Christine Henriksen

• Kvammen, Janne Anita; Thomassen, Rut Anne; Godang, Kristin; Buchner, Jochen; Bollerslev, Jens & Bentsen, Beint Sigmund [Vis alle 8 forfattere av denne artikkelen] (2026). Body Composition, Bone Health, and Dietary Intake in Children After Allogeneic Hematopoietic Stem Cell Transplantation. Nutrients. 18(13). doi: 10.3390/nu18132193. Fulltekst i vitenarkiv
• Severinsen, Frida; Varsi, Cecilie; Andersen, Lene Frost; Henriksen, Christine & Paulsen, Mari Mohn (2026). Implementation of Digital Seamless Nutrition Care throughout the Treatment Course for Patients with Head and Neck Cancer: A Process Evaluation. Current Developments in Nutrition (CDN). 10(4), s. 1–13. doi: 10.1016/j.cdnut.2026.107677. Fulltekst i vitenarkiv Vis sammendrag

  Background Nutritional interventions may reduce the prevalence of malnutrition in patients with head and neck cancer; however, implementation often fails due to barriers at various levels. Process evaluations can provide an understanding of implementation outcomes, mechanisms of impact, and context and provide information about feasibility and acceptability. Objectives To perform a process evaluation of the Nutrition Throughout the Treatment Course (NUTREAT) intervention, including use of the MyFood app and web report. Specifically, we aimed to evaluate 1) the acceptability, adoption, appropriateness, feasibility, and fidelity of the intervention, 2) the implementation plan, and 3) patient adherence to the intervention. Methods A mixed methods approach was applied, including individual interviews, a focus group discussion, log data from electronic patient records (EPRs), an experience questionnaire, and information from the MyFood web report. Proctor’s implementation outcomes guided the development of the interview guide and analysis. Themes were deductively established using codebook thematic analysis. The implementation plan was evaluated through logs of completed activities. Log data from EPRs were collected to evaluate fidelity among healthcare professionals (HCPs), and information from the MyFood web report informed patient adherence to the intervention. Results Individual interviews were conducted with patients (n = 8), registered nurses (n = 3), and leaders (n = 2), and a focus group discussion was conducted with registered dietitians (n = 6). Patients, registered nurses, registered dietitians, and leaders found the intervention acceptable, appropriate, and feasible. Patient adherence was high, whereas fidelity among HCPs was low. Conclusions The NUTREAT intervention increased patients’ awareness of their own nutritional requirements and was considered helpful by HCPs in preparing for patient consultations. However, fidelity among HCPs was low. Future efforts should focus on identifying strategies to improve fidelity among HCPs and study the long-term sustainability of the intervention.

• Slettahjell, Hanne Bjørg; Strøm, Vegard; Thoresen, Magne; Strøm, Mona; Glott, Thomas & Biering-Sørensen, Fin [Vis alle 7 forfattere av denne artikkelen] (2026). Effects of an Individualized Dietitian-Led Nutrition Intervention on Body Composition During the First Year After Traumatic Spinal Cord Injury: A Randomized Controlled Trial. Clinical Nutrition ESPEN. ISSN 2405-4577. doi: 10.1016/j.clnesp.2026.103133. Fulltekst i vitenarkiv Vis sammendrag

  Background & Aims Traumatic spinal cord injury (SCI) induces rapid and adverse changes in body composition, yet effective strategies to prevent excess fat accumulation are limited. This study aimed to evaluate the effect of an individualized dietitian-led nutrition intervention on change in fat mass and related markers of adiposity during the first year following SCI. Methods In this single-center, open-label randomized controlled trial, adults with subacute traumatic SCI were randomized to an individualized dietitian-led intervention or usual care. The primary outcome was change in total fat mass (FM) over one year, assessed by multifrequency bioimpedance analysis. Secondary outcomes included fat mass index (FMI), visceral adipose tissue (VAT), waist circumference, fat-free mass (FFM), fat-free mass index (FFMI), body weight, body mass index (BMI) and biomarkers (fasting glucose, 2-hour oral glucose tolerance test, HbA1c, LDL, HDL and triglycerides). Intention-to-treat analyses used mixed-effects models adjusted for age, sex, and neurological severity. Results Sixty-two participants were randomized (32 intervention, 30 control). Participants were predominantly male (76%) with a mean age of 48 (SD 17) years. At 1 year, the adjusted between-group difference in FM change was −1.5 kg (95% CI −4.8 to 1.9; p = 0.39). Significant between-group differences were observed for VAT (−0.5 L; 95% CI −1.0 to −0.1; p = 0.02) and waist circumference (−4.0 cm; 95% CI −7.0 to −1.0; p = 0.01), with borderline significance for FMI (−1.6 kg/m2; 95% CI −3.2 to 0.0; p = 0.05). No significant between-group differences were observed for body weight, BMI, fat-free mass, or biomarkers. Sensitivity and per-protocol analyses yielded consistent results. Conclusions Although the intervention did not significantly affect the primary endpoint of total fat mass, between-group differences were observed for VAT and waist circumference. These findings suggest that structured, individualized dietetic care initiated during SCI rehabilitation and continued post-discharge may attenuate accumulation of abdominal adiposity. Longer-term follow-up is needed to determine whether early attenuation of abdominal adiposity translates into reduced cardiometabolic risk and improved functional outcomes.

• Thomassen, Rut Anne; Kvammen, Janne Anita; Bentsen, Beint Sigmund; Bratlie, Marianne; Bøhn, Siv Kjølsrud & Farstad, Hanne [Vis alle 15 forfattere av denne artikkelen] (2025). Improving well-being in children with intestinal failure: Impact of Prebiotics on Gastrointestinal Symptoms and Quality of Life, A Randomized Study. Intestinal Failure. 6(Supplement 1). doi: 10.1016/j.intf.2025.100242. Fulltekst i vitenarkiv Vis sammendrag

  Background: Children with intestinal failure (IF) experience a high burden of illness, characterized by persistent gastrointestinal (GI) symptoms, irregular stool patterns, and reduced health-related quality of life (HRQOL). This study explored the impact of prebiotic supplementation on GI symptoms and HRQOL. Methods: An open-label randomized controlled trial with two phases. In Phase 1, children aged 1–18 years with IF received supplementation with a prebiotic blend for four weeks. In Phase 2, participants were randomized to either continue supplementation (intervention group) or cease supplementation (control group) for six months to evaluate long-term effects. Primary endpoints were GI symptoms and HRQOL, evaluated using PedsQL™ scales. Secondary endpoints included stool consistency and frequency, nutritional support, and antibiotic use. A paired t-test assessed short-term effect, while ANCOVA tested long-term differences. Results: Forty-seven children completed Phase 1. Of the 33 reporting on GI symptoms, 20 (60%) improved after short-term prebiotic supplementation. In Phase 2, 43 were randomized to intervention group (n=24) or control group (n=19). The intervention group exhibited significant improvements in GI symptoms compared to controls (mean difference 6.9, p=0.01). Furthermore, stool frequency decreased (median -1.0 vs. 0 stools/day, p=0.003) more in the intervention group, and stool consistency normalized more often (42% vs. 6%, p=0.02). No significant differences were observed in HRQOL scores, nutritional support, or antibiotic use. Conclusions: Although HRQOL did not improve, both short- and long-term prebiotic supplementation significantly improved GI symptoms, stool frequency, and stool consistency in children with IF, suggesting its potential as a therapeutic option in pediatric IF.

• Severinsen, Frida; Varsi, Cecilie; Andersen, Lene Frost; Henriksen, Christine & Paulsen, Mari Mohn (2025). Experiences with nutritional follow-up and barriers and opportunities of implementing digital seamless nutrition care in the head and neck cancer treatment course: a qualitative study from patient, family caregiver, and healthcare professional perspectives. BMC Health Services Research. 25(1). doi: 10.1186/s12913-025-13542-7. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Patients with head and neck cancer (HNC) are often malnourished. Despite evidence of beneficial effects of digital health interventions, challenges with implementation into clinical practice have been reported. Objective To investigate the implementation of a seamless nutrition care intervention into the HNC treatment course, this study aimed to (1) explore the experiences with current nutritional follow-up; and (2) identify potential barriers and opportunities associated with future implementation of the Nutrition Throughout the Treatment Course (NUTREAT) intervention. Methods This qualitative study involved semi-structured interviews with patients with HNC, family caregivers, and healthcare professionals (HCPs). The Consolidated Framework for Implementation Research (CFIR) guided the development of the interview guide and analysis. Inductive-deductive analyses were conducted. Results Interviews were conducted with patients (n = 7), family caregivers (n = 4), registered nurses (n = 5), and physicians (n = 2). Themes created to cover experiences with the current nutritional follow-up were: (1) Nutritional challenges; (2) Family caregiver support; and (3) Experience with current nutritional follow-up. Barriers and opportunities for implementing the NUTREAT intervention were analyzed within 20 constructs of CFIR. Patients were satisfied with nutritional follow-up, and spouses served as key emotional support, yet a need for closer monitoring post-treatment was identified. Exhaustion, advanced age, and dementia were potential barriers for implementing NUTREAT. Increased awareness of nutritional requirements for patients, and increased accessibility of dietary recordings for HCPs compared to current practices were opportunities. Conclusion Overall, patients and spouses were satisfied with the nutritional follow-up, though challenges were identified. The identified barriers and opportunities will inform the development of an implementation plan for an effectiveness- and implementation study.

• Beichmann, Benedicte; Sollerud, Eli; Warmbrodt, Nicole Sonja; Ottestad, Inger; Paulsen, Mari Mohn & Henriksen, Christine [Vis alle 7 forfattere av denne artikkelen] (2025). Measured and predicted energy expenditure among patients with distal bowel cancer: Results from the GAIN-project. Clinical Nutrition. ISSN 0261-5614. 53, s. 88–98. doi: 10.1016/j.clnu.2025.08.022. Fulltekst i vitenarkiv
• Thomassen, Rut Anne; Kvammen, Janne Anita; Bentsen, Beint Sigmund; Bratlie, Marianne; Bøhn, Siv Kjølsrud & Farstad, Hanne [Vis alle 15 forfattere av denne artikkelen] (2025). Effect of prebiotics on gastrointestinal symptoms and quality of life in children with intestinal failure: A pilot study. Journal of Pediatric Gastroenterology and Nutrition - JPGN. ISSN 0277-2116. 81(4), s. 975–985. doi: 10.1002/jpn3.70186. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Children with intestinal failure (IF) have a substantial disease burden, with significant gastrointestinal (GI) symptoms, abnormal stool patterns and reduced health-related quality of life (HRQOL). This study examined the effects of prebiotic supplementation on GI symptoms and HRQOL. Methods An open-label, randomised controlled trial involving two phases. In Phase 1, children aged 1–18 years with IF received supplementation with a blend of prebiotics for 4 weeks. In Phase 2, participants were randomised to either continue supplementation or cease supplementation for 6 months to evaluate long-term effects. Primary end points included parent-reported GI symptoms and HRQOL, measured by PedsQL™ scales. Secondary end points were stool consistency and frequency, nutritional support and antibiotic use. Results Out of 47 children completing Phase 1, 43 completed Phase 2 (24 in the intervention group, 19 in the control group). After 4 weeks, 60% reported reduced GI symptoms. By the end of Phase 2, the intervention group showed no significant changes in HRQOL score, but significant GI symptom improvements compared to controls (mean paediatric quality of life inventory GI score difference of 6.9, p = 0.01). Stool frequency decreased (median −1.0 vs. 0 stools/day, p = 0.003), and stool consistency normalised more frequently in the intervention group (42% vs. 6%, p = 0.02). No significant changes were noted in nutritional support or antibiotic use. Conclusion While HRQOL remained unchanged, short- and long-term prebiotic supplementation significantly improved GI symptoms, stool frequency and stool consistency in children with IF, indicating its potential as a therapeutic option in paediatric IF.

