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• Limani, Naman; Henriksen, Hege Berg; Minge, Mina Marie; Sandoval, Viviana; Landberg, Rikard & Lindqvist, Helen M. [Show all 9 contributors for this article] (2026). Effect of different sources of saturated and polyunsaturated fatty acids on postprandial inflammation: A double-blind randomized crossover trial. Clinical Nutrition ESPEN. ISSN 2405-4577. 74. doi: 10.1016/j.clnesp.2026.103335. Full text in Research Archive
• Eklo, Rakel R.; Alavi, Dena Treider; Konglevoll, Dina Moxness; Kolle, Åshild; Henriksen, Hege Berg & Rising, Russell [Show all 8 contributors for this article] (2026). Predictive equations commonly used in clinics underestimate resting energy expenditure compared with whole-room indirect calorimetry in colorectal cancer survivors. American Journal of Clinical Nutrition. ISSN 0002-9165. doi: 10.1016/j.ajcnut.2026.101209. Full text in Research Archive Show summary

  Background: Accurate methods for estimating resting energy expenditure (REE) are important to ensure adequate nutritional treatment in colorectal cancer (CRC) survivors. Objective: To determine the agreement between REE estimated by commonly used predictive equations and by whole-room indirect calorimetry (WRIC). Design: This cross-sectional study included 31 CRC survivors (age: 53–78 years; mean (standard deviation (SD)) body mass index (BMI) 28.7 (4.28) kg/m2), who underwent curative surgery. Body composition was measured by dual-energy x-ray absorptiometry (DXA). Predicted REE from equations in clinical use and derived from DXA and bioelectrical impedance analysis (BIA) were compared against REE measured by 30-min WRIC. Equations included Harris-Benedict, Mifflin-St. Jeor, FAO/WHO/UNU, Henry, Mifflin-St. JeorDXA, and FAO/WHO/UNUBIA. Paired sample t-test, Lin’s concordance correlation coefficient (CCC) and Bland-Altman analysis were used to determine the agreement between measured REEWRIC and predicted REE. Accuracy was defined as the percentage of predicted REE values that fell within ± 10 % of REEWRIC. Results: Mean (SD) REEWRIC was 1710 kcal/d (353), and respiratory quotient (RQ) was 0.79 (0.05). Most equations underestimated REE. On average, Harris-Benedict, Henry, and FAO/WHO/UNUBIA showed the best overall agreement with REEWRIC. However, these equations showed low accuracy with 65 %, 68 %, and 62 % of predicted REE values within ± 10 % of REEWRIC, respectively. Conclusions: Most predictive equations tended to underestimate REE in CRC survivors compared with REEWRIC. The Harris-Benedict, Henry and FAO/WHO/UNUBIA equations showed both best accuracy and agreement with WRIC. They were still inaccurate, with individual variability for a relevant part of the sample. Future studies need to develop improved predictive equations for CRC survivors.

• Arjmand, Elaheh Javadi; Thomassen, Lise Margrete; Druckrey-Fiskaaen, Karl Trygve; Furulund, Einar; Vold, Jørn Henrik & Madebo, Tesfaye [Show all 13 contributors for this article] (2025). The effect of fruit smoothie supplementation on psychological distress and biomarkers among people with opioid dependence receiving opioid agonist therapy: a randomized controlled trial. BMC Medicine. 23. doi: 10.1186/s12916-025-04347-w. Full text in Research Archive Show summary

  Unhealthy diets are common among individuals with opioid dependence. While fruit- and vegetable-rich diets have shown mental health benefits, evidence is limited for those receiving opioid agonist therapy (OAT). This trial evaluated the effectiveness of fruit smoothie supplementation for people receiving OAT compared to standard treatment without fruit smoothie supplementation. In this multicenter randomized controlled trial (FruktBAR), 311 participants receiving OAT were randomized (5:3 intervention:control) to receive either a daily 250 ml fruit smoothie for 16 weeks in addition to standard OAT or standard OAT alone. The primary outcome was the difference between the arms in changes in psychological distress, measured by the ten-item Hopkins Symptom Checklist (SCL-10%) from baseline to the end of the intervention. The secondary outcomes included changes in fatigue symptoms, measured using the three-item Fatigue Severity Scale, physical fitness, measured by a 4-min step test, carotenoid and folate biomarkers. At baseline, 131 participants (70%) in the intervention arm and 91 (73%) in the control arm had a low intake of fruits and vegetables. In the intervention arm, the mean SCL-10% score at baseline was 43.9% (95% confidence interval (CI): 40.4, 47.4), which was reduced to 41.6% (CI: 38.0, 5.1) at the end of the trial. In the control arm, the mean SCL-10% score was 43.6% at baseline (CI: 39.3, 48.0) and decreased to 41.5% (CI: 37.1, 45.8) at the end of the trial period. No significant difference in the change of psychological distress between the intervention and control arms was found (− 0.14%; CI: − 4.49, 2.22). Additionally, no changes were found between the intervention and control arms regarding fatigue symptoms, physical fitness, carotenoid, or folate biomarkers. The mean consumed fruit smoothies reported in the intervention arm was 3.9 bottles per week (SD 1.5).  Fruit smoothie supplementation over a 16-week period did not impact psychological distress, fatigue, physical fitness, carotenoids, or folate biomarkers among people receiving OAT. Although the smoothies were successfully delivered to the participants, our data indicates suboptimal adherence to the intervention rather than the lack of efficacy.  ClinicalTrials.gov NCT05229770. Registered on 08 February 2022.

• Nordengen, Anne Lene; Krutto, Annika; Kværner, Ane Sørlie; Alavi, Dena Treider; Henriksen, Hege Berg & Kolle, Åshild [Show all 13 contributors for this article] (2025). Plant-based diet and oxidative stress-induced DNA damage in post-surgery colorectal cancer patients: Results from a randomized controlled trial. Free Radical Biology & Medicine. ISSN 0891-5849. 233, p. 240–249. doi: 10.1016/j.freeradbiomed.2025.03.047. Full text in Research Archive Show summary

  Oxidative stress-induced DNA damage may impact long-term outcomes in colorectal cancer (CRC) patients. While bioactive compounds in plant foods have been linked to DNA protection, evidence among patients in remission remains limited. The present study aimed to investigate the effect of a one-year personalized intensive dietary intervention on DNA damage in post-surgery, non-metastatic CRC patients. Participants were enrolled 2–9 months after surgery in the ongoing randomized controlled trial, Norwegian dietary guidelines and colorectal cancer survival (CRC-NORDIET). Eligible participants (aged 50–80 years, primary stage I-III CRC) were randomized to either a plant-based dietary intervention targeting oxidative stress and inflammation, or to a control group that received standard dietary advice as a part of routine cancer care. As a secondary analysis, this study included 156 participants (78 in the intervention group and 78 in the control group) from the total 503 patients enrolled in CRC-NORDIET study. DNA damage in peripheral mononuclear blood cells (PBMCs) was assessed using the enzyme-modified comet assay during a 12-month follow-up period. A significant intervention effect on DNA base oxidation from baseline to 12 months was observed (P = 0.04), representing a 32 % reduction in the intervention group compared to the control group. No significant effect on DNA strand breaks was found. In conclusion, adherence to a plant-based dietary pattern may reduce DNA base oxidation in post-surgery CRC patients.

• Henriksen, Hege Berg; Kolle, Åshild; Stenling, Andreas; Paur, Ingvild; Bøhn, Siv Kjølsrud & Brøto, Pernille [Show all 9 contributors for this article] (2025). Spillover effect of a dietary intervention on physical activity in a randomized controlled trial with colorectal cancer patients. International Journal of Behavioral Nutrition and Physical Activity. 22, p. 1–13. doi: 10.1186/s12966-025-01757-0. Full text in Research Archive Show summary

  Background Randomized controlled studies (RCTs) targeting dietary changes may also lead to other, untargeted changes in lifestyle habits, as spillover effects. In particular, the isolated impact of the dietary intervention may be difficult to separate due to spillover effects from changes in physical activity and physical function. Therefore, the aim of this study was to investigate the spillover effect of a one-year dietary intervention in post-surgery colorectal cancer patients by comparing the changes in physical activity and physical function between the diet intervention Group and the control group in a randomized controlled trial, called the CRC-NORDIET study. Methods Men and women, aged 50–80 years were randomized into either the intervention group (n=240) or the control group (n=229). Both groups received similar incentives on physical activity. Activity sensors were used to collect data on physical activity at baseline, 6 months, and 12 months. Physical function was estimated by results from handgrip strength, 30 s sit-to-stand test and 6-min walking test. Anthropometric measurements and body composition were also measured. Results We found a significantly higher increase in moderate-to-vigorous intensity physical activity (MVPA) of 0.18 h per day from baseline to 6 months in the diet intervention group compared to the control group, respectively. However, the spillover effect of the dietary intervention on physical activity diminished to 0.10 h per day at 12 months follow-up which was not statistically significantly different (p=0.24) from the control group. All measures of physical function increased in both groups from baseline to 6 months with no further increase at the 12-month follow-up. Conclusions The dietary intervention did not induce a significant spillover effect on physical activity after 12 months of baseline, which was the main timepoint of the intervention. Providing identical physical activity guidance to both study groups during the 12-month intensive dietary intervention period, ensured comparable levels of physical activity across both study groups. This approach facilitated the isolation and analysis of the dietary intervention’s effects on primary endpoints, as well as effects of behaviour interventions in secondary preventions, such as the CRCNORDIET study. Trial registration The study is registered on the National Institutes of Health Clinical Trials website (www.ClinicalTrials.gov; Identifier: NCT01570010)

• Dahlgren, Monica Linnea; Berstad, Paula Marianna; Henriksen, Hege Berg; Blomhoff, Rune & Kværner, Ane Sørlie (2025). Characterization of Nova-classified foods in a large cohort of Norwegian colorectal cancer screening participants. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. 23(1), p. 7–19. doi: 10.18261/ntfe.23.1.3. Full text in Research Archive Show summary

  Background: Epidemiological studies on Nova-classified ultra-processed foods (Nova 4) often rely on food frequency questionnaire (FFQ) data without specifying the foods that fall into this category. We aimed to provide a detailed characterization of Nova-classified food intake relevant to the Norwegian context. Method: We applied the Nova classification system on FFQ data obtained from a large sample of Norwegian colorectal cancer screening participants (the CRCbiome study). The contribution of each Nova category (1–4) to the total diet was assessed, identifying the main food and beverage contributors within each group, both by weight (g/day) and as percentage of total energy intake (E%). Results: Nova categories 1, 2, 3, and 4 contributed 1633, 4, 329 and 562 g/day, respectively, accounting for 31, 1, 18 and 50% of total E%. Bread was the largest contributor to Nova 4, providing 19 E%. Other significant contributors included desserts and sweets (5 E%), processed meat (4 E%), processed fish (2 E%), margarine (2 E%), and dairy products (1 E%). For Nova categories 1, 2, and 3, the main contributors were fruits (4 E%), oils (1 E%), and cheese (5 E%), respectively. Although men had a slightly higher intake of Nova category 4 foods than women (51 vs. 47 E%), the overall distribution and within-group contributors were largely similar between sexes. Conclusion: Using FFQ data, as much as half of the energy intake of the present population was derived from ultra-processed foods. Bread was the predominant contributor to ultra-processed foods, far surpassing the other items.

