per day, including a safety margin of 100, to protect against increased levels of methemoglobin in the blood, which can reduce oxygen transport. This condition is rare, it can be reversible but is potentially serious. The ADI is an estimate of the amount of a substance that can be consumed daily over a lifetime without appreciable health risk. For carcinogenic substances such as the nitrosamines in this risk assessment, health risk is assessed using the Margin of Exposure (MOE). This is defined as the ratio between the dose causing increased cancer risk in animal studies and the estimated human exposure. An MOE above 10,000 indicates low health concern. Regarding exposure to nitrite and nitrosamines, VKM found the following: • Typical and average dietary exposure to nitrite was below ADI for all age groups. High intake (P95) exceeded the ADI for 1- and 4-year-olds and adults, while it was below for 2-, 9-, and 13-year-olds. • When endogenous formation was included, the total nitrite exposure in all age groups and intake levels exceeded the ADI (except typical intake in adults). • The estimated nitrite exposure is at similar level to those of EFSA when endogenous production is included. • MOE values for nitrosamines were below 10,000 for all intake levels and age groups. • Nitrosamine exposure in Norway is similar to that observed in other European countries. • The main source of exposure to nitrate was vegetables, while meat and meat products were the main sources of nitrite and nitrosamines. A major limitation of this assessment was the lack of data on nitrosamine levels in several food groups that are important contributors to nitrite exposure, particularly vegetables. This makes it difficult to assess whether, and to what extent, these food groups contribute to nitrosamine exposure. To investigate how compliance with the Norwegian dietary guidelines may affect exposure to nitrites and nitrosamines, VKM developed two scenarios based on recommended intake levels. Scenario 1 represented the lower guidance intake (e.g. 500 g fruits and vegetables per day and no red meat), while Scenario 2 represented the upper guidance intake (e.g. 800 g fruits and vegetables and up to 50 g unprocessed red meat per day). Since these scenarios cover only part of the total diet, actual exposure may be higher or lower depending on other foods consumed. The exposure estimates were adjusted for energy intake to enable comparison with average intake in adults, as calculated from the national dietary survey Norkost 4. Regarding how compliance with the dietary guidelines may affect exposure to nitrite and nitrosamines, VKM found the following: • Both scenarios resulted in higher nitrate and nitrite intake compared to the intake in Norkost 4, mainly due to increased vegetable consumption. • Nitrosamine exposure was lower in Scenario 1 and similar in Scenario 2. For the food groups included in the dietary guidelines, occurrence data were available for meat and cheese only. VKM concludes the following regarding the risk from nitrite exposure: • Total exposure, i.e. dietary and endogenous formation, exceeded the ADI at average and high (P95) intake levels in adults, and may therefore imply an increased risk of adverse health effects (methemoglobinemia). • Typical and average exposure to nitrite from food alone was below the ADI for all age groups. The same applies to high intake (P95) for 2-, 9- and 13-year-olds. This indicates negligible risk of adverse health effects at these exposure levels. High intake (P95) among 1- and 4-year-olds as well as adults exceeded the ADI and may therefore imply an increased risk of adverse health effects (methemoglobinemia) in these groups. • In adults, the endogenous synthesis of nitrite from nitrate was up to five-fold higher than the estimated nitrite exposure from food (external exposure). Total exposure was not estimated for other age groups than adults, however, by assuming that endogenous formation is of the same order of magnitude across age groups, it cannot be excluded that total exposure at typical, average, and high (P95) intake levels also exceeds the ADI in these age groups. This may indicate an increased risk of adverse health effects (methemoglobinemia) across more exposure levels and age groups. There is greater uncertainty associated with total exposure than with exposure from food alone. VKM concludes the following regarding the risk from nitrosamine exposure: • MOE values were below 10,000 for all age groups at typical, average, and high intake levels. This implies that VKM cannot exclude an increased risk of cancer resulting from dietary exposure to nitrosamines in the Norwegian population.

• Pferdmenges, Larissa E.; Colombani, Paolo C.; Carlsen, Monica Hauger; Pajari, Anne Maria; Poulsen, Anders & Dias, M. Graça [Show all 12 contributors for this article] (2025). Toward harmonizing protein data in food composition databases: evaluating perspectives, methods and implications. Critical reviews in food science and nutrition. ISSN 1040-8398. 65(33), p. 8502–8515. doi: 10.1080/10408398.2025.2503461. Full text in Research Archive Show summary

  Protein content in foods has historically been estimated by multiplying measured nitrogen content with a universal nitrogen-to-protein conversion factor (NCF) of 6.25. Despite scientific consensus that this approach leads to systematic overestimations due to variations in amino acid composition and non-protein nitrogen (NPN) content, no universally accepted revision has been implemented. This review critically examines diverse perspectives on protein quantification and their implications for Food Composition Databases (FCDBs). A structured definition of protein for FCDBs is proposed, including amino acid residues, free amino acids and small peptides, while explicitly excluding NPN and prosthetic groups. Furthermore, analytical methods and NCF calculations are evaluated in order to provide more accurate assessments of protein content across a range of food matrices. The review highlights the importance of selecting food-specific NCFs to reduce overestimations, ensuring both scientific accuracy and practical feasibility. By addressing methodological shortcomings and proposing a refined protein quantification framework, this work aims to facilitate the transition toward more precise and harmonized protein values in FCDBs, benefiting nutritional research, dietary guidelines, and food labeling regulations.

• Kucuk, Bahar; Rylander, Charlotta; Carlsen, Monica Hauger; Lundblad, Marie Wasmuth; Andersen, Lene Frost & Skeie, Guri (2025). Environmental impact of food consumption and sociodemographic factors in Northern Norway through an intersectional lens: A cross-sectional study. BMC Public Health. 25, p. 1–15. doi: 10.1186/s12889-025-23899-3. Full text in Research Archive Show summary

  Abstract Background: Food systems contribute significantly to environmental degradation. The interplay of sociodemographic factors influences food choices and thus, the environmental impacts of diet. This study investigated the environmental impact of food consumption in Northern Norway, focusing on intersectional dynamics. Methods: A cross-sectional design was employed using data from the Tromsø Study. The diet was assessed using a food frequency questionnaire, and the environmental impacts of the diet were estimated for greenhouse gas emissions, water use, land use, acidification, and eutrophication using a Norwegian life cycle analysis food database. Multiple linear regression analyses were performed to examine the associations with sociodemographic variables using three-way interactions with sex, education, and income in an inter-categorical intersectionality framework. Pairwise contrasts were calculated to assess the mean differences between interacting groups. Results: The typical diet in Northern Norway substantially impacts the environment, with dairy products being the primary contributor. When controlling for energy intake, age was inversely linked to the environmental impact, whereas a higher body mass index corresponded to a greater environmental impact. No clear association with sex was observed, and the associations among environmental impact, education, and income varied. Including intersectional analyses did not significantly improve the explanatory power of the models. Although a few pairwise comparisons were statistically significant, the effect sizes were generally small. Conclusion: The study underscores the complex dynamics of dietary habits and sociodemographic factors in shaping the environmental impact of food consumption. The findings are important to develop approaches that balance sustainability perspectives and the diverse needs of the population in Northern Norway.

• Arnesen, Erik Kristoffer; Christensen, Jacob J.; Laake, Ida; Carlsen, Monica Hauger; Veierød, Marit Bragelien & Retterstøl, Kjetil (2025). Low-fat and whole milk consumption in relation to cardiovascular disease–related and all-cause mortality: a prospective cohort study in 3 Norwegian counties. American Journal of Clinical Nutrition. ISSN 0002-9165. 122(4), p. 1075–1085. doi: 10.1016/j.ajcnut.2025.07.035. Full text in Research Archive Show summary

  Background The impact of milk consumption on cardiovascular disease (CVD) risk or mortality is unclear, and specific comparisons between types of milk are scarce. Objectives We aimed to investigate the associations between milk consumption, measured in a large Norwegian cohort in 3 counties during 1974–1988, and CVD–related mortality and all-cause mortality and to compare the associations between whole (full-fat) and low-fat milk. Methods This population-based, prospective cohort study included adults invited to repeated health screenings in the Norwegian Counties Study (>80% attendance). Dietary intake was assessed from food frequency questionnaires at each screening in 1974–1988. Cox regression analysis was used to estimate hazard ratios (HRs) with 95% CIs for the associations between milk intake (assessed as cumulative mean intake from repeated questionnaires) and risk of death from all CVD, ischemic heart disease (IHD), acute myocardial infarction (AMI), and all causes. Results Among 73,860 participants included in this study (mean age: 41.2 years at baseline; 49% females), 26,393 deaths occurred (8590 from CVD, 4372 from IHD, and 3047 from AMI) during a median follow-up of 33 y. Comparing the highest with the lowest quintile of overall milk intake, the HR was 1.12 (95% CI: 1.03, 1.21) for CVD-related mortality and 1.22 (95% CI: 1.16, 1.28) for all-cause mortality. For whole milk, high compared with no intake was positively associated with CVD (HR: 1.07; 95% CI: 0.99, 1.16), IHD (HR: 1.13; 95% CI: 1.01, 1.27), and all-cause mortality (HR: 1.15; 95% CI: 1.10, 1.21). Compared with whole milk, low-fat milk intake was associated with lower CVD-related, IHD-related, AMI-related, and all-cause mortality. The associations were attenuated in analyses considering only baseline intakes. Conclusions In this cohort with high milk consumption, whole milk is associated with higher CVD and all-cause mortality, whereas low-fat milk is not. Low-fat milk may be associated with lower risks than whole milk.

• Trømborg, Åsne Skram; Vik, Jon Olav; Carlsen, Monica Hauger & Carlsen, Harald (2025). The prevalence and co-occurrence of emulsifiers, thickeners and stabilizers in food products on the Norwegian market. Food & Nutrition Research (FNR). ISSN 1654-6628. 69. doi: 10.29219/fnr.v69.12986. Full text in Research Archive Show summary

  Background: As the intake of food that has undergone substantial processing increases, the intake of common additives like Emulsifiers, Thickeners, and Stabilizers (ETSs) also increases. Several ETSs have drawn attention due to potential negative health effects. Objective: This study aimed to map the prevalence and co-occurrence patterns of ETSs across food products on the Norwegian market, examining their distribution across different food groups and products with varying nutritional profiles, including those classified as hyper-palatable. Design: Food product information, including ingredient lists and nutritional information, was obtained from two online databases used by major grocery chains, thus representative of the Norwegian market and analyzed for presence or absence of ETSs. Results: Thirty-two percent of food products contained at least one ETS, 60% of these contained more than one ETS, and many ETSs were found more frequently in combinations with others than individually. ETSs were present in a broad range of food products, with the highest percentage seen in the food groups Bakery, Cakes & Pastries, and Desserts & Ice cream. Mono- and diglycerides of fatty acids (E471) and diphosphates (E450) were the most used food additives. Fifty-eight percent of the food products analyzed were classified as hyper-palatable, though relationships with ETSs were variable across food groups. Conclusion: This is the first comprehensive analysis of its kind, providing a basemap for future research on the potential health effects of modern food products, particularly considering the limited understanding of how multiple ETSs may interact within biological systems.

• Carlsen, Monica Hauger; Bjøntegaard, Marie Michaelsen; Oort, Bob van; Jafarzadeh, Sepideh; Mehta, Shraddha & Wright, Ellen Cecilie [Show all 7 contributors for this article] (2025). Environmental impact of Norwegian food and beverages: compilation of a life cycle assessment food database. Food & Nutrition Research (FNR). ISSN 1654-6628. 69, p. 10645–10645. doi: 10.29219/fnr.v69.10645. Full text in Research Archive Show summary

  Background: Food production contributes to greenhouse gas emissions and pollution. Climate and environmental impacts from food production vary across geographical areas. To estimate these impacts of food and diets, country-specific data are needed. Objective: This project aimed to compile an environmental impact food database, including the impact categories (ICs) global warming potential, soil acidification, freshwater and saltwater eutrophication, water use and land use, representative of the Norwegian diet. Design: The compilation was based on literature searches for original life cycle assessment (LCA) studies on foods, including domestic and imported foods, which constitute the habitual diet in Norway. Food items of importance in the average Norwegian diet were identified based on the national dietary survey Norkost 3. The study’s generic system boundaries included impacts from farm to fork: production, processing, packaging, transportation, storage and food preparation at home. Conversion factors for edible portions were applied when relevant. When LCA data of a certain food were missing, data from foods with similar cultivation conditions and nutritional composition were used as proxies. Data from other LCA food databases were also used if original LCA studies were not identified, or the LCA studies found were evaluated as being of poor quality. Results: The compiled database is tailored specifically for and covers main animal- and plant-based foods in the Norwegian diet. Discussion: Limitations of the compilation project include the fact that most LCA studies identified in the present project covered ICs up to the farm gate and used varying methodology. Also, proxy values were used when data for specific food items were missing. These methodological issues introduce variability and complicate direct comparisons. The strength of the present study is the thorough work in compiling and filling data gaps for the IC values of foods in the Norwegian diet. Conclusions: The Norwegian LCA food database enables simultaneous estimation of food and nutrient intakes and estimation of climate and environmental impacts of Norwegian diets.

• Svendsen, Camilla; Andreassen, Monica; Bruzell, Ellen Merete; Denison, Eva Marie-Louise; Devold, Tove Gulbrandsen & Granum, Berit Brunstad [Show all 9 contributors for this article] (2025). Update of the scoping review of research on gastrointestinal effects of selected emulsifiers, stabilisers, and thickeners. VKM Report. 2025(2025: 03), p. 1–63. doi: https:/vkm.no/download/18.66c3e761195a46a3cfe39417/1742306403051/Rapport_Update%20of%20the%20scoping%20review%20of%20research%20on%20gastrointestinal%20effects%20of%20selected%20emulsifiers,%20stabilisers,%20and%20thickeners_Final%20(1).pdf. Full text in Research Archive Show summary

  In an updated scoping review of research on the effects of emulsifiers, stabilisers and thickeners on the gastrointestinal tract, VKM concludes that there are few studies in which the substance studied fulfills the criteria for being used as a food additive. None of the included studies were suitable for assessing long-term effects in humans, and the uncertainty related to the results and conclusions of the studies were high. Emulsifiers, stabilisers and thickeners (EST) Emulsifiers, stabilisers and thickeners are additives used in food to improve and preserve consistency. Emulsifiers are used to mix water and fats, thickeners are used to make food more viscous, and stabilisers can be used to prevent the precipitation. Substances that do not meet the criteria in the EU regulations for food additives, which are also followed in Norway, may have different biological properties than the approved additives. Studies of emulsifiers, stabilisers and thickeners that do not describe the substances in such a way that they unambiguously satisfied the criteria could, therefore, not be included in the overview. The emulsifiers, stabilisers and thickeners included in this scoping review were carrageenan (E 407), sodium carboxymethyl cellulose (E 466), sodium alginate (E 401), agar (E 406), processed Eucheuma seaweed (E 407a), guar gum (E 412), xanthan gum (E 415), and gellan gum (E 418). Few new studies were included in the updated scoping review In 2023, VKM mapped the research on what types of effects had been studied in the gastrointestinal tract in animals, humans or in organ models after exposure to the above-mentioned eight EST. VKM found that there was insufficient information about the substances in 214 studies, and therefore we could not assess whether the reported effects in these studies were due to the approved EST or to similar substances with other properties. "In this updated scoping review, VKM sent requests by email to the corresponding authors of the publications, whenever such contact information was available," says Trine Husøy, who was the chair of the project group. "Following receipt of the requested information, six of these studies were included. It was also confirmed that in some studies, the substance tested did not fulfill the criteria for use as food additives in Norway/EU. This shows the importance of including specific eligibility criteria also for the substances. The literature search was updated, but no new studies fulfilling all eligibility criteria were identified." Conclusion The conclusion in the present updated scoping review, after inclusion of six additional studies, remains the same as in the previous scoping review (VKM, 2023). The included studies on the effects of agar (E 406), sodium alginate (E 401), carrageenan (E 407), processed Eucheuma seaweed (E 407a), sodium carboxymethyl cellulose (E 466), guar gum (E 412) and xanthan gum (E 415) on the gastrointestinal tract were few, and in most of the studies the potential for systematic errors in the results or findings was high. None of the studies lasted long enough to evaluate long-term exposure in humans. Thus, the evidence base will be weak for assessment of risk for any negative effects on the gastrointestinal tract in humans. Share this page

• Zerouga, Insaf; Valeur, Jørgen; Sommer, Christine; Carlsen, Monica Hauger; Hagen, Milada & Høivik, Marte Lie [Show all 22 contributors for this article] (2025). Habitual Intake of Macronutrients and Fermentable Oligo-, Di-, Monosaccharides and Polyols is not associated with Irritable Bowel Syndrome-like Symptoms in Inflammatory Bowel Disease. Clinical Nutrition ESPEN. ISSN 2405-4577. 67, p. 105–113. doi: 10.1016/j.clnesp.2025.03.005. Full text in Research Archive
• Engstad, Martin Kvalvik; Seynnes, Olivier R.; Vesterhus, Ingvild; Hesseberg, Eirik; Fjeldberg, Ken & Carlsen, Monica Hauger [Show all 12 contributors for this article] (2025). Effect of Oral Contraceptive Use on Muscle Hypertrophy Following Strength Training. Scandinavian Journal of Medicine & Science in Sports. ISSN 0905-7188. 35(4). doi: 10.1111/sms.70052. Full text in Research Archive Show summary

  Oral contraceptives (OC) are widely used by women, while their interactions with strength training are yet to be resolved. This study investigated the effects of OC use on muscle hypertrophy and strength adaptation to heavy strength training in young adult women. Fifteen habitual OC users and 17 non-OC users (NOC) with regular menstrual cycles completed ~12 weeks of strength training, which spanned three menstrual cycles for the NOC group. All participants were young, healthy, and strength-untrained. Isometric knee-extensor strength, muscle cross-sectional area of the vastus lateralis (ultrasound imaging), and body composition (DXA) were used to evaluate training adaptations. Blood samples for estradiol and progesterone analyses, dietary registrations, and questionnaires assessing appetite, vitality, motivation, recovery status, and sleep duration were collected during the intervention period. Both groups experienced gains in lean mass and muscle strength. However, the OC group demonstrated a significantly larger increase in arm lean mass (5.5% ± 3.9% [mean ± standard deviation] vs. 2.9% ± 2.8%, p < 0.05) and vastus lateralis cross-sectional area (10.0% ± 4.1% vs. 5.3% ± 4.4%, p < 0.05) compared to the NOC group. Despite these differences, there was no significant group difference in lower body strength gains. Both groups reported similar levels of appetite, dietary intake, vitality, motivation to exercise, and perceived recovery throughout the study, although the OC group slept an average of 42 min longer per day. Our findings suggest that OC use potentiates muscle growth during strength training, although further research is needed to elucidate the underlying mechanisms and long-term effects.