• Nordengen, Anne Lene; Krutto, Annika; Kværner, Ane Sørlie; Alavi, Dena Treider; Henriksen, Hege Berg & Kolle, Åshild [Vis alle 13 forfattere av denne artikkelen] (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, s. 240–249. doi: 10.1016/j.freeradbiomed.2025.03.047. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Kvammen, Janne Anita; Thomassen, Rut Anne; Buechner, Jochen; Myklebust, Tor Åge; Thorsby, Per Medbøe & Bollerslev, Jens [Vis alle 9 forfattere av denne artikkelen] (2025). Vitamin D status in children undergoing allogeneic hematopoietic stem cell transplantation: A prospective exploratory study. Journal of Pediatric Gastroenterology and Nutrition - JPGN. ISSN 0277-2116. 80(6), s. 1007–1017. doi: 10.1002/jpn3.70028. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Allogeneic hematopoietic stem cell transplantation (HSCT) is associated with nutritional risks. This study describes vitamin D status and intake in children undergoing HSCT and compares results to healthy children. Methods In a prospective observational study, vitamin 25(OH)D and 1,25(OH)2D were assessed at hospital admission before HSCT (baseline), at 3-month and 1-year post-transplant. Vitamin D deficiency was defined as 25(OH)D < 50 nmol/L. A 4-day diet record assessed vitamin D intake at 3-months and 1-year. Healthy children were assessed once. Results Twenty-eight HSCT patients (mean age: 10.3-years, standard deviation [SD]: 4.0) and 50 healthy children (mean age: 10.0-years, SD: 3.6) were included. Vitamin D deficiency was more prevalent in patients at baseline (36%, p < 0.001) and 3-months (24%, p = 0.007) but not at 1-year (14%, p = 0.084) than in healthy children (2%). Median 1,25(OH)2D was significantly lower than in healthy children at the two first visits (p < 0.001) but not at 1-year (p = 0.198). Median vitamin D provision was higher at 3-months (18.1 µg/day) and 1-year (25 µg/day) compared to healthy children (5.3 µg/day, p < 0.001). Conclusions Children undergoing HSCT were at a high risk of vitamin D deficiency at baseline and 3-month post-transplant, but not at 1-year compared to healthy children. Vitamin D intake was higher after transplantation than in healthy children. These findings indicate that vitamin D requirements are elevated in HSCT patients, emphasizing the need for monitoring and adequate supplementation.

• Gjelstad, Ingrid Merethe Fange; Lyckander, Christian; Høidalen, Anne; Bratland, Åse; Blomhoff, Rune & Paur, Ingvild [Vis alle 7 forfattere av denne artikkelen] (2025). Impact of radiotherapy on body weight in head and neck cancer patients: A prospective study. Clinical Nutrition ESPEN. ISSN 2405-4577. 65, s. 390–399. doi: 10.1016/j.clnesp.2024.12.019. Fulltekst i vitenarkiv Vis sammendrag

  Background Patients with head and neck cancer (HNC) undergoing radiotherapy or chemoradiotherapy often experience symptoms that affect their ability to eat. This study aimed to explore the impact of radiotherapy on body weight in HNC patients and compare the characteristics of patients receiving enteral tube feeding with those maintaining an oral diet. Methods In this prospective study, 52 patients with HNC were examined at diagnosis, at the start and end of radiotherapy, and six weeks after end of treatment. The nutritional assessment included measurements of body weight, food intake, and malnutrition using Patient-Generated Subjective Global Assessment (PG-SGA). Other variables were retrieved from the electronic patient record. Results Critical weight loss (defined as >5 % from start of radiotherapy) was present in 60 % of the patients at the end of radiotherapy, and only half of these patients received any enteral nutrition therapy. The mean weight loss was 5.8 % during radiotherapy, and an additional 2.1 % at follow-up (n = 48). A nasogastric feeding tube was used by 42 % at the end of radiotherapy, and 29 % at follow-up. The tube feeding users had a lower energy intake and higher weight loss than non-tube feeding users (22 vs 27 kcal/kg body weight, 7.8 vs 4.4 % weight loss) at the end of radiotherapy treatment. According to PG-SGA, 92 % of the patients were malnourished at the end of treatment and 71 % at follow-up (p < 0.001). Conclusion Critical weight loss and malnutrition were common in HNC patients after radiotherapy, and enteral tube feeding was initiated in only half of the cases with critical weight loss. Patients receiving enteral tube feeding may need closer monitoring to ensure adequate energy intake, and other treatment options may be necessary. These results emphasize the need for improved nutritional intervention during and after radiotherapy.

• Birketvedt, Kjersti; Mikkelsen, Audun; Hanssen, Ragnhild; Henriksen, Christine & Emblem, Ragnhild (2024). Feeding difficulties, food intake, and growth in children with esophageal atresia. JPGN repost. Fulltekst i vitenarkiv
• Berg, Hedda Beate; Alavi, Dena Treider; Beichmann, Benedicte; Pesonen, Maiju; Henriksen, Christine & Paur, Ingvild [Vis alle 10 forfattere av denne artikkelen] (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, s. 17–23. doi: 10.1016/j.clnesp.2024.01.001. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Slettahjell, Hanne Bjørg; Bastakis, Maria; Biering-Sørensen, Fin; Strøm, Vegard & Henriksen, Christine (2024). Defining malnutrition in persons with spinal cord injury – does the Global Criteria for Malnutrition work? Food & Nutrition Research (FNR). ISSN 1654-6628. 68. doi: 10.29219/fnr.v68.9989. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims: Physiologic and metabolic changes following spinal cord injury (SCI) lead to an increased risk of malnutrition. The Global Leadership Initiative on Malnutrition (GLIM) is a three-step approach to diagnose malnutrition: 1) screening; 2) phenotypic and etiological criteria; and 3) malnutrition severity. The main aim of this study was to assess malnutrition in patients with SCI, according to the GLIM criteria. Methods: Patients with SCI (≥ 18 years) admitted to rehabilitation were included. Anthropometrics, food intake, and inflammation were assessed on admission. Fat-free mass index (FFMI) was estimated from bioimpedance analysis. Malnutrition was diagnosed by the GLIM criteria, using the Malnutrition Universal Screening Tool (MUST) as the first step screening tool. Sensitivity and specificity analyses were performed. Results: In total, 66 patients were assessed (50 men) with a mean age of 51.4 (± 17.4) years and median time since injury was 37.5 (10–450) days. The mean body mass index was 24.7 (± 4.2) kg/m2, and 1-month involuntary weight loss was 5.7 (± 4.4)%. FFMI for men was 17.3 (± 1.9) and for women 15.3 (± 1.6) kg/m2. Forty-one patients (62%) were malnourished according to the GLIM criteria: 27 moderately and 14 severely malnourished. MUST was not able to detect malnutrition risk of nine patients, giving a moderate agreement (kappa 0.66), with a sensitivity of 0.78 and a specificity of 0.92 compared to the GLIM diagnosis. Conclusions: In this cross-sectional study, 62% of subacute SCI patients were malnourished according to the GLIM criteria. The screening tool MUST showed moderate agreement with the GLIM criteria and did not detect risk of all patients with a malnutrition diagnosis. The clinical implications of these findings need further investigation.

• Hatlen, Kristine Vaage; Lensnes, Therese Margrethe Lysell; Henriksen, Christine; Berg, Tore Julsrud; Nermoen, Ingrid & Lundin, Knut (2024). Suboptimal adherence to a gluten-free diet in adults with both type 1 diabetes and celiac disease using urinary gluten immunogenic peptide measurement. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 60(1), s. 28–36. doi: 10.1080/00365521.2024.2442688. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Concurrent type 1 diabetes (T1D) and celiac disease (CeD) pose challenges in insulin dosage adjustments and gluten-free dietary adherence. Urine testing for gluten immunogenic peptides (GIP) is a new method to detect gluten exposure within the last 3–12 h. Our aims were to compare gluten-free dietary adherence between T1D + CeD and CeD individuals and evaluate urinary GIP testing in an outpatient setting. Materials and methods This observational cross-sectional study included three adult groups: (1) T1D and CeD, (2) CeD only, and (3) T1D only. T1D participants were recruited from outpatient clinics, the CeD group via social media. One urine sample (12 pm–7 pm) was analyzed using a qualitative immunographic GIP test. CeD participants completed ‘Celiac Dietary Adherence Test’ (CDAT) and ‘Celiac Symptom Index’ (CSI) questionnaires. IgA anti-transglutaminase 2 (IgA-TG2) and IgG anti-deamidated gliadin (IgG-DGP) serology were also analyzed. Results 197 participants, mean (SD) age 43 (15) years, were included. Female percentages were: CeD: 90%, T1D + CeD: 64%, and T1D: 47%. Positive urinary GIP was found in 15% (14/96) of T1D + CeD and 0% (0/50) of CeD (p = 0.002). As expected, most T1D only participants had positive urinary GIP (86%, 44/51). CDAT and CSI scores did not differ between T1D + CeD and CeD groups. Positive IgA-TG2 and/or IgG-DGP levels were found in 12% of T1D + CeD and 6% of CeD participants (p = 0.38). Conclusions A single GIP urine test revealed higher gluten exposure in T1D + CeD versus CeD only, questioning dietary adherence in this population. Urinary GIP tests can be useful for clinical follow-up.

• Thomassen, Rut Anne; Kvammen, Janne Anita; Bentsen, Beint Sigmund; Solheim, Anna; Størdal, Ketil & Henriksen, Christine [Vis alle 7 forfattere av denne artikkelen] (2024). Impact of parenteral nutrition on quality of life, the family and gastrointestinal symptoms in children with intestinal failure. Journal of Pediatric Gastroenterology and Nutrition - JPGN. ISSN 0277-2116. 80(1), s. 69–79. doi: 10.1002/jpn3.12411. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Intestinal failure (IF) and dependency on parenteral nutrition (PN) are risk factors for lower health-related quality of life (HRQOL) in children. Weaning from PN is a major goal of paediatric IF treatment, however, its impact on HRQOL remains unclear. This study aimed to assess HRQOL, gastrointestinal (GI) symptoms and family impact in children with IF in relation to their need for PN. Method Data were collected in a cross-sectional study from children with IF and a reference group of healthy children using electronic versions of Paediatric Quality of Life Inventory™ forms. Results The study included 56 children with IF and 48 healthy children. Parents of children with IF reported significantly lower HRQOL than healthy children (−8.7, p = 0.001). PN dependency did not influence HRQOL scores, but families with children dependent on PN had a lower family impact score than children weaned from PN (49.9 vs. 73.6, p < 0.001). Parents of children in the PN group reported more GI problems than those in the weaned group (−8.1, p = 0.04), and diarrhoea, gas and bloating were common symptoms of IF. GI symptoms varied according to PN dependency and IF aetiology. Multivariate analysis found a significant association between HRQOL and total GI symptom score (parent scores: 0.34, p = 0.02, self-score 0.48, p = 0.02). Conclusion Children with IF had lower parent-reported HRQOL than healthy children. PN dependency did not affect HRQOL, however, the need for PN had a significant negative impact on family well-being. GI symptoms may negatively impact HRQOL in the IF population.

