Nanna Lien

• Gebremariam, Mekdes Kebede; Arah, Onyebuchi A.; Bergh, Ingunn Holden; Andersen, Lene Frost; Bjelland, Mona; Grydeland, May & Lien, Nanna (2019). Factors affecting the dose of intervention received and the participant satisfaction in a school-based obesity prevention intervention. Preventive Medicine Reports.  ISSN 2211-3355.  15 . doi: 10.1016/j.pmedr.2019.100906 Show summary

  This study assessed factors associated with the perceived dose of intervention received and with the participantsatisfaction in a school-based obesity prevention intervention. It also explored the variance in the dose of in-tervention received that was at the school level. Process evaluation data from a school-based intervention studyconducted in Oslo in 2007–2009 were used. A total of 542 11-year-olds from 12 intervention schools wereincluded. A web-based questionnaire was used to collect data. Descriptive analyses and multilevel regressionanalyses were conducted. Females and those with medium (vs. low) parental education had higher odds ofreporting a high vs. low dose of intervention received at mid-way (8 months after baseline). Perceived socialcapital and perceived social support for physical activity from friends at baseline were positively associated withthe dose of intervention received at mid-way. Perceived social capital at mid-way was positively associated withthe dose of intervention reported post-intervention (20 months after baseline). Around 20% of the variance inthe perceived dose of intervention received was at the school level. Satisfaction with the intervention was highoverall and higher for females for several intervention components at mid-way and at post-intervention. Thefactors identified in this study should be taken into consideration when planning future obesity preventioninterventions among youth.

• Gebremariam, Mekdes Kebede; Arah, Onyebuchi A.; Bergh, Ingunn Holden; Andersen, Lene Frost; Ommundsen, Yngvar; Totland, Torunn Holm; Bjelland, Mona; Grydeland, May & Lien, Nanna (2019). Gender-specific mediators of the association between parental education and adiposity among adolescents: the HEIA study. Scientific Reports.  ISSN 2045-2322.  9 . doi: 10.1038/s41598-019-43604-w Full text in Research Archive. Show summary

  Identifying the mechanisms behind socioeconomic inequalities in adiposity among youth is vital for efforts aimed at combating these inequalities. The study explored whether a broad range of behavioral and familial factors mediated the associations between parental education and indicators of adiposity among adolescents. Baseline data from a school-based intervention study conducted in 2007 among 11-year-old adolescents were used. Anthropometric outcomes, physical activity and sedentary time among adolescents were objectively measured. Other behavioral variables and parental waist circumference were self-reported. Mediation analyses were conducted. Among boys, maternal waist circumference (WC), paternal WC and TV viewing mediated 16%, 11.5% and 13% of the association between parental education and adolescent WC. The respective proportions when body fat percentage was used as the outcome variable were 22.5%, 16% and 21%. Among girls, maternal and paternal WC mediated 20% and 14% of the association between parental education and WC. The respective proportions when body fat percentage was used as the outcome variable were 14% and 10%. Other included variables did not play any mediating role. Parental WC was found to be a mediator of socioeconomic differences in adiposity in both genders; underlying mechanisms were however not investigated. Among boys, reducing TV time could contribute to the reduction of social inequalities in adiposity.

• Hausken, Solveig Elisabeth Sand; Lie, Hanne Cathrine; Lien, Nanna; Sleddens, Ester F.C.; Melbye, Elisabeth Lind & Bjelland, Mona (2019). The reliability of the general functioning scale in Norwegian 13–15-year-old adolescents and association with family dinner frequency. Nutrition Journal.  ISSN 1475-2891.  18:20, s 1- 5 . doi: 10.1186/s12937-019-0447-1
• Azevedo, Jose; Padrao, Patricia; Gregorio, Maria Joao; Almeida, Carla; Moutinho, Nuno; Lien, Nanna & Barros, Renata (2018). A Web-Based Gamification Program to Improve Nutrition Literacy in Families of 3- to 5-Year-Old Children: The Nutriscience Project. Journal of nutrition education and behavior.  ISSN 1499-4046.  s 1- 9 . doi: 10.1016/j.jneb.2018.10.008
• De Craemer, Marieke; Chastin, Sebastien; Ahrens, Wolfgang; Bernaards, C; Brug, Johannes; Buck, Christopher; Cardon, Greet; Capranica, Laura; Dargent-Molina, Patricia; De Lepeleere, Sara; Hoffman, Belinda; Kennedy, Aileen; Lakerveld, Jeroen; Lien, Nanna; Ling, Fiona; Loyen, Anne; MacDonncha, Ciaran; Nazare, Julie-Anne; O'Donoghue, Grainne; O'Gorman, Donal J; Perchoux, Camille; Pigeot, Iris; Simon, Chantal; Mueller-Stierlin, Annabel S.; van der Ploeg, Hidde P; Van Cauwenberg, Jelle & Oppert, Jean-Michel (2018). Data on Determinants Are Needed to Curb the Sedentary Epidemic in Europe. Lessons Learnt from the DEDIPAC European Knowledge Hub.. International Journal of Environmental Research and Public Health.  ISSN 1660-4601.  15(7) . doi: 10.3390/ijerph15071406
• De Craemer, Marieke; Verloigne, Maïté; Ghekiere, Ariane; Loyen, Anne; Dargent-Molina, Patricia; Brug, Johannes; Lien, Nanna; Froberg, Karsten; Wedderkopp, Niels; Chastin, Sebastien; Cardon, Greet & Van Cauwenberg, Jelle (2018). Changes in children’s television and computer time according to parental education, parental income and ethnicity: A 6-year longitudinal EYHS study.. PLoS ONE.  ISSN 1932-6203. . doi: 10.1371/journal.pone.0203592
• Gebremariam, Mekdes Kebede; Arah, Onyebuchi A.; Lien, Nanna; Næss, Øyvind; Ariansen, Inger Kristine Holtermann & Kjøllesdal, Marte Karoline Råberg (2018). Change in BMI Distribution over a 24-Year Period and Associated Socioeconomic Gradients: A Quantile Regression Analysis. Obesity.  ISSN 1930-7381.  26(4), s 769- 775 . doi: 10.1002/oby.22133 Show summary

  ObjectiveThis study assessed the change in body mass index (BMI) distribution among 18- or 19-year-olds over 24 years. It also investigated parallel changes in the distribution of birth weight and in the association between birth weight and later risk of overweight and/or obesity. Parental educational variations in the trends and associations were explored. MethodsThe study used data on 606,832 male military conscripts enlisted between 1985 and 2008. Quantile regression was used to assess the temporal change in BMI and birth weight distribution. The association between birth weight and overweight and/or obesity at age 18 or 19 years was quantified by using logistic regression. ResultsIncreases in BMI over time were found namely in the 90th, 95th, 97th, and 99th percentiles. Socioeconomic differences in this increase were documented in the 75th to 97th percentiles. The distribution of birth weight and the association between birth weight and the risk of overweight and/or obesity at age 18 or 19 years remained stable over time. ConclusionsThe difference in the increase in BMI between low and high percentiles indicates the limited role of mean BMI in reflecting population changes. The results suggest a need to focus on those with low socioeconomic position in the upper ends of the BMI distribution to combat increasing disparities in obesity-related outcomes.

• Himberg-Sundet, Anne; Kristiansen, Anne Lene; Bjelland, Mona; Moser, Thomas; Holthe, Asle; Andersen, Lene Frost & Lien, Nanna (2018). Is the environment in kindergarten associated with the vegetables served and eaten? The BRA Study. Scandinavian Journal of Public Health.  ISSN 1403-4948. . doi: 10.1177/1403494818756702 Full text in Research Archive.
• Stok, F. Marijn; Renner, Britta; Allan, Julia; Boeing, Heiner; Ensenauer, Regina; Issanchou, Sylvie; Kiesswetter, Eva; Lien, Nanna; Mazzocchi, Mario; Monsivais, Pablo; Stelmach-Mardas, Marta; Volkert, Dorothee & Hoffmann, Stefan (2018). Dietary behavior: An interdisciplinary conceptual analysis and taxonomy. Frontiers in Psychology.  ISSN 1664-1078.  9, s 1- 12 . doi: 10.3389/fpsyg.2018.01689
• Stok, F. Marijn; Renner, Britta; Clarys, Peter; Lien, Nanna; Lakerveld, Jeroen & Deliens, Tom (2018). Understanding eating behavior during the transition from adolescence to young adulthood: A literature review and perspective on future research directions. Nutrients.  ISSN 2072-6643.  10(6) . doi: 10.3390/nu10060667
• Vennerød, Frida Felicia; Nicklaus, Sophie; Lien, Nanna & Almli, Valerie Lengard (2018). The development of basic taste sensitivity and preferences in children. Appetite.  ISSN 0195-6663.  127, s 130- 137 . doi: 10.1016/j.appet.2018.04.027 Show summary

  This study aims at understanding how preference and sensitivity to the basic tastes develop in the preschool years, and how the two relate to each other. To expand on the existing literature regarding taste preferences conducted in cross-sectional studies, a longitudinal design was applied with children from age four to six years old. During the springs of 2015, 2016, and 2017, 131 children born in 2011 were tested in their kindergartens. To investigate preferences for sweet, sour and bitter tastes, the children performed ranking-by-elimination procedures on fruit-flavored beverages and chocolates with three taste intensity levels. The beverages varied in either sucrose, citric acid, or the bitter component isolone. The chocolates varied in the bitter component theobromine from cocoa and sucrose content. Each year, the children also performed paired-comparison tasks opposing plain water to tastant dilutions at four concentrations. The stimuli consisted of the five basic tastes: sweet (sucrose) sour (citric acid monohydrate) umami (monosodium glutamate), salty (sodium chloride), and bitter (quinine hydrochloride dihydrate). Preference for sweetness levels increased with age, while preference for bitterness and sourness levels were stable. Concerning taste sensitivity, the children showed an increase in sensitivity for sourness and saltiness, a decrease for sweetness, and stability for umami and bitterness. A negative association was found between sweetness sensitivity and preference for sweetness. The study highlights different trajectories of sensitivity and preferences across tastes. On average, a reduction in sweetness sensitivity combined with an increase in preference for higher sweetness was observed from the age of four to six. The weak relationship between taste sensitivity and taste preference in our data suggests that taste preference development is shaped by a multitude of factors in addition to taste sensitivity.