• Henriksen, Hege; Knudsen, Markus Dines; Hjartåker, Anette; Blomhoff, Rune & Carlsen, Monica Hauger (2024). Digital Food Frequency Questionnaire Assessing Adherence to the Norwegian Food-Based Dietary Guidelines and Other National Lifestyle Recommendations: Instrument Validation Study. Journal of Medical Internet Research (JMIR). ISSN 1439-4456. 26. doi: 10.2196/53442. Full text in Research Archive Show summary

  Background: Valid assessment tools are needed when investigating adherence to national dietary and lifestyle guidelines. Objective: The relative validity of the new digital food frequency questionnaire, the DIGIKOST-FFQ, against 7-day weighed food records and activity sensors was investigated. Methods: In total, 77 participants were included in the validation study and completed the DIGIKOST-FFQ and the weighed food record, and of these, 56 (73%) also used the activity sensors. The DIGIKOST-FFQ estimates the intake of foods according to the Norwegian food–based dietary guidelines (FBDGs) in addition to lifestyle factors. Results: At the group level, the DIGIKOST-FFQ showed good validity in estimating intakes according to the Norwegian FBDG. The median differences were small and well below portion sizes for all foods except “water” (median difference 230 g/day). The DIGIKOST-FFQ was able to rank individual intakes for all foods (r=0.2-0.7). However, ranking estimates of vegetable intakes should be interpreted with caution. Between 69% and 88% of the participants were classified into the same or adjacent quartile for foods and between 71% and 82% for different activity intensities. The Bland-Altman plots showed acceptable agreements between DIGIKOST-FFQ and the reference methods. The absolute amount of time in “moderate to vigorous intensity” was underestimated with the DIGIKOST-FFQ. However, estimated time in “moderate to vigorous intensity,” “vigorous intensity,” and “sedentary time” showed acceptable correlations and good agreement between the methods. The DIGIKOST-FFQ was able to identify adherence to the Norwegian FBDG and physical activity recommendations. Conclusions: The DIGIKOST-FFQ gave valid estimates of dietary intakes and was able to identify individuals with different degrees of adherence to the Norwegian FBDG and physical activity recommendations. Moderate physical activity was underreported, water was overreported, and vegetables showed poor correlation, which are important to consider when interpreting the data. Good agreement was observed between the methods in estimating dietary intakes and time in “moderate to vigorous physical activity,” “sedentary time,” and “sleep.”

• Slaathaug, Christine; Paulsen, Mari Mohn; Jafarzadeh, Sepideh; Carlsen, Monica Hauger & Andersen, Lene Frost (2024). Nutritional quality and climate impact of Norwegian adults’ diet classified according to the NOVA system. Nutrition Journal. 23(1), p. 1–12. doi: 10.1186/s12937-024-01066-5. Full text in Research Archive Show summary

  Information about how ultra-processed foods (UPF) contribute to the intake of energy and nutrients and environmental impact is important for future food policies and dietary recommendations. This study assessed the contribution of the four NOVA food groups, including UPF, to energy intake, nutritional quality, and climate impact in Norwegian adults' diet. We used dietary data from 348 participants in the Norkost 4 pilot study, collected through two non-consecutive 24-h dietary recalls. Foods, beverages, and dietary supplements were classified using the NOVA system. The NOVA system has four groups; NOVA 1: Unprocessed or minimally processed foods, NOVA 2: Processed culinary ingredients, NOVA 3: Processed foods, and NOVA 4: UPF. UPF contributed to 48% of the total energy intake, NOVA 3 with 19%, and NOVA 1 with 28%. Within UPF, bread contributed the most to energy intake. Foods in NOVA 1 had the highest nutrient density (expressed as amount of nutrients provided per unit of energy) for protein, fiber, and several essential micronutrients. UPF had the highest nutrient density for added sugar, fats, and sodium. UPF contributed to 32% of total GWP from the diet, while NOVA 1 contributed to 38%. In conclusion, UPF contributed to about half of the energy intake of Norwegian adults, and had lower nutritional quality compared to NOVA 1. UPF also accounted for about one-third of the GWP from the total diet. These findings emphasize the importance of addressing the intake of UPF in dietary policies and recommendations to improve nutritional quality and reduce environmental impact.

• Lengle, Julie Marie; Bjøntegaard, Marie Michaelsen; Carlsen, Monica Hauger; Jafarzadeh, Sepideh & Andersen, Lene Frost (2024). Environmental impact of Norwegian self-selected diets: comparing current intake with national dietary guidelines and EAT-Lancet targets. Public Health Nutrition (PHN). ISSN 1368-9800. 27(1). doi: 10.1017/S1368980024000715. Full text in Research Archive Show summary

  Objectives: Dietary environmental impact in a Norwegian adult population was estimated for six environmental impact categories. Moreover, environmental benefits of scenario diets complying with the Norwegian Food-Based Dietary Guidelines (FBDG) and the EAT-Lancet reference diet were assessed. Design: The current diet of Norwegian adults was estimated according to 24-h dietary recall data from a national dietary surveillance survey (Norkost 3). Scenario diets were modelled to represent the Norwegian FBDG and the EAT-Lancet healthy reference diet. Dietary environmental impact in terms of global warming potential, freshwater and marine eutrophication, terrestrial acidification, water use and transformation and use of land was estimated for the current and scenario diets using environmental impact data representative of the Norwegian market. Significant associations between impact and gender/educational attainment were assessed at P < 0·05. Setting: Norway. Participants: Adults (n=1787) aged 18–70 years who participated in the Norkost 3 survey (2010–2011). Results: Environmental impact varied significantly by gender and educational attainment. The food groups contributing most to environmental impact of Norwegian diets were meat, dairy, beverages, grains and composite dishes. Compared with the current Norwegian diet, the FBDG scenario reduced impacts from 2 % (freshwater eutrophication) to 32 % (water use), while the EAT-Lancet scenario reduced impacts from 7 % (marine eutrophication) to 61 % (land use). The EAT-Lancet scenario resulted in 3–48 % larger reductions in impact than the FBDG scenario. Conclusions: The Norwegian FBDG, while not as environmentally friendly as the EAT-Lancet reference diet, can still be an important tool in lessening environmental burden of Norwegian diets.

• Carlsen, Monica H.; Totland, Torunn Holm; Kumar, Radhika; Lensnes, Therese Margrethe Lysell; Sharma, Archana & Suntharalingam, A. Anita [Show all 9 contributors for this article] (2024). Evaluation of a digital FFQ using 24 h recalls as reference method, for assessment of habitual diet in women with South Asian origin in Norway. Public Health Nutrition (PHN). ISSN 1368-9800. 27(1). doi: 10.1017/S1368980024000302. Full text in Research Archive Show summary

  Objective: Dietary assessment tools should be designed for the target population. We developed an FFQ designed to assess diet in South Asian women in Norway. The study objective was to evaluate this FFQ using 24-h dietary recalls as reference method. Design: Approximately 3 weeks after the participants (n 40) had filled in the FFQ, the first of three non-consecutive 24-h dietary recalls was completed. The recalls were telephone-based, unannounced and performed by a trained dietitian, with 2–3 weeks between each interview. Setting: The DIASA 1 study, in Oslo, Norway. Participants: Women of South Asian ethnic origin participating in the DIASA 1 study were invited to participate in the evaluation study. Results: The WebFFQasia significantly overestimated the absolute intake of energy, protein, fat and carbohydrates compared with the 24-h dietary recalls. Absolute intakes of sugar, starch and fibre did not differ significantly between the methods. For energy percentages (E%), there were no significant differences, except for monounsaturated fat. Correlations were strong for E% from sugar and saturated fat and moderate for E% from fibre, carbohydrate, total fat and protein. Fourteen food groups out of twenty three were not significantly different compared with the reference method, and sixteen groups showed strong to moderate correlations. Conclusion: The WebFFQasia may be used to assess E% from habitual diet and can adequately estimate intakes and rank participants according to nutrient intake and main food categories at group level.

• Arnesen, Erik Kristoffer; Laake, Ida; Carlsen, Monica Hauger; Veierød, Marit Bragelien & Retterstøl, Kjetil (2024). Potato Consumption and All-Cause and Cardiovascular Disease Mortality – A Long-Term Follow-Up of a Norwegian Cohort. Journal of Nutrition. ISSN 0022-3166. 154(7), p. 2226–2235. doi: 10.1016/j.tjnut.2024.05.011. Full text in Research Archive Show summary

  Background Potatoes are a staple food in many traditional cuisines, yet their impact on long-term risk of cardiovascular disease (CVD) and mortality is unclear, hampering evidence-based dietary guidelines. Objectives This study aimed to examine the association between potato consumption and all-cause and CVD-specific death over a substantial follow-up period within a cohort predominantly consuming boiled potatoes. Methods Adults from 3 Norwegian counties were invited to 3 health screenings in 1974–1988 (>80% attendance). Dietary data were collected using semiquantitative food frequency questionnaires at each screening to categorize weekly potato consumption (≤6, 7–13, or ≥14 potatoes/wk) and calculate daily cumulative mean intakes (grams/day). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression to estimate HRs and 95% CIs for the association between potato consumption and risk of death from all causes, CVD, ischemic heart disease (IHD), and acute myocardial infarction (AMI). Results Among 77,297 participants with a mean baseline age of 41.1 y (range: 18.0–63.9 y), we observed 27,848 deaths, including 9072 deaths due to CVD, over a median follow-up of 33.5 y. Participants who consumed ≥14 potatoes/wk had a lower risk of all-cause death compared with those consuming ≤6 potatoes/wk (HR: 0.88; 95% CI: 0.84, 0.93). Potato consumption was associated with a minor, inverse risk of death due to CVD, IHD, and AMI. In continuous analyses of cumulative intakes, each 100 g/d increment was associated with 4% lower risk of death from all causes (HR: 0.96; 95% CI: 0.94, 0.98), CVD (HR: 0.96; 95% CI: 0.93, 0.99), IHD (HR: 0.96; 95% CI: 0.91, 1.00), and AMI (HR: 0.96, 95% CI: 0.91, 1.01). Conclusions In this cohort with a generally high consumption of predominantly boiled potatoes, we find modest, inverse associations between potato consumption and death from all causes, CVD, and IHD.

• Holm, Ida Marie; Lorentzen, Sissi C. Stove; Carlsen, Monica Hauger; Valeur, Jørgen; Mellin-Olsen, Tonje & Dale, Hanna Fjeldheim (2024). Evaluation of dietary quality in patients with functional gastrointestinal symptoms: a Norwegian single centre study. Food & Nutrition Research (FNR). ISSN 1654-6628. 68. doi: 10.29219/fnr.v68.10692. Full text in Research Archive Show summary

  Background: Poor dietary quality has been described as a contributor to symptoms in subjects with functional gastrointestinal (GI) symptoms. Hitherto, the focus in dietary evaluation and treatment in this patient group has mainly been on avoiding individual nutrient deficiencies, and less attention has been given to the dietary pattern and the overall food quality. Hence, we aim to describe and evaluate the dietary quality in patients with functional GI symptoms. Methods: Patients with GI symptoms and a diagnosis of irritable bowel syndrome or inflammatory bowel disease in remission, consecutively referred to a clinical dietitian for nutritional guidance, were included. All participants completed a 7-day weighed food record. The intake of foods, energy, macro- and micronutrients was computed. Dietary quality was evaluated by intake frequencies based on a predefined food index, combined with assessing achievement of nutrient intake recommendations. Results: A total of 35 patients were included. Intake frequencies of red meat, cheese and sweets were high, whereas intake frequencies of green leafy vegetables, berries, nuts, whole grain and legumes were low. The total intake of vegetables, fruit, berries, fish and nuts was lower than current recommendations, and the intake corresponded to intake below recommendations for several micronutrients, including vitamins D, C and A; iodine; folate; potassium; and selenium. Conclusion: The group of patients with GI symptoms had overall inadequate dietary quality. Low intake of nutrient-dense food groups considered as beneficial for health corresponded with insufficient intake of several micronutrients. We recommend that dietary evaluation should focus on the intake of food groups, rather than nutrients, in the treatment of patients with functional GI symptoms, to ensure a better evaluation of dietary quality.

• Konglevoll, Dina Moxness; Andersen, Lene Frost; Thoresen, Magne; Totland, Torunn Holm; Hopstock, Laila Arnesdatter & Hjartåker, Anette [Show all 7 contributors for this article] (2024). Dietary trajectories over 21 years and frailty in Norwegian older adults: the Tromsø Study 1994–2016. European Journal of Nutrition. ISSN 1436-6207. 63, p. 2987–2998. doi: 10.1007/s00394-024-03482-z. Full text in Research Archive Show summary

  Purpose To investigate the association between five dietary trajectories over 21 years and frailty in Norwegian older adults.<p> <p>Methods This study used data from three surveys of the Tromsø Study. Diet was measured using food frequency questionnaires at baseline (Tromsø4, 1994–95), after 7 years (Tromsø5, 2001) and at the end of follow-up (Tromsø7, 2015–16). Survey-specific diet scores were constructed based on the Nordic Nutrition Recommendations 2023 and group-based trajectory modelling was used to derive dietary trajectories. At follow-up, frailty was assessed with a 41-item frailty index. Linear regression analysis was performed to assess the associations between dietary trajectories and frailty, adjusted for baseline variables. <p>Results Among the 715 participants, 55% were women, with an average age of 54 years at baseline and 74 years at followup. The dietary trajectories ‘moderately healthy’ and ‘healthy increase’ were associated with a lower frailty index score at follow-up (β = −0.02, 95% confidence interval (CI)=−0.04, −0.002, β = −0.03, 95% CI=−0.06, −0.007), compared with the ‘unhealthy’ trajectory. <p>Conclusion Our findings suggest that maintaining a moderately healthy to very healthy diet from mid-life into older age is associated with a lower risk of frailty and supports the promotion of a healthy diet from adulthood to facilitate healthy ageing.