• Herfindal, Anne Mari; Nilsen, Morten; Aspholm, Trude Elise; Schultz, Gry Irene Granli; Valeur, Jørgen & Rudi, Knut [Vis alle 10 forfattere av denne artikkelen] (2024). Effects of fructan and gluten on gut microbiota in individuals with self-reported non-celiac gluten/wheat sensitivity—a randomised controlled crossover trial. BMC Medicine. 22:358(1), s. 1–19. doi: 10.1186/s12916-024-03562-1. Fulltekst i vitenarkiv Vis sammendrag

  Background Individuals with non-celiac gluten/wheat sensitivity (NCGWS) experience improvement in gastrointestinal symptoms following a gluten-free diet. Although previous results have indicated that fructo-oligosaccharides (FOS), a type of short-chain fructans, were more likely to induce symptoms than gluten in self-reported NCGWS patients, the underlying mechanisms are unresolved. Methods Our main objective was therefore to investigate whether FOS-fructans and gluten affect the composition and diversity of the faecal microbiota (16S rRNA gene sequencing), faecal metabolites of microbial fermentation (short-chain fatty acids [SCFA]; gas chromatography with flame ionization detector), and a faecal biomarker of gut inflammation (neutrophil gelatinase-associated lipocalin, also known as lipocalin 2, NGAL/LCN2; ELISA). In the randomised double-blind placebo-controlled crossover study, 59 participants with self-reported NCGWS underwent three different 7-day diet challenges with gluten (5.7 g/day), FOS-fructans (2.1 g/day), and placebo separately (three periods, six challenge sequences). Results The relative abundances of certain bacterial taxa were affected differently by the diet challenges. After the FOS-fructan challenge, Fusicatenibacter increased, while Eubacterium (E.) coprostanoligenes group, Anaerotruncus, and unknown Ruminococcaceae genera decreased. The gluten challenge was primarily characterized by increased abundance of Eubacterium xylanophilum group. However, no differences were found for bacterial diversity (α-diversity), overall bacterial community structure (β-diversity), faecal metabolites (SCFA), or NGAL/LCN2. Furthermore, gastrointestinal symptoms in response to FOS-fructans were generally not linked to substantial shifts in the gut bacterial community. However, the reduction in E. coprostanoligenes group following the FOS-fructan challenge was associated with increased gastrointestinal pain. Finally, correlation analysis revealed that changes in gastrointestinal symptoms following the FOS-fructan and gluten challenges were linked to varying bacterial abundances at baseline. Conclusions In conclusion, while FOS-fructans induced more gastrointestinal symptoms than gluten in the NCGWS patients, we did not find that substantial shifts in the composition nor function of the faecal microbiota could explain these differences in the current study. However, our results indicate that individual variations in baseline bacterial composition/function may influence the gastrointestinal symptom response to both FOS-fructans and gluten. Additionally, the change in E. coprostanoligenes group, which was associated with increased symptoms, implies that attention should be given to these bacteria in future trials investigating the impact of dietary treatments on gastrointestinal symptoms. Trial registration Clinicaltrials.gov as NCT02464150.

• Nordengen, Anne Lene; Zheng, Congying; Krutto, Annika; Kværner, Ane Sørlie; Alavi, Dena Treider & Henriksen, Hege [Vis alle 13 forfattere av denne artikkelen] (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, s. 178–189. doi: 10.1016/j.freeradbiomed.2024.04.211. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Beichmann, Benedicte; Henriksen, Christine; Paur, Ingvild & Paulsen, Mari Mohn (2024). Barriers and facilitators of improved nutritional support for patients newly diagnosed with cancer: a pre-implementation study. BMC Health Services Research. 24, s. 1–12. doi: 10.1186/s12913-024-11288-2. Fulltekst i vitenarkiv Vis sammendrag

  Background Disease-related malnutrition affects a significant number of patients with cancer and poses a major social problem worldwide. Despite both global and national guidelines to prevent and treat malnutrition, the prevalence is high, ranging from 20 to 70% in all patients with cancer. This study aimed to explore the current practice of nutritional support for patients with cancer at a large university hospital in Norway and to explore potential barriers and facilitators of the intervention in the Green Approach to Improved Nutritional support for patients with cancer (GAIN), prior to implementation in a clinical setting. Methods The study used individual interviews and a focus group discussion to collect data. Study participants included different healthcare professionals and patients with cancer treated at a nutrition outpatient clinic. The Consolidated Framework for Implementation Research (CFIR) was used to guide the thematic data analysis. Results Barriers connected to the current nutritional support were limited resources and undefined roles concerning responsibility for providing nutritional support among healthcare professionals. Facilitators included a desire for change regarding the current nutritional practice. The GAIN intervention was perceived as feasible for patients and healthcare professionals. Potential barriers included limited knowledge of technology, lack of motivation among patients, and a potential added burden experienced by the participating patients. Conclusions The identification of the potential barriers and facilitators of the current nutritional support to patients with cancer will be used to plan the implementation of improved nutritional support in a randomized controlled trial for patients with cancer prior to clinical implementation. The current findings may be of value to others trying to implement either or both nutritional support and digital application tools in a clinical healthcare setting. Trial registration The study was registered in the National Institutes of Health Clinical trials 08/09/22. The identification code is NCT05544318.

• Henriksen, Hege Berg; Henriksen, Christine; Sousa, Ana Rita Sequeira de; Alavi, Dena Helene; Augestad, Elin Maria Sandstad & Rising, Russell [Vis alle 12 forfattere av denne artikkelen] (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. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Valsdottir, Thorhildur Ditta; Øvrebø, Bente; Kornfeldt, Thea Martine; Litleskare, Sigbjørn; Johansen, Egil Ivar & Henriksen, Christine [Vis alle 7 forfattere av denne artikkelen] (2023). Effect of aerobic exercise and low-carbohydrate high-fat diet on glucose tolerance and android/gynoid fat in overweight/obese women: A randomized controlled trial. Frontiers in Physiology. 14. doi: 10.3389/fphys.2023.1056296. Fulltekst i vitenarkiv Vis sammendrag

  The study was designed to compare the effects of weight loss induced by a low-carbohydrate-high-fat diet or a normal diet, with and without exercise, on glucose tolerance measured as area under the curve (AUC), and android (A) and gynoid (G) fat distribution. The study was registered at clinicaltrials.gov; NCT04100356. In total, 57 women classified as overweight or obese (age 40 ± 3.5 years, body mass index 31.1 ± 2.6 kg/m2) were randomly assigned and completed a 10-week intervention using a low-carbohydrate high-fat diet or a normal diet, with or without aerobic interval exercise. An equal deficit of 700 kcal/day was prescribed, either restricting the diet only, or moderately restricting diet and including three 50-min high-intensity bicycle sessions per week. There were thus four groups: normal diet (NORM); low-carbohydrate-high-fat diet (LCHF); normal diet with exercise (NORM-EX); and low-carbohydrate-high-fat diet with exercise (LCHF-EX). Linear mixed models was used to assess differences between groups. With all groups pooled, the intervention resulted in a weight loss of 6.7 ± 2.5% (p < 0.001). The intervention did not result in differences between groups in AUC glucose, nor in fasting glucose or indicis for insulin resistance such as Homeostatic Model Assessment, Matsuda Insulin Sensitivity Index, insulinogenic index and disposition index. Post-intervention android fat was lower in LCHF than NORM (3,223 ± 727 vs. 2,533 ± 535 g, p = 0.041). LCHF reached a lower A/G ratio than NORM (0.94 ± 0.12 vs. 1.04 ± 0.09, p = 0.011) and LCHF-EX (0.94 ± 0.12 vs. 1.09 ± 0.09, p < 0.001) after the intervention. LCHF resulted in lower android fat mass compared to NORM and the lowest A/G ratio compared to the other matched groups, but with no accompanying improvement in AUC glucose. In conclusion, although all groups achieved improvements in glucose tolerance, no superior effect was observed with the LCHF diet, neither with nor without exercise.

• Nordengen, Anne Lene; Kværner, Ane Sørlie; Krutto, Annika; Alavi, Dena Treider; Henriksen, Hege & Henriksen, Christine [Vis alle 12 forfattere av denne artikkelen] (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, s. 174–185. doi: 10.1016/j.freeradbiomed.2023.12.016. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Megen, Frida van; Fossli, Maria; Skodje, Gry Irene; Carlsen, Monica Hauger; Andersen, Lene Frost & Veierød, Marit Bragelien [Vis alle 8 forfattere av denne artikkelen] (2023). Nutritional assessment of women with celiac disease compared to the general population. Clinical Nutrition ESPEN. ISSN 2405-4577. 54, s. 251–257. doi: 10.1016/j.clnesp.2023.01.031. Fulltekst i vitenarkiv Vis sammendrag

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

• Henriksen, Christine & Bügel, Susanne (2023). Chromium – a scoping review for Nordic Nutrition Recommendations 2023. Food & Nutrition Research (FNR). ISSN 1654-6628. 67. doi: 10.29219/fnr.v67.10325. Fulltekst i vitenarkiv Vis sammendrag

  Trivalent chromium (CrIII) is the principal form of chromium found in diet and supplements. CrIII has been claimed to be involved in the regulation of carbohydrate, lipid, and protein metabolism. Hexavalent chromium (CrVI) is a carcinogen when inhaled, which is uncommon, and occurs mainly by occupational exposures. There is a concern about adverse health effects also from exposure to CrVI by contaminated drinking water, although data from human studies are limited. Chromium had no recommendation in the Nordic Nutrition Recommendations (NNR) 2012 and the European Food Safety Authority (EFSA) did not set any reference values either. Methods for evaluating chromium status are lacking, and there is still uncertainty about how chromium deficiency in humans manifests itself. The essentiality of chromium is also disputed. This scoping review revealed new research activity relating to high-dose chromium supplements and several health outcomes (overweight, obesity, and diabetes). Although these issues are related to health concerns in the Nordic or Baltic countries, the relevance for the NNR is modest, since such a high intake of chromium cannot be achieved by diet. Thus, no strong evidence was identified in the scientific literature that justifies a recommendation for chromium intake.

• Henriksen, Christine & Aaseth, Jan (2023). Magnesium: a scoping review for Nordic Nutrition Recommendations 2023. Food & Nutrition Research (FNR). ISSN 1654-6628. 67. doi: 10.29219/fnr.v67.10314. Fulltekst i vitenarkiv Vis sammendrag

  Magnesium is a divalent ion involved in a range of biochemical reactions and cellular functions. The metabolism and requirements for magnesium are still insufficiently understood. In the Nordic Nutrition Recommendations from 2012, a recommended intake was set based on balance studies. However, the average requirement (AR) was not set. Functional indicators of magnesium status have been lacking. This scoping review reveals new research activity related to the beneficial effect of magnesium intake on several health outcomes (cardiovascular disease, diabetes and some cancers). Based on meta-analyses of cohort studies and Randomized Controlled Trials (RCTs), as well as on plausible mechanisms, a causal association is suggested. However, the optimal intake cannot be set based on these study designs and no new balance studies were found.

• Henriksen, Christine & Arnesen, Erik Kristoffer (2023). Copper – a scoping review for Nordic Nutrition Recommendations 2023. Food & Nutrition Research (FNR). ISSN 1654-6628. 67. doi: 10.29219/fnr.v67.10322. Fulltekst i vitenarkiv Vis sammendrag

  Copper functions as a structural component in many proteins involved in energy and iron metabolism, production of neurotransmitters, formation of connective tissue and endogenous antioxidant defence. Several biochemical indices have been suggested and used to assess copper status, but none of these has been found suitable for the detection of marginal copper deficiency or marginal copper toxicity. Copper imbalances have been linked to the pathogenesis of several chronic inflammatory diseases. During the last decade, a number of meta-analyses and systematic reviews have been published shedding light on the association between copper imbalances and some of these pathologies. Most of these meta-analyses are based on case–control studies. All show that blood copper concentrations are higher in cases than in controls, but there is inconclusive evidence to change the recommendations.

• Garnweidner-Holme, Lisa; Hellmann, Monica; Henriksen, Christine; Austad, Elisabeh; Watters, Solveig Ivara Nakken & Gaundal, Line [Vis alle 9 forfattere av denne artikkelen] (2023). Experiences with Gluten-Free Bread: A Qualitative Study Amongst People with Coeliac Disease Participating in a Randomised Controlled Trial. Foods. 12:4338(23), s. 1–9. doi: 10.3390/foods12234338. Fulltekst i vitenarkiv Vis sammendrag

  Background: Whole-grain bread can be an important source of fibre for people with coeliac disease (CeD) who must adhere to a gluten-free diet and avoid consuming wheat, rye and barley. Gluten-free bread frequently has a lower nutritional quality and different texture relative to gluten-containing counterparts. Objective: The aim was to investigate experiences with gluten-free bread amongst people with CeD prior to and during a randomised controlled trial (RCT). Design: We conducted individual interviews with 10 people with CeD participating in a RCT that aimed to investigate the effects of fibre-rich gluten-free products on metabolic regulation in people with CeD compared with benchmark gluten-free products. Five participants were in the control group (benchmark gluten-free bread) and five participants in the intervention group (fibre-rich gluten-free bread). The fibre-rich gluten free bread was formulated and prepared by the project group. The benchmark gluten-free bread was commercially available. The RCT lasted for four weeks. Interviews were conducted digitally between October 2021 and January 2022 and were thematically analysed. Results: Participants in both groups appeared to avoid bread prior to the study, primarily due to the poor taste and chewy consistency of the available bread in food stores and bakeries. Participants preferred the fibre-rich intervention bread as opposed to the available bread in the food market. However, participants had to become accustomed to eating the fibre-rich whole-grain bread during the study, since they avoided eating store-bought bread that they experienced chewy and not filling. Conclusions: Participants asked for fibre-rich gluten-free bread products that are satiating and have a good texture. Palatable gluten-free bread products might be an important source of fibre for people with CeD.