• Al-Shibli, Mohammed Khalid; Fadnes, Lars T.; Henriksen, Hege Berg; Arjmand, Elaheh Javadi; Thomassen, Lise Margrete & Lid, Torgeir Gilje [Show all 7 contributors for this article] (2025). Experiences with healthy eating among individuals with opioid dependence: insights from a dietary assessment. BMC Nutrition. 11, p. 1–11. doi: 10.1186/s40795-025-01106-1. Full text in Research Archive Show summary

  Background People with substance use disorders often have unhealthy diets, including a limited intake of fruits and vegetables. Additionally, individuals with substance use disorders experience a significantly higher burden of physical and mental health conditions compared to the general population. Poor diets may contribute to this, but few studies have explored how these dietary habits could be improved. Therefore, our objective is to investigate the experiences with healthy eating among individuals with opioid dependence. Methods We employed a qualitative design and recruited twelve patients undergoing opioid agonist therapy in Bergen. All participants were interviewed using a qualitative interview guide focused on experiences with healthy eating. Additionally, we conducted a dietary assessment using the DIGIKOST-FFQ tool, which was administered twice. Participants were then informed about how their diets aligned with the Norwegian dietary recommendations, and we interviewed them about their experiences with this information. Data analysis was carried out using systematic text condensation. Results Our findings show that many participants recognized the potential health benefits of healthy eating and how these were negatively impacted by their substance use. Even if many participants recognized the potential health benefits of healthy eating and how these were negatively impacted by their substance use, they had mixed reactions to receiving personalized dietary feedback. They expressed a need for support from the healthcare system to help improving their diets. Conclusion Our findings suggest that individuals with substance use disorders are interested in changing their diets but lack the skills to do so. While receiving personalized feedback may be effective for some, it would likely need to be combined with other interventions to improve their overall health.

• Westerheim, Elin; Øhman, Elisabeth Adolfsen; Fossli, Maria; Winkvist, Anna; Henriksen, Hege & Brekke, Hilde Kristin (2025). Relative validity of bioelectrical impedance analysis in estimating body composition in women with overweight and obesity 2 weeks and 6 months postpartum. Food & Nutrition Research (FNR). ISSN 1654-6628. 69. doi: 10.29219/fnr.v69.10869. Full text in Research Archive Show summary

  Objective: To investigate the relative validity of bioelectrical impedance analysis (BIA) in estimating fat mass (FM) and fat free mass (FFM) with dual-energy X-ray absorptiometry (DXA) as reference method in women with overweight and obesity 2 weeks and 6 months postpartum (pp). Methods: Body composition of 94 women with overweight and obesity was assessed using Seca mBCA 515 and GE Healthcare Lunar iDXA. Agreement between the two methods for FM and FFM at 2 weeks and 6 months pp, as well as the changes in FM and FFM between the two timepoints, were tested using paired t-test, Bland–Altman plots and regression analyses. Results: The mean (standard deviation [SD]) body mass index (BMI) at 2 weeks pp was 30.6 (2.6) kg/m2 and mean (SD) weight loss at 6 months pp was 4.7 (4.8) kg. BIA underestimated FM at both 2 weeks pp and 6 months pp by mean (SD) 0.7 (1.4) kg and 0.3 (1.3) kg and overestimated FFM at both timepoints by 1.2 (1.5) kg and 0.7 (1.4) kg, with proportional bias for FFM. BIA underestimated changes in FM by mean (SD) 0.5 (1.1) kg and overestimated changes in FFM by 0.5 (1.0) kg, with proportional bias for change in extracellular water by total body water. Agreement was generally high for both cross-sectional and longitudinal comparisons. Conclusions: At group level, BIA was a valid tool for assessment of FM and FFM in women with overweight and obesity at 2 weeks and 6 months pp when compared to DXA. We also consider it valid for following changes in FM and FFM over time when fluid distribution is stable

• Bøhn, Synne-Kristin Hoffart; Oldervoll, Line Merethe; Reinertsen, Kristin Valborg; Selland, Mette; Fosså, Alexander & Kiserud, Cecilie E. [Show all 17 contributors for this article] (2024). The feasibility of a multidimensional intervention in lymphoma survivors with chronic fatigue. Supportive Care in Cancer. ISSN 0941-4355. 32(1). doi: 10.1007/s00520-023-08204-5. Full text in Research Archive Show summary

  Purpose: Chronic fatigue (CF) affects 25–30% of lymphoma survivors, but interventions designed to reduce fatigue are lacking. The main aim of this study was to test the feasibility of a multidimensional intervention study in lymphoma survivors with CF. Secondary aims were to describe individual changes in fatigue, quality of life (QoL) and physical performance from pre (T0) to post (T1) intervention. Methods: This feasibility study was as a one-armed intervention study performed in 2021. Hodgkin or aggressive non-Hodgkin lymphoma survivors received mailed study information and Chalder Fatigue Questionnaire and were asked to respond if they suffered from fatigue. The 12-week intervention included patient education, physical exercise, a cognitive behavioural therapy (CBT)-based group program and nutritional counselling. Feasibility data included patient recruitment, completion of assessments, adherence to the intervention and patient-reported experience measures. Participants responded to questionnaires and underwent physical tests at T0 and T1. Results: Seven lymphoma survivors with CF were included. Of all assessments, 91% and 83% were completed at T0 and T1, respectively. Adherence to the interventional components varied from 69% to 91%. At T1, all participants rated exercise as useful, of whom five rated the CBT-based program and five rated individual nutritional counselling as useful. Five participants reported improved fatigue, QoL and physical performance. Conclusion: Lymphoma survivors with CF participating in a multidimensional intervention designed to reduce the level of fatigue showed high assessment completion rate and intervention adherence rate. Most of the participants evaluated the program as useful and improved their level of fatigue, QoL and physical performance after the intervention.

• 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.”

• Berg, Hedda Beate; Alavi, Dena Treider; Beichmann, Benedicte; Pesonen, Maiju; Henriksen, Christine & Paur, Ingvild [Show all 10 contributors for this article] (2024). The choice of diagnostic modality influences the proportion of low muscle strength, low muscle mass, and sarcopenia in colorectal cancer patients. Clinical Nutrition ESPEN. ISSN 2405-4577. 60, p. 17–23. doi: 10.1016/j.clnesp.2024.01.001. Full text in Research Archive Show summary

  Background and aims: Low muscle strength, low muscle mass, and sarcopenia have a negative impact on health outcomes in colorectal cancer (CRC) patients. Different diagnostic modalities are used to identify these conditions but it is unknown how well the modalities agree. The aim of this study was to compare different diagnostic modalities by means of calculating the proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients, and to investigate the agreement for sarcopenia between the various modalities. Methods: Men and women participating in the Norwegian Dietary Guidelines and colorectal cancer Survival (CRC-NORDIET) study were included in the analyses. Cut-off values for low muscle strength, low muscle mass, and sarcopenia were de ned according to the second consensus set by the European Working Group on Sarcopenia in Older People (EWGSOP2). The diagnostic modalities used to assess muscle strength were handgrip strength and the sit-to-stand test. For muscle mass, computed tomography, dual-energy X-ray absorptiometry (DXA), multi-frequency bioelectrical impedance analysis (MF-BIA), and single-frequency BIA (SF-BIA) were applied. Cohen's kappa was calculated to determine the agreement for low muscle strength and con rmed sarcopenia between diagnostic modalities. Results: Five hundred and three men and women (54 % men, mean age of 66 (range 50e80) years old) were included in the analysis. As much as 99 % (n¼ 70) of the population was identi ed with low muscle mass by MF-BIA, while the other modalities identi ed 9e49 % as having low muscle mass. Handgrip strength identi ed a lower proportion of low muscle strength as compared with the sit-to-stand test (4 % vs. 8 %). When applying various combinations of diagnostic modalities for low muscle strength and low muscle mass, the proportion of sarcopenia was found to be between 0.3 and 11.4 %. There was relatively poor agreement between the different diagnostic modalities with Cohen's Kappa ranging from 0.0 to 0.55, except for the agreement between SF-BIASergi and MF-BIASergi, which was 1. Conclusion: The proportion of low muscle strength, low muscle mass, and sarcopenia in CRC patients varied considerably depending on the diagnostic modalities used. Further studies are needed to provide modality-speci c cut-off values, adjusted to sex, age and body size.

• Nordengen, Anne Lene; Krutto, Annika; Kværner, Ane Sørlie; Alavi, Dena Treider; Henriksen, Hege & Smeland, Sigbjørn [Show all 11 contributors for this article] (2024). Attenuation of DNA base oxidation in post-surgery colorectal stage III patients at subsequent follow-ups. Free Radical Biology & Medicine. ISSN 0891-5849. 221, p. 75–80. doi: 10.1016/j.freeradbiomed.2024.05.029. Full text in Research Archive Show summary

  DNA damage caused by oxidative reactions plays a crucial role in the pathogenesis of colorectal cancer (CRC). In a previous cross-sectional study, CRC patients diagnosed with regional disease (stage III) exhibited a higher level of DNA base oxidation in peripheral blood mononuclear cells (PBMCs) 2–9 months post-surgery compared to those with localized disease (stage I-II). To further explore this observation over time, the present study aimed to investigate DNA base oxidation in CRC patients with localized versus regional disease 6 and 12 months after the initial measurements. The present study included patients enrolled in the randomized controlled trial Norwegian Dietary Guidelines and Colorectal Cancer Survival (CRC-NORDIET). The standard comet assay, modified with the lesion-specific enzyme formamidopyrimidine DNA glycosylase (Fpg), was applied to measure DNA base oxidation in PBMCs at the 6- and 12-month follow-ups. Of the 255 patients assessed at baseline, 156 were included at the 6-month follow-up, with 89 of these patients included in the 12-month follow-up. In contrast to our observation at baseline, there were no significant differences in the levels of DNA base oxidation between patients diagnosed with localized disease and those with regional involvement at the 6- and 12-month follow-up visits (P = 0.81 and P = 0.09, respectively). Patients with stage III disease exhibited a significant decrease in the levels of DNA base oxidation from baseline to 6 months (P < 0.01) and baseline to 12 months (P = 0.03), but no significant difference from 6 to 12 months (P = 0.80). In conclusion, the initially elevated levels of DNA base oxidation in PBMCs, observed 2–9 months post-surgery in patients diagnosed with regional disease (stage III), subsequently decreased to levels comparable to patients with localized disease (stage I-II) at the 6- and 12-month follow-ups.