• Zerouga, Insaf; Valeur, Jørgen; Sommer, Christine; Småstuen, Milada Cvancarova; Medhus, Asle Wilhelm & Lund, Charlotte [Show all 22 contributors for this article] (2024). Dietary intake and nutritional status in patients with newly diagnosed inflammatory bowel disease: insights from the IBSEN III study. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 59(6), p. 1–9. doi: 10.1080/00365521.2024.2313056. Full text in Research Archive Show summary

  Background: Dietary recommendations in inflammatory bowel disease (IBD) are inconclusive, and patients may follow restrictive diets with increased risk of malnutrition. The aim of this study was to compare dietary intakes and nutritional status in men and women with newly diagnosed IBD with a general population sample, and to investigate whether intakes were in line with the Nordic Nutrition Recommendations. Methods: This was a cross-sectional study including adults≥ 40 years with IBD from the Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III cohort study. A validated food frequency questionnaire (FFQ) was used in dietary data collection, and a sample from the seventh survey of the Tromsø Study was included as a comparison group. Results: A total of 227 men and women with IBD were included. IBD patients had higher intake of grain products, sweetened beverages, energy, fat and polyunsaturated fat (PUFA), but lower intake of dairy products, alcohol and iodine compared to adults from the comparison sample (p < 0.01). Intakes of saturated fat and carbohydrates in both genders, and vitamin D in women were not within recommended levels. Anemia and hypoalbuminemia were more prevalent in IBD patients than in the comparison sample. Conclusions: Dietary intakes in newly diagnosed IBD patients were mostly in line with Nordic Nutrition Recommendations. Higher proportion of IBD patients exceeded recommended allowances of fat and added sugar than the comparison sample. Insufficient micronutrient intake, anemia and hypoalbuminemia are present challenges in IBD patients that require monitoring.

• Knudsen, Markus Dines; Carlsen, Monica Hauger; Hjartåker, Anette; Blomhoff, Rune & Henriksen, Hege (2024). Reproducibility and comparison of a digital food frequency questionnaire (DIGIKOST-FFQ) assessing adherence to national diet and lifestyle recommendations. Food & Nutrition Research (FNR). ISSN 1654-6628. 68. doi: 10.29219/fnr.v68.10366. Full text in Research Archive Show summary

  Background: We have developed a digital semi-quantitative food frequency and lifestyle questionnaire, the DIGIKOST-FFQ, based on the validated paper-based NORDIET-FFQ. Objective: The study aims to investigate the reproducibility of the DIGIKOST-FFQ and to compare the DIGIKOST-FFQ against the NORDIET-FFQ for the adjusted questions for intakes of fruits, vegetables, whole grains, fish, meat, and dairy products. Design: Participants were recruited from May to September 2021 through a random sample from the National Population Register and advertisements on Facebook in Norway. In the reproducibility study, the DIGIKOST-FFQ was completed twice by the participants, 1–2 months apart. In the comparison study, the DIGIKOST-FFQ was completed 1–2 months prior to the NORDIET-FFQ. Results: In the reproducibility study, 317 individuals were included. For 12 out of 16 food groups there were no significant differences in intake estimations between the first and second DIGIKOST-FFQ administrations. A small but significant median difference was observed for fruits (6 g/day) and vegetables (24 g/day). Correlations were satisfactory for all items (r = 0.60–1.00), and in the cross-classification 85% of the participants were classified into the same or adjacent quartile for all items. The comparison study included 81 individuals. Compared to the NORDIET-FFQ a significant median difference was observed for fruits 29 g/day, vegetables 36 g/day, whole grains –10 g/day, and red meat –11 g/day, but not for fish, processed meat, or dairy products. Conclusion: The DIGIKOST-FFQ was able to reproduce diet and lifestyle at the group level. An intended difference for the food groups where questions had been adjusted, was observed between DIGIKOST-FFQ and NORDIET-FFQ in the comparison study.

• Holm, Ida Marie; Dale, Hanna Fjeldheim; Lorentzen, Sissi C. Stove; Mellin-Olsen, Tonje & Carlsen, Monica Hauger (2024). Evaluation of a dietary record used in treatment of patients with functional gastrointestinal symptoms: an initial study. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. 22(3), p. 138–147. doi: 10.18261/ntfe.22.3.5. Full text in Research Archive Show summary

  Background and aim: To evaluate diet and facilitate appropriate dietary interventions in patients with functional gastrointestinal symptoms, it is necessary to assess dietary intake. Dietitians at Lovisenberg Diaconal Hospital (LDH) have developed a dietary record to assess diet and symptoms in this patient group. This tool has been used in clinical practice for several years, but its ability to assess dietary intake has not been evaluated. The present study aimed to evaluate the Lovisenberg Food Records’ (LFR) ability to assess the frequency of intake of predefined food groups, compared to a weighed food record (WFR) as a reference method. Methods: Patients with functional gastrointestinal symptoms were recruited from the gastroenterology outpatient clinic at LDH. Participants completed the LFR for 14 days, followed by completion of a 7-day WFR. The intake frequency of predefined food groups was assessed and compared between methods. Results: A total of 35 participants were included. There was reasonably good agreement between the LFR and the WFR for the majority of food groups. The LFR showed underestimation of Other vegetables, Poultry and Nuts, and there were large individual variations. Conclusion: Our findings indicate that the LFR may be able to indicate the frequency of food intake, and thus enable clinical evaluation of food and symptom associations in patients with functional gastrointestinal symptoms. Due to the small sample size and individual variation, the results should be interpreted with caution.

• Moe, Åse Mari; Ytterstad, Elinor; Hopstock, Laila Arnesdatter; Løvsletten, Ola; Carlsen, Monica Hauger & Sørbye, Sigrunn Holbek (2023). Associations and predictive power of dietary patterns on metabolic syndrome and its components. NMCD. Nutrition Metabolism and Cardiovascular Diseases. ISSN 0939-4753. doi: 10.1016/j.numecd.2023.10.029. Full text in Research Archive Show summary

  Background and aims: Metabolic syndrome (MetS) defines important risk factors in the development of cardiovascular diseases and other serious health conditions. This study aims to investigate the influence of different dietary patterns on MetS and its components, examining both associations and predictive performance.<p> <p>Methods and results: The study sample included 10,750 participants from the seventh survey of the cross-sectional, population-based Tromsø Study in Norway. Diet intake scores were used as covariates in logistic regression models, controlling for age, educational level and other lifestyle variables, with MetS and its components as response variables. A diet high in meat and sweets was positively associated with increased odds of MetS and elevated waist circumference, while a plant-based diet was associated with decreased odds of hypertension in women and elevated levels of triglycerides in men. The predictive power of dietary patterns derived by different dimensionality reduction techniques was investigated by randomly partitioning the study sample into training and test sets. On average, the diet score variables demonstrated the highest predictive power in predicting MetS and elevated waist circumference. The predictive power was robust to the dimensionality reduction technique used and comparable to using a data-driven prediction method on individual food variables. <p>Conclusions: The strongest associations and highest predictive power of dietary patterns were observed for MetS and its single component, elevated waist circumference.

• Devold, Tove Gulbrandsen; Andreassen, Monica; Carlsen, Monica Hauger; Denison, Eva Marie-Louise; Mathisen, Gro Haarklou & Rasinger, Josef [Show all 10 contributors for this article] (2023). Mapping of nutrients, food additives and contaminants in plant-based and gluten-free food products and their meat-, dairy- and gluten-containing counterparts. VKM Report. Full text in Research Archive
• Carlsen, Monica Hauger; Kielland, Ellen; Markhus, Maria Wik & Dahl, Lisbeth (2023). Iodine concentration in tap water, mineral water, and coffee. Food & Nutrition Research (FNR). ISSN 1654-6628. 67. doi: 10.29219/fnr.v67.9517. Full text in Research Archive Show summary

  Sufficient iodine intake is important for thyroid function and, particularly, among women of reproductive age. Water is a universal component of the diet and could be an important source of iodine. Iodine concentration in drinking water varies geographically. It is therefore of nutritional interest to explore the variation and the contribution of iodine from water and beverages.

• Megen, Frida van; Fossli, Maria; Skodje, Gry Irene; Carlsen, Monica Hauger; Andersen, Lene Frost & Veierød, Marit Bragelien [Show all 8 contributors for this article] (2023). Nutritional assessment of women with celiac disease compared to the general population. Clinical Nutrition ESPEN. ISSN 2405-4577. 54, p. 251–257. doi: 10.1016/j.clnesp.2023.01.031. Full text in Research Archive Show summary

  Background & aims The nutritional quality of a gluten-free diet is debated because of the elimination of grains that are important sources of nutrients. The aim of this cross-sectional study was to perform a nutritional assessment in treated women with celiac disease and ongoing symptoms, and compare dietary intake with a healthy reference group (Norkost 3). Methods Celiac disease patients with biopsy confirmed mucosal healing, but persistent gastrointestinal symptoms, were included from an ongoing clinical trial. Nutritional assessment included anthropometrics, blood samples and dietary intake obtained by two 24 h recalls. Dietary intake in celiac women was compared with dietary intake in healthy women (Norkost 3). Two sample t-test was used for comparison of CeD and Norkost 3 women. Adjustment for age, BMI, education and smoking, by use of multiple linear regression analysis, did not change the results. Results In total, 59 women with celiac disease and 925 women that participated in Norkost 3 were included, with a mean age of 45 years in both groups. Women with celiac disease had a higher proportion of energy (E%) from fat (39 vs 34%, P < 0.001) and saturated fat (15 vs 13%, P = 0.01), a lower E% from protein (16 vs 18%, P = 0.01) and a lower intake of dietary fiber (19 vs 22 g, P = 0.002) compared to Norkost 3 women. Women with celiac disease had a lower intake of bread, fruit and milk, and a higher intake of cereals and cheese compared to Norkost 3 women. The average requirement was not met for several micronutrients, but blood analysis revealed few nutritional deficiencies: two women with insufficient vitamin D status and one with insufficient folic acid status. Conclusion The women with celiac disease had an unbalanced diet with a higher intake of total- and saturated fatty acids and a lower intake of fiber compared to the general population. These findings emphasizes the need for nutritional follow-up of celiac patients and development of nutrient dense gluten-free products.

• Saunders, Carina Madelen; Rehbinder, Eva Maria; Carlsen, Karin Cecilie Lødrup; Jonassen, Christine M; Leblanc, Marissa Erin & Nordlund, Bjørn Kristian [Show all 10 contributors for this article] (2023). Feeding Practices and Dietary Diversity in the First Year of Life: PreventADALL, a Scandinavian Randomized Controlled Trial and Birth Cohort Study. Journal of Nutrition. ISSN 0022-3166. 153(8), p. 2463–2471. doi: 10.1016/j.tjnut.2023.06.015. Full text in Research Archive Show summary

  Background Breastmik is considered the optimal source of nutrition in early infancy. However, recommendations and practices for when and how complementary food should be introduced in the first year of life vary worldwide. Early introduction of allergenic foods may prevent food allergies, but if early food introduction influences infant feeding practices is less known. Objectives We sought to assess infant feeding practices in the first year of life and to determine if early interventional food introduction influences breastfeeding and dietary diversity. Methods Dietary intake was assessed in infants from the population-based clinical trial Preventing Atopic Dermatitis and ALLergies (PreventADALL) in children study. A total of 2397 infants were cluster-randomized at birth into 4 different groups: 1) control, 2) skin intervention, 3) introduction to 4 allergenic foods between 3 and 4 mo of age: peanut, cow milk, wheat, and egg, as small tastings until 6 mo, and 4) combined skin and food interventions. Dietary data were available from at least one of the 3-, 6-, 9-, and 12-mo questionnaires in 2059 infants. In the present analysis, groups 1 and 2 constitute the No Food Intervention group, whereas groups 3 and 4 constitute the Food Intervention group. We used the log-rank test and Cox regression to assess the impact of food intervention on age of breastfeeding cessation. Mixed effects logistic regression was used to compare dietary diversity, defined as the number of food categories consumed, between intervention groups. Results At 3, 6, 9, and 12 mo, 95%, 88%, 67%, and 51% were breastfed, respectively, and breastfeeding duration was not affected by the food intervention. In the No Food Intervention group, mean age of complementary food introduction was 18.3 wk (confidence interval [CI]: 18.1, 18.5). In the Food Intervention group, the dietary diversity score was 1.39 units (CI: 1.16, 1.62) higher at 9 mo (P < 0.001) and 0.7 units (CI: 0.5, 0.9) higher at 12 mo (P < 0.001) compared to the No Food Intervention group. Conclusions Early food intervention did not affect breastfeeding rates and increased dietary diversity at 9 and 12 mo.

• Wright, Ellen Cecilie; Oort, Bob van; Bjøntegaard, Marie Michaelsen; Carlsen, Monica Hauger & Andersen, Lene Frost (2023). Environmental and nutritional assessment of young children’s diets in Norway: comparing the current diet with national dietary guidelines and the EAT-Lancet reference diet. European Journal of Nutrition. ISSN 1436-6207. 62, p. 3383–3396. doi: 10.1007/s00394-023-03243-4. Full text in Research Archive Show summary

  Purpose Introducing healthy and sustainable diets early in life can promote lifelong healthy dietary patterns with a low environmental impact. Therefore, we aimed to estimate the environmental and nutritional consequences of a dietary change for 2-year-old children in Norway towards healthier dietary patterns. Methods Environmental impacts of the current habitual diet among 2-year-olds (n = 1413) were estimated for six impact categories and compared with scenario diets based on the Norwegian food-based dietary guidelines (FBDG) and the EAT-Lancet Commission reference diet. Last, we evaluated the nutritional adequacy of the diets against the Norwegian nutrition recommendations for children aged 2–5 years. The current diet was assessed by an FFQ. Results Environmental impacts of the current habitual diet were up to two times higher than those of the scenario diets. Compared with the current diet, impacts from the FBDG scenario diet were reduced by 35% for water use and 18% for terrestrial acidification, whereas impacts from the EAT-Lancet scenario diet were reduced by 51% for water use, 57% for terrestrial acidification, 36% for global warming potential and 27% for freshwater eutrophication. Milk and dairy products were the main contributors to environmental impacts in both the current diet and the FBDG scenario diet. The scenario diets were nutritionally adequate and improved the dietary quality among Norwegian 2-year-olds. Conclusion Compared to current diets among young children, more plant-based dietary patterns in line with national FBDG or the EAT-Lancet Commission reference diet can improve the nutritional adequacy of diets and simultaneously reduce environmental impacts.

• Konglevoll, Dina Moxness; Andersen, Lene Frost; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Totland, Torunn Holm [Show all 8 contributors for this article] (2023). Fish intake and pre-frailty in Norwegian older adults - a prospective cohort study: the Tromsø Study 1994–2016. BMC Geriatrics. 23(1). doi: 10.1186/s12877-023-04081-z. Full text in Research Archive Show summary

  Background Pre-frailty is an intermediate, potentially reversible state before the onset of frailty. Healthy dietary choices may prevent pre-frailty. Fish is included in most healthy diets, but little is known about the association between long-term habitual fish intake and pre-frailty. We aimed to elucidate the longitudinal association between the frequency of fish intake and pre-frailty in a cohort of older adults in Norway.<p> <p>Methods 4350 participants (52% women,≥65 years at follow-up) were included in this prospective cohort study. Data was obtained from three waves of the population-based Tromsø Study in Norway; Tromsø4 (1994–1995), Tromsø6 (2007–2008) and Tromsø7 (follow-up, 2015–2016). Frailty status at follow-up was defined by a modifed version of Fried’s phenotype. Fish intake was self-reported in the three surveys and assessed as three levels of frequency of intake: low (0–3 times/month), medium (1–3 times/week) and high (≥4 times/week). The fsh–pre-frailty association was analysed using multivariable logistic regression in two ways; (1) frequency of intake of lean, fatty and total fish in Tromsø6 and pre-frailty at follow-up, and (2) patterns of total fsh intake across the three surveys and pre-frailty at follow-up. <p>Results At follow-up, 28% (n=1124) were pre-frail. Participants with a higher frequency of lean, fatty and total fish intake had 28% (odds ratio (OR)=0.72, 95% confidence interval (CI)=0.53, 0.97), 37% (OR=0.63, 95% CI=0.43, 0.91) and 31% (OR=0.69, 95% CI=0.52, 0.91) lower odds of pre-frailty 8 years later compared with those with a low intake, respectively. A pattern of stable high fish intake over 21 years was associated with 41% (OR=0.59, 95% CI=0.38, 0.91) lower odds of pre-frailty compared with a stable low intake. <p>Conclusions A higher frequency of intake of lean, fatty and total fish, and a pattern of consistent frequent fish intake over time, were associated with lower odds of pre-frailty in older community-dwelling Norwegian adults. These results emphasise the important role of fish in a healthy diet and that a frequent fish intake should be promoted to facilitate healthy ageing.