• Alavi, Dena Treider; Henriksen, Hege Berg; Lauritzen, Peter Mæhre; Zucknick, Manuela; Bøhn, Siv Kjølsrud & Henriksen, Christine [Vis alle 9 forfattere av denne artikkelen] (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, s. 414–422. doi: 10.1016/j.clnesp.2023.06.037. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Herfindal, Anne Mari; Megen, Frida van; Gilde, Mari Kristine Overvik; Valeur, Jørgen; Rudi, Knut & Skodje, Gry [Vis alle 9 forfattere av denne artikkelen] (2023). Effects of a low FODMAP diet on gut microbiota in individuals with treated celiac disease having persistent gastrointestinal symptoms-a randomized controlled trial. British Journal of Nutrition. ISSN 0007-1145. 130(12), s. 2061–2075. doi: 10.1017/S0007114523001253. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Individuals with coeliac disease (CeD) often experience gastrointestinal symptoms despite adherence to a gluten-free diet (GFD). While we recently showed that a diet low in fermentable oligo-, di-, monosaccharides and polyols (FODMAP) successfully provided symptom relief in GFD-treated CeD patients, there have been concerns that the low FODMAP diet (LFD) could adversely affect the gut microbiota. Our main objective was therefore to investigate whether the LFD affects the faecal microbiota and related variables of gut health. In a randomised controlled trial GFD-treated CeD adults, having persistent gastrointestinal symptoms, were randomised to either consume a combined LFD and GFD ( n 39) for 4 weeks or continue with GFD (controls, n 36). Compared with the control group, the LFD group displayed greater changes in the overall faecal microbiota profile (16S rRNA gene sequencing) from baseline to follow-up (within-subject β -diversity, P &lt; 0·001), characterised by lower and higher follow-up abundances (%) of genus Anaerostipes ( P group &lt; 0·001) and class Erysipelotrichia ( P group = 0·02), respectively. Compared with the control group, the LFD led to lower follow-up concentrations of faecal propionic and valeric acid (GC-FID) in participants with high concentrations at baseline ( P interaction ≤ 0·009). No differences were found in faecal bacterial α -diversity ( P group ≥ 0·20) or in faecal neutrophil gelatinase-associated lipocalin (ELISA), a biomarker of gut integrity and inflammation ( P group = 0·74), between the groups at follow-up. The modest effects of the LFD on the gut microbiota and related variables in the CeD patients of the present study are encouraging given the beneficial effects of the LFD strategy to treat functional GI symptoms (Registered at clinicaltrials.gov as NCT03678935).

• Skodje, Gry Irene; Megen, Frida van; Stendahl, Marianne; Henriksen, Christine; Lundin, Knut Erik Aslaksen & Veierød, Marit Bragelien (2022). Detection of gluten immunogenic peptides and the Celiac Disease Adherence Test to monitor gluten-free diet: a pilot study. European Journal of Clinical Nutrition. ISSN 0954-3007. 76. doi: 10.1038/s41430-021-01054-6. Fulltekst i vitenarkiv
• Megen, Frida van; Skodje, Gry Irene; Lergenmuller, Simon; Zühlke, Stephanie; Aabakken, Lars & Veierød, Marit Bragelien [Vis alle 8 forfattere av denne artikkelen] (2022). A low FODMAP diet reduces symptoms in treated celiac patients with ongoing symptoms–A randomized controlled trial. Clinical Gastroenterology and Hepatology. ISSN 1542-3565. 20(10), s. 2258–2266.E3. doi: 10.1016/j.cgh.2022.01.011. Fulltekst i vitenarkiv Vis sammendrag

  Background & Aims A gluten-free diet usually leads to mucosal remission in celiac disease, but persistent symptoms are common. A low fermentable oligo-, di-, monosaccharides and polyols (FODMAP) diet is an established treatment for irritable bowel syndrome (IBS). We have assessed the efficacy of a moderately low FODMAP diet on persistent symptoms in treated celiac patients. Methods A randomized controlled trial was performed from 2018 to 2019 in 70 adults with biopsy-proven celiac disease. Inclusion criteria were as follows: persistent gastrointestinal symptoms defined by a Gastrointestinal Symptom Rating Scale (GSRS)–IBS version score of 30 or higher, gluten-free diet adherence for 12 months or longer, and serologic and mucosal remission. Participants were randomized to a low FODMAP–gluten-free diet (intervention) or usual gluten-free diet (control). The GSRS-IBS score was recorded at baseline and at weeks 1 to 4, and the Celiac Symptom Index at baseline and at week 4. Statistics included marginal models for repeated data and analyses of covariance. Results We included 34 participants in the intervention group and 36 in the control group. Time development of GSRS–IBS total scores differed significantly between the groups (Pinteraction < .001), evident after 1 week (mean difference in intervention vs control, -8.2; 95% CI, -11.5 to -5.0) and persisting through week 4 (mean difference in intervention vs control, -10.8; 95% CI, -14.8 to -6.8). Moreover, significantly lower scores were found for the dimensions of pain, bloating, diarrhea, and satiety (Pinteraction ≤ .04), but not constipation (Pinteraction = .43). FODMAP intake during the intervention was moderately low (mean, 8.1 g/d; 95% CI, 6.7–9.3 g/d). The Celiac Symptom Index was significantly lower in the intervention group at week 4 (mean difference, -5.8; 95% CI, -9.6 to -2.0). Conclusions A short-term moderately low FODMAP diet significantly reduced gastrointestinal symptoms and increased celiac disease–specific health, and should be considered for the management of persistent symptoms in celiac disease. ClinicalTrials.gov: NCT03678935.

• Paulsen, Mari Mohn; Paur, Ingvild; Henriksen, Christine & Andersen, Lene Frost (2022). Low inter-rater reliability between nurses and researchers for the NRS-2002 screening tool for malnutrition in a hematological hospital ward. Clinical Nutrition ESPEN. ISSN 2405-4577. 51, s. 490–492. doi: 10.1016/j.clnesp.2022.06.107. Fulltekst i vitenarkiv Vis sammendrag

  Background & aims NRS-2002 is one of the recommended tools to screen hospitalized patients for malnutrition. NRS-2002 is considered as valid and reliable, but little is known about the inter-rater reliability between different groups of healthcare professionals. The aim of this study was to test the inter-rater reliability of the NRS-2002 tool between department nurses and researchers. Methods Inter-rater reliability was measured between the NRS-2002 scores given by department nurses and researchers, using data from a randomized controlled trial (RCT) at a hematological department in a Norwegian hospital. Results The mean NRS-2002 score was significantly higher when using researchers' scores compared to the department nurses’ scores. The total agreement between the two groups of raters was 59%, kappa = 0.27. Conclusion The inter-rater reliability of the NRS-2002 scores given by nurses and researchers was low. More research is needed to study if this is applicable also to other patient groups and in other wards.

• Kvammen, Janne Anita; Stensvold, Einar; Godang, Kristin; Bollerslev, Jens; Myklebust, Tor Åge & Brandal, Petter [Vis alle 8 forfattere av denne artikkelen] (2022). Bone mineral density and nutrition in long-term survivors of childhood brain tumors. Clinical Nutrition ESPEN. ISSN 2405-4577. 50, s. 162–169. doi: 10.1016/j.clnesp.2022.05.025. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims Childhood cancer survivors are at risk of unwanted late effects. The primary aim of this study was to assess bone mineral density Z-scores (BMDz) in long-term survivors of childhood medulloblastoma (MB) or central nervous system supratentorial primitive neuroectodermal tumor (CNS-PNET). Secondary aims were to describe nutrient intake, vitamin D status, physical activity and explore potential risk factors for decreased BMDz. Methods All MB and CNS-PNET survivors treated at Oslo University Hospital from 1974 to 2013 were invited to participate in a cross-sectional study. Dual-energy x-ray absorptiometry (Lunar Prodigy) assessed BMDz lumbar spine, BMDz total body, and lean body mass. Decreased BMDz was defined as a combination of low BMDz −1 to −1.99 and very low BMDz ≤−2. Lean body mass index (LMI) was calculated by dividing lean body mass by the squared height. Nutrient intake was assessed by a 3-day food record. Serum 25(OH)D was analyzed. Physical activity was reported by a questionnaire. Descriptive statistics and multivariable Cox regression analyses were applied. Results Fifty survivors with a median age of 25.5 years (5.5–51.9) and a median follow-up time of 19.5 years (3.2–40.5) were included. Mean BMDz lumbar spine was −0.8 (SD 1.1, 95% CI: −1.1 to −0.4), and BMDz total body was −0.6 (SD 1.1, 95% CI: −0.9 to −0.3). Decreased BMDz was detected in 48% of the lumbar spine and 34% of the total body measurements. In all, 62% had low calcium, and 69% had low vitamin D intake. 26% of participants had serum 25(OH)D < 50 nmol/L, and 62% reported an inactive lifestyle. Male sex, higher age at diagnosis, and lower LMI were potential risk factors for decreased BMDz. Conclusions Long-term survivors of childhood MB and CNS-PNET had decreased BMDz, and risk factors were male sex, higher age at diagnosis, and lower LMI. Inadequate calcium and vitamin D intake, an inactive lifestyle, and a high prevalence of 25(OH)D ≤ 50 nmol/L were detected.

• Garnweidner-Holme, Lisa; Hallquist, Marit; Watters, Solveig Ivara Nakken; Gjøvik, Mia; Fredriksen, Marius Pihl & Jonassen, Stephanie [Vis alle 10 forfattere av denne artikkelen] (2022). Attitudes towards and experiences with sourdough and baker’s yeast bread amongst participants in a randomised controlled trial: a qualitative study. Food & Nutrition Research (FNR). ISSN 1654-6628. 66. doi: 10.29219/fnr.v66.8839. Fulltekst i vitenarkiv Vis sammendrag

  Background: Bread is an important source of dietary fibre. However, an increasing number of individuals exclude bread from their habitual diet for various reasons. In recent years, sourdough bread has increased in popularity, and clinical studies have indicated that sourdough bread may decrease gastrointestinal symptoms. Objective: To investigate attitudes towards and experiences with sourdough and baker’s yeast bread amongst participants in a randomised controlled trial (RCT), the health effects and consumer aspects of bread (HELFAB) study. Design: We conducted individual interviews with 10 participants who stated to be sceptical about bread and who participated in an RCT to investigate the health effects of sourdough bread versus baker’s yeast bread. The participants were interviewed on two occasions (before and after the RCT). Interviews were conducted digitally between September and December 2020 and were thematically analysed. Results: Half of the interviewed participants experienced gastrointestinal symptoms, such as pain in the stomach, when they consumed bread prior to the RCT. They often preferred sourdough bread to baker’s yeast bread both before and after the study, since they found that sourdough bread was easier to digest. Participants who were sceptical about bread prior to the study became more positive about bread because of their experiences with the intervention breads. This finding was mainly related to the taste and consistency of sourdough bread. The participants often associated bread with healthiness, mainly due to the dietary fibre content in bread. Conclusions: Sourdough bread with increased dietary fibre may be an important source of dietary fibre for those who perceive gastrointestinal problems from baker’s yeast bread. Participants in this qualitative study stated to change their attitudes towards bread, mainly due to perceived healthiness of the intervention bread.