• Winpenny, Eleanor; van Sluijs, Esther M F; White, Martin; Klepp, Knut Inge; Wold, Bente & Lien, Nanna (2018). Changes in diet through adolescence and early adulthood: longitudinal trajectories and association with key life transitions.. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  15:86 . doi: 10.1186/s12966-018-0719-8 Full text in Research Archive.
• Altenburg, Teatske Maria; Singh, Amika Sonja; te Velde, Saskia J.; De Bourdeaudhuij, Ilse; Lien, Nanna; Bere, Elling; Molnár, Dénés; Jan, Nataša; Fernández-Alvira, Juan Miguel; Manios, Yanis; Bringolf-Isler, Bettina; Brug, Johannes & Chinapaw, Mai J. (2017). Actual and perceived weight status and its association with slimming and energy-balance related behaviours in 10- to 12-year-old European children: the ENERGY-project. Pediatric Obesity.  ISSN 2047-6302.  12(2), s 137- 145 . doi: 10.1111/ijpo.12120
• Gebremariam, Mekdes Kebede; Chinapaw, Mai J.; Bringolf-Isler, Bettina; Bere, Elling; Kovács, Éva; Verloigne, Maïté; Stok, F. Marijn; Manios, Yannis; Brug, Johannes & Lien, Nanna (2017). Screen-based sedentary time: Association with soft drink consumption and the moderating effect of parental education in European children: The ENERGY study. PLoS ONE.  ISSN 1932-6203.  12(2) . doi: 10.1371/journal.pone.0171537 Full text in Research Archive.
• Gebremariam, Mekdes Kebede; Lien, Nanna; Nianogo, Roch A. & Arah, Onyebuchi A. (2017). Mediators of socioeconomic differences in adiposity among youth: a systematic review. Obesity Reviews.  ISSN 1467-7881.  18(8), s 880- 898 . doi: 10.1111/obr.12547
• Gebremariam, Mekdes Kebede; Vaqué-Crusellas, Cristina; Andersen, Lene Frost; Stok, F. Marijn; Stelmach-Mardas, Marta; Brug, Johannes & Lien, Nanna (2017). Measurement of availability and accessibility of food among youth: A systematic review of methodological studies. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  14:22, s 1- 19 . doi: 10.1186/s12966-017-0477-z
• Holdsworth, Michelle; Nicolaou, Mary; Langøien, Lars Jørun; Osei-Kwasi, Hibbah; Chastin, Sebastien F.M.; Stok, F.M.; Capranica, Laura; Lien, Nanna; Terragni, Laura; Monsivais, Pablo; Mazzocchi, Mario; Maes, Lea; Roos, Gun; Mejean, Caroline; Powell, Katie & Stronks, Karien (2017). Developing a systems-based framework of the factors influencing dietary and Physical activity behaviours in ethnic minority populations living in Europe - a DEDIPAC study. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  14(1), s 1- 15 . doi: 10.1186/s12966-017-0608-6 Full text in Research Archive.
• Klohe, Katharina; Da Costa, Clarissa; Lien, Nanna; Holmboe-Ottesen, Gerd; Rychlik, Michael; Haavardsson, Ingeborg K; Stordalen, Gunhild A.; Singh, S; Engebretsen, Ingunn Marie S.; Iversen, Per Ole & Winkler, Andrea Sylvia (2017). Nutrition – A global challenge for health.. Tidsskrift for Den norske legeforening.  ISSN 0029-2001. . doi: 10.4045/tidsskr.17.0679
• Kristiansen, Anne Lene; Bjelland, Mona; Himberg-Sundet, Anne; Lien, Nanna & Andersen, Lene Frost (2017). Associations between physical home environmental factors and vegetable consumption among Norwegian 3-5-year-olds: the BRA-study. Public Health Nutrition.  ISSN 1368-9800. . doi: 10.1017/S1368980016003396 Full text in Research Archive.
• Kristiansen, Anne Lene; Bjelland, Mona; Himberg-Sundet, Anne; Lien, Nanna & Andersen, Lene Frost (2017). Associations between sociocultural home environmental factors and vegetable consumption among Norwegian 3?5-year olds: BRA-study. Appetite.  ISSN 0195-6663.  117, s 310- 320 . doi: 10.1016/j.appet.2017.06.031 Full text in Research Archive.
• Lakerveld, Jeroen; Loyen, Anne; Schotman, Nina; Peeters, Carel F.W.; Cardon, Greet; van der Ploeg, Hidde P.; Lien, Nanna; Chastin, Sebastien & Brug, Johannes (2017). Sitting too much: A hierarchy of socio-demographic correlates. Preventive Medicine.  ISSN 0091-7435.  101, s 77- 83 . doi: 10.1016/j.ypmed.2017.05.015
• Langøien, Lars Jørun; Terragni, Laura; Rugseth, Gro; Nicolaou, Mary; Holdsworth, Michelle; Stronks, Karien; Lien, Nanna & Roos, Gun (2017). Systematic mapping review of the factors influencing physical activity and sedentary behaviour in ethnic minority groups in Europe: A DEDIPAC study. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  14:99, s 1- 24 . doi: 10.1186/s12966-017-0554-3 Show summary

  Background: Physical activity and sedentary behaviour are associated with health and wellbeing. Studies indicate that ethnic minority groups are both less active and more sedentary than the majority population and that factors influencing these behaviours may differ. Mapping the factors influencing physical activity and sedentary behaviour among ethnic minority groups living in Europe can help to identify determinants of physical activity and sedentary behaviour, research gaps and guide future research. Methods: A systematic mapping review was conducted to map the factors associated with physical activity and sedentary behaviour among ethnic minority groups living in Europe (protocol PROSPERO ID = CRD42014014575). Six databases were searched for quantitative and qualitative research published between 1999 and 2014. In synthesizing the findings, all factors were sorted and structured into clusters following a data driven approach and concept mapping. Results: Sixty-three articles were identified out of 7794 returned by the systematic search. These included 41 quantitative and 22 qualitative studies. Of these 58 focused on physical activity, 5 on both physical activity and sedentary behaviour and none focused on sedentary behaviour. The factors associated with physical activity and sedentary behaviour were grouped into eight clusters. Social & cultural environment (n = 55) and Psychosocial (39) were the clusters containing most factors, followed by Physical environment & accessibility (33), Migration context (15), Institutional environment (14), Social & material resources (12), Health and health communication (12), Political environment (3). An important finding was that cultural and religious issues, in particular those related to gender issues, were recurring factors across the clusters. Conclusion: Physical activity and sedentary behaviour among ethnic minority groups living in Europe are influenced by a wide variety of factors, especially informed by qualitative studies. More comparative studies are needed as well as inclusion of a wider spectrum of the diverse ethnic minority groups resettled in different European countries. Few studies have investigated factors influencing sedentary behaviour. It is important in the future to address specific factors influencing physical activity and sedentary behaviour among different ethnic minority groups in order to plan and implement effective interventions.

• Méjean, Caroline; Si Hassen, Wendy; Gojard, Séverine; Ducrot, Pauline; Lampuré, Aurélie; Brug, Hans; Lien, Nanna; Nicolaou, Mary; Holdsworth, Michelle; Terragni, Laura; Hercberg, Serge & Castetbon, Katia (2017). Social disparities in food preparation behaviours: A DEDIPAC study. Nutrition Journal.  ISSN 1475-2891.  16:62, s 1- 13 . doi: 10.1186/s12937-017-0281-2 Full text in Research Archive.
• Stok, F. Marijn; Hoffmann, Stefan; Volkert, Dorothee; Boeing, Heiner; Ensenauer, Regina; Stelmach-Mardas, Marta; Kiesswetter, Eva; Weber, Alisa; Rohm, Harald; Lien, Nanna; Brug, Johannes; Holdsworth, Michelle & Renner, Britta (2017). The DONE framework: Creation, evaluation, and updating of an interdisciplinary, dynamic framework 2.0 of determinants of nutrition and eating. PLoS ONE.  ISSN 1932-6203.  12:e0171077(2), s 1- 23 . doi: 10.1371/journal.pone.0171077 Full text in Research Archive.
• Symmank, Claudia; Mai, Robert; Hoffmann, Stefan; Stok, F. Marijn; Renner, Britta; Lien, Nanna & Rohm, Harald (2017). Predictors of food decision making: A systematic interdisciplinary mapping (SIM) review. Appetite.  ISSN 0195-6663.  110, s 25- 35 . doi: 10.1016/j.appet.2016.11.023
• Vennerød, Frida Felicia; Almli, Valerie Lengard; Berget, Ingunn & Lien, Nanna (2017). Do parents form their children’s sweet preference? The role of parents and taste sensitivity on preferences for sweetness in pre-schoolers. Food Quality and Preference.  ISSN 0950-3293.  62, s 172- 182 . doi: 10.1016/j.foodqual.2017.06.013 Full text in Research Archive. Show summary

  Children generally have a high acceptance for sweetness, but differ in their preferences for the intensity of the taste. This study investigates how food exposure, parental attitudes and behaviours, and children’s taste sensitivity are associated with five-year olds’ preferences for sweetness. Preference data were collected from 135 children at ages four (Mean age: 46.3 months, SD: 3.4, 56% boys) and five years old (Mean age: 57.5 months, SD: 3.3; 58% boys) in a ranking by elimination procedure in the springs of 2015 and 2016. The taste carriers were fruit-flavoured beverages and dark chocolate, both with three levels of sugar content. Quantitative descriptive analysis testified three distinct levels of sweetness in each sample triad. The same children were also tested for sweetness and bitterness taste sensitivity in a paired comparison procedure. The protocols did not require the children to respond verbally, and included elements of gamification in order to engage the children. In addition, a parental questionnaire enquired about exposure to different foods, parental food attitudes and behaviours as well as socio-demographic characteristics. Path modelling using PLS-SEM indicated that differences in children’s preference for sweetness could be explained by differences in exposure to foods, including more frequent exposure to sweet foods and snacks associated with a higher sweet preference. More frequent exposure to fruit and bitter snacks, were associated with a lower sweet preference for the drink and chocolate, respectively. Parental attitudes and behaviours as well as children’s sensitivity to sweetness and bitterness were significantly associated with what foods the children were frequently exposed to, and to their sweetness preferences in beverages and chocolate.