• Denison, Eva Marie-Louise; Andreassen, Monica; Bruzell, Ellen Merete; Carlsen, Monica Hauger; Devold, Tove Gulbrandsen & Granum, Berit Brunstad [Show all 10 contributors for this article] (2023). Scoping review of research on gastrointestinal effects of selected emulsifiers, stabilisers, and thickeners. VKM Report. Full text in Research Archive
• Svendsen, Camilla; Amlund, Heidi; Carlsen, Monica Hauger; Eriksen, Gunnar Sundstøl; Husøy, Trine & Lillegaard, Inger Therese Laugsand [Show all 27 contributors for this article] (2022). Food and chemical substances relevant for monitoring - Scientific Opinion of the Scientific Steering Committee of the Norwegian Scientific Committee for Food and Environment. VKM Report. Full text in Research Archive Show summary

  At request from the Norwegian Food Safety Authority (NFSA), VKM has identified food groups and food items consumed by the Norwegian population that are relevant for monitoring regarding content of one or more undesirable chemical substances (Figure 1). Undesirable chemical substances were defined as chemical substances in food that may constitute a potential health risk. VKM has created a knowledge base (an Excel file) as a tool for planning and prioritising monitoring of foods and undesirable chemical substances. The substance groups included in the knowledge base are flavourings, food additives, metals and metalloids, natural toxins, persistent organic pollutants, process-induced contaminants, substances in food contact materials, substances in food supplements, and trace elements. More than 40 different substances were included. Food items that are known contributors to exposure to an undesirable chemical substance were identified from quantitative and qualitative data, mainly from EFSA opinions and VKM risk assessments. Four national dietary surveys were used for identification of food items and food groups habitually eaten by the Norwegian population. The habitual diet was used to identify potential unknown sources of the substances. The information on known and unknown sources was compiled in a knowledge base comprised of 456 “undesirable chemical substance/food item” pairs that were identified to be relevant for monitoring. For each “undesirable chemical substance/food item” pair, the following information are included in the knowledge base: - Food category - Contribution to total exposure, including degree of contribution - Origin of occurrence data, and availability of Norwegian occurrence data - Remarks regarding sampling - Sources of the undesirable chemical substances in food - Risk (a combined score for hazard and exposure) Sampling of food is a complex area. Careful planning of the sampling strategy is needed and several parameters should be taken into consideration, depending on the properties of the chemical substance and the food item. Generic guidelines on sampling strategy, including sample number and frequency, have been provided in the report. Key words: VKM, health risk, monitoring, Norwegian Scientific Committee for Food and Environment, Norwegian Food Safety Authority, undesirable chemical substance.

• Nordhagen, Live Solveig; Løfsgaard, Vibeke; Småstuen, Milada Cvancarova; Glavin, Kari; Carlsen, Kai-Håkon & Carlsen, Monica Hauger [Show all 21 contributors for this article] (2022). Maternal food-avoidance diets and dietary supplements during breastfeeding. Nursing Open. 10(1), p. 230–240. doi: 10.1002/nop2.1298. Full text in Research Archive Show summary

  Aims To identify maternal food-avoidance diets and dietary supplement use during breastfeeding, and to explore factors associated with food avoidance diets. Design A prospective mother–child birth cohort study. Methods Electronic questionnaires were answered by 1,462 breastfeeding mothers 6 months postpartum in the Preventing Atopic Dermatitis and Allergies in Children (PreventADALL) study from 2014–2016. Demographic and antenatal factors were analysed for associations with food avoidance diets in 1,368 women by multiple logistic regression. Results Overall, 289 breastfeeding women (19.8%) avoided at least one food item in their diet, most commonly cow's milk in 99 women (6.8%). Foods were most often avoided due to conditions in the child, maternal factors or lifestyle choice. The odds for food avoidance diets were 2.1 (95% CI: 1.3, 3.4) for food allergy (presumed or diagnosed) and 19.4 (5.4, 70.1) for celiac disease in the mother. Dietary supplements were reported by nearly 80%, most commonly cod liver oil.

• Henriksen, Hege; Knudsen, Markus Dines; Carlsen, Monica Hauger; Hjartåker, Anette & Blomhoff, Rune (2022). A Short Digital Food Frequency Questionnaire (DIGIKOST-FFQ) Assessing Dietary Intake and Other Lifestyle Factors Among Norwegians: Qualitative Evaluation With Focus Group Interviews and Usability Testing. JMIR Formative Research. 6(11). doi: 10.2196/35933. Full text in Research Archive Show summary

  Background In-person dietary counseling and interventions have shown promising results in changing habits toward healthier lifestyles, but they are costly to implement in large populations. Developing digital tools to assess individual dietary intake and lifestyle with integrated personalized feedback systems may help overcome this challenge. We developed a short digital food frequency questionnaire, known as the DIGIKOST-FFQ, to assess diet and other lifestyle factors based on the Norwegian Food-Based Dietary Guidelines. The DIGIKOST-FFQ includes a personalized feedback system, the DIGIKOST report, that benchmarks diet and lifestyle habits. We used qualitative focus group interviews and usability tests to test the feasibility and usability of the DIGIKOST application. Objective We aimed to explore attitudes, perceptions, and challenges in completing the DIGIKOST-FFQ. We also investigated perceptions and understanding of the personalized feedback in the DIGIKOST report and the technical flow and usability of the DIGIKOST-FFQ and the DIGIKOST report. Methods Healthy individuals and cancer survivors were invited to participate in the focus group interviews. The transcripts were analyzed using thematic analysis. Another group of healthy individuals completed the usability testing, which was administered individually by a moderator and 2 observers. The results were analyzed based on predefined assignments and discussion with the participants about the interpretation of the DIGIKOST report and technical flow of the DIGIKOST-FFQ. Results A total of 20 individuals participated in the focus group interviews, divided into 3 groups of healthy individuals and 3 groups of cancer survivors. Each group consisted of 3 to 4 individuals. Five main themes were investigated: (1) completion time (on average 19.1, SD 8.3, minutes, an acceptable duration), (2) layout (participants reported the DIGIKOST-FFQ was easy to navigate and had clear questions but presented challenges in reporting dietary intake, sedentary time, and physical activity in the last year), (3) questions (the introductory questions on habitual intake worked well), (4) pictures (the pictures were very helpful, but some portion sizes were difficult to differentiate and adding weight in grams would have been helpful), and (5) motivation (users were motivated to obtain personalized feedback). Four individuals participated in the usability testing. The results showed that the users could seamlessly log in, give consent, fill in the DIGIKOST-FFQ, and receive, print, and read the DIGIKOST report. However, parts of the report were perceived as difficult to interpret. Conclusions The DIGIKOST-FFQ was overall well received by participants, who found it feasible to use; however, some adjustments with regard to reporting dietary intake and lifestyle habits were suggested. The DIGIKOST report with personalized feedback was the main motivation to complete the questionnaire. The results from the usability testing revealed a need for adjustments and updates to make the report easier to read.

• Andersen, Lene Frost; Berstad, Paula; Bukhvalova, Barbara Alexandra; Carlsen, Monica Hauger; Dahl, Lisbeth Jane & Goksøyr, Anders [Show all 35 contributors for this article] (2022). Benefit and risk assessment of fish in the Norwegian diet - Scientific Opinion of the Steering Committee of the Norwegian Scientific Committee for Food and Environment. VKM Report. 2022(17). Full text in Research Archive Show summary

  In 2006, VKM published “A comprehensive assessment of fish and other seafood in the Norwegian diet”. The assessment supported the recommendation from Norwegian Health authorities to eat more fish both for dinner and on sandwiches. In an update of the assessment in 2014 VKM concluded that “the benefits from fish consumption clearly outweigh the negligible risk presented by current levels of contaminants and other undesirable substances in fish”. Because of new knowledge available, the Norwegian Food Safety Authority requested a new benefit and risk assessment of fish in the Norwegian diet in 2019. In the assignment, they asked VKM to answer the following questions:<p> <p>Which health consequences will it have for the Norwegian population if they:<uli> <li>Continue with the same fish consumption levels as of today</li> <li>Increase the consumption of fish to match the recommendations given by the Norwegian Directorate of Health</li> </uli>

• Moe, Åse Mari; Sørbye, Sigrunn Holbek; Hopstock, Laila Arnesdatter; Carlsen, Monica Hauger; Løvsletten, Ola & Ytterstad, Elinor (2022). Identifying dietary patterns across age, educational level and physical activity level in a cross-sectional study: the Tromsø Study 2015 - 2016. BMC Nutrition. 8(1). doi: 10.1186/s40795-022-00599-4. Full text in Research Archive Show summary

  <p><b>Background</b> A healthy diet can decrease the risk of several lifestyle diseases. From studying the health effects of single foods, research now focuses on examining complete diets and dietary patterns reflecting the combined intake of different foods. The main goals of the current study were to identify dietary patterns and then investigate how these differ in terms of sex, age, educational level and physical activity level (PAL) in a general Nordic population. <p><b>Methods</b> We used data from the seventh survey of the population-based Tromsø Study in Norway, conducted in 2015-2016. The study included 21,083 participants aged 40−99 years, of which 72% completed a comprehensive food frequency questionnaire (FFQ). After exclusion, the study sample included 10,899 participants with valid FFQ data. First, to cluster food variables, the participants were partitioned in homogeneous cohorts according to sex, age, educational level and PAL. Non-overlapping diet groups were then identified using repeated hierarchical cluster analysis on the food variables. Second, average standardized diet intake scores were calculated for all individuals for each diet group. The individual diet (intake) scores were then modelled in terms of age, education and PAL using regression models. Differences in diet scores according to education and PAL were investigated by pairwise hypothesis tests, controlling the nominal significance level using Tukey’s method. <p><b>Results</b> The cluster analysis revealed three dietary patterns, here named the Meat and Sweets diet, the Traditional diet, and the Plant-based- and Tea diet. Women had a lower intake of the Traditional diet and a higher preference for the Plant-based- and Tea diet compared to men. Preference for the Meat and Sweets diet and Traditional diet showed significant negative and positive trends as function of age, respectively. Adjusting for age, the group having high education and high PAL compared favourably with the group having low education and low PAL, having a significant lower intake of the Meat and Sweets and the Traditional diets and a significant higher intake of the Plant-based- and Tea diet. <p><b>Conclusions</b> Three dietary patterns (Meat and Sweets, Traditional, and Plant-based- and Tea) were found by repeated clustering of randomly sampled homogeneous cohorts of individuals. Diet preferences depended significantly on sex, age, education and PAL, showing a more unhealthy dietary pattern with lower age, low education and low PAL.

• Konglevoll, Dina Moxness; Hjartåker, Anette; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Andersen, Lene Frost [Show all 7 contributors for this article] (2022). Protein Intake and the Risk of Pre-Frailty and Frailty in Norwegian Older Adults. The Tromsø Study 1994–2016. Journal of Frailty & Aging (JFA). ISSN 2260-1341. 11(3), p. 256–266. doi: 10.14283/jfa.2022.16. Full text in Research Archive Show summary

  Background Protein intake is suggested as an important dietary factor in the prevention of frailty, however, the influence of lifelong intake remains unclear. Objectives The present study investigated the relationship between daily protein intake and patterns of protein intake over 21 years and the risk of pre-frailty/frailty. Design Prospective cohort study. Setting The population-based Tromsø Study in Tromsø municipality, Norway. Participants In total, 1,906 women and 1,820 men aged ≥45 years in 1994 who participated in both Tromsø4 (1994–95) and Tromsø7 (2015–16). Measurements Frailty status in Tromsø7 was measured according to Fried’s phenotype, classifying participants as “robust” (frailty components present: 0), “pre-frail” (1–2) or “frail” (≥3). Daily intake of protein was estimated from self-reported habitual dietary intake using food frequency questionnaires and assessed as grams per kilogram bodyweight (g/kg BW) and per megajoule energy intake (g/MJ). The protein–frailty association was assessed via longitudinal and cross-sectional multivariable logistic regression analyses. Results The prevalence of pre-frailty and frailty in this study was 27% and 1.0%, respectively. Longitudinal analysis showed that the odds of pre-frailty/frailty decreased by 57% (odds ratio (OR) = 0.43, 95% confidence interval (CI) = 0.31;0.58, p<0.001) with the increase in intake of one additional gram of dietary protein per kg BW. The results obtained from cross-sectional analysis were similar. Tracking analysis showed that, compared to a stable high intake of protein in g/kg BW over time, other patterns of protein intake increased the risk of pre-frailty/frailty. No associations were found between intake of protein in g/MJ and pre-frailty/frailty. Conclusions Intake of protein in g/kg BW both in mid-life and later in life was inversely associated with pre-frailty/frailty in older adults. This emphasizes the importance of an adequate protein intake to facilitate healthy ageing in Norwegian older adults.

• Bruzell, Ellen Merete; Carlsen, Monica Hauger; Caspersen, Ida Henriette; Denison, Eva Marie-Louise; Devold, Tove Gulbrandsen & Granum, Berit [Show all 12 contributors for this article] (2022). Risk-benefit assessment of sunscreen: Opinion of the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food, and Cosmetics of the Norwegian Scientific Committee for Food and Environment. VKM Report. Full text in Research Archive
• Bøhn, Siv Kjølsrud; Myhrstad, Mari; Thoresen, Magne; Erlund, Iris; Vasstrand, Ann Kristin & Marciuch, Anne [Show all 11 contributors for this article] (2021). Bilberry/red grape juice decreases plasma biomarkers of inflammation and tissue damage in aged men with subjective memory impairment –a randomized clinical trial. BMC Nutrition. 7(75). doi: 10.1186/s40795-021-00482-8. Full text in Research Archive Show summary

  Background: Few randomized clinical trials have explored the health effects of bilberries in humans. The aim was to test the effect of bilberry and red grape-juice consumption on visual memory, motor speed and dexterity as well as inflammatory and tissue damage biomarkers of plasma in aged men with subjective memory impairment. Methods: Nine-week double-blind, placebo-controlled, dietary intervention study of aged men (n = 60, age ≥ 67 years) with subjective memory impairment randomized to consume a 50/50 mix of bilberry/red grape-juice or an iso-caloric placebo juice. A selection of Cambridge Cognition Test Battery (CANTAB), Grooved Pegboard tests and blood-sampling for biomarker analysis were performed before and after the intervention. Results: Compared to placebo the selected memory and motor test scores were un-affected by the bilberry/red grape intervention. However, the plasma levels of tissue damage biomarkers decreased significantly more in the bilberry/red grape group. In particular lactate dehydrogenase (LDH) decreased from 362 U/L (median, baseline) to 346 U/L (median, post intervention) in the bilberry/red grape group. Also, several biomarkers of inflammation (EGF, IL6, IL9, IL10 and TNFα) decreased significantly more in the bilberry/red grape group. Furthermore, several plasma polyphenols; p-coumaric acid, hippuric acid, protocatechuic acid, 3HPAA and vanillic acid, increased significantly more in the bilberry/red grape group compared to placebo with the largest increase in p-coumaric acid with 116%; from 2.2 [1.0,5.5] to 4.7 [2.8,8.1] μM/L (median [95% CL]). Conclusions: The results indicate that a nine-week bilberry/red grape juice intervention has no measurable effects on the selected memory scores in aged men experiencing memory problems but decreases the level of biomarkers of inflammation and tissue damage. Whether the dampening effects on inflammation and tissue damage biomarkers have relevance for neuroinflammatory brain pathology remains to be established.

• Carlsen, Monica Hauger; Andersen, Lene F. & Hjartåker, Anette (2021). Reproducibility and feasibility of an online self-administered food frequency questionnaire for use among adult norwegians. Food & Nutrition Research (FNR). ISSN 1654-6628. 65, p. 1–14. doi: 10.29219/FNR.V65.7561. Full text in Research Archive
• Carlsen, Monica Hauger; Andersen, Lene Frost & Hjartåker, Anette (2021). Reproducibility and feasibility of an online self-administered food frequency questionnaire for use among adult Norwegians. Food & Nutrition Research (FNR). ISSN 1654-6628. doi: 10.29219/fnr.v65.7561. Full text in Research Archive Show summary

  Background: New methods of dietary assessment are increasingly making use of online technologies. The development of a new online food frequency questionnaire warranted investigation of its feasibility and the reproducibility of its results. Objective: To investigate the feasibility and reproducibility of a newly developed online FFQ (WebFFQ). Design: The semiquantitative WebFFQ was designed to assess the habitual diet the previous year, with questions about frequency of intake and portion sizes. Estimations of portion sizes include both pictures and household measures, depending on the type of food in question. In two independent cross-sectional studies conducted in 2015 and 2016, adults were recruited by post following random selection from the general population. In the first study, participants (n = 229) filled in the WebFFQ and answered questions about its feasibility, and in two subsequent focus group meetings, participants (n = 9) discussed and gave feedback about the feasibility of the WebFFQ. In the second study, the WebFFQ’s reproducibility was assessed by asking participants (n = 164) to fill it in on two separate occasions, 12 weeks apart. Moreover, in the second study, participants were offered personal dietary feedback, a monetary gift certificate, or both, as incentives to complete the study. Results: In the feasibility study, evaluation form results showed that participants raised issues regarding the estimation of portion size and the intake of seasonal foods as being particularly challenging; furthermore, in the focus group discussions, personal feedback on diet was perceived to be a more motivating factor than monetary reward. In the reproducibility study, total food intake was lower in the second WebFFQ; however, 63% of the food groups were not significantly different from those in the first WebFFQ. Correlations of food intake ranged from 0.62 to 0.90, >86% of the participants were classified into the same or adjacent quartiles, and misclassification ranged from 0 to 3%. Average energy intake was 3.5% lower (p = 0.001), fiber showed the least difference at 1.6% (p = 0.007), and sugar intake differed the most at −6.8% (borderline significant, p = 0.08). Percentage energy obtained from macronutrients did not differ significantly between the first and second WebFFQs. Conclusion: Our results suggest that at group level, the WebFFQ showed good reproducibility for the estimations of intake of food groups, energy, and nutrients. The feasibility of the WebFFQ is good; however, revisions to further improve portion size estimations should be included in future versions. The WebFFQ is considered suitable for dietary assessments for healthy adults in the Norwegian population.