• Kvammen, Janne Anita; Thomassen, Rut Anne; Buechner, Jochen; Sitsabesan, Ajiitha; Bentsen, Beint Sigmund & Bechensteen, Anne Grete [Vis alle 7 forfattere av denne artikkelen] (2022). Impact of allogeneic hematopoietic stem cell transplantation on nutritional status and intake in children. Journal of Pediatric Gastroenterology and Nutrition - JPGN. ISSN 0277-2116. 75(5), s. 675–682. doi: 10.1097/MPG.0000000000003592. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: This study aimed to describe the impact of allogeneic/haploidentical hematopoietic stem cell transplantation on nutritional status and intake in a group of children aged 2 to 18 years. Methods: In an observational study, data were collected prospectively. Patients were prescribed individual nutritional support by hospital routines. Anthropometrics were measured pre-transplant at hospital admission and weekly from the day of transplant (day 0) until day +28. z scores for weight, height, and BMI were calculated using Norwegian growth references to assess nutritional status. Pre-transplant diet was assessed on the day of hospitalization. Nutrient provision from enteral nutrition (EN = oral and tube) and parenteral nutrition (PN) was assessed by daily records from day +1 until day +28, or previous discharge, and compared with recommendations (RI) from the Nordic Nutrition Recommendations and ESPGHAN guidelines. Total energy intake was presented as the percentage (%) of basal metabolic rate (BMR) calculated by the Schofield equation. Macro- and micronutrient provisions were presented as medians (interquartile range) and the % of RI. Results: Twenty-eight patients, mean age 10.3 years (range 3.5–16.6), were included. Two-thirds (n = 18) had malignant diseases. At admission, mean weight Z-score was −0.3, height z scores −0.7, and BMI Z-score 0.1. Eighteen percent (n = 5) were stunted and 25% (n = 7) had overweight. At admission, 25% (n = 7) had established tube feeding, and 7% (n = 2) also had PN. No significant changes in weight z scores were detected during the studied weeks (P = 0.454). The median daily energy provision was 115% (110–123) of BMR and proteins 1.5 (1.3–1.8) g/kg. EN was provided during a median of 93% of the studied days and provided 21% of the energy. PN was given on a median of 96% of the studied days and provided 79% of energy. RI for vitamins, magnesium, and zinc was met. Provision of copper, iodine, selenium, calcium, and phosphate was below RI. Conclusions: Combined EN and PN providing 115% of BMR and 1.5 g/kg protein ensured stable weight by day +28 and covered RI, except for trace elements and minerals.

• Megen, Frida van; Skodje, Gry Irene; Stendahl, Marianne; Veierød, Marit Bragelien; Lundin, Knut E. A. & Henriksen, Christine (2021). High disease burden in treated celiac patients–a web-based survey. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 56(8), s. 882–888. doi: 10.1080/00365521.2021.1930146. Fulltekst i vitenarkiv Vis sammendrag

  Background Strict adherence to a gluten-free diet usually leads to clinical and histological remission in celiac disease. Few studies have investigated the prevalence of persistent symptoms in a celiac population. We aimed to study the impact of gastrointestinal symptoms on general health in a large number of treated celiac patients, and describe the prevalence of persistent gastrointestinal symptoms and investigate associated factors. Methods Adults with celiac disease filled out background questions, the Celiac Symptom Index (CSI) and the celiac disease adherence test (CDAT) in a web-based national survey. Participants who reported gastrointestinal symptoms during the previous week also recorded the gastrointestinal symptom rating scale-irritable bowel syndrome version (GSRS-IBS). Statistical analysis included chi-squared test, t-test, correlation, and linear regression. Results Of 3834 participants (82% women; mean age 47 years), 54% reported gastrointestinal symptoms the previous week, and 30% of these had CSI score ≥45, indicative of the relatively poor quality of life (vs. 5% among those without gastrointestinal symptoms). The prevalence of persistent gastrointestinal symptoms (GSRS-IBS ≥30) was 40% and the most prominent symptoms were bloating (44%) and pain (37%). Age, sex, symptoms at the time of diagnosis, comorbidity, dietary adherence and CeD-specific health were significantly associated with gastrointestinal symptoms (p < .001). Conclusion In this national cross-sectional study among participants with celiac disease, persistent gastrointestinal symptoms were frequent, and were associated with a high symptom burden and reduced CeD-specific health. Several factors were associated with gastrointestinal symptoms, but more research is needed to find the cause of persistent symptoms in patients with celiac disease.

• Wendel, Kristina; Pfeiffer, Helle Cecilie; Fugelseth, Drude; Nestaas, Eirik; Domellöf, Magnus & Skålhegg, Bjørn Steen [Vis alle 42 forfattere av denne artikkelen] (2021). Effects of nutrition therapy on growth, inflammation and metabolism in immature infants: a study protocol of a double-blind randomized controlled trial (ImNuT). BMC Pediatrics. 21. doi: 10.1186/s12887-020-02425-x. Fulltekst i vitenarkiv Vis sammendrag

  Background: Current nutritional management of infants born very preterm results in significant deficiency of the essential fatty acids (FAs) arachidonic acid (ARA) and docosahexaenoic acid (DHA). The impact of this deficit on brain maturation and inflammation mediated neonatal morbidities are unknown. The aim of this study is to determine whether early supply of ARA and DHA improves brain maturation and neonatal outcomes in infants born before 29 weeks of gestation. Methods: Infants born at Oslo University Hospital are eligible to participate in this double-blind randomized controlled trial. Study participants are randomized to receive an enteral FA supplement of either 0.4 ml/kg MCT-oil™ (medium chain triglycerides) or 0.4 ml/kg Formulaid™ (100 mg/kg of ARA and 50 mg/kg of DHA). The FA supplement is given from the second day of life to 36 weeks' postmenstrual age (PMA). The primary outcome is brain maturation assessed by Magnetic Resonance Imaging (MRI) at term equivalent age. Secondary outcomes include quality of growth, incidence of neonatal morbidities, cardiovascular health and neuro-development. Target sample size is 120 infants (60 per group), this will provide 80% power to detect a 0.04 difference in mean diffusivity (MD, mm2/sec) in major white matter tracts on MRI. Discussion: Supplementation of ARA and DHA has the potential to improve brain maturation and reduce inflammation related diseases. This study is expected to provide valuable information for future nutritional guidelines for preterm infants. Trial registration: Clinicaltrials.gov ID: NCT03555019 . Registered 4 October 2018- Retrospectively registered.

• Henriksen, Christine; Paur, Ingvild; Pedersen, Astrid; Kværner, Ane Sørlie; Ræder, Hanna & Henriksen, Hege [Vis alle 9 forfattere av denne artikkelen] (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), s. 329–336. doi: 10.1016/j.clnu.2021.12.024. Fulltekst i vitenarkiv Vis sammendrag

  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 [Vis alle 12 forfattere av denne artikkelen] (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, s. 360–368. doi: 10.1016/j.clnesp.2021.03.022. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Rosnes, Kristin Stenger; Henriksen, Christine; Høidalen, Anne & Paur, Ingvild (2021). Agreement between the GLIM criteria and PG-SGA in a mixed patient population at a nutrition outpatient clinic. Clinical Nutrition. ISSN 0261-5614. 40(8), s. 5030–5037. doi: 10.1016/j.clnu.2021.07.019. Fulltekst i vitenarkiv Vis sammendrag

  Background & aims The Global Leadership Initiative on Malnutrition (GLIM) criteria is a step-wise process including a screening tool of choice for risk assessment of malnutrition before assessment of diagnosis and grading of malnutrition severity. The agreement between GLIM and the established malnutrition assessment method Patient Generated-Subjective Global Assessment (PG-SGA) is uncertain. Also, several aspects of GLIM remain to be clearly defined. In this study, we compared diagnosis of malnutrition with the GLIM criteria to the PG-SGA, and explored the differences between the methods. Methods This cross-sectional study was conducted at the Nutrition Outpatient Clinic at Oslo University Hospital, Norway. Patients were included from September–December 2019. Nutritional Risk Screening 2002 (NRS-2002) was used as the screening tool in the GLIM process before diagnosing and grading the severity of malnutrition. Results are presented with and without the initial risk screening. The diagnostic results from the GLIM process were compared to the malnutrition diagnosis using the PG-SGA. Results In total, 144 patients, median age 58 years, participated in the study. The full GLIM process identified 36% of the patients as malnourished, while the PG-SGA identified 69% of the patients as malnourished. Comparison of GLIM and PG-SGA showed fair agreement, however the agreement was better when the NRS-2002 screening was excluded. Considering the PG-SGA a gold standard, GLIM had a sensitivity of 51% and a specificity of 98%. The introduction of new cut-off values for fat-free mass did not considerably alter the diagnosis of malnutrition within GLIM. Conclusions The GLIM criteria showed only fair agreement with the PG-SGA, however the agreement was better when the initial NRS-2002 screening was excluded. A joint consensus on how to perform the GLIM process is needed for comparisons of future studies, and before routine use in clinical practice.

• Myhrstad, Mari; Slydahl, Marlene Mari; Hellmann, Monica; Garnweidner-Holme, Lisa; Lundin, Knut Erik Aslaksen & Henriksen, Christine [Vis alle 7 forfattere av denne artikkelen] (2021). Nutritional quality and costs of gluten-free products: a case-control study of food products on the Norwegian marked. Journal of Food and Nutrition Research. ISSN 1336-8672. 65. doi: 10.29219/fnr.v65.6121. Fulltekst i vitenarkiv Vis sammendrag

  Background: Celiac disease is a chronic autoimmune disease triggered by gluten exposure in genetically predisposed individuals. A life-long intake of a gluten-free (GF) diet is required for its management. Wheat, rye and barley are eliminated in a GF diet and the nutritional adequacy of the diet has been questioned. In Norway, cereals and bread constitute a key role of the diet and are the main source of fiber intake. Gluten restrictions may therefore offer important implications for nutrient adequacy especially linked to fiber intake in people with celiac disease. Objective: The aim of the study was to investigate the nutritional quality and price of GF products and compare with gluten-containing counterparts available at instead of in the Norwegian market. Design: The macronutrient content of 423 unique GF products were compared with 337 equivalents with gluten. All products were selected from grocery stores and web-based shops, with the aim of including as many GF products as possible. Listed macronutrients content and price in 11 different food categories were compared to gluten-containing counterparts with Wilcoxon signed rank test. Results: The GF products contained less protein and fiber, and higher content of saturated fat, carbohydrate and salt compared to the gluten-containing products. The total amount of fat was not different between the groups. A similar pattern was found within several of the food categories. More gluten-containing products met the nutrition claim “high in fiber” (fiber > 6 g/100 g) compared to the GF products. The price of the GF products was higher; ranging from 46%–443% more expensive than the gluten-containing products. Conclusion: GF products are less nutritious and have a higher price compared to equivalent gluten-containing products. Knowing that an unhealthy diet is the most important risk factor for developing non-communicable diseases, the nutritional quality of a GF diet needs to be addressed and should be improved.

• Bärebring, Linnea; Kværner, Ane Sørlie; Skotnes, Madeleine; Henriksen, Hege; Skjetne, Anne Juul & Henriksen, Christine [Vis alle 12 forfattere av denne artikkelen] (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, s. 201–207. doi: 10.1016/j.clnesp.2020.09.021. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Birketvedt, Kjersti; Mikkelsen, Audun; Klingen, Louise Laigaard; Henriksen, Christine; Helland, Ingrid B & Emblem, Ragnhild (2020). Nutritional Status in Adolescents with Esophageal Atresia. Journal of Pediatrics. ISSN 0022-3476. 218, s. 130–137. doi: 10.1016/j.jpeds.2019.11.034. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To examine factors that may affect nutritional status in adolescents with esophageal atresia. Study design Anthropometric measurements, blood samples, pH measuring, mapping of dysphagia with a modified Easting Assessment Test questionnaire, 4-day dietary record, and a semistructured interview about eating habits and nutrition counseling were performed in a cross-sectional cohort of adolescents with esophageal atresia. Results Out of 102 eligible patients, 68 (67%) participated. The median height-for-age Z score was −0.6 (−4.6 to 1.8). Ten (15%) were classified as stunted (height-for-age Z score <−2). Fourteen (21%) were overweight. More than two-thirds reported symptoms of dysphagia (Easting Assessment Test score ≥3) and avoided specific foods. Forty-eight (71%) completed the 4-day dietary record, which showed daily intake of energy below age-appropriate recommendations. One-third reported an energy intake below their estimated basal metabolic rate. Only 24% had received counselling from a dietitian. Conclusions Adolescents with a history of esophageal atresia have growth below reference values and energy intake below recommendations. Energy intake and its relation to stunting needs to be further studied in patients with esophageal atresia.