• Nordengen, Anne Lene; Zheng, Congying; Krutto, Annika; Kværner, Ane Sørlie; Alavi, Dena Treider & Henriksen, Hege [Show all 13 contributors for this article] (2024). Effect of a personalized intensive dietary intervention on base excision repair (BER) in colorectal cancer patients: Results from a randomized controlled trial. Free Radical Biology & Medicine. ISSN 0891-5849. 218, p. 178–189. doi: 10.1016/j.freeradbiomed.2024.04.211. Full text in Research Archive Show summary

  DNA repair is essential to maintain genomic integrity and may affect colorectal cancer (CRC) patients’ risk of secondary cancers, treatment efficiency, and susceptibility to various comorbidities. Bioactive compounds identified in plant food have the potential to modulate DNA repair mechanisms, but there is limited evidence of how dietary factors may affect DNA repair activity in CRC patients in remission after surgery. The aim of this study was to investigate the effect of a 6 months personalized intensive dietary intervention on DNA repair activity in post-surgery CRC patients (stage I-III). The present study included patients from the randomized controlled trial CRC-NORDIET, enrolled 2-9 months after surgery. The intervention group received an intensive dietary intervention emphasizing a prudent diet with specific plant-based foods suggested to dampen inflammation and oxidative stress, while the control group received only standard care advice. The comet-based in vitro repair assay was applied to assess DNA repair activity, specifically base excision repair (BER), in peripheral blood mononuclear cells (PBMCs). Statistical analyses were conducted using gamma generalized linear mixed models (Gamma GLMM). A total of 138 CRC patients were included, 72 from the intervention group and 66 from the control group. The BER activity in the intervention group did not change significantly compared to the control group. Our findings revealed a substantial range in both inter- and intra-individual levels of BER. In conclusion, the results do not support an effect of dietary intervention on BER activity in post-surgery CRC patients during a 6-month intervention period.

• 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.

• Hafskjold, Ingrid; Rangul, Vegar; Ringvoll, Hanne; Kolberg, Marit; Haug, Eirin Beate & Blomhoff, Rune [Show all 8 contributors for this article] (2023). Postpartum Lifestyle Behaviors among Women with Hypertensive Disorders of Pregnancy: Data from the HUNT Study. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 20(21). doi: 10.3390/ijerph20217025. Full text in Research Archive Show summary

  Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of cardiovascular disease later in life. Clinical guidelines for postpartum follow-up after HDP often recommend lifestyle counseling to reduce this risk. However, knowledge about lifestyle behaviors and perceptions among women with a history of HDP is limited. We linked data from the fourth survey of the population-based Trøndelag Health Study (HUNT4) with data from the Medical Birth Registry of Norway. The associations between HDP and postpartum lifestyle behaviors and perceptions were examined using multivariable logistic regression. In a secondary analysis, HUNT4 participants with a recent history of pre-eclampsia were compared with women with a recent history of pre-eclampsia participating in a postpartum pilot intervention study. Lifestyle behaviors and perceptions were self-reported and included diet (intake frequency of fruits, vegetables, meat, fish, and sugar-sweetened beverages), alcohol intake, physical activity, sleep, smoking, lifestyle satisfaction, and the importance of a healthy lifestyle. Among 7551 parous HUNT4 participants, 610 had a history of HDP. We found no differences in lifestyle behaviors between women with and without a history of HDP. However, women with HDP had higher odds of being unsatisfied with their lifestyle. Women with pre-eclampsia participating in a postpartum lifestyle intervention study tended to have a healthier lifestyle at baseline than women participating in HUNT4. Future studies should explore how lifestyle intervention programs could be adapted to the needs of women who have experienced HDP or other pregnancy complications that are associated with an increased risk of CVD.

• Henriksen, Hege Berg; Henriksen, Christine; Sousa, Ana Rita Sequeira de; Alavi, Dena Helene; Augestad, Elin Maria Sandstad & Rising, Russell [Show all 12 contributors for this article] (2023). Validity and reproducibility of a whole-room indirect calorimeter for the estimation of VO<inf>2</inf>, VCO<inf>2</inf>, and resting metabolic rate. Physiological Reports. 11(7). doi: 10.14814/phy2.15658. Full text in Research Archive Show summary

  Abstract Whole‐room indirect calorimeters (WRICs) provide accurate instruments for the measurement of respiratory exchange, energy expenditure, and macronutrient oxidation. Here, we aimed to determine the validity and reproducibility of a 7500 L WRIC for the measurement of ventilation rates and resting metabolic rate (RMR). Technical validation was performed with propane combustion tests ( n  = 10) whereas biological reproducibility was tested in healthy subjects (13 women, 6 men, mean ± SD age 39.6 ± 15.3) in two 60 min measurements separated by 24 h. Subjects followed a run‐in protocol prior to measurements. The coefficient of variation (CV) and intraclass correlation coefficient (ICC) were calculated for ventilation rates of O2 (VO2), CO2 (VCO2), the respiratory quotient (RQ; VCO2/VO2), and RMR. Technical validation showed good validity with CVs ranging from 0.67% for VO 2 to 1.00% for energy expenditure. For biological reproducibility, CVs were 2.89% for VO 2 ; 2.67% for VCO 2 ; 1.95% for RQ; and 2.68% for RMR. With the exception of RQ (74%), ICCs were excellent for VO 2 (94%), VCO 2 (96%) and RMR (95%). Excluding participants that deviated from the run‐in protocol did not alter results. In conclusion, the 7500 L WRIC is technically valid and reproducible for ventilation rates and RMR.

• Horn, Julie; Kolberg, Marit; Rangul, Vegar; Magnussen, Elisabeth Balstad; Åsvold, Bjørn Olav & Henriksen, Hege Berg [Show all 9 contributors for this article] (2023). Feasibility of a Postpartum Web- and Phone-Based Lifestyle Program for Women with a History of Preeclampsia or Gestational Diabetes: A Pilot Intervention Study. Women's Health Reports. 4(1), p. 345–357. doi: 10.1089/whr.2023.0039. Full text in Research Archive Show summary

  Background: Women with a history of preeclampsia (PE) or gestational diabetes mellitus (GDM) are at increased risk of diabetes and cardiovascular disease (CVD) later in life. Increased awareness of pregnancy complications as early warning signs for CVD has called for postpartum primordial prevention strategies. The aim of this study was to evaluate the feasibility of a postpartum web- and phone-based lifestyle program promoting healthy lifestyle behaviors to women after a pregnancy complicated by PE or GDM. Materials and Methods: Women with a validated history of PE or GDM were invited to participate in a nonrandomized pilot intervention study 3–12 months after delivery. The intervention was delivered over 6 months. All participants received tailored lifestyle counseling by a registered dietitian and access to information material on healthy lifestyle behaviors on the study's website. After inclusion, participants were invited to three study visits at baseline, 3 months, and 6 months. Feasibility outcomes included assessment of recruitment, retention, and acceptability. Secondary outcomes were changes in lifestyle behaviors and cardiovascular risk factors. Results: Of the 207 women invited, 44 were enrolled in the feasibility study and 40 women completed the intervention, corresponding to a recruitment rate of 21% and a retention rate of 91%. At the 3-month study visit, 94.6% of participants reported they had used the website. A total of 41.7% of the participants reported that they had achieved their personal goals during the intervention period. Conclusions: This study suggested the feasibility and potential acceptability of a web- and phone-based lifestyle intervention for mothers with recent PE or GDM.

• Western, Benedikte; Demmelmaier, Ingrid; Vistad, Ingvild; Hansen, Bjørge Hermann; Stenling, Andreas & Henriksen, Hege [Show all 9 contributors for this article] (2023). How many days of continuous physical activity monitoring reliably represent time in different intensities in cancer survivors. PLOS ONE. 18(4). doi: 10.1371/journal.pone.0284881. Full text in Research Archive Show summary

  Background Physical activity (PA) monitoring is applied in a growing number of studies within cancer research. However, no consensus exists on how many days PA should be monitored to obtain reliable estimates in the cancer population. The objective of the present study was to determine the minimum number of monitoring days required for reliable estimates of different PA intensities in cancer survivors when using a six-days protocol. Furthermore, reliability of monitoring days was assessed stratified on sex, age, cancer type, weight status, and educational level. Methods Data was obtained from two studies where PA was monitored for seven days using the SenseWear Armband Mini in a total of 984 cancer survivors diagnosed with breast, colorectal or prostate cancer. Participants with ≥22 hours monitor wear-time for six days were included in the reliability analysis (n = 736). The intra-class correlation coefficient (ICC) and the Spearman Brown prophecy formula were used to assess the reliability of different number of monitoring days. Results For time in light PA, two monitoring days resulted in reliable estimates (ICC >0.80). Participants with BMI ≥25, low-medium education, colorectal cancer, or age ≥60 years required one additional monitoring day. For moderate and moderate-to-vigorous PA, three monitoring days yielded reliable estimates. Participants with BMI ≥25 or breast cancer required one additional monitoring day. Vigorous PA showed the largest within subject variations and reliable estimates were not obtained for the sample as a whole. However, reliable estimates were obtained for breast cancer survivors (4 days), females, BMI ≥30, and age <60 years (6 days). Conclusion Shorter monitoring periods may provide reliable estimates of PA levels in cancer survivors when monitored continuously with a wearable device. This could potentially lower the participant burden and allow for less exclusion of participants not adhering to longer protocols.

• Ringvoll, Hanne; Kolberg, Marit; Rangul, Vegar; Hafskjold, Ingrid; Haug, Eirin Beate & Blomhoff, Rune [Show all 8 contributors for this article] (2023). Postpartum lifestyle behaviour among women with prior gestational diabetes mellitus: evidence from the HUNT study. BMJ Nutrition, Prevention and Health. 6(2). doi: 10.1136/bmjnph-2022-000612. Full text in Research Archive Show summary

  Introduction Women with a history of gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Recommendations for postpartum follow-up include targeted lifestyle advice to lower the risk. The aim of this study was to compare postpartum lifestyle behaviours and perceptions among women with and without a history of GDM. In addition, we examined whether lifestyle behaviours of women with a history of GDM participating in a lifestyle intervention study differed from lifestyle behaviours of women with a history of GDM in the general population. Research design and methods We linked data from the fourth survey of the population-based Trøndelag Health Study (HUNT4) to information from the Medical Birth Registry of Norway for women with registered births between 2000 and 2019. Using logistic regression, we compared lifestyle behaviours in women with and without GDM. In secondary analyses, lifestyle behaviours in women with GDM participating in a postpartum lifestyle intervention study were compared with HUNT participants with GDM using Fisher’s exact tests/t-tests. Results A high proportion of the women in our population, regardless of GDM history, reported several unhealthy lifestyle behaviours. We found no significant association between history of GDM and lifestyle behaviours. The lifestyle intervention study for women with a history of GDM appeared to recruit women with more favourable lifestyle behaviours. Conclusions Women, regardless of GDM history, could potentially benefit from further support for lifestyle improvement, but it may be especially important in women with a history of GDM given their increased risk of T2DM and CVD. Interventions targeting women with GDM might not reach the women with the unhealthiest lifestyle behaviours, and measures to reach out to all women should be further investigated.