• Carlsen, Monica Hauger; Devold, Tove Gulbrandsen; Granum, Berit Brunstad; Lillegaard, Inger Therese Laugsand; Mathisen, Gro Haarklou & Rasinger, Josef [Show all 12 contributors for this article] (2021). Risk assessment of caffeine exposure from diet and personal care products. Opinion of the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food, and Cosmetics of the Norwegian Scientific Committee for Food and Environment. VKM Report. 2021:05(5). Full text in Research Archive
• Nilsen, Linn; Hopstock, Laila Arnesdatter; Grimsgaard, Sameline; Carlsen, Monica Hauger & Lundblad, Marie Wasmuth (2021). Intake of Vegetables, Fruits and Berries and Compliance to “Five-a-Day” in a General Norwegian Population—The Tromsø Study 2015–2016. Nutrients. 13(7). doi: 10.3390/nu13072456. Full text in Research Archive Show summary

  Vegetables, fruits and berries are associated with reduced disease risk, and recommended intake is “five-a-day”. We studied the intake of vegetables, fruits and berries and compliance with “five-a-day” in 11,425 adults (40–96 years) who completed a food frequency questionnaire in the seventh wave of the Tromsø Study (2015–2016). Intake and proportion above/below recommended intake (250 g/day of vegetables and 250 g/day of fruits/berries, combined and separately) were analyzed. Logistic regression was used to examine compliance with recommendations in 10-year age-groups, and level of education, body mass index (BMI) and physical activity, in strata of sex and adjusted for total energy. Median intake of vegetables was 228 and 168 g/day, and fruits/berries 292 and 268 g/day, in women and men, respectively. In total, 31% of women and 17% of men met the five-a-day recommendation, and 44% and 60% of women, and 25% and 54% of men, met the recommendation for vegetables and fruits/berries, respectively. Odds of compliance with recommendation for both vegetables and fruits/berries were positively associated with age, education and physical activity (<i>p</i> trend < 0.001). The intake of vegetables, fruits and berries was suboptimal, in particular for vegetables. More women than men met the recommendation, and intake varied by education, physical activity level, age and BMI.

• Medin, Anine Christine; Carlsen, Monica Hauger & Andersen, Lene Frost (2020). Iodine intake among children and adolescents in Norway: Estimates from the national dietary survey Ungkost 3 (2015-2016). Journal of Trace Elements in Medicine and Biology. ISSN 0946-672X. doi: 10.1016/j.jtemb.2019.126427. Full text in Research Archive Show summary

  Abstract BACKGROUND: Iodine is crucial for normal growth and neurodevelopment. Before 1950, goitre caused by iodine deficiency was widespread in Norway, but decreased significantly after mandatory fortification of animal fodder. Recent dietary changes in milk consumption and fish intake may again have increased the risk of inadequate intakes in some population groups in Norway. The situation for children and adolescents is unclear, and data from nationally representative studies are highly needed. We aimed to describe the iodine intake in Norwegian children and adolescents and estimate the proportion of individuals with an increased risk of suboptimal, adequate and excessive usual iodine intake. In addition, we aimed to investigate whether individuals' characteristics were associated with iodine intake, and to identify the major iodine contributing foods in the diet of this population. METHODS: Data from 1722 individuals (4-, 9- and 13-year-olds) from a national dietary survey in Norway from 2015-2016 was used. Both descriptive and inferential statistics were conducted. Usual iodine intakes were estimated, stratified by age group and sex and compared to dietary reference intake cut-offs. Linear regression models were used to assess the association between iodine intake and participants' characteristics. The contribution of iodine from different foods was described for all and across different participant groups. RESULTS: We estimated that the proportion of participants with an increased risk of a suboptimal usual intake of iodine varied from 3-36%. A significant increased risk was observed for older children and girls compared to younger children and boys. Excessive usual intakes were not observed in any age group. Iodine intake was associated with sex, maternal educational level and area of residence. A lower intake was observed for girls and those with a mother with a low educational level. Moreover, those living in the western part and Mid-Norway had statistically significantly higher intakes compared to those living in the capital city and surroundings. Milk, milk products, cheese, fish and shellfish were the main contributors to iodine intake. Supplements contributed with very little of the total iodine intake. CONCLUSIONS: We have shown that the estimated risk of suboptimal usual iodine intakes among children and adolescents in Norway varies according to age, sex, maternal educational level and area of residence. Those with a limited intake of the main dietary contributors to iodine intake may be at risk, and adolescent girls seem to be especially vulnerable.

• Madar, Ahmed Ali; Heen, Espen Kolstad; Hopstock, Laila Arnesdatter; Carlsen, Monica Hauger & Meyer, Haakon E (2020). Iodine intake in Norwegian women and men: The population-based Tromsø Study 2015–2016. Nutrients. 12(11), p. 1–13. doi: 10.3390/nu12113246. Full text in Research Archive Show summary

  Ensuring sufficient iodine intake is a public health priority, but we lack knowledge about the status of iodine in a nationally representative population in Norway. We aimed to assess the current iodine status and intake in a Norwegian adult population. In the population-based Tromsø Study 2015–2016, 493 women and men aged 40–69 years collected 24-h urine samples and 450 participants also completed a food frequency questionnaire (FFQ). The 24-h urinary iodine concentration (UIC) was analyzed using the Sandell–Kolthoff reaction on microplates followed by colorimetric measurement. Iodine intake was estimated from the FFQ using a food and nutrient calculation system at the University of Oslo. The mean urine volume in 24 h was 1.74 L. The median daily iodine intake estimated (UIE) from 24-h UIC was 159 µg/day (133 and 174 µg/day in women and men). The median daily iodine intake estimated from FFQ was 281 µg/day (263 and 318 µg/day in women and men, respectively). Iodine intake estimated from 24-h UIC and FFQ were moderately correlated (Spearman rank correlation coefficient r = 0.39, <i>p</i> < 0.01). The consumption of milk and milk products, fish and fish products, and eggs were positively associated with estimated iodine intake from FFQ. In conclusion, this shows that iodine intake estimated from 24-h UIC describes a mildly iodine deficient female population, while the male population is iodine sufficient. Concurrent use of an extensive FFQ describes both sexes as iodine sufficient. Further studies, applying a dietary assessment method validated for estimating iodine intake and repeated individual urine collections, are required to determine the habitual iodine intake in this population.

• Nilsen, Morten; Schinagl, Carina Madelen; Angell, Inga Leena; Arntzen, Magnus Øverlie; Carlsen, Karin C. Lødrup & Carlsen, Kai-Håkon [Show all 18 contributors for this article] (2020). Butyrate Levels in the Transition from an Infant-to an Adult-Like Gut Microbiota Correlate with Bacterial Networks Associated with Eubacterium Rectale and Ruminococcus Gnavus. Genes. 11(11). doi: 10.3390/genes11111245. Full text in Research Archive Show summary

  Relatively little is known about the ecological forces shaping the gut microbiota composition during infancy. Therefore, the objective of the present study was to identify the nutrient utilization- and short-chain fatty acid (SCFA) production potential of gut microbes in infants during the first year of life. Stool samples were obtained from mothers at 18 weeks of pregnancy and from infants at birth (first stool) at 3, 6, and 12-months of age from the general population-based PreventADALL cohort. We identified the taxonomic and SCFA composition in 100 mother-child pairs. The SCFA production and substrate utilization potential of gut microbes were observed by multiomics (shotgun sequencing and proteomics) on six infants. We found a four-fold increase in relative butyrate levels from 6 to 12 months of infant age. The increase was correlated to Eubacterium rectale and its bacterial network, and Faecalibacterium prausnitzii relative abundance, while low butyrate at 12 months was correlated to Ruminococcus gnavus and its associated network of bacteria. Both E. rectale and F. prausnitzii expressed enzymes needed for butyrate production and enzymes related to dietary fiber degradation, while R. gnavus expressed mucus-, fucose, and human milk oligosaccharides (HMO)-related degradation enzymes. Therefore, we believe that the presence of E. rectale, its network, and F. prausnitzii are key bacteria in the transition from an infant- to an adult-like gut microbiota with respect to butyrate production. Our results indicate that the transition from an infant- to an adult-like gut microbiota with respect to butyrate producing bacteria, occurs between 6 and 12 months of infant age. The bacteria associated with the increased butyrate ratio/levels were E. rectale and F. prausnitzii, which potentially utilize a variety of dietary fibers based on the glycoside hydrolases (GHs) expressed. R. gnavus with a negative association to butyrate potentially utilizes mucin, fucose, and HMO components. This knowledge could have future importance in understanding how microbial metabolites can impact infant health and development.

• Svendsen, Camilla; Asmyhr, Maria Gulbrandsen; Denison, Eva Marie-Louise; Devold, Tove Gulbrandsen; Mathisen, Gro Haarklou & Rohloff, Jens [Show all 13 contributors for this article] (2020). A scoping review of systematic reviews on environmental effects of sunscreen ingredients. Scientific Opinion of the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food, and Cosmetics of the Norwegian Scientific Committee for Food and Environment. VKM Report. 2020:14, p. 1–68. Full text in Research Archive
• Schinagl, Carina Madelen; Rehbinder, Eva Maria; Carlsen, Karin C. Lødrup; Gudbrandsgard, Malén; Carlsen, Kai-Håkon & Haugen, Guttorm [Show all 17 contributors for this article] (2019). Food and nutrient intake and adherence to dietary recommendations during pregnancy: A nordic mother?child population-based cohort. Food & Nutrition Research (FNR). ISSN 1654-6628. 63:3676, p. 1–11. doi: 10.29219/fnr.v63.3676. Full text in Research Archive Show summary

  Background: A woman’s food intake during pregnancy has important implications not only for herself but also for the future health and well-being of her child. Suboptimal dietary quality has been consistently reported in many high-income countries, reflecting poor adherence to dietary guidelines. Objective: This study aimed to explore the intake of food and nutrients in a cohort of pregnant women in Norway and their adherence to Nordic Nutrition Recommendations (NNR) and Norwegian food-based guidelines (NFG). Design: We investigated the dietary intake in 1,674 pregnant women from the mother–child birth cohort, PreventADALL, recruited at approximately 18-week gestational age. Dietary intake was assessed by an electronic validated food frequency questionnaire (PrevFFQ) in the first half of pregnancy. Results: Total fat intake was within the recommended intake (RI) range in most women; however, the contribution of saturated fatty acids to the total energy intake was above RI in the majority (85.2%) of women. Carbohydrate intake was below RI in 43.9% of the women, and 69.5% exceeded the RI of salt. Intakes of fiber, vegetables, and fish were high in a large part of the population. Many women had a high probability of inadequate intakes of the following key micronutrients during pregnancy: folate (54.4%), iron (49.6%), calcium (36.2%), vitamin D (28.7%), iodine (24.4%), and selenium (41.3%). A total of 22.8% women reported an alcohol intake of >1 g/day, and 4.4% reported an alcohol intake of >10 g/day. Women with higher educational levels showed a tendency towards healthier eating habits, except for higher intakes of alcohol and coffee, compared to women with lower educational level. Discussion: Excessive saturated fat intake and limited intake of many important micronutrients during pregnancy were common, potentially increasing the risk for adverse pregnancy and birth outcomes. Conclusions: This study highlights the need for improved nutritional guidance to pregnant women across all educational levels.

• Husøy, Trine; Andreassen, Monica; Hjertholm, Hege; Carlsen, Monica Hauger; Norberg, Nina & Sprong, Corinne [Show all 10 contributors for this article] (2019). The Norwegian biomonitoring study from the EU project EuroMix: Levels of phenols and phthalates in 24-hour urine samples and exposure sources from food and personal care products. Environment International. ISSN 0160-4120. 132, p. 1–13. doi: 10.1016/j.envint.2019.105103. Full text in Research Archive Show summary

  Background Exposure to multiple chemicals occurs daily through several routes; diet, inhalation and dermal contact. Real-life exposure assessment is needed to understand the risk. Therefore, a human biomonitoring (BM) study was performed to examine the plausibility of source-to-dose calculations for chemical mixtures in the Horizon 2020 EuroMix project. Objectives To provide a detailed description of the design of the EuroMix BM study, and to present the initial results for urinary phenols and phthalates and to describe their exposure determinants from foods and personal care products (PCPs). Method Adults (44 males and 100 females) kept detailed diaries on their food consumption, PCP use and handling of cash receipts. Urine samples were collected over the same 24-hour period. Urinary levels of four parabens, five bisphenols, oxybenzone/benzophenone-3 (OXBE), triclosan (TCS), triclocarban (TCC) and metabolites of eight phthalates and 1,2-cyclohexane dicarboxylic acid diisononyl ester (DINCH) were analysed by ultra-high-performance liquid chromatography and tandem mass spectrometry. Multivariable linear regressions were performed between PCPs/food categories and each dependent chemical variable separately, and were only sex-stratified when an interactions between sex and the independent variable was significant. Results The detection rate for the metabolites of phthalates and DINCH, and bisphenol A (BPA) and TCS in urine was 88–100%, while bisphenol S (BPS) and bisphenol F (BPF) were only found in 29% and 4% of the urine samples, respectively. Bisphenol B (BPB), bisphenol AF (BPAF) and TCC were not detected. Food groups associated with phenol exposure were meat, bread, beverages and butter and oil. Food determinants for phthalate exposure were sweets, butter and oil, fruit and berries and other foods. The only positive association between the use of PCPs and phenols was found between BPA and lip gloss/balm. Phthalate exposure was associated with the use of shower gel, hand cream (females), toothpaste, anti-wrinkle cream (females) and shaving products (males). Conclusion The participants in the EuroMix BM study were exposed to a mixture of phenols and phthalates. A variety of food categories and PCPs were found to be possible sources of these chemicals. This indicates a complex pattern of exposure to numerous chemicals from multiple sources, depending on individual diet and PCP preferences.

• Lundblad, Marie Wasmuth; Andersen, Lene Frost; Jacobsen, Bjarne Koster; Carlsen, Monica Hauger; Hjartåker, Anette & Grimsgaard, Sameline [Show all 7 contributors for this article] (2019). Energy and nutrient intakes in relation to National Nutrition Recommendations in a Norwegian population-based sample: the Tromsø Study 2015–16. Food & Nutrition Research (FNR). ISSN 1654-6628. 63:3616, p. 1–10. doi: 10.29219/fnr.v63.3616. Full text in Research Archive Show summary

  <i>Introduction</i>: According to the Global Burden of Disease project, unhealthy diet accounts for most of the disease burden in Norway. Current recommendations on nutrient intake in Norway reflect those published in the evidence-based Nordic Nutrition Recommendations from 2012 (NNR2012).<p> <p><i>Aim</i>: To study energy and nutrient intakes and compliance with the NNR2012 among women and men in a population-based study.<p> <p><i>Methods</i>: A total of 15,146 participants (aged 40–99 years) completed a validated food frequency questionnaire (261 questions on food items, meals, and beverages) in the seventh survey of the Tromsø Study in 2015–16; 11,425 participants were eligible for the current analysis. Nutrient intake was estimated by a food and nutrient calculation system at the University of Oslo, Norway. We compared energy, macronutrient, and micronutrient intakes with the NNR2012.<p> <p><i>Results</i>: In total, 85% of the women and men were not in compliance with the maximum recommended intake of saturated fat, and 40 and 77% of women and men, respectively, were not in compliance with the lowest recommended intake of fiber. More than 30% of women and 25% of men had a relatively high probability of inadequate intake of vitamin D, and more than 10% of the men had a relatively high probability of inadequate intake of vitamin B6 and vitamin C. More than 20% of women and men had a high probability of excessive intake of niacin, and almost 40% of women had a high probability of excessive intake of vitamin A.<p> <p><i>Conclusion</i>: Although most participants were in compliance with NNR2012, a large proportion of participants had higher intakes than maximum recommended for saturated fat, and lower than recommended for fiber and vitamin D.