• Thomassen, Rut Anne; Kvammen, Janne Anita; Sæland, Camilla; Kjeserud, Christina; Eikeland, Joakim & Juliusson, Petur Benedikt [Vis alle 8 forfattere av denne artikkelen] (2020). Micronutrients in paediatric Intestinal Failure Patients receiving home parenteral nutrition. Clinical Nutrition. ISSN 0261-5614. 39(11), s. 3452–3460. doi: 10.1016/j.clnu.2020.02.039. Fulltekst i vitenarkiv Vis sammendrag

  Background & aims Children with intestinal failure (IF) receive parental nutrition to ensure adequate growth and development. The aim of this study was to assess micronutrient status in paediatric IF patients receiving home parenteral nutrition (HPN) in comparison to a group of healthy children. Methods An observational cross-sectional study was performed at Oslo University Hospital and at the Department of Nutrition, University of Oslo from January to September 2017. All children with IF, aged two to 18 years, were invited to participate. A reference group of healthy children was recruited through social media advertisement. Dietary intake was assessed by a four-day food record, and enteral and parenteral provision was recorded. Blood samples were analysed for vitamins, minerals and haematology to assess iron status. Two spot urine samples from each subject were analysed for iodine concentration (UIC) and creatinine. Results Nineteen children with IF and 50 healthy children were included. The mean age of the participants was 10.0 years. IF-patients received a median of 76% of their estimated energy requirements from parenteral nutrition (PN). Recommended intake (RI) for iodine from the diet was reached by 16% of IF patients and 28% of healthy children. In the IF group there was a significant positive correlation between UIC and the percentage of iodine intake from oral diet and enteral nutrition support (r = 0.57, p = 0.03). Although the IF patients had a median parenteral iodine supply of more than twice the ESPGHAN recommendation, the median UIC was 89 μg/L indicating insufficient iodine status. This may suggest that the ESPGHAN recommendation for iodine in paediatric parenteral nutrition is too low. The healthy children had sufficient iodine status according to the median UIC (133 μg/L). IF patients had significantly lower total provision of iron compared to the healthy children, 4,9 vs 8,4 mg/day (p = 0.01) with 21% of IF patients and 28% of healthy children reaching RI for iron. The prevalence of anaemia was higher in IF patients than in the healthy children (40 vs.10%, p = 0.016). Conclusion The study indicates an insufficient iodine and iron status among paediatric IF patients. Iodine status was associated with enteral provision and patients had insufficient status even if they received the ESPGHAN recommendation of iodine.

• Valsdottir, Thorhildur Ditta; Øvrebø, Bente; Falck, Thea Martine; Litleskare, Sigbjørn; Johansen, Egil Ivar & Henriksen, Christine [Vis alle 7 forfattere av denne artikkelen] (2020). Low-Carbohydrate High-Fat Diet and Exercise: Effect of a 10-Week Intervention on Body Composition and CVD Risk Factors in Overweight and Obese Women—A Randomized Controlled Trial. Nutrients. 13(1). doi: 10.3390/nu13010110. Fulltekst i vitenarkiv Vis sammendrag

  We assessed the effect of weight-loss induced with a low-carbohydrate-high-fat diet with and without exercise, on body-composition, cardiorespiratory fitness and cardiovascular risk factors. A total of 57 overweight and obese women (age 40 ± 3.5 years, body mass index 31.1 ± 2.6 kg∙m−2) completed a 10-week intervention using a low-carbohydrate-high-fat diet, with or without interval exercise. An equal deficit of 700 kcal∙day−1 was prescribed, restricting diet only, or moderately restricting diet and adding exercise, producing four groups; normal diet (NORM); low-carbohydrate-high-fat diet (LCHF); normal diet and exercise (NORM-EX); and low-carbohydrate-high-fat diet and exercise (LCHF-EX). Linear Mixed Models were used to assess between-group differences. The intervention resulted in an average 6.7 ± 2.5% weight-loss (p < 0.001). Post-intervention % fat was lower in NORM-EX than NORM (40.0 ± 4.2 vs. 43.5 ± 3.5%, p = 0.024). NORM-EX reached lower values in total cholesterol than NORM (3.9 ± 0.6 vs. 4.7 ± 0.7 mmol/L, p = 0.003), and LCHF-EX (3.9 ± 0.6 vs. 4.9 ± 1.1 mmol/L, p = 0.004). Post intervention triglycerides levels were lower in NORM-EX than NORM (0.87 ± 0.21 vs. 1.11 ± 0.34 mmol/L, p = 0.030). The low-carbohydrate-high-fat diet had no superior effect on body composition, V˙O2peak or cardiovascular risk factors compared to a normal diet, with or without exercise. In conclusion, the intervention decreased fat mass, but exercise improved body composition and caused the most favorable changes in total cholesterol and triglycerides in the NORM-EX. Exercise increased cardiorespiratory fitness, regardless of diet.

• Garnweidner-Holme, Lisa; Sende, Karla; Hellmann, Monica; Henriksen, Christine; Lundin, Knut Erik Aslaksen & Myhrstad, Mari [Vis alle 7 forfattere av denne artikkelen] (2020). Experiences of managing a gluten-free diet on multiple levels of society: a qualitative study. BMC Nutrition. 6:65, s. 1–7. doi: 10.1186/s40795-020-00390-3. Fulltekst i vitenarkiv Vis sammendrag

  Background: Coeliac disease (CD) is an immune-mediated enteropathy against dietary gluten. The treatment for CD is a strict life-long gluten-free (GF) diet, which has a profound effect on a person’s life. In recent years, there has been an increase in the availability of gluten-free products. This study investigates how people with CD experience and manage a GF diet. Methods: Semi-structured, individual interviews were conducted in different areas of Norway. The analysis was guided by Interpretative Phenomenological Analysis. Participants with CD (n = 12) varied in terms of gender, age, family composition and time since diagnosed. Results: The analysis revealed challenges for a GF diet at the individual, interpersonal, community and policy levels. At the individual level, the participants explained that it took time to gain knowledge about a GF diet, and they expressed uncertainty about the healthiness of a GF diet. At the interpersonal level, the feeling of being different and the fear of gluten contamination were barriers to the enjoyment of social meals. At the community level, the participants asked for a wider selection of tastier GF products to purchase and increased knowledge about CD among those who prepare and sell GF foods. At the policy level, the participants asked for political action to make GF products more affordable. Conclusions: This study indicates that people with CD should be given information about how to manage a GF diet right after being diagnosed with CD. The food industry should be encouraged to produce healthy and tasty GF products.

• Henriksen, Christine; Thoresen, Britt Lene; Fjøseide, Berit; Lorentzen, Sissi C. Stove; Balstad, Trude Rakel & Ottery, Faith [Vis alle 7 forfattere av denne artikkelen] (2020). Linguistic and content validation of the translated and culturally adapted PG-SGA, as perceived by Norwegian cancer patients and healthcare professionals. Clinical Nutrition ESPEN. ISSN 2405-4577. 38, s. 178–184. doi: 10.1016/j.clnesp.2020.05.006. Fulltekst i vitenarkiv Vis sammendrag

  Background & aims The Scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a validated nutritional screening, assessment, monitoring, and triage tool. When translated to other languages, the questions and answering items need to be conceptually, semantically, and operationally equivalent to the original tool. In this study, we aimed to assess linguistic and content validity of the PG-SGA translated and culturally adapted for the Norwegian setting, as perceived by Norwegian cancer patients and healthcare professionals (HCPs). Methods We have translated and culturally adapted the original PG-SGA for the Norwegian setting, in concordance with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Cancer patients and HCPs, including nurses, dietitians and physicians, were invited to participate. Comprehensibility and difficulty were assessed by patients for the patient component (PG-SGA Short Form), and by HCPs for the professional component. Content validity was assessed for the full PG-SGA by HCPs only. The data were collected by a questionnaire and evaluations were operationalized by a 4-point scale. Item and scale indices were calculated for comprehensibility (Item CI, Scale CI), difficulty (Item DI, Scale DI) and content validity (Item CVI, Scale CVI). Results Fifty-one cancer patients and 92 HCPs participated in the study. The patients perceived comprehensibility and difficulty of the Norwegian PG-SGA Short Form as excellent (Scale CI = 0.99 and DI = 0.97). However, HCPs perceived comprehensibility and difficulty of the professional component as below acceptable (Scale CI = 0.78 and DI = 0.66), and the physical exam was being rated as the most difficult part (Item DI 0.26 to 0.65). Content validity for the full Norwegian PG-SGA was considered excellent (Scale CVI = 0.99) by the HCPs. Conclusion The patient component of PG-SGA was considered clear and easy to complete, and the full Norwegian PG-SGA was considered as relevant by HCPs. In the final Norwegian PG-SGA, changes have been made to improve comprehensibility of the professional component. To improve perceived difficulty of completing the professional component, training of professionals is indicated.

• Kvammen, Janne Anita; Thomassen, Rut Anne; Kjeserud, Christina; Sæland, Camilla; Godang, Kristin & Bollerslev, Jens [Vis alle 10 forfattere av denne artikkelen] (2020). Bone mineral density and vitamin D in paediatric intestinal failure patients receiving home parenteral nutrition. Clinical Nutrition ESPEN. ISSN 2405-4577. 39, s. 234–241. doi: 10.1016/j.clnesp.2020.06.006. Fulltekst i vitenarkiv Vis sammendrag

  Background & aims Patients with intestinal failure (IF) are dependent on long-term home parenteral nutrition (HPN) to ensure growth and development. The primary aim of the present study was to assess bone mineral density (BMD) and vitamin D status in paediatric IF patients on HPN and a group of healthy children aged 2–18 years. Secondary aims were to assess growth, body composition, nutrient provision and physical activity. Methods An observational cross-sectional study was performed at Oslo University Hospital and at the Department of Nutrition, University of Oslo, from January to September 2017. Dual energy x-ray absorptiometry (DXA; Lunar Prodigy in IF patients and Lunar iDXA in healthy subjects) was performed to assess BMD and body composition. BMD z-score (BMDz) was calculated for total body and lumbar spine L2-L4 based on the integrated reference population in the software. Weight and height were measured for growth assessment. Nutrient provision was assessed by a 4-day food record. Blood samples were analysed for 25-hydroxy-vitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D). Physical activity was reported by a questionnaire. Results Nineteen IF patients and 50 healthy children were included. The mean age of participants was 10.0 years. The aetiology of IF patients was paediatric intestinal pseudo-obstruction (58%), short bowel syndrome (26%), and intestinal enteropathy (16%). Lower median BMDz for total body (−0.4 vs 1.1, P < 0.001) and lumbar spine L2-L4 (−0.9 vs 0.2, P = 0.01) were found in the IF group compared with the healthy children. Vitamin D provision was significantly higher in IF patients (17 μg/d vs 5.3 μg/d, P < 0.001). Both groups were sufficient in 25(OH)D (IF patients 71 nmol/L vs healthy 81 nmol/L). Nevertheless, IF patients had significantly lower 1,25(OH)2D than healthy children (71 pmol/L vs 138 pmol/L, P < 0.001). The IF group was significantly shorter (height for age z-score −1,5 vs 0,1, P = 0.001) and lighter (weight for age z-score −1,0 vs 0,1, P = 0.009) compared with the healthy subjects. BMIz did not differ; however, body fat percentage was significantly higher in IF patients compared with healthy children (34% vs 25%, P = 0.02). A lower frequency of physical activity was found in the IF group compared with the healthy group (P = 0.001). Conclusions Paediatric IF patients on HPN had lower BMD, impaired growth, and higher body fat percentage in comparison with the healthy children. Despite a higher total supply of vitamin D in the IF group, the levels of 25(OH)D did not differ. Nevertheless, a significantly lower level of 1,25(OH)2D was found in IF patients. The results raise questions regarding differences between oral and parenteral vitamin D provision and whether intestinal function is important for the metabolism of vitamin D.