• Nordengen, Anne Lene; Kværner, Ane Sørlie; Krutto, Annika; Alavi, Dena Treider; Henriksen, Hege & Henriksen, Christine [Show all 12 contributors for this article] (2023). DNA base oxidation in relation to TNM stages and chemotherapy treatment in colorectal cancer patients 2–9 months post-surgery. Free Radical Biology & Medicine. ISSN 0891-5849. 212, p. 174–185. doi: 10.1016/j.freeradbiomed.2023.12.016. Full text in Research Archive Show summary

  Accumulation of DNA damage is a critical feature of genomic instability, which is a hallmark of various cancers. The enzyme-modified comet assay is a recognized method to detect specific DNA lesions at the level of individual cells. In this cross-sectional investigation, we explore possible links between clinicopathological and treatment related factors, nutritional status, physical activity and function, and DNA damage in a cohort of colorectal cancer (CRC) patients with non-metastatic disease. Levels of DNA damage in peripheral mononuclear blood cells (PBMCs) assessed 2–9 months post-surgery, were compared across tumour stage (localized (stage I-II) vs. regional (stage III) disease), localization (colon vs. rectosigmoid/rectum cancer), and adjuvant chemotherapy usage, with the last dosage administrated 2–191 days prior to sampling. Associations between DNA damage and indicators of nutritional status, physical activity and function were also explored. In PBMCs, DNA base oxidation was higher in patients diagnosed with regional compared with localized tumours (P = 0.03), but no difference was seen for DNA strand breaks (P > 0.05). Number of days since last chemotherapy dosage was negatively associated with DNA base oxidation (P ＜ 0.05). In conclusion, DNA base oxidation measured with the enzyme-modified comet assay varies according to tumour and lifestyle related factors in CRC patients treated for non-metastatic disease.

• Alavi, Dena Treider; Henriksen, Hege Berg; Lauritzen, Peter Mæhre; Zucknick, Manuela; Bøhn, Siv Kjølsrud & Henriksen, Christine [Show all 9 contributors for this article] (2023). Effect of a one-year personalized intensive dietary intervention on body composition in colorectal cancer patients: Results from a randomized controlled trial. Clinical Nutrition ESPEN. ISSN 2405-4577. 57, p. 414–422. doi: 10.1016/j.clnesp.2023.06.037. Full text in Research Archive Show summary

  Background & aims Changes in body composition may affect colorectal cancer (CRC) patient's risk of cancer recurrence, secondary cancer, and other chronic diseases. The suggested interventions for changes in body composition such as low muscle mass or high fat mass, are diet and physical activity. Nevertheless, there is limited evidence of how dietary intervention alone can impact body composition. This study aimed to investigate the effect of a 6 and 12 month dietary intervention with a focus on healthy eating according to Norwegian food-based dietary guidelines on weight and body composition in patients with CRC stage I-III, post-surgery.<p> <p>Methods This study included participants from the randomized controlled trial CRC-NORDIET study 2–9 months after surgery. The intervention group received an intensive dietary intervention, while the control group underwent similar measurements, but no dietary intervention. Body composition was measured with Lunar iDXA, and the results were analyzed using linear mixed models. <p>Results A total of 383 participants were included, 192 in the intervention group and 191 in the control group. After 6 months, the intervention group showed a 0.7 kg lower mean weight gain (p = 0.020) and 0.6 kg lower fat mass gain (p = 0.019) than the control group, but no difference at 12 months. Moreover, the fat mass increase was 0.5 percentage points lower at 6 months (p = 0.012), and 0.7 percentage points lower at 12 months (p = 0.011) in the intervention group compared to the controls. At 6 months, the intervention group had 63 g lower gain of visceral adipose tissue compared to the control group (p = 0.031). No differences were seen for fat-free mass or subcutaneous adipose tissue at any time point. The intervention group showed a lower increase in the ratio between fat mass and fat-free mass at both 6 months (p = 0.025) and 12 months (p = 0.021). <p>Conclusion The dietary intervention reduced the increases in total weight and fat masses, without changing fat-free mass. Although the individual changes are small, the dietary intervention may have resulted in an overall more favourable body composition profile. These findings suggest that dietary intervention may be part of a treatment strategy for prevention of weight and fat mass gain in CRC survivors.

• Kværner, Ane Sørlie; Andersen, Astrid Riseth; Henriksen, Hege Berg; Knudsen, Markus Dines; Johansen, Anne Marte Wetting & Hjartåker, Anette [Show all 13 contributors for this article] (2023). Associations of the 2018 World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) cancer prevention recommendations with stages of colorectal carcinogenesis. Cancer Medicine. 12(13), p. 14806–14819. doi: 10.1002/cam4.6119. Full text in Research Archive Show summary

  Background: While adherence to cancer prevention recommendations is linked to lower risk of colorectal cancer (CRC), few have studied associations across the entire spectrum of colorectal carcinogenesis. Here, we studied the relationship of the standardized 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score for cancer prevention recommendations with detection of colorectal lesions in a screening setting. As a secondary objective, we examined to what extent the recommendations were being followed in an external cohort of CRC patients. Methods: Adherence to the seven-point 2018 WCRF/AICR Score was measured in screening participants receiving a positive fecal immunochemical test and in CRC patients participating in an intervention study. Dietary intake, body fatness and physical activity were assessed using self-administered questionnaires. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for screen-detected lesions. Results: Of 1486 screening participants, 548 were free from adenomas, 524 had non-advanced adenomas, 349 had advanced lesions and 65 had CRC. Adherence to the 2018 WCRF/AICR Score was inversely associated with advanced lesions; OR 0.82 (95% CI 0.71, 0.94) per score point, but not with CRC. Of the seven individual components included in the score, alcohol, and BMI seemed to be the most influential. Of the 430 CRC patients included in the external cohort, the greatest potential for lifestyle improvement was seen for the recommendations concerning alcohol and red and processed meat, where 10% and 2% fully adhered, respectively. Conclusions: Adherence to the 2018 WCRF/AICR Score was associated with lower probability of screen-detected advanced precancerous lesions, but not CRC. Although some components of the score seemed to be more influential than others (i.e., alcohol and BMI), taking a holistic approach to cancer prevention is likely the best way to prevent the occurrence of precancerous colorectal lesions.

• Henriksen, Hege Berg; Berg, Hedda Beate; Andersen, Lene Frost; Weedon-Fekjær, Harald & Blomhoff, Rune (2023). Development of the Norwegian diet index and the Norwegian lifestyle index and evaluation in a national survey. Food & Nutrition Research (FNR). ISSN 1654-6628. 67. doi: 10.29219/fnr.v67.9217. Full text in Research Archive Show summary

  Background: Dietary and lifestyle indices are composite tools that are used to estimate risk of health outcomes. Objective: We aimed to develop a diet and a lifestyle index assessing adherence to the national guidelines in Norway, and to investigate adherence in a nationwide survey of healthy subjects (Norkost3). Design: Cut-off values for the indices were based on the Norwegian food based dietary guidelines and national lifestyle guidelines. Adherence was evaluated in the Norkost3 (n = 1,787). Results: Twelve dietary components were included in the diet index 1) fruit and berries, 2) vegetables, 3) whole grains, 4) unsalted nuts, 5) fish, 6) low-fat dairy products, 7) margarine/oils, 8) red meat, 9) processed meat, 10) foods rich in sugar and fat, 11) drinks with added sugar, and 12) dietary supplements. Each of the components was assigned a value of 0, 0.5 or 1 corresponding to low, intermediate and high adherence, except for plant-based foods, which were assigned a value of 0, 1.5 or 3, providing a composite diet index ranging from 0 to 20 points. The five components in the lifestyle index (i.e. diet, body mass index (BMI), physical activity, tobacco and alcohol) was assigned a value of 0, 0.5 or 1, giving a final score ranging from zero to five points. In Norkost3, 49% (95% CI: 47, 52) of the participants had low adherence to the diet component, whereas only 2% (95% CI: 2, 3) achieved high adherence, although most of the subjects had high educational level. High adherence to the recommendations of BMI, tobacco and alcohol intake was observed in 50% (95% CI: 47, 52), 72% (95% CI: 70, 74) and 68% (95% CI: 66, 70) of the participants, respectively. Due to the lack of data on physical activity, adherence to this component in the lifestyle index is not presented in this study. Conclusion: The new diet and lifestyle indices assess adherence to the Norwegian food-based dietary guidelines (FBDGs) and other national lifestyle guidelines. In this study, half of the subjects had low diet and lifestyle index scores. There is a need to implement interventions to improve this by focusing on the specific lifestyle components with low adherence.

• Alavi, Dena Helene; Sakinis, Tomas; Henriksen, Hege; Beichmann, Benedicte; Fløtten, Ann-Monica & Blomhoff, Rune [Show all 7 contributors for this article] (2022). Body composition assessment by artificial intelligence from routine computed tomography scans in colorectal cancer: Introducing BodySegAI. JCSM Clinical Reports. 7, p. 55–64. doi: 10.1002/crt2.53. Full text in Research Archive Show summary

  Background Body composition is of clinical importance in colorectal cancer patients, but is rarely assessed because of time-consuming manual segmentation. We developed and tested BodySegAI, a deep learning-based software for automated body composition quantification from routinely acquired computed tomography (CT) scans. Methods A two-dimensional U-Net convolutional network was trained on 2989 abdominal CT slices from L2 to S1 to segment skeletal muscle (SM), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and intermuscular and intramuscular adipose tissue (IMAT). Human ground truth was established by combining segmentations from three human readers. BodySegAI was tested using 154 slices against the human ground truth and compared with a software named AutoMATiCA. Results Median Dice scores for BodySegAI against human ground truth were 0.969, 0.814, 0.986, and 0.990 for SM, IMAT, VAT, and SAT, respectively. The mean differences per slice for SM were −0.09 cm3, IMAT: −0.17 cm3, VAT: −0.12 cm3, and SAT: 0.67 cm3. Median absolute errors for SM, IMAT, VAT, and SAT were 1.35, 10.54, 0.91, and 1.07%, respectively. When analysing different anatomical levels separately, L3 and S1 demonstrated the overall highest and lowest Dice scores, respectively. On average, BodySegAI segmented 148 times faster than human readers (4.9 vs. 726.5 seconds, P < 0.001). Also, BodySegAI presented higher Dice scores for SM, IMAT, SAT, and VAT than AutoMATiCA (slices = 154). Conclusions BodySegAI rapidly generates excellent segmentation of SM, VAT, and SAT and good segmentation of IMAT in L2 to S1 among colorectal cancer patients and may replace semi-manual segmentation.

• 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.