• Carlsen, Monica Hauger; Andersen, Lene Frost; Dahl, Lisbeth; Norberg, Nina & Hjartåker, Anette (2018). New iodine Food composition database and updated calculations of iodine intakes amongs Norwegians. Nutrients. 10(7). doi: 10.3390/nu10070930. Full text in Research Archive Show summary

  Iodine food composition data of Norwegian foods have been sparse and knowledge about different dietary iodine sources limited. We compiled a comprehensive iodine food composition database and estimated dietary iodine intake among adults in the latest Norwegian national dietary survey (Norkost 3). The iodine content of food and beverages were compiled using international guidelines and standards. Iodine content of 3259 food items were compiled, including analytical values, values from other food composition databases, estimated values, and values that were based on recipes. Estimated iodine intake in the Norkost 3 population ranged from 15 to 1462 µg/day. Men had significantly higher intake of iodine than women (p < 0.001). The proportion of men and women with estimated iodine intake below average requirement was 19% and 33%, respectively. In young women, 46% had estimated iodine intakes below average requirement and a high probability of inadequate iodine intake. Several dietary sources contributed to iodine intake and differences in the consumption pattern may put subgroups at risk of insufficient iodine intake. In the coming years, the determination of iodine in foods and national dietary surveys should be regularly performed to monitor the iodine intake in the Norwegian population.

• Svendsen, Karianne; Henriksen, Hege; Østengen, Beate; Jacobs, David R. Jr.; Telle-Hansen, Vibeke & Carlsen, Monica Hauger [Show all 7 contributors for this article] (2018). Evaluation of a short Food Frequency Questionnaire to assess cardiovascular disease-related diet and lifestyle factors :. Food & Nutrition Research (FNR). ISSN 1654-6628. 62:1370, p. 1–12. doi: 10.29219/fnr.v62.1370. Full text in Research Archive Show summary

  BACKGROUND: The Vascular lifestyle-Intervention and Screening in phArmacies (VISA) study investigates diet and lifestyle factors associated with risk of cardiovascular disease (CVD). As part of the study methodology, a short Food Frequency Questionnaire (FFQ), the VISA-FFQ, was adapted from the Norwegian NORDIET-FFQ. OBJECTIVE: The aim of this study was to evaluate the VISA-FFQ and its ability to estimate intakes of foods and lifestyle factors in screening for elevated risk of CVD. The evaluation included assessment of relative validity of intake of milk fat and assessment of reproducibility of several foods and lifestyle factors. DESIGN: Relative validity of milk fat estimated from the VISA-FFQ was assessed in 307 participants by comparing estimated dietary intake of the fatty acids pentadecanoic acid (15:0) and heptadecanoic acid (17:0), from milk fat with whole blood biomarkers 15:0 and 17:0. Reproducibility was evaluated in 122 participants by comparing consistency in intakes of different foods and lifestyle factors reported by the VISA-FFQ and administered twice with a 4-week interval. RESULTS: Dietary 15:0 milk fat estimated from the VISA-FFQ correlated positively with whole blood 15:0 (r = 0.32, P < 0.05). Men presented higher correlations than women did. Acceptable and consistent reproducibility (r = 0.44-0.94 and no large difference between test and retest) was observed for most beverages, milk products, spreads on bread and meat (all of which included food items categorised into at least two fat categories) and also for eggs, fruits and vegetables, nuts, pasta and rice, dessert/sweets, smoking and physical activity. Reproducibility did not consistently meet a satisfactory standard (r ≤ 0.41 or large difference between test and retest) for unsweetened cereals, fatty fish, cakes, oils, white-, bread, crispbread and rice. CONCLUSION: The validity of the VISA-FFQ was acceptable for intake of milk fat, and there was an overall satisfactory, though variable, reproducibility for intake of several foods and lifestyle factors in the VISA-FFQ.

• Henriksen, Hege; Berntsen, Sveinung; Paur, Ingvild; Zucknick, Manuela; Skjetne, Anne Juul & Bøhn, Siv Kjølsrud [Show all 10 contributors for this article] (2018). Validation of two short questionnaires assessing physical activity in colorectal cancer patients. BMC sports science, medicine and rehabilitation. 10:8(8), p. 1–12. doi: 10.1186/s13102-018-0096-2. Full text in Research Archive Show summary

  Background In order to investigate the impact of adherence to recommendations of physical activity and sedentary time on health outcomes in clinical trials, there is a need for feasible tools such as questionnaires that can give representative estimates of these measures. The primary aim of the present study was to validate two such questionnaires and their ability to estimate adherence to the recommendations of physical activity defined as moderate-to- vigorous physical activity or moderate physical activity of at least 150 min/week in colorectal cancer patients. Secondarily, self-reported sedentary time from the HUNT-PAQ was also evaluated. Methods Participants from 'The Norwegian dietary guidelines and colorectal cancer survival-study’ (CRC-NORDIET study) completed two short questionnaires; the NORDIET-FFQ (n = 78) and the HUNT-PAQ (n = 77). The physical activity monitor SenseWear Armband Mini was used as the reference method during seven consecutive days. Results The NORDIET-FFQ provided better estimates of time in moderate-to- vigorous physical activity and moderate physical activity than the HUNT-PAQ. The NORDIET-FFQ was unable to rank individual time in moderate-to- vigorous physical activity and moderate physical activity (Spearman’s rho = 0.08, p = 0.509 and Spearman’s rho rho = 0.01, p = 0.402, respectively). All intensities were under-reported by the HUNT-PAQ, but ranking of individual time in moderate physical activity and sedentary time were acceptable among women only (Spearman’s rho = 0.37, p = 0.027 and Spearman’s rho = 0.36, p = 0.035, respectively). The HUNT-PAQ correctly classified 71% of those not meeting the recommendations (sensitivity), and the NORDIET-FFQ correctly classified 63% of those who met the recommendations (specificity). About 67% and 33% reported to meet the recommendation of moderate-to- vigorous physical activity with the NORDIET-FFQ and HUNT-PAQ, respectively, whereas 55% actually met the moderate-to- vigorous physical activity according to the SenseWear Armband Mini. Conclusions The NORDIET-FFQ provided better specificity and better estimates of PA than the HUNT-PAQ. The HUNT-PAQ provided better sensitivity, and provided better ranking of PA and sedentary time among women than NORDIET-FFQ. It is important to be aware of the limitations documented in the present study. Trial registration The study is registered on the National Institutes of Health Clinical Trials (Identifier: NCT01570010). Registered 4 April 2012.

• Henriksen, Hege; Carlsen, Monica Hauger; Paur, Ingvild; Berntsen, Sveinung; Bøhn, Siv Kjølsrud & Skjetne, Anne Juul [Show all 11 contributors for this article] (2018). Relative validity of a short food frequency questionnaire assessing adherence to the Norwegian dietary guidelines among colorectal cancer patients. Food & Nutrition Research (FNR). ISSN 1654-6628. 62:1306, p. 1–15. doi: 10.29219/fnr.v62.1306. Full text in Research Archive
• Nesvold, Marianne Bakke; Jensen, Janicke Liaaen; Hove, Lene Hystad; Singh, Preet Bano; Young, Alix & Palm, Øyvind [Show all 9 contributors for this article] (2018). Dietary intake, body composition and oral health parameters among female patients with primary Sjögren’s syndrome. Nutrients. 10:866(7), p. 1–12. doi: 10.3390/nu10070866. Full text in Research Archive Show summary

  There is limited knowledge about dietary intake and body composition among patients with primary Sjögren’s syndrome. We assessed dietary intakes with 24-h recalls and body composition with anthropometry and bioelectrical impedance in 20 female patients. Various scoring tools were used to assess oral health. The patients had a lower energy percentage (E%) from carbohydrates (p = 0.02) and a higher E% from fat (p = 0.01) compared to a reference group. The lower intake of carbohydrates was due to a lower bread intake (p = 0.04), while the higher intake of fat was due to a higher intake of butter, margarine, and oil (p = 0.01). The patients ate more than twice (p = 0.02) as much fish as the reference group. The compliance to recommended intakes of macro- and micronutrients was good. Forty-percent of the patients were overweight/obese. Increased intake of beverages was observed in patients with severe xerostomia and/or low oral health-related quality of life, whereas reduced fat intake was found in hyposmic patients. In conclusion, the dietary intake among the patients was not much different from the reference group and complied with recommendations. Most oral health parameters were not associated with nutrient intakes. Specific dietary guidelines are probably not needed to ensure adequate nutrition among such patients.

• Medin, Anine Christine; Carlsen, Monica Hauger; Hambly, Catherine; Speakman, John R.; Strohmaier, Susanne & Andersen, Lene Frost (2017). The validity of a web-based FFQ assessed by doubly labelled water and multiple 24-h recalls. British Journal of Nutrition. ISSN 0007-1145. 118(12), p. 1106–1117. doi: 10.1017/S0007114517003178. Full text in Research Archive Show summary

  The aim of this study was to validate the estimated habitual dietary intake from a newly developed web-based FFQ (WebFFQ), for use in an adult population in Norway. In total, ninety-two individuals were recruited. Total energy expenditure (TEE) measured by doubly labelled water was used as the reference method for energy intake (EI) in a subsample of twenty-nine women, and multiple 24-h recalls (24HR) were used as the reference method for the relative validation of macronutrients and food groups in the entire sample. Absolute differences, ratios, crude and deattenuated correlations, cross-classifications, Bland–Altman plot and plots between misreporting of EI (EI–TEE) and the relative misreporting of food groups (WebFFQ–24HR) were used to assess the validity. Results showed that EI on group level was not significantly different from TEE measured by doubly labelled water (0·7 MJ/d), but ranking abilities were poor (r −0·18). The relative validation showed an overestimation for the majority of the variables using absolute intakes, especially for the food groups ‘vegetables’ and ‘fish and shellfish’, but an improved agreement between the test and reference tool was observed for energy adjusted intakes. Deattenuated correlation coefficients were between 0·22 and 0·89, and low levels of grossly misclassified individuals (0–3 %) were observed for the majority of the energy adjusted variables for macronutrients and food groups. In conclusion, energy estimates from the WebFFQ should be used with caution, but the estimated absolute intakes on group level and ranking abilities seem acceptable for macronutrients and most food groups. © The Authors 2017

• Paur, Ingvild; Lilleby, Wolfgang; Bøhn, Siv Kjølsrud; Hulander, Erik; Klein, Willibrord & Vlatkovic, Ljiljana [Show all 19 contributors for this article] (2016). Tomato-based randomized controlled trial in prostate cancer patients: Effect on PSA. Clinical Nutrition. ISSN 0261-5614. 36(3), p. 672–679. doi: 10.1016/j.clnu.2016.06.014. Full text in Research Archive Show summary

  Background & aims: The effect of lycopene-containing foods in prostate cancer development remains undetermined. We tested whether a lycopene-rich tomato intervention could reduce the levels of prostate specific antigen (PSA) in prostate cancer patients. Methods: Prior to their curative treatment, 79 patients with prostate cancer were randomized to a nutritional intervention with either 1) tomato products containing 30 mg lycopene per day; 2) tomato products plus selenium, omega-3 fatty acids, soy isoflavones, grape/pomegranate juice, and green/black tea (tomato-plus); or 3) control diet for 3 weeks. Results: The main analysis, which included patients in all risk categories, did not reveal differences in changes of PSA-values between the intervention and control groups. Post-hoc, exploratory analyses within intermediate risk (n = 41) patients based on tumor classification and Gleason score post-surgery, revealed that median PSA decreased significantly in the tomato group as compared to controls (−2.9% and +6.5% respectively, p = 0.016). In separate post-hoc analyses, we observed that median PSA-values decreased by 1% in patients with the highest increases in plasma lycopene, selenium and C20:5 n-3 fatty acid, compared to an 8.5% increase in the patients with the lowest increase in lycopene, selenium and C20:5 n-3 fatty acid (p = 0.003). Also, PSA decreased in patients with the highest increase in lycopene alone (p = 0.009). Conclusions: Three week nutritional interventions with tomato-products alone or in combination with selenium and n-3 fatty acids lower PSA in patients with non-metastatic prostate cancer. Our observation suggests that the effect may depend on both aggressiveness of the disease and the blood levels of lycopene, selenium and omega-3 fatty acids.

• Russnes, Kjell Magne; Möller, Elisabeth; Wilson, Kathryn M.; Carlsen, Monica Hauger; Blomhoff, Rune & Smeland, Sigbjørn [Show all 10 contributors for this article] (2016). Total antioxidant intake and prostate cancer in the Cancer of the Prostate in Sweden (CAPS) study. A case control study. BMC Cancer. 16:438, p. 1–12. doi: 10.1186/s12885-016-2486-8. Full text in Research Archive Show summary

  Background The total intake of dietary antioxidants may reduce prostate cancer risk but available data are sparse and the possible role of supplements unclear. We investigated the potential association between total and dietary antioxidant intake and prostate cancer in a Swedish population. Methods We used FFQ data from 1499 cases and 1112 controls in the population based case–control study Cancer of the Prostate in Sweden (CAPS). The ferric reducing antioxidant potential (FRAP) assay was used to assess the total antioxidant capacity (TAC) of diet and supplements. We calculated odds ratios (ORs) for the risk of prostate cancer across quintiles of antioxidant intake from all foods, from fruit and vegetables only, and from dietary supplements using unconditional logistic regression. Results Coffee comprised 62 % of the dietary antioxidant intake, tea 4 %, berries 4 %, chocolate 2 %, and boiled potatoes 2 %. In total 19 % and 13 % of the population took multivitamins and supplemental Vitamin C respectively, on a regular basis. Antioxidant intake from all foods and from fruits and vegetables separately measured by the FRAP assay was not associated with prostate cancer risk. For antioxidant intake from supplements we found a positive association with total, advanced, localized, high grade and low grade prostate cancer in those above median supplemental TAC intake of users compared to non-users (Adjusted ORs for total prostate cancer: 1.37, 95 % CI 1.08–1.73, advanced: 1.51, 95 % CI 1.11–2.06, localized: 1.36. 95 % CI 1.06–1.76, high grade 1.60, 95 % CI 1.06–2.40, low grade 1.36, 95 % CI 1.03–1.81). A high intake of coffee (≥6 cups/day) was associated with a possible risk reduction of fatal and significantly with reduced risk for high grade prostate cancer, adjusted OR: 0.45 (95 % CI: 0.22–0.90), whereas a high intake of chocolate was positively associated with risk of total, advanced, localized and low grade disease (adjusted OR for total: 1.43, 95 % CI 1.12–1.82, advanced: 1.40, 95 % CI 1.01–1.96, localized: 1.43, 95 % CI 1.08–1.88, low-grade: 1.41, 95 % CI 1.03–1.93). Conclusions Total antioxidant intake from diet was not associated with prostate cancer risk. Supplement use may be associated with greater risk of disease.

• Medin, Anine Christine; Carlsen, Monica Hauger & Andersen, Lene Frost (2016). Associations between reported intakes of carotenoid-rich foods and concentrations of carotenoids in plasma: a validation study of a web-based food recall for children and adolescents. Public Health Nutrition (PHN). ISSN 1368-9800. 19(18), p. 3265–3275. doi: 10.1017/S1368980016001622. Full text in Research Archive Show summary

  To validate estimated intakes of carotenoid-rich foods from a web-based food recall (WebFR) using carotenoids in blood as an objective reference method. Cross-sectional validation study using carotenoids in plasma to evaluate estimated intakes of selected carotenoid-rich foods. Participants recorded their food intake in the WebFR and plasma concentrations of β-carotene, α-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin were measured. Schools and homes of families in a suburb of the capital of Norway. A total of 261 participants in the age groups 8–9 and 12–14 years. Spearman’s rank correlation coefficients ranged from 0·30 to 0·44, and cross-classification showed that 71·6–76·6 % of the participants were correctly classified, when comparing the reported intakes of carotenoid-rich foods and concentrations of the corresponding carotenoids in plasma, not including lutein and zeaxanthin. Correlations were acceptable and cross-classification analyses demonstrated that the WebFR was able to rank participants according to their reported intake of foods rich in α-carotene, β-carotene, β-cryptoxanthin and lycopene. The WebFR is a promising tool for dietary assessment among children and adolescents. © The Authors 2016

• Qureshi, Samera Azeem; Lund, Annette Christin; Veierød, Marit Bragelien; Carlsen, Monica Hauger; Blomhoff, Rune & Andersen, Lene Frost [Show all 7 contributors for this article] (2014). Food items contributing most to variation in antioxidant intake; A cross-sectional study among Norwegian women. BMC Public Health. 14(1). doi: 10.1186/1471-2458-14-45. Full text in Research Archive Show summary

  Background Fruit and vegetable intake has been found to reduce the risk of cardiovascular disease, certain types of cancer and diabetes mellitus. It is possible that antioxidants play a large part in this protective effect. However, which foods account for the variation in antioxidant intake in a population is not very clear. We used food frequency data from a population-based sample of women to identify the food items that contributed most to the variation in antioxidant intake in Norwegian diet. Methods We used data from a study conducted among participants in the Norwegian Breast Cancer Screening Program (NBCSP), the national program which invites women aged 50–69 years to mammographic screening every 2 years. A subset of 6514 women who attended the screening in 2006/2007 completed a food frequency questionnaire (FFQ). Daily intake of energy, nutrients and antioxidant intake were estimated. We used multiple linear regression analysis to capture the variation in antioxidant intake. Results The mean (SD) antioxidant intake was 23.0 (8.5) mmol/day. Coffee consumption explained 54% of the variation in antioxidant intake, while fruits and vegetables explained 22%. The twenty food items that contributed most to the total variation in antioxidant intake explained 98% of the variation in intake. These included different types of coffee, tea, red wine, blueberries, walnuts, oranges, cinnamon and broccoli. Conclusions In this study we identified a list of food items which capture the variation in antioxidant intake among these women. The major contributors to dietary total antioxidant intake were coffee, tea, red wine, blueberries, walnuts, oranges, cinnamon and broccoli. These items should be assessed in as much detail as possible in studies that wish to capture the variation in antioxidant intake.