• Paulsen, Mari Mohn; Paur, Ingvild; Gjestland, Johanna; Henriksen, Christine; Varsi, Cecilie & Tangvik, Randi Julie [Vis alle 7 forfattere av denne artikkelen] (2020). Effects of using the MyFood decision support system on hospitalized patients' nutritional status and treatment: A randomized controlled trial. Clinical Nutrition. ISSN 0261-5614. 39(12), s. 3607–3617. doi: 10.1016/j.clnu.2020.03.012. Fulltekst i vitenarkiv Vis sammendrag

  Background & aims Compliance to guidelines for disease-related malnutrition is documented as poor. The practice of using paper-based dietary recording forms with manual calculation of the patient's nutritional intake is considered cumbersome, time-consuming and unfeasible among the nurses and does often not lead to appropriate nutritional treatment. We developed the digital decision support system MyFood to deliver a solution to these challenges. MyFood is comprised of an app for patients and a website for nurses and includes functions for dietary recording, evaluation of intake compared to requirements, and a report to nurses including tailored recommendations for nutritional treatment and a nutritional care plan for documentation. The study aimed to investigate the effects of using the MyFood decision support system during hospital stay on adult patients' nutritional status, treatment and hospital length of stay. The main outcome measure was weight change. Methods The study was a parallel-arm randomized controlled trial. Patients who were allocated to the intervention group used the MyFood app during their hospital stay and the nurses were encouraged to use the MyFood system. Patients who were allocated to the control group received routine care. Results We randomly assigned 100 patients (51.9 ± 14 y) to the intervention group (n = 49) and the control group (n = 51) between August 2018 and February 2019. Losses to follow-up were n = 5 in the intervention group and n = 1 in the control group. No difference was found between the two groups with regard to weight change. Malnutrition risk at discharge was present in 77% of the patients in the intervention group and 94% in the control group (p = 0.019). Nutritional treatment was documented for 81% of the patients in the intervention group and 57% in the control group (p = 0.011). A nutritional care plan was created for 70% of the intervention patients compared to 16% of the control patients (p < 0.001). Conclusions The intervention had no effect on weight change during hospital stay. A higher proportion of the patients in the control group was malnourished or at risk of malnutrition at hospital discharge compared to the patients in the intervention group. The documentation of nutritional intake, treatment and nutritional care plans was higher for the patients using the MyFood system compared to the control group. This trial was registered at clinicaltrials.gov (NCT03412695).

• Skodje, Gry Irene; Minelle, Ingunn Hillestad; Rolfsen, Kjersti; Iacovou, Marina; Lundin, Knut Erik Aslaksen & Veierød, Marit Bragelien [Vis alle 7 forfattere av denne artikkelen] (2019). Dietary and symptom assessment in adults with self-reported non-coeliac gluten sensitivity. Clinical Nutrition ESPEN. ISSN 2405-4577. 31, s. 88–94. doi: 10.1016/j.clnesp.2019.02.012. Fulltekst i vitenarkiv
• Valsdottir, Thorhildur; Henriksen, Christine; Odden, Nancy; Nellemann, Birgitte; Jeppesen, Per B & Hisdal, Jonny [Vis alle 8 forfattere av denne artikkelen] (2019). Effect of a Low-Carbohydrate High-Fat Diet and a Single Bout of Exercise on Glucose Tolerance, Lipid Profile and Endothelial Function in Normal Weight Young Healthy Females. Frontiers in Physiology. 10, s. 1–15. doi: 10.3389/fphys.2019.01499. Fulltekst i vitenarkiv Vis sammendrag

  Low-carbohydrate-high-fat (LCHF) diets are efficient for weight loss, and are also used by healthy people to maintain bodyweight. The main aim of this study was to investigate the effect of 3-week energy-balanced LCHF-diet, with >75 percentage energy (E%) from fat, on glucose tolerance and lipid profile in normal weight, young, healthy women. The second aim of the study was to investigate if a bout of exercise would prevent any negative effect of LCHF-diet on glucose tolerance. Seventeen females participated, age 23.5 ± 0.5 years; body mass index 21.0 ± 0.4 kg/m2, with a mean dietary intake of 78 ± 1 E% fat, 19 ± 1 E% protein and 3 ± 0 E% carbohydrates. Measurements were performed at baseline and post-intervention. Fasting glucose decreased from 4.7 ± 0.1 to 4.4 mmol/L (p < 0.001) during the dietary intervention whereas fasting insulin was unaffected. Glucose area under the curve (AUC) and insulin AUC did not change during an OGTT after the intervention. Before the intervention, a bout of aerobic exercise reduced fasting glucose (4.4 ± 0.1 mmol/L, p < 0.001) and glucose AUC (739 ± 41 to 661 ± 25, p = 0.008) during OGTT the following morning. After the intervention, exercise did not reduce fasting glucose the following morning, and glucose AUC during an OGTT increased compared to the day before (789 ± 43 to 889 ± 40 mmol/L∙120min–1, p = 0.001). AUC for insulin was unaffected. The dietary intervention increased total cholesterol (p < 0.001), low-density lipoprotein (p ≤ 0.001), high-density lipoprotein (p = 0.011), triglycerides (p = 0.035), and free fatty acids (p = 0.021). In conclusion, 3-week LCHF-diet reduced fasting glucose, while glucose tolerance was unaffected. A bout of exercise post-intervention did not decrease AUC glucose as it did at baseline. Total cholesterol increased, mainly due to increments in low-density lipoprotein. LCHF-diets should be further evaluated and carefully considered for healthy individuals.

• Henriksen, Hege Berg; Henriksen, Christine; Ræder, Hanna; Kværner, Ane Sørlie; Skjetne, Anne Juul & Bøhn, Siv Kjølsrud [Vis alle 11 forfattere av denne artikkelen] (2019). Hvilke kostråd skal man gi til pasienter behandlet for tarmkreft? Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. s. 32–36. Fulltekst i vitenarkiv
• Madsen, Andrea; Fredwall, Svein Otto; Månum, Grethe; Henriksen, Christine & Slettahjell, Hanne Bjørg (2019). Anthropometrics, diet, and resting energy expenditure in Norwegian adults with achondroplasia. American Journal of Medical Genetics. Part A. ISSN 1552-4825. 179(9), s. 1745–1755. doi: 10.1002/ajmg.a.61272. Fulltekst i vitenarkiv Vis sammendrag

  Individuals with achondroplasia have a high prevalence of obesity and increased risk of cardiovascular disease. Fat distribution, diet, and caloric intake are known risk factors, but the literature concerning diet and energy balance in achondroplasia is limited. The main aim of this study was to describe the anthropometrics, diet, and resting energy expenditure (REE) in a Norwegian adult achondroplasia population. Here, we present a descriptive cross‐sectional study with the following variables: anthropometrics, the SmartDiet questionnaire, and dietary records. In addition, REE was measured and estimated using indirect calorimetry and prediction equations. A total of 33 adults with achondroplasia participated with a mean age of 40 years. Mean body mass index was 34.1 kg/m2, and mean waist circumference was 94.1 cm for men and 82.2 cm for women. Their diets were classified as unhealthy (38%) or in need of improvement (62%). The mean REE values for the total group were 21 kcal/kg for the male (n = 15) and 20 kcal/kg for the female (n = 18). This study revealed a high frequency of central obesity and unhealthy dietary habits in Norwegian adults with achondroplasia. Mean energy intake was low and only 10% higher than the mean REE, and does not explain the high prevalence of abdominal obesity in our population.

• Bjørkhaug, Steinar Traae; Aanes, Håvard; Neupane, Sudan Prasad; Bramness, Jørgen Gustav; Malvik, Stine & Henriksen, Christine [Vis alle 9 forfattere av denne artikkelen] (2019). Characterization of gut microbiota composition and functions in patients with chronic alcohol overconsumption. Gut microbes. ISSN 1949-0976. 10(6), s. 663–675. doi: 10.1080/19490976.2019.1580097. Fulltekst i vitenarkiv Vis sammendrag

  Excessive alcohol intake can alter the gut microbiota, which may underlie the pathophysiology of alcohol-related diseases. We examined gut microbiota composition and functions in patients with alcohol overconsumption for >10 years, compared to a control group of patients with a history of no or low alcohol intake. Faecal microbiota composition was assessed by 16S rRNA sequencing. Gut microbiota functions were evaluated by quantification of short-chain fatty acids (SCFAs) and predictive metagenome profiling (PICRUSt). Twenty-four patients, mean age 64.8 years (19 males), with alcohol overconsumption, and 18 control patients, mean age 58.2 years (14 males) were included. The two groups were comparable regarding basic clinical variables. Nutritional assessment revealed lower total score on the screening tool Mini Nutritional Assessment, lower muscle mass as assessed by handgrip strength, and lower plasma vitamin C levels in the alcohol overconsumption group. Bacteria from phylum Proteobacteria were found in higher relative abundance, while bacteria from genus Faecalibacterium were found in lower relative abundance in the group of alcohol overconsumers. The group also had higher levels of the genera Sutterella, Holdemania and Clostridium, and lower concentration and percentage of butyric acid. When applying PICRUSt to predict the metagenomic composition, we found that genes related to invasion of epithelial cells were more common in the group of alcohol overconsumers. We conclude that gut microbiota composition and functions in patients with alcohol overconsumption differ from patients with low consumption of alcohol, and seem to be skewed into a putative pro-inflammatory direction.

• Kværner, Ane Sørlie; Minaguchi, Jun; Yamani, Naouale El; Henriksen, Christine; Ræder, Hanna & Paur, Ingvild [Vis alle 12 forfattere av denne artikkelen] (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, s. 16–24. doi: 10.1016/j.dnarep.2018.01.005. Fulltekst i vitenarkiv
• Kvammen, Janne Anita; Thomassen, Rut Anne; eskerud, mari borge; Rugtveit, Jarle & Henriksen, Christine (2018). Micronutrient Status and Nutritional Intake in 0- to 2-Year-old Children Consuming a Cows' Milk Exclusion Diet. Journal of Pediatric Gastroenterology and Nutrition - JPGN. ISSN 0277-2116. 66(5), s. 831–837. doi: 10.1097/MPG.0000000000001942. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: To study micronutrient status and nutritional intake from complementary feeding in children on a cows’ milk exclusion (CME) diet. Methods: Fifty-seven children with cows’ milk allergy, younger than 2 years, were included in a cross-sectional study. Blood was analyzed for micronutrient status. Complementary feeding was defined as all solids and liquids except of breast milk, and assessed by 3-day food diary. The results were analyzed according to 3 feeding patterns: mainly breast-fed (mBF), partially breast-fed, and no breast milk group (nBM). Results: The children had a median age of 9 months and micronutrient status was within normal range for total homocysteine (p-tHcy), s-B12, s-folate, b-Hb, s-ferritin, s-zinc, and s-25(OH)D. There were no significant differences between feedings groups, except for B12-biomarkers. The mBF had higher p-tHcy (P < 0.000) and lower s-B12 (P = 0.002) compared nBM. Vitamin B12 deficiency (p-tHcy >6.5 μmol/L combined with s-B12 <250 pmol/L) was found in 12% of participants, most frequently among the mBF (36%) and none in nBM group (P = 0.009). Vitamin B12 intake from complementary feeding was negatively correlated with p-tHcy (r = −0.479, P = 0.001) and positively with s-B12 (r = 0.410, P = 0.003). Iron deficiency anemia was found in 5%. Iron intake correlated positively with b-Hb (r = 0.324, P = 0.02). Zinc deficiency was found in 7% and low 25(OH)D in 9%. Vitamin D intake was positively correlated with the use of supplements (r = 0.456, P = 0.001). Conclusion: The risk of B12 deficiency was high in mBF infants on CME diet, and complementary feeding was associated with better B12 status. Iron, zinc, and vitamin D deficiencies were present in all feeding groups. Complementary feeding should be introduced at 4 to 6 months of age. Vitamin D supplement is recommended to ensure adequate intake.