• Henriksen, Hege; Alavi, Dena Helene & Blomhoff, Rune (2021). Precision of Lunar Dual-energy X-ray Absorptiometry (iDXA) in measuring body composition among colorectal cancer patients and healthy subjects. Clinical Nutrition ESPEN. ISSN 2405-4577. 44, p. 316–323. doi: 10.1016/j.clnesp.2021.05.025. Full text in Research Archive Show summary

  Background & aims High quality and precise methods are needed when monitoring changes in body composition among colorectal cancer (CRC) patients and healthy subjects. The aim of this study was to estimate precision of the Dual-energy X-ray absorptiometry (Lunar iDXA, GE Healthcare software enCORE version 16) in measuring body composition in CRC patients and healthy subjects. Methods Precision error of iDXA in measuring body composition was investigated in the current study. Thirty CRC patients and 30 healthy subjects, including both men and women underwent two consecutive whole-body DXA scan with repositioning. Precision estimates of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in the abdominal region, and total fat mass (FM), fat-free mass (FFM), lean mass (LM), bone mineral density (BMD) and bone mineral content (BMC) were calculated. Results Precision error expressed as coefficient of variation (% CV) of VAT and SAT were estimated to be 3.56% and 3.28% among CRC patients, and 5.30% and 3.46% among healthy subjects. Estimated precision errors for body masses in the total region ranged between 0.49-1.01% and 0.40–0.88% in CRC patients and healthy subjects, respectively. Least significant change (LSC) in VAT mass, SAT mass, FM and LM were 140.9 g, 121.4 g, 637.0 g and 701.0 g, respectively, among CRC patients. Among healthy subjects the LSC in VAT, SAT, FM and LM were 80.93 g, 98.90 g, 484.0 g and 618.0 g, respectively. Only minor and non-significant differences between the two consecutive measurements for each body compartment were observed within both populations, and we found no systematic bias in the distribution of the differences. Conclusion The Lunar iDXA demonstrated high precision in body composition measurements among both CRC patients and healthy subjects. Hence, iDXA is a useful tool in clinical following-up and interventions targeted towards changes in body composition.

• Henriksen, Christine; Paur, Ingvild; Pedersen, Astrid; Kværner, Ane Sørlie; Ræder, Hanna & Henriksen, Hege [Show all 9 contributors for this article] (2021). Agreement between GLIM and PG-SGA for diagnosis of malnutrition depends on the screening tool used in GLIM. Clinical Nutrition. ISSN 0261-5614. 41(2), p. 329–336. doi: 10.1016/j.clnu.2021.12.024. Full text in Research Archive Show summary

  Background & aim The Global Leadership Initiative on Malnutrition (GLIM) has suggested a process for the diagnosis of malnutrition. The process consists of applying an existing screening tool for malnutrition screening, followed by malnutrition diagnostics, and finally categorization of malnutrition severity (moderate or severe) according to specific GLIM criteria. However, it is not known how well the GLIM process agrees with other diagnostic tools used in the current clinical practice. The aim of this study was to validate the GLIM process against the Patient Generated-Subjective Global Assessment (PG-SGA) when different screening tools were applied in the screening step of the GLIM process. Methods Colorectal cancer (CRC) patients from the ongoing CRC-NORDIET study were included. For the GLIM process, the patients were first screened for malnutrition using either 1) Nutritional risk screening, first 4 questions (NRS-2002-4Q), 2) Malnutrition Screening Tool (MST), 3) Malnutrition Universal Screening Tool (MUST) or 4) the PG-SGA short form (PG-SGA-SF). The GLIM malnutrition diagnosis was then based on combining the result from each of the screening methods with the etiological and phenotypic GLIM-criteria including weight loss, BMI and fat free mass. In parallel, the patients were diagnosed using the PG-SGA methodology categorizing the patients into either A: well nourished, B: moderately malnourished or C: severely malnourished. The four different GLIM based diagnoses were then validated against the diagnosis obtained by the PG-SGA tool. Sensitivity, specificity and positive predictive value (PPV) were calculated to evaluate validity. Results In total, 426 patients were included (mean age: 66, ±8 years) at a mean time of 166 (±56) days after surgery. The GLIM diagnosis based on the four different screening tools identified 10–24% of the patients to be malnourished, of which 3–8% were severely malnourished. The PG-SGA method categorized 15% as moderately malnourished (PG-SGA: category B) and no patients as severely malnourished (PG-SGA: category C). The agreement between the PG-SGA and GLIM process was in general low, but differed according to the tools: PG-SGA SF (sensitivity 47%, PPV 71%), MST (sensitivity 56%, PPV 47%), NRS-2002-4Q (sensitivity 63%, PPV 53%) and MUST (sensitivity 53%, PPV 34%). Conclusion In this cross-sectional study of patients with CRC, the concordance between the GLIM-criteria and PG-SGA depended on the screening tool used in the GLIM process. Malnutrition frequency based on the GLIM process schould be reported with and without the use of a screening tool.

• Alavi, Dena Helene; Henriksen, Hege; Lauritzen, Peter Mæhre; Kværner, Ane Sørlie; Sakinis, Tomas & Langleite, Torgrim Mikal [Show all 12 contributors for this article] (2021). Quantification of adipose tissues by Dual-Energy X-Ray Absorptiometry and Computed Tomography in colorectal cancer patients. Clinical Nutrition ESPEN. ISSN 2405-4577. 43, p. 360–368. doi: 10.1016/j.clnesp.2021.03.022. Full text in Research Archive Show summary

  Background & aims Excess adipose tissue may affect colorectal cancer (CRC) patients' disease progression and treatment. In contrast to the commonly used anthropometric measurements, Dual-Energy X-Ray Absorptiometry (DXA) and Computed Tomography (CT) can differentiate adipose tissues. However, these modalities are rarely used in the clinic despite providing high-quality estimates. This study aimed to compare DXA's measurement of abdominal visceral adipose tissue (VAT) and fat mass (FM) against a corresponding volume by CT in a CRC population. Secondly, we aimed to identify the best single lumbar CT slice for abdominal VAT. Lastly, we investigated the associations between anthropometric measurements and VAT estimated by DXA and CT. Methods Non-metastatic CRC patients between 50-80 years from the ongoing randomized controlled trial CRC-NORDIET were included in this cross-sectional study. Corresponding abdominal volumes were acquired by Lunar iDXA and from clinically acquired CT examinations. Also, single CT slices at L2-, L3-and L4-level were obtained. Agreement between the methods was investigated using univariate linear regression and Bland–Altman plots. Results Sixty-six CRC patients were included. Abdominal volumetric VAT and FM measured by DXA explained up to 91% and 96% of the variance in VAT and FM by CT, respectively. Bland–Altman plots demonstrated an overestimation of VAT by DXA compared to CT (mean difference of 76 cm3) concurrent with an underestimation of FM (mean difference of −319 cm3). A higher overestimation of VAT (p = 0.015) and underestimation of FM (p = 0.036) were observed in obese relative to normal weight subjects. VAT in a single slice at L3-level showed the highest explained variance against CT volume (R2 = 0.97), but a combination of three slices (L2, L3, L4) explained a significantly higher variance than L3 alone (R2 = 0.98, p < 0.006). The anthropometric measurements explained between 31-65% of the variance of volumetric VAT measured by DXA and CT. Conclusions DXA and the combined use of three CT slices (L2-L4) are valid to predict abdominal volumetric VAT and FM in CRC patients when using volumetric CT as a reference method. Due to the poor performance of anthropometric measurements we recommend exploring the added value of advanced body composition by DXA and CT integrated into CRC care.

• Bärebring, Linnea; Kværner, Ane Sørlie; Skotnes, Madeleine; Henriksen, Hege; Skjetne, Anne Juul & Henriksen, Christine [Show all 12 contributors for this article] (2020). Use of bioelectrical impedance analysis to monitor changes in fat-free mass during recovery from colorectal cancer– a validation study. Clinical Nutrition ESPEN. ISSN 2405-4577. 40, p. 201–207. doi: 10.1016/j.clnesp.2020.09.021. Full text in Research Archive Show summary

  Background & aims Although previous research show high correlation between fat-free mass (FFM) measured by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA), the validity of BIA to track longitudinal changes in FFM is uncertain. Thus, the aim of this study was to validate the ability of BIA to assess changes in FFM during 6 months of recovery from non-metastatic colorectal cancer (CRC). Methods A total of 136 women and men (50–80 years) with stage I-III CRC and a wide range of baseline FFM (35.7–73.5 kg) were included in the study. Body composition was measured at study baseline within 2–9 months of surgery and again 6 months later. Whole-body BIA FFM estimates (FFMBIA) were calculated using three different equations (manufacturer's, Schols' and Gray's) before comparison to FFM estimates obtained by DXA (FFMDXA). Results Correlation between changes in FFMBIA and FFMDXA was intermediate regardless of equation (r ≈ 0.6). The difference in change of FFMBIA was significant compared to FFMDXA, using all three equations and BIA overestimated both loss and gain. However, BIA showed 100% sensitivity and about 90% specificity to identify individuals with ≥5% loss in FFM, using all three equations. Sensitivity of FFMBIA to detect a smaller loss of FFM (60–76%) or a gain in FFM of ≥5% (33–62%) was poor. Conclusion In a well-nourished population of non-metastatic CRC patients, a single-frequency whole-body BIA device yielded imprecise data on changes in FFM, regardless of equation. BIA is thus not a valid option for quantifying changes in FFM in individuals. However, BIA could be used to identify patients with loss in FFM ≥5% in this population. The validity of BIA to monitor changes in FFM warrants further investigation before implementation in clinical praxis.

• Kværner, Ane Sørlie; Harnæs, Helene; Alavi, Dena Helene; Bärebring, Linnea; Henriksen, Hege & Guren, Marianne [Show all 11 contributors for this article] (2020). Bør beregning av cellegiftdose ved tarmkreft baseres på kroppssammensetning? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 140(8), p. 1–10. doi: 10.4045/tidsskr.19.0769. Full text in Research Archive
• Svendsen, Karianne; Jr., David R. Jacobs; Mørch-Reiersen, Lisa Therese; Garstad, Kjersti W.; Henriksen, Hege Berg & Telle-Hansen, Vibeke [Show all 7 contributors for this article] (2020). Evaluating the use of the heart age tool in community pharmacies: a 4-week cluster-randomized controlled trial. European Journal of Public Health. ISSN 1101-1262. 30(6), p. 1139–1145. doi: 10.1093/eurpub/ckaa048. Full text in Research Archive Show summary

  Background: Joint British Societies have developed a tool that utilizes information on cardiovascular disease (CVD) risk factors to estimate an individual's 'heart age'. We studied if using heart age as an add-on to conventional risk communication could enhance the motivation for adapting to a healthier lifestyle resulting in improved whole-blood cholesterol and omega-3 status after 4 weeks. Methods: A total of 48 community pharmacies were cluster-randomized to use heart age+conventional risk communication (intervention) or only conventional risk communication (control) in 378 subjects after CVD risk-factor assessment. Dried blood spots were obtained with a 4-week interval to assay whole-blood cholesterol and omega-3 fatty acids. We also explored pharmacy-staff's (n=27) perceived utility of the heart age tool. Results: Subjects in the intervention pharmacies (n=137) had mean heart age 64 years and chorological age 60 years. In these, cholesterol decreased by median (interquartile range) -0.10 (-0.40, 0.35) mmol/l. Cholesterol decreased by -0.20 (-0.70, 0.30) mmol/l (P difference =0.24) in subjects in the control pharmacies (n=120) with mean chronological age 60 years. We observed increased concentrations of omega-3 fatty acids after 4 weeks, non-differentially between groups. Pharmacy-staff (n=27) agreed that heart age was a good way to communicate CVD risk, and most (n=25) agreed that it appeared to motivate individuals to reduce elevated CVD risk factors. Conclusions: The heart age tool was considered a convenient and motivating communication tool by pharmacy-staff. Nevertheless, communicating CVD risk as heart age was not more effective than conventional risk communication alone in reducing whole-blood cholesterol levels and improving omega-3 status.