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• Hovland, Ida Heir; Bang, Lasse; Herfindal, Anne Mari; Strømland, Stine Sofie; Bogetvedt, Tina & Jahanshahi, Armita [Show all 29 contributors for this article] (2026). The Norwegian Microbiota Study in Anorexia Nervosa (NORMA): Integrating a clinical trial with preclinical experiments–A study protocol. doi: 10.1371/journal.pone.0342275. Full text in Research Archive Show summary

  Background: Anorexia nervosa (AN) remains difficult to treat, partly due to co-occurring mental health challenges and gastrointestinal symptoms. Emerging research suggests that individuals with AN exhibit gut microbiota dysbiosis and dysregulation in the gut-brain axis (GBA). However, research examining the role of gut microbiota as a potential driver of AN-related pathologies remains limited. The Norwegian Microbiota Study in Anorexia Nervosa (NORMA) will therefore investigate gut microbiota and its interaction with the GBA in AN. Methods: NORMA is a collaboration between the Norwegian University of Life Sciences and seven Norwegian specialized eating disorder inpatient treatment units, consisting of three work packages (WP): a clinical observational trial (WP1), in vitro fermentation experiments (WP2), and animal experiments (WP3). In WP1, 90 patients with AN (age 16-50, BMI < 18.5) admitted for treatment and 90 healthy controls (HCs, age 16-50, BMI 18.5-27) will be recruited. Data on mental and physical health, dietary intake, and blood and fecal samples for biomarker and microbiota analyses will be collected at baseline, 6 and 12 weeks after start of treatment for AN patients and once for HCs. Outcomes will be compared between groups, and longitudinal effects of standard treatment examined within the AN group. In WP2, fecal microorganisms from patients and HCs will be grown in vitro to assess influence of prebiotics. In WP3, mice will receive fecal microbiota from AN and HC donors to determine if and how AN‑related microbiota affects AN‑relevant phenotypes. Conclusion: NORMA is pioneering in its integration of clinical, in vitro, and animal studies, providing the most comprehensive gut microbiota study of AN so far. By investigating the role of gut microbiota in AN and effects of standardized treatment on gut microbiota composition, this study aims to inform the development of innovative therapeutic strategies and ultimately improve treatment outcomes and life quality for individuals with AN. Trial registration: NORMA is a registered clinical trial: clinicaltrials.gov as NCT06144905.

• Carlsen, Harald; Bøhn, Siv Kjølsrud; Rosa, Sabina Leanti La; Trømborg, Åsne Skram; Westereng, Bjørge & Carlsen, Monica Hauger [Show all 7 contributors for this article] (2025). AdHealth- introduksjon av et nytt forskningsprosjekt. Full text in Research Archive Show summary

  Oppstartsmøte for partnere i AdHealth

• Birkeland, Signe; Trømborg, Åsne Skram; Boysen, Preben; Carlsen, Monica Hauger & Carlsen, Harald (2025). On barrier functions in the mouse intestine. Full text in Research Archive
• Carlsen, Harald; Trømborg, Åsne Skram & Carlsen, Monica Hauger (2025). Food thickeners and their relation to health – a closer look at the gut. Full text in Research Archive Show summary

  Gjennomgang av litteraturen vedrørende fortykningsstoffer og tarmhelse på NutriNORs sommerskole 2025

• Husøy, Trine; Andreassen, Monica; Bruzell, Ellen Merete; Denison, Eva Marie-Louise; Devold, Tove Gulbrandsen & Granum, Berit [Show all 9 contributors for this article] (2025). Update of the scoping review of research on gastrointestinal effects of selected emulsifiers, stabilisers, and thickeners. Scientific opinion of the panel on food additives, flavourings, processing aids,materials in contact with food, and cosmetics. VKM Report. 2025(3), p. 1–63. doi: https:/vkm.no/risikovurderinger/allevurderinger/konsistensmidlerogtarmenoppdatering.4.a627a4c190302ffd8525e33.html. Full text in Research Archive Show summary

  Summary This scoping review was commissioned by the Norwegian Food Safety Authority. The aim was to update a previous scoping review of research literature on the effects of emulsifiers, stabilisers and thickeners (EST) on the gastrointestinal (GI) tract, specifically agar (E 406), sodium alginate (E 401), carrageenan (E 407), processed Eucheuma seaweed (E 407a), sodium carboxymethyl cellulose (E 466), gellan gum (E 418), guar gum (E 412), and xanthan gum (E 415). The effects could be beneficial, adverse or neutral. A scoping review contrasts with a safety evaluation that consists of assessment of biological and chemical properties, potential toxicity of any organ, and dietary exposure estimates. It does not report on measures of the strength of the relationship between EST exposures and effects on the GI tract. The literature search covered the period from March 1, 2023 (end of search of the previous review) to June 11, 2024. The search strategy and the eligibility criteria were the same in the previous and the updated scoping reviews. Fifteen studies fulfilling the eligibility criteria were identified in the previous scoping review (VKM, 2023). In addition, 214 studies fulfilled all eligibility criteria except the criterion that the substance tested must be in accordance with the regulations for food additives in the EU and Norway. The information about the substance tested in these studies was insufficient, and to obtain this information for the present update, the VKM sent requests by email to the corresponding authors of the publications, whenever such contact information was available. If delivery failed, an effort was made to identify a new email address to which the request was re-sent. Six additional studies from five publications were included following receipt of requested information. No studies were included from the updated literature search. Four of the included studies examined effects of sodium alginate (E 401) and guar gum (E 412) in humans and two other studies examined effects of guar gum (E 412) and carboxymethyl cellulose (E 466) in pigs. From both the previous scoping review (VKM, 2023) and the present update, 21 controlled studies fulfilling the eligibility criteria were identified: five studies in humans and 16 in animals. The dose ranges reported or estimated, across all ESTs in the human and animal studies (four different species), were 36-214 mg/kg bw per day and 51-6000 mg/kg bw per day, respectively. The study durations of the human controlled studies were between 1 day and 1 week, i.e. acute exposures only. Study durations were subchronic (exposure ≥13 weeks) in four of the animal experimental studies and subacute (≤12 weeks) in the remainder. The endpoints addressed in the human studies were: • Faecal weight and consistency • Gastric emptying (time and frequency) • Glucose and insulin homeostasis • Satiety and appetite The endpoints addressed in the animal studies were: 10 Update of the scoping review of research on gastrointestinal effects of selected EST • Changes in gut microbiota composition or number of bacteria • Enzymatic activity (digestive, microbial, cell proliferation, and inflammatory) • Intestinal utilisation and fermentation of nutrients • Macroscopic changes (stomach, small intestine, colon) • Microscopic changes (digestive tract) including inflammation • Mucosal weight, content (colon) • Presence of blood or mucus in faeces • Tumor promotion in cancer-induced mice (genetic or chemical) The risk of bias was assessed as high in the human studies and as high and moderate in the animal studies. High risk of bias means that there is high likelihood that the features of the study design or conduct of the study will give misleading results and thus, conclusions. Conclusion There were few eligible studies on the effects of agar (E 406), sodium alginate (E 401), carrageenan (E 407), processed Eucheuma seaweed (E 407a), sodium carboxymethyl cellulose (E 466), guar gum (E 412) and xanthan gum (E 415) on the gastrointestinal tract. In most of the studies the potential was high for systematic errors in the results or findings. None of the studies lasted long enough to evaluate long-term exposure in humans. Thus, the evidence base will be weak for assessment of the risk for negative effects on the gastrointestinal tract in humans. The conclusion in the present updated scoping review, after inclusion of six additional studies, remains the same as in the previous scoping review (VKM, 2023). Key words: Colon, mapping review, eligibility criteria, EU regulation, food a

• Konglevoll, Dina Moxness; Andersen, Lene Frost; Thoresen, Magne; Totland, Torunn Holm; Hopstock, Laila Arnesdatter & Hjartåker, Anette [Show all 7 contributors for this article] (2025). Dietary trajectories over 21 years and frailty in Norwegian older adults. doi: 10.1007/s00394-024-03482-z. Full text in Research Archive Show summary

  This study investigated the association between dietary trajectories over two decades and frailty in older adults in the large Norwegian population-based study, the Tromsø Study. We found that there was an association between maintaining a moderately healthy to very healthy diet through adulthood and lower frailty in older age.

• Carlsen, Monica Hauger; Andreassen, Monica; Bernhard, Annette; Bruzell, Ellen; Devold, Tove Gulbrandsen & Lillegaard, Inger Therese Laugsand [Show all 9 contributors for this article] (2025). Nitrat og nitritt i mat og drikke. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. doi: 10.18261/ntfe.23.1.8. Full text in Research Archive
• Husøy, Trine; Andreassen, Monica; Bernhard, Annette; Bruzell, Ellen Merete; Carlsen, Monica Hauger & Denison, Eva Marie-Louise [Show all 11 contributors for this article] (2025). Part 2 of the risk assessment of nitrate, nitrite and nitrosamines in food: The protocol. VKM Bulletin. p. 1–45. Full text in Research Archive Show summary

  The Norwegian Scientific Committee for Food and Environment (VKM) shall assess whether exposure to nitrates and nitrites from food poses a health risk for one or more groups in the Norwegian population. The Norwegian Scientific Committee for Food and Environment (VKM) will calculate the intake of nitrate and nitrite from food for different groups in the population and assess whether this constitutes a health risk. This is a two-part task commissioned by the Norwegian Food Safety Authority. As the first step, VKM has created an overview of which food items contain these substances and how much nitrate and nitrite they contain. The second part of the task is underway, where VKM will estimate nitrate and nitrite intake among different demographic groups in Norway and conduct a risk assessment. Background There is no existing data on which food items in the Norwegian market contain nitrate and nitrite, nor on the amounts present. Furthermore, the intake of nitrate and nitrite among different population groups in Norway is not known. Nitrate and nitrite can occur naturally in food and may also be added as a preservative or plant extract. Preservatives E 249, E 250, E 251, and E 252 are used to delay bacterial growth, thereby increasing food shelf life. Nitrate and nitrite have been linked to both positive and negative health effects. Read more about part 1 here: Foods containing nitrate and nitrite - Vitenskapskomiteen for mat og miljø (...)

• Hovland, Ida Heir; Bang, Lasse; Herfindal, Anne Mari; Strømland, Stine Sofie; Spernes, Tina & Jahanshahi, Armita [Show all 28 contributors for this article] (2024). The NORMA study - Gut microbiota alterations in anorexia nervosa - paving the way for personalized prebiotic treatment strategies. Presented by Siv Kjølsrud Bøhn. Full text in Research Archive Show summary

  Background & aim: Treatment of anorexia nervosa (AN) usually combines nutritional treatment with various types of psychotherapeutic approaches. The treatment is however complicated and only 50 percent of patients get satisfactory outcomes. In the NORMA-study the role of the gut microbiota for key features of AN is investigated and it is investigated whether the gut microbiota normalizes during treatment. The study also aims at developing strategies to improve treatment outcomes through microbiota manipulation. Method: The clinical trial is conducted as a longitudinal, multicenter study consisting of a clinical trial, a laboratory study and an animal study. In the clinical trial we will recruit a total of 90 patients with AN and 90 healthy controls (HC). Participants will complete self-reported questionnaires on mental and physical health, dietary intake and provide blood and fecal samples at three timepoints to analyze microbiota composition, specific blood biomarkers and nutrient intake associated to AN. Fecal microbial transplantation from humans to mice will be performed to investigate the impact of the microbiota on weight development, anxiety and obsessive-compulsive disorder (OCD)-like behavior. Prebiotics (carbohydrate types) will then be screened for their potential to normalize the anorexia associated microbiota using both in ex vivo and in vivo studies. Conclusion: The NORMA-study is the largest longitudinal microbiota study in AN ever conducted and will provide valuable insight into the role of the gut microbiota in AN and lay foundations for innovative treatment strategies that potentially can improve treatment outcomes and quality of life for patients.

• Andersen, Lene Frost & Carlsen, Monica Hauger (2024). Local vs global impact data in life cycle assessment food databases – does it matter? Full text in Research Archive
• Carlsen, Monica Hauger (2024). Begrepet ultraprosessert mat og dets utfordringer i et kostholdsmetodologisk perspektiv. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. 22(4), p. 233–236. doi: 10.18261/ntfe.22.4.10. Full text in Research Archive
• Andreassen, Monica; Carlsen, Monica Hauger; Bruzell, Ellen Merete; Denison, Eva Marie-Louise; Devold, Tove Gulbrandsen & Granum, Berit Brunstad [Show all 12 contributors for this article] (2024). Mapping of dietary sources of nitrates and nitrites. VKM Bulletin. VKM Bulletin 2024: 27, p. 1–53. Full text in Research Archive Show summary

  Vitenskapskomiteen for mat og miljø (VKM) skal beregne hvor mye nitrat og nitritt ulike grupper i befolkningen får i seg fra maten, og vurdere om dette utgjør en helserisiko. VKM har i første omgang laget en oversikt over hvilke matvarer som inneholder disse stoffene, og hvor mye nitritt og nitrat som finnes i disse matvarene. Det finnes ingen oversikt over hvilke matvarer på det norske markedet som inneholder nitrat og nitritt og hvor mye de inneholder, og det er heller ikke kjent hvor mye nitrat og nitritt ulike befolkningsgrupper i Norge får i seg fra kosten. Nitrat og nitritt kan forkomme naturlig i en matvare, og stoffene kan være tilsatt som konserveringsmiddel eller som planteekstrakt. Konserveringsmidlene E249, E 250, E 251 og E 252 brukes for å bremse vekst av bakterier, og øker dermed matens holdbarhet. Nitrat og nitritt knyttes både til både positive og negative helseeffekter. Om oppdraget VKM fikk i oppdrag å lage en oversikt over hvilke matvarer på det norske markedet som inneholder nitrat og nitritt, og i hvilke mengder stoffene forekommer. Vi fant at produkter fra de fleste matvaregrupper inneholder nitrat og nitritt, enten hver for seg eller samtidig. Stoffene finnes i ulike drikkevarer, fisk, frukt, grønnsaker, belgvekster, poteter, kjøtt, korn og kornprodukter, melk og melkeprodukter, salt og krydder, smør, margarin og oljer, samt i spedbarnsmat og sammensatte retter. Det er store forskjeller i mengden nitrat og nitritt som er funnet i de ulike matvaregruppene. Oversikten viser også i hvilke matvaregrupper vi ikke fant informasjon om nitrat- og nitrittinnhold. Dette er første del i et todelt oppdrag fra Mattilsynet. I neste omgang skal VKM beregne hvor mye nitrat og nitritt ulike grupper i den norske befolkningen får i seg fra maten, og foreta en risikovurdering av dette. Dette arbeidet startes i januar 2025. Oversikten er godkjent av VKMs faggruppe for tilsetningsstoffer, aroma, matemballasje og kosmetikk.