• Altenburg, Teatske; Velde, Saskia J. te; Chiu, Kai-Jan; Moschonis, George; Manios, Yannis; De Bourdeaudhuij, Ilse; Vik, Frøydis Nordgård; Lien, Nanna; Brug, Johannes & Chinapaw, Mai JM (2016). Interrater reliability of the ENERGY photo-rating instrument for school environments related to physical activity and eating. Journal of Physical Activity and Health.  ISSN 1543-3080.  13(4), s 433- 439 . doi: 10.1123/jpah.2015-0025
• Chastin, Sebastien F.M.; De Craemer, Marieke; Lien, Nanna; Bernaards, C; Buck, Christopher; Oppert, Jean-Michel; Nazare, JA; Lakerveld, Jeroen; O'Donoghue, Grainne; Holdsworth, Michelle; Owen, Neville; Brug, Johannes & Cardon, Greet (2016). The SOS-framework (Systems of Sedentary behaviours): an international transdisciplinary consensus framework for the study of determinants, research priorities and policy on sedentary behaviour across the life course: a DEDIPAC-study.. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  13(1) . doi: 10.1186/s12966-016-0409-3
• Gebremariam, Mekdes Kebede; Lien, Nanna; Torheim, Liv Elin; Andersen, Lene Frost; Melbye, Elisabeth Lind; Glavin, Kari; Hausken, Solveig Elisabeth Sand; Sleddens, Ester FC & Bjelland, Mona (2016). Perceived rules and accessibility: measurement and mediating role in the association between parental education and vegetable and soft drink intake. Nutrition Journal.  ISSN 1475-2891.  15:76 . doi: 10.1186/s12937-016-0196-3 Full text in Research Archive.
• Melbye, Elisabeth Lind; Bergh, Ingunn Holden; Hausken, Solveig Elisabeth Sand; Sleddens, Ester FC; Glavin, Kari; Lien, Nanna & Bjelland, Mona (2016). Adolescent impulsivity and soft drink consumption: The role of parental regulation. Appetite.  ISSN 0195-6663.  96, s 432- 442 . doi: 10.1016/j.appet.2015.09.040
• Osei-Kwasi, Hibbah; Nicolau, Mary; Powell, Katie; Terragni, Laura; Maes, Lea; Stronks, Karien; Lien, Nanna & Holdsworth, Michelle (2016). Systematic mapping review of the factors influencing dietary behaviour in ethnic minority groups living in Europe: a DEDIPAC study. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  13:85 . doi: 10.1186/s12966-016-0412-8
• Schoeppe, Stephanie; Vandelanotte, Corneel; Bere, Elling; Lien, Nanna; Verloigne, Maïté; Kovacs, Eva; Manios, Yannis; Bjelland, Mona; Vik, Frøydis Nordgård & Van Lippevelde, Wendy (2016). The influence of parental modelling on children's physical activity and screen time: Does it differ by gender?. European Journal of Public Health.  ISSN 1101-1262. . doi: 10.1093/eurpub/ckw182
• Si Hassen, Wendy; Castetbon, Katia; Cardon, Philippe; Enaux, Christophe; Nicolaou, Mary; Lien, Nanna; Terragni, Laura; Holdsworth, Michelle; Stronks, Karien; Hercberg, Serge & Mejean, Caroline (2016). Socioeconomic indicators are independently associated with nutrient intake in French adults: A DEDIPAC study. Nutrients.  ISSN 2072-6643.  8(3) . doi: 10.3390/nu8030158 Full text in Research Archive.
• Bergh, Ingunn Holden; Skare, Øivind; Aase, Annalena; Klepp, Knut Inge & Lien, Nanna (2015). Weight development from age 13 to 30 years and adolescent socioeconomic status: The Norwegian Longitudinal Health Behaviour study. International Journal of Public Health.  ISSN 1661-8556. . doi: 10.1007/s00038-015-0748-x
• Bjelland, Mona; Hausken, Solveig E. Sand; Bergh, Ingunn Holden; Grydeland, May; Klepp, Knut Inge; Andersen, Lene Frost; Totland, Torunn Holm & Lien, Nanna (2015). Changes in adolescents’ and parents’ intakes of sugar-sweetened beverages, fruit and vegetables after 20 months : results from the HEIA study - a comprehensive, multi-component school-based randomized trial. Food & Nutrition Research.  ISSN 1654-6628.  59:25932 . doi: 10.3402/fnr.v59.25932
• Bjelland, Mona; Soenens, Bart; Bere, Elling; Kovács, Éva; Lien, Nanna; Maes, Lea; Manios, Yannis; Moschonis, George & Te Velde, Saskia J. (2015). Associations between parental rules, style of communication and children's screen time Health behavior, health promotion and society. BMC Public Health.  ISSN 1471-2458.  15:1002 . doi: 10.1186/s12889-015-2337-6 Full text in Research Archive.
• Gebremariam, Mekdes; Altenburg, Teatske; Lakerveld, Jeroen; Andersen, Lene Frost; Stronks, Karien; Chinapaw, Mai J. & Lien, Nanna (2015). Associations between socioeconomic position and correlates of sedentary behaviour among youth: A systematic review. Obesity Reviews.  ISSN 1467-7881.  16(11), s 988- 1000 . doi: 10.1111/obr.12314
• Gebremariam, Mekdes; Andersen, Lene Frost; Bjelland, Mona; Bergh, Ingunn Holden; Totland, Torunn Holm; Ommundsen, Yngvar; Grydeland, May & Lien, Nanna (2015). Are weight-related attitudes and behaviours associated with the accuracy of BMI derived from self-reported weight and height among 13-year-olds?. Scandinavian Journal of Public Health.  ISSN 1403-4948.  43(2), s 130- 137 . doi: 10.1177/1403494814563370
• Lehto, Elviira; Ray, Carola; Te Velde, Saskia; Petrova, Stefka; Duleva, Vesselka; Krawinkel, Michael; Behrendt, Isabel; Papadaki, Angeliki; Kristjansdottir, Asa; Thorsdottir, Inga; Yngve, Agneta; Lien, Nanna; Lynch, Christel; Ehrenblad, Bettina; Vaz De Almeida, Maria Daniel; Ribic, Cirila Hlastan; Simčic, Irena & Roos, Eva (2015). Mediation of parental educational level on fruit and vegetable intake among schoolchildren in ten European countries. Public Health Nutrition.  ISSN 1368-9800.  18(1), s 89- 99 . doi: 10.1017/S136898001300339X
• Vik, Frøydis Nordgård; Lien, Nanna; Berntsen, Sveinung; De Bourdeaudhuij, Ilse; Grillenberger, Monika; Manios, Yannis; Kovacs, Eva; Chinapaw, Mai JM; Brug, Johannes & Bere, Elling (2015). Evaluation of the UP4FUN intervention: A cluster randomized trial to reduce and break up sitting time in European 10-12-year-old children. PLoS ONE.  ISSN 1932-6203.  10(3) . doi: 10.1371/journal.pone.0122612 Full text in Research Archive. Show summary

  BACKGROUND: The UP4FUN intervention is a family-involved school-based intervention aiming at reducing and breaking up sitting time at home (with special emphasis on screen time), and breaking up sitting time in school among 10-12 year olds in Europe. The purpose of the present paper was to evaluate its short term effects. METHODOLOGY/PRINCIPAL FINDINGS: A total of 3147 pupils from Belgium, Germany, Greece, Hungary and Norway participated in a school-randomized controlled trial. The intervention included 1-2 school lessons per week for a period of six weeks, along with assignments for the children and their parents. Screen time and breaking up sitting time were registered by self-report and total sedentary time and breaking up sitting time by accelerometry. The effect of the intervention on these behaviors was evaluated by multilevel regression analyses. All analyses were adjusted for baseline values and gender. Significance level was p≤0.01. No significant intervention effects were observed, neither for self-reported TV/DVD or computer/game console time, nor for accelerometer-assessed total sedentary time and number of breaks in sitting time. The intervention group, however, reported more positive attitudes towards (β = 0.25 (95% CI 0.11, 0.38)) and preferences/liking for (β = 0.20 (95% CI 0.08, 0.32)) breaking up sitting time than the control group. CONCLUSIONS/SIGNIFICANCE: No significant intervention effect on self-reported screen time or accelerometer-assessed sedentary time or breaks in sitting time was observed, but positive effects on beliefs regarding breaking up sitting time were found in favor of the intervention group. Overall, these results do not warrant wider dissemination of the present UP4FUN intervention.

• Bergh, Ingunn Holden; van Stralen, Maartje M.; Bjelland, Mona; Grydeland, May; Lien, Nanna; Klepp, Knut Inge; Anderssen, Sigmund Alfred & Ommundsen, Yngvar (2014). Post-intervention effects on screen behaviours and mediating effect of parental regulation : the HEalth In Adolescents study – a multi-component school-based randomized controlled trial. BMC Public Health.  ISSN 1471-2458.  14(1) . doi: 10.1186/1471-2458-14-200 Show summary

  Background: To improve effectiveness of future screen behaviour interventions, one needs to know whether an intervention works via the proposed mediating mechanisms and whether the intervention is equally effective among subgroups. Parental regulation is identified as a consistent correlate of screen behaviours, but prospective evidence as well as the mediation role of parental regulation is largely lacking. This study investigated postintervention main effects on screen behaviours in the HEIA-intervention – a Norwegian school-based multiplebehaviour study, as well as mediation effects of parental regulation by adolescents’ and parents’ report. In addition, moderating effects of gender and weight status on the intervention and mediating effects were explored. Methods: Participating schools were randomized to control (n = 25) or intervention (n = 12) condition. Adolescents (n = 908 Control; 510 Intervention) self-reported their weekday and weekend TV-viewing and computer/game-use. Change in adolescents’ behaviours was targeted through school and parents. Adolescents, mothers (n = 591 Control; 244 Interventions) and fathers (n = 469 Control; 199 Intervention) reported parental regulation of the screen behaviours post-intervention (at 20 month). The product-of-coefficient test using linear regression analysis was conducted to examine main and mediating effects. Results: There was no intervention effect on the screen behaviours in the total sample. Gender moderated effect on weekend computer/game-use, while weight status moderated the effect on weekday TV-viewing and computer/game-use. Stratified analyses showed a small favourable intervention effect on weekday TV-viewing among the normal weight. Parental regulation did not mediate change in the screen behaviours. However, stronger parental regulation was associated with less TV-viewing and computer/game-use with effects being conditional on adolescents’ versus parental reports. Parental regulation of the screen behaviours, primarily by the parental report, was associated with change in the respective behaviours. Conclusion: Multiple behaviour intervention may not affect all equally well, and the effect may differ by weight status and gender. In future interventions parents should be encouraged to regulate their adolescents’ TV-viewing and computer/game-use on both weekdays and weekends as parental regulation was identified as a determinant of these screen behaviours. However, future intervention studies may need to search for more effective intervention strategies targeting parental regulation.