• Kjønigsen, Lisa Jannicke; Harneshaug, Magnus; Fløtten, Ann-Monica; Karterud, Lena Korsmo; Petterson, Kent & Skjolde, Grethe [Show all 10 contributors for this article] (2019). Reproducibility of semiautomated body composition segmentation of abdominal computed tomography: a multiobserver study. European Radiology Experimental. 3:42, p. 1–8. doi: 10.1186/s41747-019-0122-5. Full text in Research Archive Show summary

  Background: Segmentation of computed tomography (CT) images provides quantitative data on body tissue composition, which may greatly impact the development and progression of diseases such as type 2 diabetes mellitus and cancer. We aimed to evaluate the inter- and intraobserver variation of semiautomated segmentation, to assess whether multiple observers may interchangeably perform this task. Methods: Anonymised, unenhanced, single mid-abdominal CT images were acquired from 132 subjects from two previous studies. Semiautomated segmentation was performed using a proprietary software package. Abdominal muscle compartment (AMC), inter- and intramuscular adipose tissue (IMAT), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were identified according to pre-established attenuation ranges. The segmentation was performed by four observers: an oncology resident with extensive training and three radiographers with a 2-week training programme. To assess interobserver variation, segmentation of each CT image was performed individually by two or more observers. To assess intraobserver variation, three of the observers did repeated segmentations of the images. The distribution of variation between subjects, observers and random noise was estimated by a mixed effects model. Inter- and intraobserver correlation was assessed by intraclass correlation coefficient (ICC). Results: For all four tissue compartments, the observer variations were far lower than random noise by factors ranging from 1.6 to 3.6 and those between subjects by factors ranging from 7.3 to 186.1. All interobserver ICC was ≥ 0.938, and all intraobserver ICC was ≥ 0.996. Conclusions: Body composition segmentation showed a very low level of operator dependability. Multiple observers may interchangeably perform this task with highly reproducible results. Keywords: Body composition, Abdominal fat, Skeletal muscle, Tomography (X-ray computed), Observer variation

• Henriksen, Hege Berg; Henriksen, Christine; Ræder, Hanna; Kværner, Ane Sørlie; Skjetne, Anne Juul & Bøhn, Siv Kjølsrud [Show all 11 contributors for this article] (2019). Hvilke kostråd skal man gi til pasienter behandlet for tarmkreft? Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. p. 32–36. Full text in Research Archive
• Kværner, Ane Sørlie; Minaguchi, Jun; Yamani, Naouale El; Henriksen, Christine; Ræder, Hanna & Paur, Ingvild [Show all 12 contributors for this article] (2018). DNA damage in blood cells in relation to chemotherapy and nutritional status in colorectal cancer patients — A pilot study. DNA Repair. ISSN 1568-7864. 63, p. 16–24. doi: 10.1016/j.dnarep.2018.01.005. Full text in Research Archive
• Svendsen, Karianne; Telle-Hansen, Vibeke; Telle-Hansen, Vibeke; Mørch-Reiersen, Lisa T.; Mørch-Reiersen, Lisa Therese & Garstad, Kjersti W. [Show all 14 contributors for this article] (2018). A randomized controlled trial in Norwegian pharmacies on effects of risk alert and advice in people with elevated cardiovascular risk. Preventive Medicine Reports. 12, p. 79–86. doi: 10.1016/j.pmedr.2018.08.004. Full text in Research Archive Show summary

  We investigated if alerting subjects to elevated total cholesterol (TC), hemoglobin A1c (HbA1c) and blood pressure (BP) (cardiovascular disease (CVD) risk factors that are usually asymptomatic), and if providing advice would result in reduced risk. We conducted a multicenter (50 community pharmacies) parallel three-arm 8-week randomized controlled trial (RCT) with a 52-week follow-up visit. During six days of screening, TC, HDL- and LDL-cholesterol, triglycerides, HbA1c, BP and body mass index (BMI) were assessed in 1318 individuals. Of these, 582 with a measured and predefined elevated ad hoc CVD risk score were randomized to either Alert/advice (n = 198) (immediately alerted of their screening result and received healthy lifestyle-advice), Advice-only (n = 185) (received only advice) or Control (n = 199) (not alert, no advice). Changes in risk score and self-reported health-related behaviors (diet, alcohol, physical activity) were assessed in pharmacies after 8 weeks (N = 543; 93%). Although the primary analysis showed no significant difference between groups, the Control group had the largest reduction in risk score of 14%. The total (uncontrolled) sample (N = 543) reduced the risk score by 3.2% beyond estimated regression towards the mean and improved their health-related behaviors. Among the 65% (n = 377) who returned 52 weeks after baseline, 14% reported started using CVD preventive medication after the screening. The study demonstrated that while assessing risk factors and behaviors in pharmacies proved efficient and possibly led to a small risk decrease, alerting people to their screening result did not seem to be more effective than a self-directed approach. ClinicalTrials.gov identifier: NCT02223793.

• 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.

• Ræder, Hanna; Henriksen, Christine; Bøhn, Siv Kjølsrud; Vilbo, Anne-Rikke; Henriksen, Hege & Kværner, Ane Sørlie [Show all 10 contributors for this article] (2018). Agreement between PG-SGA category and fat-free mass in colorectal cancer patients. Clinical Nutrition ESPEN. ISSN 2405-4577. 27, p. 24–31. doi: 10.1016/j.clnesp.2018.07.005. Full text in Research Archive Show summary

  Background and aims Low fat-free mass (FFM) is associated with adverse outcomes in colorectal cancer (CRC) patients. Patient-Generated Subjective Global Assessment (PG-SGA) is a widely used tool developed to detect patients with malnutrition or at risk of malnutrition. The aim of this study was to investigate the agreement between PG-SGA category and FFM in patients with non-metastatic CRC. Methods Ninety-seven patients were included and categorized as well nourished (PG-SGA:A, n = 67) or malnourished (PG-SGA:B, n = 30). No patients were severely malnourished (PG-SGA: C). Bioelectrical impedance analysis (BIA) was used to assess FFM. Low FFM was defined as low fat-free mass index (FFMI) according to cut-off values recently proposed by The European Society for Clinical Nutrition and Metabolism (ESPEN). Results Twenty-nine percent of the patients were identified with low FFMI. The proportion with low FFMI was significantly higher among patients classified as malnourished by PG-SGA compared to well nourished (p = 0.015). The sensitivity was however low, as the PG-SGA categorization classified only 50.0% of the patients with low FFMI as malnourished (PG-SGA B). Using the PG-SGA scores (cut-off point > 4), the sensitivity increased to 60.7%. Physical examination in the PG-SGA identified only 64.3% of the patients with low FFMI as muscle depleted. Conclusion Our results indicate a low agreement between PG-SGA category and low FFMI among patients with non-metastatic CRC. In clinical practice, PG-SGA should be supplemented by muscle mass assessments by BIA or other methods in order to detect low FFM in this patient group.

• 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
• Ræder, Hanna; Kværner, Ane Sørlie; Henriksen, Christine; Florholmen, Geir; Henriksen, Hege & Bøhn, Siv Kjølsrud [Show all 9 contributors for this article] (2017). Validity of bioelectrical impedance analysis in estimation of fat-free mass in colorectal cancer patients. Clinical Nutrition. ISSN 0261-5614. 37(1), p. 292–300. doi: 10.1016/j.clnu.2016.12.028. Full text in Research Archive Show summary

  Background & aims: Bioelectrical impedance analysis (BIA) is an accessible and cheap method to measure fat-free mass (FFM). However, BIA estimates are subject to uncertainty in patient populations with altered body composition and hydration. The aim of the current study was to validate a whole-body and a segmental BIA device against dual-energy X-ray absorptiometry (DXA) in colorectal cancer (CRC) patients, and to investigate the ability of different empiric equations for BIA to predict DXA FFM (FFMDXA). Methods: Forty-three non-metastatic CRC patients (aged 50–80 years) were enrolled in this study. Whole-body and segmental BIA FFM estimates (FFMwhole-bodyBIA, FFMsegmentalBIA) were calculated using 14 empiric equations, including the equations from the manufacturers, before comparison to FFMDXA estimates. Results: Strong linear relationships were observed between FFMBIA and FFMDXA estimates for all equations (R2 = 0.94–0.98 for both devices). However, there were large discrepancies in FFM estimates depending on the equations used with mean differences in the ranges −6.5–6.8 kg and −11.0–3.4 kg for whole-body and segmental BIA, respectively. For whole-body BIA, 77% of BIA derived FFM estimates were significantly different from FFMDXA, whereas for segmental BIA, 85% were significantly different. For whole-body BIA, the Schols* equation gave the highest agreement with FFMDXA with mean difference ±SD of −0.16 ± 1.94 kg (p = 0.582). The manufacturer's equation gave a small overestimation of FFM with 1.46 ± 2.16 kg (p < 0.001) with a tendency towards proportional bias (r = 0.28, p = 0.066). For segmental BIA, the Heitmann* equation gave the highest agreement with FFMDXA (0.17 ± 1.83 kg (p = 0.546)). Using the manufacturer's equation, no difference in FFM estimates was observed (−0.34 ± 2.06 kg (p = 0.292)), however, a clear proportional bias was detected (r = 0.69, p < 0.001). Both devices demonstrated acceptable ability to detect low FFM compared to DXA using the optimal equation. Conclusion: In a population of non-metastatic CRC patients, mostly consisting of Caucasian adults and with a wide range of body composition measures, both the whole-body BIA and segmental BIA device provide FFM estimates that are comparable to FFMDXA on a group level when the appropriate equations are applied. At the individual level (i.e. in clinical practice) BIA may be a valuable tool to identify patients with low FFM as part of a malnutrition diagnosis.