• Konglevoll, Dina Moxness; Hjartåker, Anette; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Andersen, Lene Frost [Show all 7 contributors for this article] (2023). Proteininntak og skrøpelighet hos eldre deltagere i Tromsøundersøkelsen (1994–2016). Full text in Research Archive
• Konglevoll, Dina Moxness; Andersen, Lene Frost; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Totland, Torunn Holm [Show all 8 contributors for this article] (2023). Fish intake and pre-frailty in Norwegian older adults. A prospective cohort: the Tromsø Study 1994-2016. Full text in Research Archive
• Konglevoll, Dina Moxness; Andersen, Lene Frost; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Totland, Torunn Holm [Show all 8 contributors for this article] (2023). Fish intake and pre-frailty in Norwegian older adults. A prospective cohort: the Tromsø Study 1994-2016. Full text in Research Archive
• Konglevoll, Dina Moxness; Andersen, Lene Frost; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Totland, Torunn Holm [Show all 8 contributors for this article] (2023). Fish intake and pre-frailty in Norwegian older adults. A prospective cohort study: the Tromsø Study 1994-2016. Full text in Research Archive
• Konglevoll, Dina Moxness; Andersen, Lene Frost; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Totland, Torunn Holm [Show all 8 contributors for this article] (2023). Fiskeinntak of pre-skrøpelighet hos eldre deltagere i Tromsøundersøkelsen: et prospektivt studie (1994-2016). Full text in Research Archive
• Henriksen, Hege Berg; Carlsen, Monica Hauger; Knudsen, Markus Dines; Hjartåker, Anette & Blomhoff, Rune (2023). Digikost: A digital application for diet and lifestyle assessment and benchmarking against national guidelines. Full text in Research Archive
• Zerouga, Insaf; Sommer, Christine; Carlsen, Monica Hauger; Valeur, Jørgen; Kristensen, Vendel Ailin & Høivik, Marte Lie [Show all 8 contributors for this article] (2023). Kosthold og ernæringsstatus ved nydiagostisert IBD: resultater fra IBSEN III. Full text in Research Archive
• Bjøntegaard, Marie Michaelsen; Carlsen, Monica Hauger; Wright, Ellen Cecilie & Andersen, Lene Frost (2023). Poster Throne Holst Symposium 2023: Compilation of an environmental LCA food database. Full text in Research Archive
• Konglevoll, Dina Moxness; Hjartåker, Anette; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Andersen, Lene Frost [Show all 7 contributors for this article] (2022). Protein intake and the risk of pre-frailty/frailty in Norwegian older adults. The Tromsø Study 1994-2016. Full text in Research Archive
• Konglevoll, Dina Moxness; Hjartåker, Anette; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Andersen, Lene Frost [Show all 7 contributors for this article] (2022). Protein intake and the risk of pre-frailty/frailty in Norwegian older adults. The Tromsø Study 1994-2016. Full text in Research Archive
• Konglevoll, Dina Moxness; Hjartåker, Anette; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Andersen, Lene Frost [Show all 7 contributors for this article] (2022). Protein intake and the risk of pre-frailty/frailty in Norwegian older adults. The Tromsø Study 1994-2016. Full text in Research Archive
• Konglevoll, Dina Moxness; Hjartåker, Anette; Hopstock, Laila Arnesdatter; Strand, Bjørn Heine; Thoresen, Magne & Andersen, Lene Frost [Show all 7 contributors for this article] (2022). Protein intake and the risk of pre-frailty/frailty in Norwegian older adults. The Tromsø Study 1994-2016. Full text in Research Archive
• Ottestad, Inger; Ulven, Stine Marie; Sandvei, Kristin Søfteland; Carlsen, Monica Hauger; Gundersen, Thomas & Gjevestad, Gyrd Omholt [Show all 8 contributors for this article] (2019). Iodine status and effect of increased intake of milk among older Norwegian adults. Full text in Research Archive
• Lundblad, Marie Wasmuth; Jacobsen, Bjarne K.; Grimsgaard, Sameline; Andersen, Lene Frost; Carlsen, Monica Hauger & Johansson, Jonas [Show all 7 contributors for this article] (2019). Total energy and macronutrient intake according to body mass index, fat mass index and body fat percentage: The seventh Tromsø Study 2015-16. Full text in Research Archive
• Lundblad, Marie Wasmuth; Jacobsen, Bjarne K.; Grimsgaard, Sameline; Andersen, Lene Frost; Carlsen, Monica Hauger & Hopstock, Laila Arnesdatter (2018). Energy and macronutrient intake and associations with body mass index and fat mass index: The seventh Tromsø Study 2015-16. Norsk Epidemiologi, Supplement. ISSN 0803-4206. p. 30–30. Full text in Research Archive
• Carlsen, Karin C. Lødrup; Rehbinder, Eva Maria; Skjerven, Håvard Ove; Carlsen, Monica Hauger; Fatnes, Thea Aspelund & Fugeli, Pål [Show all 20 contributors for this article] (2018). Preventing Atopic Dermatitis and ALLergies in Children-the PreventADALL study. Allergy. European Journal of Allergy and Clinical Immunology. ISSN 0105-4538. 73(10), p. 2063–2070. doi: 10.1111/all.13468. Full text in Research Archive
• Lundblad, Marie Wasmuth; Andersen, Lene Frost; Jacobsen, Bjarne K.; Carlsen, Monica Hauger; Hjartåker, Anette & Grimsgaard, Sameline [Show all 7 contributors for this article] (2017). Nutrient intake in the 7th survey of the Tromsø Study 2015-16, and comparison with Norwegian national dietary recommendations. Norsk Epidemiologi, Supplement. ISSN 0803-4206. Full text in Research Archive
• Lundblad, Marie Wasmuth; Andersen, Lene Frost; Jacobsen, Bjarne K.; Carlsen, Monica Hauger; Hjartåker, Anette & Grimsgaard, Sameline [Show all 7 contributors for this article] (2017). Nutrient intake in the 7th survey of the Tromsø Study 2015-16, and comparison with Norwegian national dietary recommendations. Full text in Research Archive
• Carlsen, Monica Hauger; Norberg, Nina & Hjartåker, Anette (2016). Assigning fatty acid composition to foods in a comprehensive nutrient calculation system (KBS). Full text in Research Archive
• Carlsen, Harald; Carlsen, Monica Hauger; Trømborg, Åsne Skram & Teistung, Linnestad, Maren (2024). Mapping the occurrence of 11 common hydrocolloids in the Norwegian diet using the Norkost4 pilot study. Norges miljø- og biovitenskapelige universitet (NMBU). Full text in Research Archive Show summary

  Background: New ways of processing food were introduced during the 20th century. This has resulted in a diet where minimally processed foods increasingly have been replaced by products with a higher degree of processing. Highly processed food, often referred to as ultra-processed food (UPF), has been associated with obesity and other chronic diseases. Several aspects of highly processed food products have been suggested as causative in increased risk of chronic diseases, one of which involves hydrocolloids, through their interactions with the gut microbiota. These are food additives exclusively found in highly processed food. In Norway, there is growing concern over using hydrocolloids in foods due to their potential negative impact on intestinal health. Aims: The overall aim was to map the intake of foods with 11 common hydrocolloids in study participants of the pilot study of the national dietary survey Norkost4 and assess whether the intake of foods with hydrocolloids varied between sex and age. Methods: Dietary data from the Norkost4 pilot study collected through two non-consecutive 24-hour recall interviews were used. The foods and beverages were classified according to the NOVA classification by a former master’s student at the University of Oslo, and only foods classified as UPF were used in the present master thesis. These foods and beverages were assigned with global trade item numbers (GTINs) to be able to identify these in the VetDuAt.no product database, for the subsequent extraction of data on hydrocolloid content from the product declaration, using an application programming interface (API). Data was further analyzed in RStudio. Results: Virtually all participants consumed hydrocolloids daily, of whom 70% consumed between three to seven different hydrocolloids, and the remaining 30% consumed more than seven or fewer than three. Guar gum (E412) and xanthan gum (E415) were found to be the most frequently used hydrocolloids in foods and beverages, and the most consumed by 82% and 75% of the study participants respectively. The average intake of foods with hydrocolloids ranged from about two to 50 grams per person daily. Significant differences (p<0.05) in the intake of foods with hydrocolloids were found between sex (E401, E406, E407, E412, and E440) and age groups (E406, E407, E410, and E440). Conclusion: The 11 selected hydrocolloids were frequently consumed by the study participants and guar gum and xanthan gum were the most frequently consumed. Findings from the current study indicate that hydrocolloids are consumed daily in the Norwegian population, providing a basis for further investigation to elucidate possible long term health effects in humans.

• Aakra, Ågot; Abass, Khaled; Adlard, Bryan; Amos, Helen; Averina, Maria & Ayotte, Pierre [Show all 53 contributors for this article] (2021). AMAP Assessment 2021: Human Health in the Arctic. AMAP - Arctic Monitoring and Assessment Programme. ISSN 9788279712008. Full text in Research Archive
• Carlsen, Monica Hauger; Devold, Tove Gulbrandsen; Granum, Berit; Lillegaard, Inger Therese L.; Mathisen, Gro Haarklou & Rasinger, Josef Daniel [Show all 11 contributors for this article] (2020). Protocol for a risk assessment of caffeine exposure from multiple sources. Protocol from the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food, and Cosmetics of the Norwegian Scientific Committee for Food and Environment. The Norwegian Scientific Committee for Food and Environment (VKM). ISSN 9788282593380. Full text in Research Archive
• Bruzell, Ellen Merete; Denison, Eva Marie-Louise; Devold, Tove Gulbrandsen; Granum, Berit Brunstad; Mathisen, Gro Haarklou & Rasinger, Josef Daniel [Show all 11 contributors for this article] (2020). Revised protocol for a risk-benefit assessment of sunscreen. From the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food, and Cosmetics of the Norwegian Scientific Committee for Food and Environment. The Norwegian Scientific Committee for Food and Environment. ISSN 9788282593373. Full text in Research Archive
• Svendsen, Camilla; Asmyhr, Maria Gulbrandsen; Denison, Eva Marie-Louise; Devold, Tove Gulbrandsen; Mathisen, Gro Haarklou & Rohloff, Jens [Show all 12 contributors for this article] (2020). Protocol for a scoping review of systematic reviews on environmental effects of sunscreen ingredients. From the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food, and Cosmetics of the Norwegian Scientific Committee for Food and Environment. The Norwegian Scientific Committee for Food and Environment. ISSN 9788282593403. Full text in Research Archive
• Andersen, Lene Frost; Berstad, Paula; Carlsen, Monica Hauger; Dahl, Lisbeth Jane; Goksøyr, Anders & Knutsen, Helle Katrine [Show all 32 contributors for this article] (2020). Protocol and description of literature searches for the risk-benefit assessment of fish in the Norwegian diet. The Steering Committee of the Norwegian Scientific Committee for Food and Environment. The Norwegian Scientific Committee for Food Safety. ISSN 9788282593359. Full text in Research Archive Show summary

  Fish contains nutrients that are positive for our health. At the same time, it contains varying levels of undesirable substances that can have a negative effect on health. Undesirable substances can be found in different levels in most types of food. In a risk-benefit assessment, both the nutrients and the undesirable substances are assessed and it is evaluated whether it in total gives a more positive effect to eat certain foodstuff than not, and possibly how much one should eat to achieve optimal use of the positive health effects.

• Bruzell, Ellen Merete; Carlsen, Monica Hauger; Granum, Berit; Lillegaard, Inger Therese L.; Mathisen, Gro Haarklou & Rasinger, Josef Daniel [Show all 10 contributors for this article] (2019). Risk assessment of energy drinks and caffeine. Scientific Opinion of the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food, and Cosmetics of the Norwegian Scientific Committee for Food and Environment. Norwegian Scientific Committee for Food and Environment (VKM). ISSN 9788282593175. Full text in Research Archive
• Husøy, Trine; Andreassen, Monica; Lillegaard, Inger Therese L.; Mathisen, Gro Haarklou; Rohloff, Jens & Starrfelt, Jostein [Show all 12 contributors for this article] (2019). Risk assessment of butylated hydroxytoluene (BHT). Opinion of the Panel on Food Additives, Flavourings, Processing Aids, Materials in Contact with Food, and Cosmetics of the Norwegian Scientific Committee for Food and Environment. Norwegian Scientific Committee for Food and Environment (VKM). ISSN 9788282593311. Full text in Research Archive Show summary

  Butylated hydroxytoluene (BHT, E321) is a synthetic antioxidant authorised as food and feed additive in the EU. In addition, BHT is used in e.g. cosmetics and food contact materials. To our knowledge, risk assessments including exposure estimates for BHT from multiple sources and exposure pathways have not been performed. BHT is characterised by extensive use and multiple exposure sources and routes. Therefore, it is important that these sources and routes are included in the estimations to arrive at the most accurate picture of the population's exposure. In addition, the main sources contributing to the exposure should be identified. Toxicity An acceptable daily intake (ADI) of 0.25 mg/kg bodyweight (bw) per day was established by EFSA based on effects on the litter size and pup body weight in two 2-generation studies in rats (EFSA, 2012). The ADI was based on the no observed adverse effect level (NOAEL) of 25 mg/kg bw per day in these two studies and an uncertainty factor of 100. The ADI was used as reference point for BHT toxicity in this risk assessment. Exposure The exposure was estimated for «realistic» and «high» scenarios. The consumption data used for the exposure estimation were from Norkost 3 (foods), EuroMix (foods and personal care products) and the Environmental Protection Agency (US; indoor dust). The concentration data used were from scientific literature, and identified through literature searches. The concentration data for the exposure estimation from foods and PCPs were limited and therefore considered to be the largest source of uncertainty in the exposure estimates. Data considered most realistic for the Norwegian exposure were used for «realistic» exposure estimation, whereas the «high» exposure scenario was a worst-case estimation representing a risk assessment for potentially high consumers. To calculate the total internal exposure, absorption factors for BHT uptake from the gastrointestinal tract and skin were used. BHT reaching the physical barriers in the body was defined as external exposure, and the absorbed BHT was defined as total internal exposure. The «realistic» total internal exposure from all routes, for the lowest 5 and the highest 95 percentile, was estimated to be within 1.4 – 9.7 µg BHT/kg bw per day for females and 0.8 – 9.7 µg BHT/kg bw per day for males. The 50 percentile was estimated to be within 3.5 – 4.2 and 2.2 – 2.8 µg BHT/kg bw per day (rounded numbers) for females and males, respectively. The «high» total internal exposure from all routes, for the lowest 5 and the highest 95 percentile, was estimated to be within 23 – 281 µg BHT/kg bw per day for females and 9 - 319 µg BHT/kg bw per day for males. The 50 percentile was estimated to be within 85 – 111 and 46 – 61 µg BHT/kg bw per day (rounded numbers) for females and males, respectively. The predominant route of exposure is oral intake; on average 80% of the internal exposure in females is from food, dust and oral intake of PCPs, while for males even more (92%). Sources of BHT exposure were mainly from food through oral intake (females 41%, males 59%, with substantial contributions also from PCPs through oral uptake (females 38%, males 34%) and through dermal uptake from PCPs (females 21%, males 7.1%). The main contributors to the estimated dietary «realistic» external exposure were the food groups «milk, cream, ice cream», followed by «chewing gum» and «fatty fish». The personal care product categories «body lotion» and «deodorant»» were the two major contributors to the estimated dermal «realistic» external exposure. Oral exposure from personal care products was mainly from toothpaste. Risk characterisation and conclusions Both «realistic» and «high» total internal BHT exposure was used in the risk characterisation. The estimated «realistic» exposure was below the ADI for both women and men. The 50 percentile of the estimated «high» exposure (the worst-case estimation representing a cautious risk assessment approach) was below the ADI, whereas the 95 percentile was above the ADI. Thus, a small fraction of the population may exceed the ADI and be at risk for negative effects on reproductive health. The Panel concludes that BHT exposure is unlikely to cause adverse health effects in adults.

• Bruzell, Ellen Merete; Mathisen, Gro Haarklou; Carlsen, Monica Hauger; Granum, Berit; Rasinger, Josef Daniel & Rohloff, Jens [Show all 8 contributors for this article] (2018). Protocol for the risk assessment of energy drinks and caffeine. Norwegian Scientific Committee for Food and Environment. ISSN 9788282593151. Full text in Research Archive
• Valsta, Liisa; Pastell, Helena; Aalto, Sanni; Virtanen, Suvi & Carlsen, Monica Hauger (2017). Nordic co-operation on Food information. Activities of the Nordic Food Analysis Network 2013-2016. Nordic Council of Ministers, TemaNord 2017. ISSN 9789289348423. doi: 10.6027/TN2017-503. Full text in Research Archive
• Dalane, Jorån Østerholt; Bergvatn, Thea Amalie Martinsen; Kielland, Ellen & Carlsen, Monica Hauger (2015). Mål, vekt og porsjonsstørrelser for matvarer. Universitetet i Oslo. Full text in Research Archive
• Ôhrvik, Veronica; Carlsen, Monica Hauger; Källman, Anna & Martinsen, Thea Amalie B (2015). Improving food composition data by standardizing calculation methods. TemaNord, Nordic Council of Ministers. ISSN 9789289343107. Full text in Research Archive

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