• Bjelland, Mona; Hausken, Solveig E. Sand; Sleddens, Ester FC; Andersen, Lene Frost; Lie, Hanne Cathrine; Finset, Arnstein; Maes, Lea; Melbye, Elisabeth Lind; Glavin, Kari; Hanssen-Bauer, Merete Waage & Lien, Nanna (2014). Development of family and dietary habits questionnaires: the assessment of family processes, dietary habits and adolescents’ impulsiveness in Norwegian adolescents and their parents. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  11 . doi: 10.1186/s12966-014-0130-z Full text in Research Archive.
• Brug, Johannes; Uijtdewilligen, Léonie; van Stralen, Maartje M.; Singh, Annika S.; Chinapaw, Mai J.M.; De Bourdeaudhuij, Ilse; Lien, Nanna; Bere, Elling; Maes, Lea; Fernández-Alvira, Juan M.; Jan, Nataša; Kovacs, Eva; Dössegger, Alain; Manios, Yannis & te Velde, Saskia J. (2014). Differences in beliefs and home environments regarding energy balance behaviors according to parental education and ethnicity among schoolchildren in Europe: The ENERGY cross sectional study. BMC Public Health.  ISSN 1471-2458.  14(1:610) . doi: 10.1186/1471-2458-14-610
• Grydeland, May; Bjelland, Mona; Anderssen, Sigmund Alfred; Klepp, Knut Inge; Bergh, Ingunn Holden; Andersen, Lene Frost; Ommundsen, Yngvar & Lien, Nanna (2014). Effects of a 20-month cluster randomised controlled school-based intervention trial on BMI of school-aged boys and girls: The HEIA study. British Journal of Sports Medicine.  ISSN 0306-3674.  48(9), s 768- 773 . doi: 10.1136/bjsports-2013-092284 Show summary

  Background: School-based interventions that target prevention of overweight and obesity in children have been tested with mixed results. Thus, successful interventions are still called for. The aim of the present study was to investigate effects of a multicomponent school-based intervention programme targeting physical activity, sedentary and dietary behaviours on anthropometric outcomes. Methods: A 20-month intervention was evaluated in a cluster randomised, controlled study of 1324 11-year-olds. Outcome variables were body mass index (BMI), BMI-for-age z-score (BMIz), waist circumference (WC), waist-to-height ratio (WTHR) and weight status (International Obesity Task Force's cut-offs). Weight, height and WC were measured objectively; pubertal status was self-reported and parental education was self-reported by the parents. Intervention effects were determined by one-way analysis of covariance and logistic regression, after checking for clustering effects of school, and moderating effects of gender, pubertal status and parental education. Results: Beneficial effects were found for BMI (p=0.02) and BMIz (p=0.003) in girls, but not in boys. While a beneficial effect was found for BMI (p=0.03) in participants of parents reporting a high level of education, a negative effect was found for WTHR in participants with parents reporting a low level of education (p=0.003). There were no intervention effects for WC and weight status. Conclusions: A multicomponent 20-month school-based intervention had a beneficial effect on BMI and BMIz in adolescent girls, but not in boys. Furthermore, children of higher educated parents seemed to benefit more from the intervention, and this needs attention in future interventions to avoid further increase in social inequalities in overweight and obesity.

• Lehto, Reetta; Määttä, Suvi; Lehto, Elviira; Ray, Carola; te Velde, Saskia J.; Lien, Nanna; Thórsdóttir, Inga; Yngve, Agneta & Roos, Eva (2014). The PRO GREENS intervention in Finnish schoolchildren - the degree of implementation affects both mediators and the intake of fruits and vegetables. British Journal of Nutrition.  ISSN 0007-1145.  112(7), s 1185- 1194 . doi: 10.1017/S0007114514001767
• Lien, Nanna; Haerens, L; Te Velde, SJ; Mercken, L; Klepp, Knut Inge; Moore, L; De Bourdeaudhuij, I; Faggiano, F & Van Lenthe, FJ (2014). Exploring subgroup effects by socioeconomic position of three effective school-based dietary interventions: The European TEENAGE project. International Journal of Public Health.  ISSN 1661-8556.  59(3), s 493- 502 . doi: 10.1007/s00038-013-0524-8
• Lien, Nanna; Van Stralen, Maartje M; Androutsos, Odysseas; Bere, Elling; Fernandez-Alvira, Juan M; Jan, Natasa; Kovacs, Eva; van Lippevelde, Wendy; Manios, Yannis; Te Velde, Saskia J & Brug, Johannes (2014). The school nutrition environment and its association with soft drink intakes in seven countries across Europe - the ENERGY project. Health and Place.  ISSN 1353-8292.  30, s 28- 35 . doi: 10.1016/j.healthplace.2014.07.013
• Lien, Nanna; Vik, Frøydis Nordgård; Berntsen, Sveinung; Brug, Johannes; De Bourdeaudhuij, Ilse; Chinapaw, Mai JM; Grillenberger, Monika; Kovacs, Eva; Maes, Lea; Manios, Yannis; Moschonis, George; van Stralen, Maartje M.; Willhöft, Corinna & Bere, Elling (2014). UP4FUN - A school-based and family-involved intervention to reduce and break up sitting time among European 10-12 year olds – systematic development and formative evaluation. Skriftserien, Universitet i Agder.  ISSN 1504-9280.
• Van Lippevelde, Wendy; Bere, Elling; Verloigne, Maïté; van Stralen, Maartje M.; De Bourdeaudhuij, Ilse; Lien, Nanna; Vik, Frøydis Nordgård; Manios, Yannis; Grillenberger, Monika; Kovacs, Eva; Chinapaw, Mai JM; Brug, Johannes & Maes, Lea (2014). The role of family-related factors in the effects of the UP4FUN school-based family-focused intervention targeting screen time in 10- to 12-year-old children: the ENERGY project. BMC Public Health.  ISSN 1471-2458.  14(1), s 857- 869 . doi: 10.1186/1471-2458-14-857
• Gebremariam, Mekdes; Bergh, Ingunn Holden; Andersen, Lene Frost; Ommundsen, Yngvar; Totland, Torunn Holm; Bjelland, Mona; Grydeland, May & Lien, Nanna (2013). Are screen-based sedentary behaviors longitudinally associated with dietary behaviors and leisure-time physical activity in the transition into adolescence?. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  10 . doi: 10.1186/1479-5868-10-9
• Grydeland, May; Bergh, Ingunn Holden; Bjelland, Mona; Lien, Nanna; Andersen, Lene Frost; Ommundsen, Yngvar; Klepp, Knut Inge & Anderssen, Sigmund Alfred (2013). Intervention effects on physical activity: the HEIA study - a cluster randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  10 . doi: 10.1186/1479-5868-10-17 Show summary

  Background: Although school-based interventions to promote physical activity in adolescents have been suggested in several recent reviews, questions have been raised regarding the effects of the strategies and the methodology applied and for whom the interventions are effective. The aim of the present study was to investigate effects of a school-based intervention program: the HEalth in Adolescents (HEIA) study, on change in physical activity, and furthermore, to explore whether potential effects varied by gender, weight status, initial physical activity level and parental education level. Methods: This was a cluster randomized controlled 20 month intervention study which included 700 11-year-olds. Main outcome-variable was mean count per minute (cpm) derived from ActiGraph accelerometers (Model 7164/GT1M). Weight and height were measured objectively. Adolescents reported their pubertal status in a questionnaire and parents reported their education level on the consent form. Linear mixed models were used to test intervention effects and to account for the clustering effect of sampling by school. Results: The present study showed an intervention effect on overall physical activity at the level of p = 0.05 with a net effect of 50 cpm increase from baseline to post intervention in favour of the intervention group (95% CI -0.4, 100). Subgroup analyses showed that the effect appeared to be more profound among girls (Est 65 cpm, CI 5, 124, p = 0.03) and among participants in the low-activity group (Est 92 cpm, CI 41, 142, p < 0.001), as compared to boys and participants in the high-activity group, respectively. Furthermore, the intervention affected physical activity among the normal weight group more positively than among the overweight, and participants with parents having 13--16 years of education more positively than participants with parents having either a lower or higher number of years of education. The intervention seemed to succeed in reducing time spent sedentary among girls but not among boys. Conclusions: A comprehensive but feasible, multi-component school-based intervention can affect physical activity patterns in adolescents by increasing overall physical activity. This intervention effect seemed to be more profound in girls than boys, low-active adolescents compared to high-active adolescents, participants with normal weight compared to the overweight, and for participants with parents of middle education level as opposed to those with high and low education levels, respectively. An implementation of the HEIA intervention components in the school system may have a beneficial effect on public health by increasing overall physical activity among adolescents and possibly among girls and low-active adolescents in particular.

• Hjelkrem, Kristiane; Lien, Nanna & Wandel, Margareta (2013). Perceptions of slimming and healthiness among Norwegian adolescent girls. Journal of nutrition education and behavior.  ISSN 1499-4046.  45(3), s 196- 203 . doi: 10.1016/j.jneb.2012.06.007
• Totland, Torunn Holm; Bjelland, Mona; Lien, Nanna; Bergh, Ingunn Holden; Gebremariam, Mekdes; Grydeland, May; Ommundsen, Yngvar & Andersen, Lene Frost (2013). Adolescents' prospective screen time by gender and parental education, the mediation of parental influences. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  10 . doi: 10.1186/1479-5868-10-89 Show summary

  Background: The present study investigated associations in gender dyads of parents’ and adolescents’ time spent on television and video viewing (TV/DVD), and computer and electronic game use (PC/games) at the ages of 11 and 13 years. Possible mediating effects of parental modelling and parental regulation in the relationship between parental education and adolescents’ prospective TV/DVD and PC/game time were further examined. Methods: A total of 908 adolescents, participating at both ages 11 and 13 years in the Norwegian HEalth In Adolescents (HEIA) cohort study (2007–2009), were included in the analyses. Data on adolescents’, mothers’ and fathers’ self reported time spent on TV/DVD and PC/games were measured at both time points by questionnaires. Correlation coefficients were used to examine gender dyads of parents’ and adolescents’ reports. Mediation analyses using linear regression investigated possible mediation effects of parental modelling and parental regulation in the prospective relationship between parental education and adolescents’ time spent on TV/DVD and PC/games between the ages of 11 and 13 years. Results: Correlations of screen time behaviours in gender dyads of parents and adolescents showed significant associations in time spent on TV/DVD at the age of 11 and 13 years. Associations between mothers and sons and between fathers and daughters were also observed in time spent on PC/games at the age of 11 years. Maternal and paternal modelling was further found to mediate the relationship between parental education and adolescents’ prospective TV/DVD time between the ages of 11 and 13 years. No mediation effect was observed for parental regulation, however a decrease in both maternal and paternal regulation at the age of 11 years significantly predicted more TV/DVD time among adolescents at the age of 13 years. Conclusion: Cross-sectional and longitudinal relationships were observed in gender dyads of parents’ and adolescents’ screen time behaviours at the ages of 11 and 13 years, and further studies including both parents and their children should be emphasized. Moreover, maternal and paternal modelling were found to be important target variables in interventions aiming to reduce social differences by parental education in adolescents’ prospective time spent on TV/DVD.