• Henriksen, Hege; Ræder, Hanna; Bøhn, Siv Kjølsrud; Paur, Ingvild; Kværner, Ane Sørlie & Billington, Siv Åshild [Show all 14 contributors for this article] (2017). The Norwegian dietary guidelines and colorectal cancer survival (CRC-NORDIET) study: A food-based multicentre randomized controlled trial. BMC Cancer. 17(1). doi: 10.1186/s12885-017-3072-4. Full text in Research Archive Show summary

  Background Colorectal cancer survivors are not only at risk for recurrent disease but also at increased risk of comorbidities such as other cancers, cardiovascular disease, diabetes, hypertension and functional decline. In this trial, we aim at investigating whether a diet in accordance with the Norwegian food-based dietary guidelines and focusing at dampening inflammation and oxidative stress will improve long-term disease outcomes and survival in colorectal cancer patients. Methods/design This paper presents the study protocol of the Norwegian Dietary Guidelines and Colorectal Cancer Survival study. Men and women aged 50–80 years diagnosed with primary invasive colorectal cancer (Stage I-III) are invited to this randomized controlled, parallel two-arm trial 2–9 months after curative surgery. The intervention group (n = 250) receives an intensive dietary intervention lasting for 12 months and a subsequent maintenance intervention for 14 years. The control group (n = 250) receives no dietary intervention other than standard clinical care. Both groups are offered equal general advice of physical activity. Patients are followed-up at 6 months and 1, 3, 5, 7, 10 and 15 years after baseline. The study center is located at the Department of Nutrition, University of Oslo, and patients are recruited from two hospitals within the South-Eastern Norway Regional Health Authority. Primary outcomes are disease-free survival and overall survival. Secondary outcomes are time to recurrence, cardiovascular disease-free survival, compliance to the dietary recommendations and the effects of the intervention on new comorbidities, intermediate biomarkers, nutrition status, physical activity, physical function and quality of life. Discussion The current study is designed to gain a better understanding of the role of a healthy diet aimed at dampening inflammation and oxidative stress on long-term disease outcomes and survival in colorectal cancer patients. Since previous research on the role of diet for colorectal cancer survivors is limited, the study may be of great importance for this cancer population. Trial registration ClinicalTrials.gov Identifier: NCT01570010 .

• Lien, Nanna; Bjelland, Mona; Bergh, Ingunn Holden; Grydeland, May; Anderssen, Sigmund A. & Ommundsen, Yngvar [Show all 10 contributors for this article] (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, p. 38–51. doi: 10.1177/1403494810379894. Full text in Research Archive 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 (PHN). ISSN 1368-9800. 13(10A), p. 1680–1687. doi: 10.1017/S1368980010002223. Full text in Research Archive
• Henriksen, Hege & Kolset, Svein Olav (2009). Sukker- forbruk, tannhelse og overvekt. Tenner i Fokus. ISSN 0802-0752. p. 14–18. Full text in Research Archive
• Henriksen, Hege & Kolset, Svein Olav (2009). Sukker- forbruk, tannhelse og overvekt. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 119(6), p. 350–354. Full text in Research Archive
• Lemmens, Valery; Oenema, Anke; Klepp, Knut Inge; Henriksen, Hege & Brug, Johannes (2008). A systematic review of the evidence regarding efficacy of obesity prevention interventions among adults. Obesity Reviews. ISSN 1467-7881. doi: 10.1111/j.1467-789X.2008.00468.x. Full text in Research Archive
• Henriksen, Hege & Kolset, Svein Olav (2007). Sukkerforbruk og folkehelse. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 127, p. 2259–2262. Full text in Research Archive
• Henriksen, HB; Andersen, Reidar; Hewison, AJM; Gaillard, Jean-Michel; Bronndal, M & Jonsson, S [Show all 8 contributors for this article] (2005). Reproductive biology of captive female Eurasian lynx, Lynx lynx. European Journal of Wildlife Research. ISSN 1612-4642. 51, p. 151–156. doi: 10.1007/s10344-005-0104-1. Full text in Research Archive
• Drevon, Christian A; Henriksen, Hege; Sanderud, Marianne; Gundersen, Thomas Erik & Blomhoff, Rune (2004). Biologiske effekter av vitamin K og forekomst i norsk kosthold. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. p. 1650-1653–1650-1653. Full text in Research Archive
• Drevon, Christian A & Henriksen, Hege (2002). Dietary habits, lifestyle factors and social determinants in obesity. In Palou, Andreu; Bonet, Luisa M & Serra, Francisca (Ed.), Obesity and Functional Foods in Europe. European Commission, COST Action 918. ISSN 9789289442923. p. 172–179. Full text in Research Archive
• Storaas, Torstein; Gundersen, Hege; Henriksen, Hege & Andreassen, Harry Peter (2001). THE ECONOMIC VALUE OF MOOSE IN NORWAY - A REVIEW. Alces. ISSN 0835-5851. Full text in Research Archive Show summary

  The landowners income from forestry and farming has decreased, mainly due to changes in international trade and trade conventions, and they are looking for new sources of income. In Norway, as opposed to Canada and USA, the landowner holds the right to hunt on their own land, and the meat from the hunt is sold on the free market. Still, a large, but unknown portion of the hunting permits are used in a closed market of landowners, their friends and local people where the only economic value of hunting is free or cheap meat to hunter and landowner. With increasing moose populations and increasing potential income for the landowner, more hunting permits are sold on the open market, where the hunters pay for the meat and/or the hunting experience. The main economic costs are moose browsing on pine plantations and moose-vehicle collisions. Crop damage is an additional small cost. The socio-economic estimates of benefits and costs vary considerably depending on the methods used. The two main estimation problems are the closed hunting market and damage to plantations, which first gives economical losses in about 100 years. The estimates of the total annual revenue range from 70 to 90 million US$ and the costs from 23 to 80 million US$. When setting the economic carrying capacity for moose the increased costs of forest damage and traffic accidents and mitigating countermeasures should be compared to the increase in income associated with one more moose added to the population. In Norway, the regional management units sets the regional goals, whereas the duty of national wildlife authorities is to see that violating of national and international goals not occurs. To succeed in managing the moose population to an optimal economic carrying capacity, a broad co-operation between interest groups and detailed spatial-economic and ecological knowledge will be needed. We predict that increased economic revenue will become an important objective for many of the coming moose regions.

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• Mortensen, AJ; Landa, A; Wikan, S; Steinseth, OK; Odden, John & Henriksen, Hege [Show all 7 contributors for this article] (2008). På sporet av de fire store. Spor og tegn - feltbiologi - praktisk forvaltning. Cappelen Damm Høyskoleforlaget. ISBN 9788276345865. 328 p. Full text in Research Archive

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• Bøhn, Synne-Kristin Hoffart; Reinertsen, Kristin V; Kiserud, Cecilie E; Loge, Jon Håvard; Fosså, Alexander & Skaali, Tone [Show all 27 contributors for this article] (2025). Effects of a Multidisciplinary Intervention on Fatigue in Lymphoma Survivors With Chronic Fatigue: Protocol for a Randomized Controlled Trial (REFUEL). doi: 10.2196/69336. Full text in Research Archive Show summary

  Background Chronic fatigue (CF) is a highly disabling late effect after cancer, affecting 25% to 40% of lymphoma survivors years after cancer treatment. There is a lack of randomized controlled trials testing interventions to reduce fatigue levels among survivors with CF. Objective The primary aim of the Randomized Controlled Trial in Chronically Fatigued Lymphoma Survivors (REFUEL) is to examine the effects of a multidisciplinary intervention on the level of fatigue among lymphoma survivors with CF before and immediately after the intervention (3 months after randomization). Secondary aims are to (1) investigate the effects of the intervention on the level of fatigue 6 and 9 months after randomization and the effects on health-related quality of life (HRQoL); other patient-reported outcome measures; and physical fitness 3, 6, and 9 months after randomization; (2) evaluate the cost-utility of the intervention; (3) examine the effect of the intervention on HRQoL among the survivors’ partners; and (4) investigate the long-term perceived benefits and daily use of acquired self-management strategies, as well as measure changes in fatigue, daily functioning, HRQoL, mental health, and work-life balance management within each group at 1- and 2-year follow-ups. Methods The REFUEL trial is a 2-armed randomized controlled trial. Lymphoma survivors (2-12 years after diagnosis) with CF are randomly allocated to a 12-week multidisciplinary intervention including patient education, physical exercise, a cognitive behavioral therapy–based group program, and individual nutrition counseling or to usual care. Fatigue is measured by the Chalder Fatigue Questionnaire. Other patient-reported outcome measures are measured by validated questionnaires (eg, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, the Patient Health Questionnaire-9, and the Generalized Anxiety Disorder-7). Cardiorespiratory fitness is measured as peak oxygen consumption during a cardiopulmonary exercise test or indirectly using a modified Balke treadmill protocol. Muscle strength is assessed by push-ups and leg press. The primary analyses will be performed using a generalized linear mixed model for repeated measures, with an intention-to-treat approach. Results A total of 150 survivors were included from December 2021 to March 2023. Three-month postrandomization assessments were completed in June 2023 and 2-year follow-up assessments were completed in June 2025. Conclusions The REFUEL trial will provide new and highly needed scientific evidence about the effects of a multidisciplinary intervention on the level of fatigue and secondary outcomes regarding HRQoL aspects among lymphoma survivors with CF. Trial Registration ClinicalTrials.gov NCT05130099; https://www.clinicaltrials.gov/study/NCT05130099 International Registered Report Identifier (IRRID) DERR1-10.2196/69336

• Johansen, Trine Bjerke; Borge, Tiril Cecilie; Echavez, Jose Francisco Meneses; Refsdal, Tonje Lehne & Henriksen, Hege Berg (2025). Betydningen av klimaendringer og klimarelaterte hendelser på sosial ulikhet og likestilling - Prosjektplan for en systematisk kartleggingsoversikt. 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
• Kværner, Ane Sørlie; Knudsen, Markus Dines; Hjartåker, Anette; Henriksen, Hege; Blomhoff, Rune & Hoff, Geir Svein [Show all 9 contributors for this article] (2021). Kost, livsstil og tarmscreening. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. Full text in Research Archive
• Kværner, Ane Sørlie; Minaguchi, Jun; Yamani, Naouale El; Henriksen, Christine; Ræder, Hanna & Paur, Ingvild [Show all 12 contributors for this article] (2017). DNA damage in blood cells in relation to chemotherapy and nutritional status in colorectal cancer patients. Full text in Research Archive
• Ræder, Hanna; Henriksen, Christine; Bøhn, Siv Kjølsrud; Vilbo, Anne Rikke O`de Fey; Henriksen, Hege & Kværner, Ane Sørlie [Show all 9 contributors for this article] (2016). A high proportion of cachectic cancer patients are not identified by the Patient-Generated Subjective Global Assessment tool. Full text in Research Archive
• Bøhn, Siv Kjølsrud; Kværner, Ane Sørlie; Henriksen, Hege; Ræder, Hanna; Paur, Ingvild & Blomhoff, Rune (2015). The nutrigenomic response to a 12 months dietary RCT in CRC patients. Full text in Research Archive
• Kværner, Ane Sørlie; Bøhn, Siv Kjølsrud; Henriksen, Hege; Paur, Ingvild; Ræder, Hanna & Blomhoff, Rune (2015). Kjøttkonsum og kreftrisiko – hva sier forskningen? Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. p. 18–22. Full text in Research Archive
• Henriksen, Hege; Bøhn, Siv Kjølsrud; Erlund, Iris & Blomhoff, Rune (2010). Health Effects of a Typical Norwegian Diet among Colorectal Cancer Survivors. Full text in Research Archive
• Johansen, Trine Bjerke; Borge, Tiril Cecilie; Echavez, Jose Francisco Meneses; Refsdal, Tonje Lehne & Henriksen, Hege Berg (2026). Klimaendringer og klimarelaterte hendelser: betydningen for likestilling og sosial ulikhet. Folkehelseinstituttet. ISSN 9788284065328. Full text in Research Archive Show summary