• Totland, Torunn Holm; Gebremariam, Mekdes; Lien, Nanna; Bjelland, Mona; Grydeland, May; Bergh, Ingunn Holden; Klepp, Knut Inge & Andersen, Lene Frost (2013). Does tracking of dietary behaviours differ by parental education in children during the transition into adolescence?. Public Health Nutrition.  ISSN 1368-9800.  16(4), s 673- 682 . doi: 10.1017/S1368980012003060
• Totland, Torunn Holm; Lien, Nanna; Bergh, Ingunn Holden; Bjelland, Mona; Gebremariam, Mekdes; Klepp, Knut Inge & Andersen, Lene Frost (2013). The relationship between parental education and adolescents’ soft drink intake from the age of 11–13 years, and possible mediating effects of availability and accessibility. British Journal of Nutrition.  ISSN 0007-1145.  110(5), s 926- 933 . doi: 10.1017/S0007114512005946
• Vik, Frøydis Nordgård; Bjørnarå, Helga Birgit T.; Øverby, Nina Cecilie; Lien, Nanna; Androutsos, Odysseas; Maes, Lea; Jan, Natasa; Kovacs, Erik; Moreno, Luis A.; Dössegger, Alain; Manios, Yannis; Brug, Johannes & Bere, Elling (2013). Associations between eating meals, watching TV while eating meals and weight status among children, ages 10-12 years in eight European countries: the ENERGY cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  10 . doi: 10.1186/1479-5868-10-58
• Bergh, Ingunn Holden; Bjelland, Mona; Grydeland, May; Lien, Nanna; Andersen, Lene Frost; Klepp, Knut Inge; Anderssen, Sigmund Alfred & Ommundsen, Yngvar (2012). Mid-way and post-intervention effects on potential determinants of physical activity and sedentary behavior, results of the HEIA study - a multi-component school-based randomized trial. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  9 . doi: 10.1186/1479-5868-9-63 Show summary

  Background: There is limited knowledge as to whether obesity prevention interventions are able to produce change in the determinants hypothesized to precede change in energy balance-related behaviors in young people. The aim of this study was to evaluate the effect of a multi-component intervention on a wide range of theoretically informed determinants of physical activity (PA) and sedentary behavior (SB). Moderation effects of gender, weight status and parental education level and whether the perceived intervention dose received influenced the effects were also explored. Methods: The HEIA study was a 20-month school-based, randomized controlled trial to promote healthy weight development. In total, 1418 11-year-olds participated at baseline and post-intervention assessment. Enjoyment, self-efficacy, perceived social support from parents, teachers and friends related to PA, perceived parental regulation of TV-viewing and computer/game-use and perceived social inclusion at schools were examined by covariance analyses to assess overall effects and moderation by gender, weight status and parental education, mid-way and post-intervention. Covariance analyses were also used to examine the role of intervention dose received on change in the determinants. Results: At mid-way enjoyment (p = .03), perceived social support from teachers (p = .003) and self-efficacy (p = .05) were higher in the intervention group. Weight status moderated the effect on self-efficacy, with a positive effect observed among the normal weight only. At post-intervention results were sustained for social support from teachers (p = .001), while a negative effect was found for self-efficacy (p = .02). Weight status moderated the effect on enjoyment, with reduced enjoyment observed among the overweight. Moderation effects for parental education level were detected for perceived social support from parents and teachers. Finally, positive effects on several determinants were observed among those receiving a high as opposed to a low intervention dose. Conclusion: The intervention affected both psychological and social-environmental determinants. Results indicate that social support from teachers might be a potential mediator of PA change, and that overweight adolescents might be in need of specially targeted interventions to avoid reducing their enjoyment of PA. Further studies should continue to assess how intervention effectiveness is influenced by the participants’ self-reported dose of intervention received.

• Bergh, Ingunn Holden; van Stralen, Maartje M.; Grydeland, May; Bjelland, Mona; Lien, Nanna; Andersen, Lene Frost; Anderssen, Sigmund Alfred & Ommundsen, Yngvar (2012). Exploring mediators of accelerometer assessed physical activity in young adolescents in the Health in adolescents study - a group randomized controlled trial. BMC Public Health.  ISSN 1471-2458.  12 . doi: 10.1186/1471-2458-12-814 Show summary

  Background: There is a shortage of information about the factors that mediate physical activity intervention effects which involve youth. The purpose of this study was to examine whether personal, social and physical-environmental factors mediated the intervention effect on physical activity and whether gender and weight status moderated mediated effects in the Health In Adolescents Study – a school-based intervention to promote healthy weight development among young adolescents. Methods: Participating schools were randomized to Control (n = 25) and Intervention (n = 12). The intervention components to enhance physical activity targeted change through theoretically informed mediators embedded in a social-ecological framework. Accelerometer assessed physical activity (mean count per minute) and self-efficacy, enjoyment, perceived social support from parents, teachers and friends and perceived environmental opportunities were measured by questionnaires at baseline and post-intervention after 20 months among 700 11–13 year-old adolescents (Intervention = 485; Control = 215). The product-of-coefficient test was used to examine mediation. Results: No mediating effect of any of the hypothesized mediators was identified and gender and weight status did not moderate any mediated effects with the exception of weight status that moderated the mediated effect of enjoyment. Few intervention effects were seen on the mediators, except for a positive change in social support from teachers among girls and the normal weight, and a negative effect on enjoyment and self-efficacy among the overweight. However, change in enjoyment, self-efficacy, perceived social support from friends and environmental opportunities were associated with change in mean count per minute with some variation across the investigated subgroups, and thus show evidence of being potential mediators of physical activity change in adolescents. Conclusions: While no mediation effects were observed, change in both personal and social-environmental factors predicted change in physical activity behavior. Hence, a social- ecological approach targeting a wide range of determinants to promote change in physical activity holds promise. Overweight and normal weight adolescents may not respond in the same way to school-based physical activity interventions. Therefore, strategies to better reach the overweight seem needed. Future studies should continue to identify mediating and moderation mechanisms in physical activity change in adolescents.

• Brug, J.; van Stralen, MM; Chinapaw, MJM; De Bourdeaudhuij, Ilse; Lien, Nanna; Bere, Elling; Singh, A. S.; Maes, L.; Moreno, L.; Jan, Nataša; Kovacs, Erik; Lobstein, T; Manios, Yannis & te Velde, S. J. (2012). Differences in weight status and energy-balance related behaviours according to ethnic background among adolescents in seven countries in Europe: the ENERGY-project. International Journal of Pediatric Obesity.  ISSN 1747-7166.  7(5), s 399- 411 . doi: 10.1111/j.2047-6310.2012.00067.x
• Brug, Johannes; van Stralen, Maartje M.; te Velde, Saskia J; Chinapaw, Mai J.M.; De Bourdeaudhuij, Ilse; Lien, Nanna; Bere, Elling; Maskini, Victoria; Singh, Amika S; Maes, Lea; Moreno, Luis; Jan, Nataša; Kovacs, Eva; Lobstein, T & Manios, Yannis (2012). Differences in Weight Status and Energy-Balance Related Behaviors among Schoolchildren across Europe: The ENERGY-Project. PLoS ONE.  ISSN 1932-6203.  7(4) . doi: 10.1371/journal.pone.0034742 Show summary

  Background Current data on the prevalence of overweight and energy-balance behaviors among European children is necessary to inform overweight prevention interventions. Methodology/Principal Findings A school-based survey among 10–12 year old children was conducted in seven European countries using a standardized protocol. Weight, height, and waist circumference were measured; Engagement in physical activity, sedentary and dietary behaviors, and sleep duration were self-reported. Descriptive analyses were conducted, looking at differences according to country, gender, and parental education. 7234 children (52%girls; 11.6±0.7 years) participated. 25.8% and 5.4% of boys, and 21.8% and 4.1% of girls were overweight (including obese) and obese (according to International Obesity Task Force criteria), respectively. Higher prevalence of overweight/obesity was observed in Greece, Hungary, Slovenia and Spain than in Belgium, Netherlands and Norway. Large differences between countries were found in intakes of sugar-sweetened beverages, breakfast, active transport, TV and computer time. More favorable overweight status and behavior patterns were found in girls than boys and in children of higher educated parents than in children of lower educated parents. Conclusions/Significance High levels and striking differences in overweight status and potential risk behaviors were found among schoolchildren across Europe.

• Gebremariam, Mekdes; Andersen, Lene Frost; Bjelland, Mona; Klepp, Knut Inge; Totland, Torunn Holm; Bergh, Ingunn Holden & Lien, Nanna (2012). Does the school food environment influence the dietary behaviours of Norwegian 11-year-olds? The HEIA study. Scandinavian Journal of Public Health.  ISSN 1403-4948.  40(5), s 491- 497 . doi: 10.1177/1403494812454948
• Gebremariam, Mekdes; Bergh, Ingunn Holden; Andersen, Lene Frost; Ommundsen, Yngvar; Bjelland, Mona & Lien, Nanna (2012). Stability and change in potential correlates of physical activity and association with pubertal status among Norwegian children in the transition between childhood and adolescence. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  9 . doi: 10.1186/1479-5868-9-56 Show summary

  Background: Whereas tracking and change in physical activity (PA) in children and adolescents have been well documented, studies investigating these patterns in its correlates are lacking. The present study aims to address this gap and in addition explore the impact of pubertal status on PA and its potential psychological and social-environmental correlates in a sample of Norwegian children over a 20-month period. Methods: A total of 885 students from 25 control schools of an intervention study, the HEalth In Adolescents (HEIA) study were included (mean age at baseline 11.2 (0.3)). The baseline took place in September 2007, the first follow-up in May 2008 and the second follow-up in May 2009. PA and its potential correlates (enjoyment of PA, self-efficacy related to barriers to PA, perceived support for PA from parents, friends and teachers, perceived social inclusion and perceived environmental opportunities for PA) were self-reported. Pubertal status was assessed using the Pubertal Development Scale. Repeated-measures ANOVA was used to explore changes. Tracking was assessed using Spearman’s rank order correlation. Pubertal groups were compared using ANOVA or ANCOVA (controlling for BMI). Multiple regression analyses were used to investigate whether pubertal stage at age 11 would predict levels of correlates and PA at age 13. Results: Potential correlates of PA and the behaviour itself were found to track moderately in the transition between childhood and adolescence. Small but significant changes in enjoyment of PA and teachers’ support for PA in both genders and in friends’ support for PA and perceived environmental opportunities for PA in females in a direction unfavourable to PA were detected. A few weak positive associations between pubertal stage and correlates of PA at age 11 were noted among boys. Conclusions: Enjoyment of PA, self-efficacy related to barriers to PA, perceived social support for PA, perceived social inclusion, perceived environmental opportunities for PA and the behaviour itself were found to be moderately stable in the transition between childhood and adolescence. Health promotion efforts in childhood targeting PA and its psychosocial and social-environmental correlates might have favourable effects in later years.