  Når klimaendringer og klimarelaterte hendelser inntreffer, påvirkes både menneskers sosiale nettverk, deres økonomiske situasjon og deres helse. Personer med svake sosiale og økonomiske ressurser vil kunne oppleve større utfordringer med å beskytte seg mot og omstille seg klimaendringene. Hensikten med vår kunnskapsoppsummering var å oppsummere forskningen om betydningen av klimaendringer og klimarelaterte hendelser for likestilling og sosial ulikhet. Vi gjorde omfattende søk etter forskningslitteratur, og inkluderte 76 studier fra ti land. De fleste studiene omhandlet hetebølger, temperaturstigning og betydningen av slike hendelser for sosial ulikhet. Resultatene tyder på at: • Klimaendringer og klimarelaterte hendelser ser ut til å forsterke eksisterende sosiale forskjeller i befolkningen. • Hvem som rammes hardest avhenger av alvorlighetsgraden og varigheten på eksponeringen, hvor sårbar personen er i utgangspunktet, og ressursene til å beskytte seg og tilpasse seg i etterkant. • De som rammes hardest er oftest eldre, personer med kronisk sykdom eller funksjonsnedsettelse, minoriteter, leietakere og ugifte/aleneboende, personer med svak økonomi og de som bor i boliger med lav standard. • Å bo alene, ha svake nettverk eller lav sosial deltakelse øker belastningen fra klimarelaterte hendelser, mens sosial støtte og lokale nettverk ser ut til å redusere belastningen og delvis dempe forskjellene. • Tilgang til og forståelse av varsler gir bedre beredskap, mens manglende tilgang øker belastningen og ulempene. • Det er geografiske forskjeller i klimabelastningen mellom nabolag, kommuner og regioner, og skyldes variasjoner i boligstandard, nærmiljø, infrastruktur og helsetjenester.

• Henriksen, Hege Berg; Fernandez, Sara; Vist, Gunn Elisabeth & Hval, Gyri (2025). Sammenligning av tidlig og sen ultralydundersøkelse for estimering av termindato: en systematisk oversikt. Folkehelseinstituttet. ISSN 9788284065199. doi: https:/www.fhi.no/publ/2025/sammenligning-av-tidlig-og-sen-ultralydundersokelse-for-estimering-av-termindato/. Full text in Research Archive Show summary

  Nøyaktig bestemmelse av forventet termindato er viktig for å sikre best mulig svangerskapsomsorg og riktig tidspunkt for nødvendig medisinsk oppfølging og eventuell behandling. Ultralydbiometri er den standardiserte metoden i de fleste høyinntektsland. Vi utarbeidet en systematisk oversikt der hensikten var å sammenligne tidlig (svangerskapsuke 11-14) og sen (svangerskapsuke 17-20) ultralydundersøkelse for beregning av termindato. Kunnskapsoppsummeringen er et ledd i arbeidet med å vurdere behovet for endringer i nasjonal faglig retningslinje for svangerskapsomsorg. Vi søkte i fem elektroniske databaser (mars 2025) og OpenAlex (juni 2025) for å identifisere kontrollerte studier som sammenligner presisjon av terminbestemmelse estimert ved ultralyd i svangerskapsuke 11-14 (tidlig ultralyd) og terminbestemmelse estimert ved ultralyd i svangerskapsuke 17-20 (sen ultralyd). Utfallet var presisjon i datering av termindato i forhold til faktisk fødselsdato. Litteratursøket identifiserte 5708 unike publikasjoner. To medarbeidere vurderte uavhengig av hverandre tittel og sammendrag av søketreffene, og deretter mulige relevante studier i fulltekst, etter våre forhåndsdefinerte inklusjonskriterier. Vi vurderte 25 publikasjoner som mulig relevante og leste disse i fulltekst. Vi fant ingen studier som sammenlignet tidlig (svangerskapsuke 11-14) og sen (svangerskapsuke 17-20) ultralydundersøkelse for beregning av termindato.

• Echavez, Jose Francisco Meneses; Henriksen, Hege Berg & Bjornes, Solveig Skjeggedal (2025). Behov og kjennetegn hos barn og unge plassert i barnevernsinstitusjoner i Norge: hurtigoversikt. Folkehelseinstituttet. ISSN 9788284064918. Full text in Research Archive Show summary

  De aller fleste barn og ungdom har trygge oppvekstsvilkår hos en eller begge av sine foreldre, men enkelte er plassert utenfor hjemmet på en type barnevernsinstitusjon. Vi utførte en hurtigoversikt over norske primærstudier om behov og kjennetegn hos barn og ungdom i barnevernsinstitusjoner. Vi utførte grundige litteratursøk, valgte ut studier publisert i perioden 20142024, trakk ut data og grupperte resultatene narrativt. Vi inkluderte åtte studier (20 publikasjoner). Studiene benyttet ulike studiedesign, hovedsakelig tverrsnittstudier med registerdata og spørreskjemaer. Alle studiene rapporterte om kjennetegn hos barn og unge. Ingen undersøkte spesifikt hvilke behov de hadde. De mest fremtredende kjennetegnene hos barn og unge i barnevernsinstitusjoner var: • Psykiske lidelser, som ADHD, depresjon, angst, personlighetsforstyrrelser og selvskading (syv studier). • Utfordringer med skolegang, som lave akademiske prestasjoner og høyt fravær (fem studier). • Rusmisbruk (fire studier) og kriminalitet (tre studier). Andre kjennetegn inkluderte sosial støtte, livskvalitet og mishandling. Norske studier fra 2014-2024 om barn og ungdom i barnevernsinstitusjoner har hovedsakelig fokusert på kjennetegn ved deres psykisk helse, skolegang og rusmisbruk. Forskning som eksplisitt undersøker barn og ungdoms behov mangler. Det vil være nyttig med mer kunnskap om deres behov for å sikre dem trygghet og gode utviklingsmuligheter.

• Henriksen, Hege Berg; Vist, Gunn Elisabeth; Fernandez, Sara & Hval, Gyri (2025). Sammenlikning av tidlig og sen ultralydundersøkelse for estimering av termindato. Prosjektplan for en systematisk oversikt. Folkehelseinstituttet. ISSN 9788284065014. Full text in Research Archive Show summary

  Nøyaktig bestemmelse av forventet termindato er avgjørende for å sikre optimal svangerskapsomsorg og riktig tidspunkt for nødvendige medisinsk oppfølging og eventuell behandling. Ultralydbiometri er den standardiserte metoden i de fleste høyinntektsland. Vi vil utarbeide en systematisk oversikt over kontrollerte studier som sammenligner presisjon av terminbestemmelse estimert ved ultralyd i svangerskapsuke 11-14 (tidlig ultralyd) og terminbestemmelse estimert ved svangerskapsuke 17-20 (sen ultralyd). Utfall er presisjon i datering av termindato. Resultatene fra den systematiske oversikten vil være en del av kunnskapsgrunnlaget som skal brukes i revideringen av de nasjonale retningslinjene for svangerskapsomsorgen. To medarbeidere skal uavhengig av hverandre vurdere tittel og sammendrag av søketreffene, og deretter mulige relevante studier i fulltekst, etter våre forhåndsdefinerte inklusjonskriterier. Vi vil hente ut data fra studiene slik som informasjon om mødrene, tidspunkt for ultralydundersøkelsen, metoder, studiedesign, årstall og land der studien ble utført, og presisjon av termindato. Vi skal vurdere risiko for systematiske skjevheter for presisjon av terminbestemmelsen (utfallet) i de inkluderte studiene. For randomiserte kontrollerte studier (RCT) benytter vi Cochranes Risk of Bias v2 og for ikke-randomiserte kontrollerte studier vil vi benytte Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I). I tillegg vil vi utføre metaanalyser dersom flere studier er sammenlignbare og stratifisere på ulike studiedesign. Vi vil vurdere tilliten til resultatene med GRADE-metoden.

• Østengen, Beate; Svendsen, Karianne & Henriksen, Hege (2016). Evaluation of selected food categories in a short FFQ covering questions regarding dairy and meat products among participants with moderate to high risk of cardiovascular disease. OsloMet - storbyuniversitetet. Full text in Research Archive Show summary

  Introduksjon: Denne studien er en del av det landsomfattende VISA-prosjektet. Validering av matvarefrekvens spørreskjema (FFQ) brukt i ernæringsforskning er essensielt for å kunne arbeide med troverdig informasjon innen ernæringsepidemiologien. Kostholdet i Norge viser et høyt inntak av fete meieri- og kjøttprodukter. Kolesterolet blir påvirket av disse mettede fettsyrene og er en av risikofaktorene for å utvikle hjerte- og karsykdommer (HKS). Videre er HKS fortsatt hovedårsaken til dødelighet, og en kartlegging av kostholdet er viktig for å finne eventuelle risikofaktorer som kan lede til sykdom. Problemstilling: Hovedmålet med denne masteroppgaven er å evaluere den relative validiteten og reproduserbarheten til ulike mat-kategorier i et kort FFQ, og undersøke mulige sammenhenger mellom matvaregrupper og fettsyrer målt i blod hos norske voksne med moderat til høy risiko for HKS. Metode: Et underutvalg av 500 deltakere fra VISA-prosjektet ble inkludert i denne studien og videre delt i to grupper. 318 deltakere kvalifiserte til validerings-biomarkør studien (VB), hvor deltakerene fylte ut et kort FFQ og tok blodprøver med Dried Blood Spots i 48 Boots apotek. Fire uker senere fullførte 122 deltakere det samme spørreskjemaet for andre gang i deres hjem i validerings test-retest studien (VTR). Reproduserbarheten av spørreskjemaet ble testet med test-retest, videre ble validiteten testet ved hjelp av fettsyrer målt i blod som referansemetode. Resultater og konklusjon: VB: 82 menn og 234 kvinner med en gjennomsnittsalder på 58,32 (±13,43) år og et gjennomsnittlig totalkolesterol på 6,50 (±1,17) mmol/L deltok. VTR: 26 menn og 96 kvinner med en median alder på 60,50 (50, 70) år og en gjennomsnittlig BMI på 27,0 (±3,70) kg/m2 deltok. Tilfredsstillende korrelasjoner (> 0,50) ble observert for 12/18 spørsmål, og C15:0 hadde korrelasjoner med fete meieriprodukter. Den korte FFQ’en kan måle inntaket av meieriprodukter, egg og bruk av kolesterolsenkende margarin hos voksne med moderat til høy risiko for hjerte-og karsykdom

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