• Gebremariam, Mekdes; Totland, Torunn Holm; Andersen, Lene Frost; Bergh, Ingunn Holden; Bjelland, Mona; Grydeland, May; Ommundsen, Yngvar & Lien, Nanna (2012). Stability and change in screen-based sedentary behaviours and associated factors among Norwegian children in the transition between childhood and adolescence. BMC Public Health.  ISSN 1471-2458.  12 . doi: 10.1186/1471-2458-12-104 Show summary

  Background In order to inform interventions to prevent sedentariness, more longitudinal studies are needed focusing on stability and change over time in multiple sedentary behaviours. This paper investigates patterns of stability and change in TV/DVD use, computer/electronic game use and total screen time (TST) and factors associated with these patterns among Norwegian children in the transition between childhood and adolescence. Methods The baseline of this longitudinal study took place in September 2007 and included 975 students from 25 control schools of an intervention study, the HEalth In Adolescents (HEIA) study. The first follow-up took place in May 2008 and the second follow-up in May 2009, with 885 students participating at all time points (average age at baseline = 11.2, standard deviation ± 0.3). Time used for/spent on TV/DVD and computer/electronic games was self-reported, and a TST variable (hours/week) was computed. Tracking analyses based on absolute and rank measures, as well as regression analyses to assess factors associated with change in TST and with tracking high TST were conducted. Results Time spent on all sedentary behaviours investigated increased in both genders. Findings based on absolute and rank measures revealed a fair to moderate level of tracking over the 2 year period. High parental education was inversely related to an increase in TST among females. In males, self-efficacy related to barriers to physical activity and living with married or cohabitating parents were inversely related to an increase in TST. Factors associated with tracking high vs. low TST in the multinomial regression analyses were low self-efficacy and being of an ethnic minority background among females, and low self-efficacy, being overweight/obese and not living with married or cohabitating parents among males. Conclusions Use of TV/DVD and computer/electronic games increased with age and tracked over time in this group of 11-13 year old Norwegian children. Interventions targeting these sedentary behaviours should thus be introduced early. The identified modifiable and non-modifiable factors associated with change in TST and tracking of high TST should be taken into consideration when planning such interventions.

• Grydeland, May; Bergh, Ingunn Holden; Bjelland, Mona; Lien, Nanna; Andersen, Lene Frost; Ommundsen, Yngvar; Klepp, Knut Inge & Anderssen, Sigmund Alfred (2012). Correlates of weight status among Norwegian 11-year-olds: The HEIA study. BMC Public Health.  ISSN 1471-2458.  12 . doi: 10.1186/1471-2458-12-1053 Show summary

  Background: The underlying mechanisms of overweight and obesity in adolescents are still not fully understood. The aim of this study was to investigate modifiable and non-modifiable correlates of weight status among 1103 Norwegian 11-year-old adolescents in the HEalth in Adolescents (HEIA) study, including demographic factors such as gender and parental education, and behavioral factors such as intake of sugar-sweetened beverages, snacks and breakfast consumption, watching TV and playing computer games, physical activity and sedentary time. Methods: Weight and height were measured objectively, body mass index (BMI) was calculated and International Obesity Task Force cut-offs were used to define weight status. Physical activity and sedentary time were measured by accelerometers. Other behavioral correlates and pubertal status were self-reported by questionnaires. Parental education was reported by the parents on the consent form for their child. Associations were investigated using logistic regressions. Results: There were gender differences in behavioral correlates of weight status but not for weight status itself. Adolescents with parents in the highest education category had a 46% reduced odds of being overweight compared to adolescents with parents in the lowest education category. Adolescents with parents with medium education had 42% lower odds of being overweight than adolescents with parents with the lowest education category. Level of parental education, breakfast consumption and moderate to vigorous physical activity were positively associated with being normal weight, and time watching TV was positively associated with being overweight for the total sample. Gender differences were detected; boys had a doubled risk of being overweight for every additional hour of watching TV per week, while for girls there was no association. Conclusions: The present study showed a social gradient in weight status in 11-year-olds. Both breakfast consumption and moderate to vigorous physical activity were inversely associated with weight status. No associations were found between intake of sugar-sweetened beverages and snacks, playing computer games and weight status. Watching TV was positively associated with weight status for boys but not for girls. Interventions are needed to gain more insight into the correlates of change in weight status.

• Mercken, L.; Moore, L; Crone, M R; De Vries, H; De Bourdeaudhuij, I; Lien, Nanna; Fagiano, F; Vitoria, P D & van Lenthe, FJ (2012). The effectiveness of school-based smoking prevention interventions among low- and high-SES European teenagers. Health Education Research.  ISSN 0268-1153.  27(3), s 459- 469 . doi: 10.1093/her/cys017
• Van Lippevelde, Wendy; Verloigne, Maïté; De Bourdeaudhuij, Ilse; Brug, Johannes; Bjelland, Mona; Lien, Nanna & Maes, Lea (2012). Does parental involvement make a difference in school-based nutrition and physical activity interventions? A systematic review of randomized controlled trials. International Journal of Public Health.  ISSN 1661-8556.  57(4), s 673- 678 . doi: 10.1007/s00038-012-0335-3
• Verloigne, Maïté; Bere, Elling; Van Lippevelde, Wendy; Maes, Lea; Lien, Nanna; Vik, Frøydis Nordgård; Brug, Johannes; Cardon, Greet & De Bourdeaudhuij, Ilse (2012). The effect of the UP4FUN pilot intervention on objectively measured sedentary time and physical activity in 10--12 year old children in Belgium: the ENERGY-project. BMC Public Health.  ISSN 1471-2458.  18(12), s 805 . doi: 10.1186/1471-2458-12-805
• Bergh, Ingunn Holden; Grydeland, May; Bjelland, Mona; Lien, Nanna; Andersen, Lene Frost; Klepp, Knut Inge; Anderssen, Sigmund Alfred & Ommundsen, Yngvar (2011). Personal and social-environmental correlates of objectively measured physical activity in Norwegian pre-adolescent children. Scandinavian Journal of Medicine & Science in Sports.  ISSN 0905-7188.  21(6), s E315- E324 . doi: 10.1111/j.1600-0838.2011.01295.x Show summary

  The aim of this study was to examine modifiable biological, psychological, behavioral and social-environmental correlates of physical activity among 1129 Norwegian 11-year-old children within a cross-sectional sample from the HEalth In Adolescents study. Physical activity was assessed by accelerometer, and weight and height were measured objectively. Age- and gender-specific cut-off points proposed by the International Obesity Task Force were used to define body mass index. Social-environmental variables were self-reported by questionnaire. Hierarchical regression (linear mixed models) revealed that normal weight children scored higher on percentage daily moderate-to-vigorous physical activity [% daily moderate to vigorous physical activity (MVPA)] than overweight/obese children (P<0.001). Self-efficacy (P<0.01) and perceived social support from friends (P<0.01) were positively associated with children's % daily MVPA, and a negative association was found for computer/game-use on weekends (P<0.01). A moderator effect of weight category (normal vs overweight/obese) in the relationship between computer/game-use on weekends and % daily MVPA was detected (P<0.05), reflecting that higher computer/game-use on weekends was associated with lower % MVPA among the overweight/obese, but not among the normal weight. Modifiable correlates from multiple domains accounted for 14% of the variance in % daily MVPA. Prospective and intervention studies are needed to examine whether these factors act as mediators for physical activity change in pre-adolescent children.

• Bjelland, Mona; Bergh, Ingunn Holden; Grydeland, May; Klepp, Knut Inge; Andersen, Lene Frost; Anderssen, Sigmund Alfred; Ommundsen, Yngvar & Lien, Nanna (2011). Changes in adolescents' intake of sugar-sweetened beverages and sedentary behaviour: Results at 8 month mid-way assessment of the HEIA study - a comprehensive, multi-component school-based randomized trial. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  8 . doi: 10.1186/1479-5868-8-63 Show summary

  Background: Inconsistent effects of school-based obesity prevention interventions may be related to how different subgroups receive them. The aim of this study was to evaluate the effect of an intervention program, including fact sheets to parents and classroom components, on intake of sugar-sweetened beverages (SSB) and screen time. Further, to explore whether potential effects and parental involvement varied by adolescents’ gender, weight status (WS) and parental educational level. Methods: In total, 1465 11-year-olds participated at the pre-test and the 8 month mid-way assessment of the HEIA study. Parents (n = 349) contributed with process evaluation data. Self-reported intake of SSB was collected from the 11-year-olds assessing frequency and amount, while time used on watching TV/DVD and computer/game-use (weekday and weekend day) were assed by frequency measures. Data on awareness of the intervention and dose received were collected from parents. Covariance analyses (ANCOVA) were conducted testing for effects by gender and for moderation by WS and parental education. Results: Time spent on TV/DVD (week p = 0.001, weekend p = 0.03) and computer/game-use (week p = 0.004, weekend p <.001), and the intake of SSB during weekend days (p = 0.04), were significantly lower among girls in the intervention group compared to the control group girls after 8 months. Girls’ WS did not moderate these findings. However, no significant effects of the intervention were found for boys, but moderation effects were found for WS (week days: TV/DVD, p = 0.03 and computer/games, p = 0.02). There were no moderating effects of parental education for neither boys nor girls with respect to intake of SSB, time used for watching TV/DVD and computer/game-use. Parental awareness of the intervention was significantly higher among the parents of girls, while the parents of boys were more satisfied with the fact sheets. Conclusions: The preventive initiatives appeared to change behaviour in girls only. This study suggests that exploration of potential beneficial or negative effects of intervention in subgroups is important. In formative evaluation of obesity prevention studies it seems warranted to include issues related to gender, WS and parental involvement in order to enhance the effectiveness of preventive initiatives.

• Bjelland, Mona; Lien, Nanna; Grydeland, May; Bergh, Ingunn Holden; Anderssen, Sigmund Alfred; Ommundsen, Yngvar; Klepp, Knut Inge & Andersen, Lene Frost (2011). Intakes and perceived home availability of sugar-sweetened beverages, fruit and vegetables as reported by mothers, fathers and adolescents in the HEIA (HEalth In Adolescents) study. Public Health Nutrition.  ISSN 1368-9800.  14(12), s 2156- 2165 . doi: 10.1017/S1368980011000917 Show summary

  Objective: To investigate the intakes of sugar-sweetened beverages (SSB), fruit and vegetables (FV) among adolescents and their parents and to explore differences in the perceived availability by gender and parental education. Design: Baseline data from the HEIA (HEalth In Adolescents) study. Setting: Data on intake of SSB were collected assessing frequency and amounts, whereas consumption of FV was assessed on the basis of frequency. Further, perceived availability at home and at school (taken from home) was reported. Subjects: Participants were 1528 Norwegian adolescents aged 11 years, as well as 1200 mothers and 1057 fathers. Results The adolescents’ intake of SSB was low on weekdays but doubled during weekend days. This pattern was observed among parents as well. There were significant differences in intake between boys, girls, mothers and fathers, except for vegetables. Fathers reported the lowest frequency of FV intake. Compared with adolescents, mothers reported lower availability of SSB and higher availability of FV. Compared with their sons, fathers reported higher availability of vegetables and lower availability of sugar-sweetened fruit drinks at school. Significant differences in adolescents’ intake of SSB and in the perceived availability of both SSB and FV by parental education were found. Conclusions: The intake of SSB was higher during weekend days than during weekdays, whereas the frequency of FV intake was low. Differences in adolescents’ perceived availability of both SSB and FV on the basis of parental education were found, whereas the differences in intake were significant only for SSB. Increasing parental awareness of availability and their potential as role models across parental gender and educational level could improve adolescents’ dietary habits.

• De Bourdeaudhuij, I.; Simon, C.; De Meester, F.; van Lenthe, F; Spittaels, H.; Lien, Nanna; Faggiano, F.; Mercken, L.; Moore, L. & Haerens, L. (2011). Are physical activity interventions equally effective in adolescents of low and high socio-economic status (SES): results from the European Teenage project. Health Education Research.  ISSN 0268-1153.  26(1), s 119- 130 . doi: 10.1093/her/cyq080
• Van Lippevelde, W; Verloigne, M; De bourdeaudhuij, Ilse; Bjelland, Mona; Lien, Nanna; Fernández-Alvira, JM; Moreno, LM; Kovacs, E; Brug, Johannes & Maes, L (2011). What do parents think about parental participation in school-based interventions on energy balance-related behaviours? A qualitative study in 4 countries. BMC Public Health.  ISSN 1471-2458.  11(1) . doi: 10.1186/1471-2458-11-881
• Brug, Johannes; Velde, ST; Chinapaw, MJM; Bere, Elling Tufte; Bourdeaudhuij, Ilse de; Moore, H.; Maes, Louis; Jensen, Jørgen; Salmon, Jo; Manios, Yannis; Lien, Nanna; Klepp, Knut Inge; Lobstein, T; Martens, M; Salmon, J & Singh, Amika S (2010). Evidence-based development of school-based and family-involved prevention of overweight across Europe: The ENERGY-project's design and conceptual framework. BMC Public Health.  ISSN 1471-2458.  10 . doi: 10.1186/1471-2458-10-276 Show summary

  Background There is an urgent need for more carefully developed public health measures in order to curb the obesity epidemic among youth. The overall aim of the "EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY)-project is the development and formative evaluation of a theory-informed and evidence-based multi-component school-based and family-involved intervention program ready to be implemented and evaluated for effectiveness across Europe. This program aims at promoting the adoption or continuation of health behaviors that contribute to a healthy energy balance among school-aged children. Earlier studies have indicated that school and family environments are key determinants of energy-balance behaviors in schoolchildren. Schools are an important setting for health promotion in this age group, but school-based interventions mostly fail to target and involve the family environment. Methods Led by a multidisciplinary team of researchers from eleven European countries and supported by a team of Australian experts, the ENERGY-project is informed by the Environmental Research Framework for Weight gain Prevention, and comprises a comprehensive epidemiological analysis including 1) systematic reviews of the literature, 2) secondary analyses of existing data, 3) focus group research, and 4) a cross European school-based survey. Results and discussion The theoretical framework and the epidemiological analysis will subsequently inform stepwise intervention development targeting the most relevant energy balance-related behaviors and their personal, family-environmental and school-environmental determinants applying the Intervention Mapping protocol. The intervention scheme will undergo formative and pilot evaluation in five countries. The results of ENERGY will be disseminated among key stakeholders including researchers, policy makers and the general population. Conclusions The ENERGY-project is an international, multidisciplinary effort to develop and test an evidence-based and theory-informed intervention program for obesity prevention among school-aged children

• Bjelland, Mona; Lien, Nanna; Bergh, Ingunn Holden; Grydeland, May; Anderssen, Sigmund Alfred; Klepp, Knut Inge; Ommundsen, Yngvar & Andersen, Lene Frost (2010). Overweight and waist circumference among Norwegian 11-year-olds and associations with reported parental overweight and waist circumference: The HEIA study. Scandinavian Journal of Public Health.  ISSN 1403-4948.  38, s 19- 27 . doi: 10.1177/1403494810385036
• Brug, Johannes; Lien, Nanna; Klepp, Knut Inge & van Lenthe, Frank J (2010). Exploring overweight, obesity and their behavioural correlates among children and adolescents: results from the Health-promotion through Obesity Prevention across Europe project. Public Health Nutrition.  ISSN 1368-9800.  13(10A), s 1676- 1679 . doi: 10.1017/S1368980010002211
• de Gouw, L; Klepp, Knut Inge; Vignerová, Jana; Lien, Nanna; Steenhuis, Ingrid HM & Wind, Marianne (2010). Associations between diet and (in)activity behaviours with overweight and obesity among 10-18-year-old Czech Republic adolescents. Public Health Nutrition.  ISSN 1368-9800.  13(10A), s 1701- 1707 . doi: 10.1017/S1368980010002259
• Lien, Nanna; Bjelland, Mona; Bergh, Ingunn Holden; Grydeland, May; Anderssen, Sigmund A.; Ommundsen, Yngvar; Andersen, Lene Frost; Henriksen, Hege; Randby, Jorunn Sofie & Klepp, Knut Inge (2010). Design of a 20-month comprehensive, multicomponent school-based randomised trial to promote healthy weight development among 11-13 year olds: The HEalth In Adolescents study. Scandinavian Journal of Public Health.  ISSN 1403-4948.  38, s 38- 51 . doi: 10.1177/1403494810379894 Show summary

  Background and purpose: The lack of effective school-based interventions for preventing obesity in children has caused a call for longer duration of interventions and better reporting on design and evaluation methodology. The purpose of this paper is to present the development of the intervention, the design of the effectiveness study, and the test-retest reliability of the main outcome measures in the HEalth In Adolescents (HEIA) study. Methods/design: The HEIA intervention programme was developed based on literature reviews, a social ecological framework, and focus groups. The intervention aimed to increase total physical activity (PA) and consumption of fruit and vegetables and to decrease screen time and consumption of sugar-sweetened beverages. The intervention programme consisted of a classroom component, including dietary behaviour lessons, computer tailoring, fruit/vegetable and PA breaks, and posters, and an environmental component including active transport campaigns, equipment, suggestions for easy improvements of schoolyards, inspirational courses for teachers (all with regards to PA), and fact sheets to parents. The effect of the intervention programme is evaluated in a cluster randomised controlled trial design (intervention = 12 schools, control = 25 schools) including process evaluation. Main outcomes include anthropometry, PA, screen time, and consumption of fruit, vegetables, and sugar-sweetened beverages. A 2-week test? retest study was conducted among 114 pupils. Determinants of the behaviours were assessed. Similar data were collected from parents. Children?s PA was measured objectively by accelerometers. Conclusions: The HEIA study represents a theoretically informed randomised trial comprising a comprehensive set of multilevel intervention components with a thorough evaluation using reliable outcome measures. The study will contribute to a better understanding of determinants of healthy weight development among young people and how such determinants can be modified.

• Lien, Nanna; Henriksen, Hege; Nymoen, Lena Lie; Wind, Marianne & Klepp, Knut Inge (2010). Availability of data assessing the prevalence and trends of overweight and obesity among European adolescents. Public Health Nutrition.  ISSN 1368-9800.  13(10A), s 1680- 1687 . doi: 10.1017/S1368980010002223
• van der Sluis, Maria; Lien, Nanna; Twisk, Jos WR; Steenhuis, Ingrid HM; Bere, Elling Tufte; Klepp, Knut Inge & Wind, Marianne (2010). Longitudinal associations of energy balance-related behaviours and cross-sectional associations of clusters and body mass index in Norwegian adolescents. Public Health Nutrition.  ISSN 1368-9800.  13(10A), s 1716- 1721 . doi: 10.1017/S1368980010002272 Show summary

  Background Insight into the role of energy balance-related behaviours (EBRB) is of great importance when it comes to prevention of weight gain and design of interventions tailored to target these behaviours. Objectives First, the present study examines the longitudinal association of four EBRB in Norwegian adolescents. Second, it aims to examine whether clusters of EBRB are cross-sectionally associated with being overweight. Design The present study is part of the ?Fruits and Vegetables Make the Marks? project. The study sample consists of twenty control schools in two Norwegian counties. Methods Survey questionnaires were completed by 884 pupils with an average age at baseline, September 2001, of 11·8 years. In the follow-up surveys in May 2002 and May 2005, a total of 809 and 724 adolescents participated, respectively. Four EBRB were measured: habitual fruit and vegetable intake, snacking and soda consumption, television and computer use and physical activity. Results Results of the associations between EBRB were similar for boys and girls. The odds, ranging from 1·14 to 12·06, were mostly significant. One out of four clusters, the unhealthy cluster, was significantly and cross-sectionally associated with overweight and obesity. Conclusions Longitudinal associations of EBRB show that it is important to start early with interventions that aim to prevent unhealthy behaviours becoming habitual. These behaviours should be targeted at the same time as they tend to co-occur. More research, preferably longitudinal and more objective, is needed to investigate associations between health behaviours and body weight among adolescents.

• Vik, Frøydis Nordgård; Lien, Nanna; Bere, Elling & Øverby, Nina Cecilie (2010). Number of meals eaten in relation to weight status among Norwegian adolescents. Scandinavian Journal of Public Health.  ISSN 1403-4948.  38, s 13- 18 . doi: 10.1177/1403494810378920 Show summary

  Aim: To assess the relationship between number of meals eaten and weight status, and to assess potential confounders of this relationship. Methods: A total of 2870 (participation rate: 85%) 9th and 10th graders (mean age: 15.5 years) at 33 schools completed questionnaires in May 2005. Number of meals was measured with questions asking whether they ate breakfast, lunch, dinner, and supper the day before, giving a scale ranging from zero to four meals/day. Data on gender, height, weight, education plans, intake of fruits and vegetables, consumption of unhealthy snacks, TV/computer time, physical activity level, and dieting were also collected. Results: The proportions of overweight adolescents related to the number of meals eaten were: 10% (0-1 meals, n=107), 18% (2 meals, n=399), 14% (3 meals, n=925), and 10% (4 meals, n= 1402), p <= 0.001. Low education plans, high TV/computer time, low physical activity level, and dieting were all positively associated with both being overweight and not having four meals. Being a boy was positively associated with being overweight but negatively associated with not having four meals. High intake of unhealthy snacks was negatively associated with being overweight, but positively associated with not having four meals. In a logistic regression analysis, adjusting for all variables mentioned, odds ratio for being overweight were 0.8 (95% CI 0.3-1.9), 1.8 (95% CI 1.2-2.7) and 1.6 (95% CI 1.2-2.3), respectively, for eating one or zero, two, and three meals compared to four meals. Conclusions: Eating four meals/day was significantly negatively related to being overweight, also when controlling for potential confounding factors.

• de Meester, Femke; van Lenthe, Frank J; Spittaels, Heleen; Lien, Nanna & De Bourdeaudhuij, Ilse (2009). Interventions for promoting physical activity among European teenagers: a systematic review. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  6 . doi: 10.1186/1479-5868-6-82
• van Lenthe, FJ; de Bourdeaudhuij, I; Klepp, Knut Inge; Lien, Nanna; Moore, L; Faggiano, F; Kunst, AE & Mackenbach, JP (2009). Preventing socioeconomic inequalities in health behaviour in adolescents in Europe: Background, design and methods of project TEENAGE. BMC Public Health.  ISSN 1471-2458.  9 . doi: 10.1186/1471-2458-9-125

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• Roos, Gun; Langøien, Lars Jørun; Terragni, Laura; Rugseth, Gro; Nicolaou, Mary; Holdsworth, Michelle; Stronks, Karien & Lien, Nanna (2018). Systematic mapping review of factors influencing physical activity and sedentary behaviour in ethnic minority groups in Europe: a DEDIPAC study.
• Brug, Johannes; van der Ploeg, Hidde P; Loyen, Anne; Ahrens, Wolfgang; Allais, Olivier; Andersen, Lene Frost; Cardon, Greet; Capranica, Laura; Chastin, Sebastien; De Bourdeaudhuij, Ilse; De Craemer, Marieke; Donnelly, Alan; Ekelund, Ulf; Finglas, Paul; Flechtner-Mors, Marion; Hebestreit, Antje; Kubiak, Thomas; Lanza, Massimo; Lien, Nanna; MacDonncha, Ciaran; Mazzocchi, Mario; Monsivais, Pablo; Murphy, Marie; Nicolaou, Mary; Nöthlings, Ute; O'Gorman, Donal J; Renner, Britta; Roos, Gun; van den Berg, Matthijs; Schulze, Matthias B; Steinacker, Jurgen; Stronks, Karien; Volkert, Dorothee & Lakerveld, Jeroen (2017). Determinants of diet and physical activity (DEDIPAC): A summary of findings. International Journal of Behavioral Nutrition and Physical Activity.  ISSN 1479-5868.  14(1) . doi: 10.1186/s12966-017-0609-5
• Klepp, Knut Inge & Lien, Nanna (2017). Overvekt og fedme: den tunge folkehelseutfordringen, I: Knut Inge Klepp & Leif Edvard Aarø (red.),  Ungdom, livsstil og helsefremmende arbeid.  Gyldendal Akademisk.  ISBN 978-82-05-46398-1.  12.  s 255 - 270
• Vennerød, Frida Felicia; Monnery-Patris, Sandrine; Lien, Nanna & Almli, Valerie Lengard (2016). Children and sweet preferences..
• Melbye, Elisabeth Lind; Bergh, Ingunn Holden; Hausken, Solveig E S; Sleddens, Ester FC; Glavin, Kari; Lien, Nanna & Bjelland, Mona (2015). Adolescent impulsivity and soft drink consumption: The role of parental regulation.
• Hersleth, Margrethe; Lien, Nanna & Vatn, Solveig Veronica Dånmark (2014). Barns sensitivitet og aksept av grunnsmaker og betydning for dere matvaner.
• Hersleth, Margrethe; Vatn, Solveig Veronica Dånmark; Berget, Ingunn; Almli, Valerie Lengard & Lien, Nanna (2014). Children’s sensitivity to basic tastes and their corresponding acceptance and intake of representative lemonades.
• Totland, Torunn Holm; Andersen, Lene Frost & Lien, Nanna (2014). Home environmental influences on adolescents' energy balance related behaviours.
• Bjelland, Mona; Bergh, Ingunn Holden; Grydeland, May & Lien, Nanna (2013). Utvikling, gjennomføring og evaluering av HEIA-prosjektet: Kan skolen være en arena for å fremme sunn vektutvikling blant 11-13 åringer?. Norsk Tidsskrift for Ernæring.  ISSN 1503-5034.  (2), s 30- 33
• Grydeland, May; Bjelland, Mona; Anderssen, Sigmund Alfred; Klepp, Knut Inge; Bergh, Ingunn Holden; Andersen, Lene Frost; Ommundsen, Yngvar & Lien, Nanna (2013). Intervention effect on BMI in adolescent girls: The HEalth in Adolescents (HEIA) Study – A school-­based two-­year cluster randomized trial.
• Totland, Torunn Holm; Lien, Nanna; Bergh, Ingunn Holden; Bjelland, Mona; Gebremariam, Mekdes Kebede; Klepp, Knut Inge & Andersen, Lene Frost (2013). Prediction of parental education on adolescents’ soft drink intake, and mediation effects of availability and accessibility at home.
• Vik, Frøydis Nordgård; Bjørnarå, Helga Birgit; Øverby, Nina Cecilie; Lien, Nanna; Androutsos, Odysseas; Maes, Lea; Jan, Natasa; Kovacs, Eva; Moreno, Luis A; Dössegger, Alain; Manios, Yannis; Brug, Johannes & Bere, Elling (2013). ASSOCIATIONS BETWEEN EATING MEALS, EATING MEALS WHILE WATCHING TV AND WEIGHT STATUS AMONG CHILDREN, 10-12 YEARS: THE ENERGY-CROSS SECTIONAL STUDY. Annals of Nutrition and Metabolism.  ISSN 0250-6807.  63, s 286- 286 . doi: 10.1159/000354245
• Vik, Frøydis Nordgård; Bjørnarå, Helga Birgit; Øverby, Nina Cecilie; Lien, Nanna; Androutsos, Odysseas; Maes, Lea; Jan, Natasa; Kovacs, Eva; Moreno, Luis A; Dössegger, Alain; Manios, Yannis; Brug, Johannes & Bere, Elling (2013). Associations between eating meals, eating meals while watching TV and weight status among children, 10-12 years: The energy-cross sectional study.
• Vik, Frøydis Nordgård; Lien, Nanna; Berntsen, Sveinung; De Bourdeaudhuij, Ilse; Grillenberger, Monika; Manios, Yannis; Kovacs, Eva; Brug, Johannes & Bere, Elling (2013). Outcome evaluation of the UP4FUN pilot intervention in 10 – 12 year old children in Europe - the ENERGY project.
• Vik, Frøydis Nordgård; Bere, Elling; Øverby, Nina Cecilie; Lien, Nanna; Maes, Lea; Moore, Helen; Summerbell, Carolyn; Grammatikaki, Evangelia; Manios, Yannis & Brug, Johannes (2011). ASSOCIATIONS BETWEEN BREAKFAST SKIPPING AND WEIGHT STATUS IN SEVEN EUROPEAN COUNTRIES: THE ENERGY-PROJECT.
• Lien, Nanna; Hallén, Ninna; Roos, Eva; Ray, Carola; Karlsson, Christina; Santiago, Raquel Izquierdo de; Binard, Philippe; Yngve, Agneta; Ehrenblad, Bettina; Lynch, Christel & Klepp, Knut Inge (2010). Developing a low cost, sustainable school-based intervention to promote fruit and vegetables: the pro greens project. Public Health Nutrition.  ISSN 1368-9800.  (9(A)), s 22
• Yngve, Agneta; Lynch, Christel; Ehrenblad, Bettina; Lien, Nanna & Klepp, Knut Inge (2010). Pro greens - a fruit and vegetable promotion project in eleven European countries. Public Health Nutrition.  ISSN 1368-9800.  (9(A)), s 21- 27
• Bergh, Ingunn Holden; Grydeland, May; Bjelland, Mona; Lien, Nanna; Klepp, Knut-Inge; Anderssen, Sigmund A. & Ommundsen, Yngvar (2009). Correlates of children?s computer use on weekends: Baseline results from HEIA, a two-year multi-component school based intervention program. Show summary

  Introduction In order to regulate children?s weight it is important to increase physical activity (PA) and reduce sedentary activities (van Sluijs et al, 2008). As part of sedentary activities, children?s computer use has increased substantially. Hence, determinants of children?s computer use seem important to identify. Purpose To examine the associations of gender, BMI and social-environmental influences with children?s computer use on weekends. Methods Eleven year olds 6th graders from the eastern part of Norway and their parents (n=1209) taking part in the HEIA project, a school based intervention to promote healthy weight development, participated at the baseline data collection (September 2007). The dependent variable consisted of child?s self-reported time spent on computer use on weekends. Independents were gender and BMI and parental (mother) data on a) mother?s computer use on weekends, regulation of child?s computer use and support of child?s PA, and b) perceived screen use as an indoor limitation to PA. Results Entered in step 1 gender (beta = .23, p < .001) and BMI (beta = .09, p < .01) related significantly to child?s computer use on weekends; altogether accounting for 6% of the variance in computer use. Entered in step 2, mother?s time spent on computer use on weekends (beta = .11, p < .01); parental regulation of child?s computer use (beta = -.07, p < .05) and parental social support for child?s PA (beta = -.08, p < .05); altogether accounting for 2% additional explained variance in child?s computer use. By entering screen use as a perceived limitations to PA (beta = .15, p < .001) this added 2% additional variance in child?s computer use. The total predictor set accounted for 10% of the total variance in child?s computer use. When entering screen use as a perceived limitation to PA in step 3, the relative influence of parental support for child?s PA and parental regulation of child?s computer use no longer were significant. In contrast, the role of mothers computer use on weekends for child?s computer use was upheld. Discussion Current findings suggest that boys more strongly than girls use computers on weekends and that parents to some extent may be in the position to reduce child?s computer use by reducing their own computer use, by being more supportive of child?s PA, and by strengthening their regulation of child?s computer use. Interestingly, when parents report screen use to be a limitation to child?s PA child?s computer use is increased.

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