• Ræder, Hanna; Henriksen, Christine; Bøhn, Siv Kjølsrud; Vilbo, Anne-Rikke; Henriksen, Hege & Kværner, Ane Sørlie [Vis alle 10 forfattere av denne artikkelen] (2018). Agreement between PG-SGA category and fat-free mass in colorectal cancer patients. Clinical Nutrition ESPEN. ISSN 2405-4577. 27, s. 24–31. doi: 10.1016/j.clnesp.2018.07.005. Fulltekst i vitenarkiv Vis sammendrag

  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 [Vis alle 10 forfattere av denne artikkelen] (2018). Validation of two short questionnaires assessing physical activity in colorectal cancer patients. BMC sports science, medicine and rehabilitation. 10:8(8), s. 1–12. doi: 10.1186/s13102-018-0096-2. Fulltekst i vitenarkiv Vis sammendrag

  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 [Vis alle 11 forfattere av denne artikkelen] (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, s. 1–15. doi: 10.29219/fnr.v62.1306. Fulltekst i vitenarkiv
• Henriksen, Christine; Brenno, Silje Golberg; Ulven, Stine Marie; Holven, Kirsten Bjørklund & Ottestad, Inger (2018). Helserelatert livskvalitet og ernæringsstatus blant eldre hjemmeboende over 70 år. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. doi: 10.18261/ntfe.16.2.2. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Det er vanlig å inkludere helserelatert livskvalitet i kliniske studier, men det er få som har undersøkt dette hos eldre hjemme boende ≥ 70 år. Hensikten med denne studien var primært å beskrive helserelatert livskvalitet blant eldre hjemme boende personer. Sekundært ønsket vi å undersøkeom livskvalitet varierte med kjønn, alder og ernæringsstatus. Materiale og metode: 406 eldre ≥ 70 år deltok i denne tverrsnittstudien. Livskvalitet ble målt ved Short Form (SF)-36 Health Survey versjon 2 som består av åtte domener: fysisk funksjon, fysisk rolle funksjon, smerte, generell helse, sosial funksjon, vitalitet, psykisk rollefunk sjon og mental helse. Ernæringsstatus ble vurdert ved bruk av Mini Nutrition al Assessment (MNA). Resultater: Deltakerne hadde høy helserelatert livskvalitet, men kvinner over 80 år skåret lavere enn de yngre. Gjennomsnittsskår varierte fra 65-91 for kvinner og fra 68-91 hos menn for de ulike domene. Kvinner hadde signifikant lavere poeng sum på tre helsedomener (fysisk funksjon, smerte og psykisk rolle funksjon) sammenliknet med menn. Total MNA poengskår korrelerte signifikant med alle helsedomenene (r=0,13-0,39). Fortolkning: Denne selekterte gruppen av hjemmeboende eldre rapporterte om god helserelatert livskvalitet, men den var lavere blant de over 80 år, spesielt hos kvinner. Kvinner hadde en lavere livskvalitet enn menn. Dårligere ernæringsstatus var assosiert med lavere helserelatert livskvalitet.

• Skodje, Gry Irene; Henriksen, Christine; Salte, Tore; Drivenes, Therese; Toleikyte, Ieva & Løvik, Astrid [Vis alle 8 forfattere av denne artikkelen] (2017). Wheat challenge in self-reported gluten sensitivity: a comparison of scoring methods. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 52(2), s. 185–192. doi: 10.1080/00365521.2016.1244705. Fulltekst i vitenarkiv Vis sammendrag

  Background: The condition non-coeliac gluten sensitivity (NCGS) is clinically similar to coeliac disease, but lack objective diagnostic criteria. Symptom relief on gluten-free diet followed by gluten containing food challenge may confirm the condition in clinical settings. Aim: To describe the results of an open bread challenge in patients with suspected NCGS, and to compare the results with recently suggested cut-offs for symptom change. Material and methods: Fifty-six patients (12 males) self-instituted on gluten-free diet with negative coeliac disease diagnostics were examined for NCGS by an open bread challenge. Symptoms were reported by Gastrointestinal Symptom Rating Scale, IBS-version (GSRS-IBS) and visual analogue scale (VAS). Results were retrospectively compared to the Salerno and Monash cut-offs for symptom change. Results: Forty-seven patients were diagnosed with NCGS. Total GSRS-IBS score and overall symptoms by VAS increased significantly in NCGS (p < .001), but not in non-NCGS patients (p < .12 and p = .08, respectively). Total GSRS-IBS challenge score and overall symptoms by VAS were significantly higher in NCGS than in non-NCGS patients (53 vs. 37, p = .004 and 76 vs. 39 mm, p = .02, respectively). Applying the Salerno and Monash cut-offs, 63 and 75% would be classified with NCGS, respectively. According to total GSRS–IBS absolute agreement was lowest between clinician’s diagnosis and Salerno cut-off (63%) and highest between Salerno and Monash cut-offs (88%). Conclusion: Clinician diagnosed 85% with NCGS. The proportion of NCGS was lower according to the Salerno and Monash cut-offs. The Salerno cut-off should be the starting point for a common definition of symptom change. This research has been published in the Scandinavian Journal of Gastroenterology. © 2016 Taylor & Francis

• Skodje, Gry Irene; Sarna, Vikas Kumar; Minelle, Ingunn Hillestad; Rolfsen, Kjersti Langballe; Muir, Jane & Gibson, Peter R. [Vis alle 9 forfattere av denne artikkelen] (2017). Fructan, rather than gluten, as symptom trigger in self-reported non-celiac gluten sensitivity. Gastroenterology. ISSN 0016-5085. 154(3), s. 529–539.e2. doi: 10.1053/j.gastro.2017.10.040. Fulltekst i vitenarkiv Vis sammendrag

  Background & Aims: Non-celiac gluten sensitivity is characterized by symptom improvement after gluten withdrawal in absence of celiac disease. The mechanisms of non-celiac gluten sensitivity are unclear, and there are no biomarkers for this disorder. Foods with gluten often contain fructans, a type of fermentable oligo-, di-, monosaccharides and polyols. We aimed to investigate the effect of gluten and fructans separately in individuals with self-reported gluten sensitivity. Methods: We performed a double-blind crossover challenge of 59 individuals on a self-instituted gluten-free diet, for whom celiac disease had been excluded. The study was performed at Oslo University Hospital in Norway from October 2014 through May 2016. Participants were randomly assigned to groups placed on diets containing gluten (5.7 g), fructans (2.1 g), or placebo, concealed in muesli bars, for 7 days. Following a minimum 7-day washout period (until the symptoms induced by the previous challenge were resolved), participants crossed over into a different group, until they completed all 3 challenges (gluten, fructan, and placebo). Symptoms were measured by Gastrointestinal Symptom Rating Scale Irritable Bowel Syndrome (GSRS-IBS) version. A linear mixed model for analysis was used. Results: Overall GSRS-IBS scores differed significantly during gluten, fructan, and placebo challenges; mean values were 33.1 ± 13.3, 38.6 ± 12.3, and 34.3 ± 13.9, respectively (P = .04). Mean scores for GSRS-IBS bloating were 9.3 ± 3.5, 11.6 ± 3.5, and 10.1 ± 3.7, respectively, during the gluten, fructan, and placebo challenges (P = .004). The overall GSRS-IBS score for participants consuming fructans was significantly higher than for participants consuming gluten (P = .049), as was the GSRS bloating score (P = .003). Thirteen participants had the highest overall GSRS-IBS score after consuming gluten, 24 had the highest score after consuming fructan, and 22 had the highest score after consuming placebo. There was no difference in GSRS-IBS scores between gluten and placebo groups. Conclusions: In a randomized, double-blind, placebo-controlled crossover study of individuals with self-reported non-celiac gluten sensitivity, we found fructans to induce symptoms, measured by the GSRS-IBS. Clinicaltrials.gov no: NCT02464150.

• Henriksen, Christine; Gjelstad, Ingrid Merethe Fange; Nilssen, Hugo & Blomhoff, Rune (2017). A low proportion of malnourished patients receive nutrition treatment - results from nutritionDay. Food & Nutrition Research (FNR). ISSN 1654-6628. 61:1391667, s. 1–9. doi: 10.1080/16546628.2017.1391667. Fulltekst i vitenarkiv Vis sammendrag

  NutritionDay is a yearly point-prevalence study of malnutrition in hospitals from more than 50 countries. The aim of the present study was to quantify the frequency of malnutrition and the proportion of malnourished patients receiving nutritional treatment in two university hospitals in Norway using data from nutritionDay. All units at Oslo University Hospital (OUH) and University Hospital of Northern Norway (UNN) were invited to participate in nutritionDay 2014, and 28 out of 85 eligible units agreed to take part. Malnutrition was diagnosed based on body mass index (BMI), weight reduction and food intake in the previous week, according to national guidelines and ESPEN criteria. Data from 488 patients were available, representing 90.1% of occupied beds in participating units. Thirty percent of the patients were diagnosed malnourished when national criteria were used, and only 41% of these patients received nutritional treatment. The estimated malnutrition rate was 11% when the ESPEN consensus criteria were used. Data on weight or height were frequently missing in the patient records, and BMI could only be calculated in two-thirds of the patients. The frequency of low BMI (<18.5 kg/m 2 ) was only 5%. Involuntary weight loss was present in 37% of the patients, and 60% had eaten less than normal in the previous week. Oncology units had the highest frequency of patients with low BMI, and the highest weight loss and overall malnutrition rate. Surgery and geriatric units had the highest rate of patients with low food intake. In this study, nearly 60% of the malnourished patients did not receive any nutritional treatment, and this indicates a potential for improved nutritional care and cost savings. Low food intake and weight loss were frequent at these two Norwegian hospitals, and in line with previous reports from nutritionDay in other countries.

• Alhaug, Johanne; Gay, Caryl; Henriksen, Christine & Lerdal, Anners (2017). Pressure ulcer is associated with malnutrition as assessed by Nutritional Risk Screening (NRS 2002) in a mixed hospital population. Food & Nutrition Research (FNR). ISSN 1654-6628. 61. doi: 10.1080/16546628.2017.1324230. Fulltekst i vitenarkiv Vis sammendrag

  Background and aim : Pressure ulcers (PUs) and malnutrition represent a significant health problem for hospital inpatients. Satisfactory nutritional status is crucial for proper wound healing. Risk of malnutrition can be identified using standardized screening tools, such as the Nutritional Risk Screening (NRS) 2002. Objective : The objective of this study was to examine whether nutritional status based on the NRS 2002 is associated with PU in hospital inpatients. Design : The data for this cross-sectional analysis were based on 10 screening days between September 2012 and May 2014. All adult inpatients admitted to a medical or surgical ward on the screening days were evaluated for eligibility. Nursing students and ward nurses conducted the NRS 2002 initial screening and skin examinations for PU classification (Stages I–IV). A registered clinical dietician conducted all NRS 2002 final screenings. Results : The sample consisted of 651 patients, with mean age 62.9 years. Skin examinations indicated an 8% PU prevalence. Factors associated with PUs included age ≥ 70 years, low body mass index (BMI) and hospitalization in the medical department. Based on the initial screening, 48% were at ‘Low risk’ for malnutrition and 52% were at ‘Possible risk’. After final screening, 34% of the sample was identified as ‘At risk’ for malnutrition. Patients identified at ‘Possible risk’ by the initial screening or ‘At risk’ by the final screening were more likely than patients at ‘Low risk’ to have a PU (OR = 2.58 and 2.55, respectively). Each of the three initial screening items was significantly associated PU, with ‘Is BMI<20?’ and ‘Ate less past week?’ having the strongest associations. Conclusion : Nutritional risk using the NRS 2002 is associated with the presence of PU in a mixed hospital population. The final screening had a slightly stronger association with PU compared to the initial screening.

• Ræder, Hanna; Kværner, Ane Sørlie; Henriksen, Christine; Florholmen, Geir; Henriksen, Hege & Bøhn, Siv Kjølsrud [Vis alle 9 forfattere av denne artikkelen] (2017). Validity of bioelectrical impedance analysis in estimation of fat-free mass in colorectal cancer patients. Clinical Nutrition. ISSN 0261-5614. 37(1), s. 292–300. doi: 10.1016/j.clnu.2016.12.028. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Almaas, Astrid; Tamnes, Christian Krog; Nakstad, Britt; Henriksen, Christine; Grydeland, Håkon & Walhovd, Kristine B [Vis alle 9 forfattere av denne artikkelen] (2016). Diffusion tensor imaging and behavior in premature infants at 8 years of age, a randomized controlled trial with long-chain polyunsaturated fatty acids. Early Human Development. ISSN 0378-3782. 95, s. 41–46. doi: 10.1016/j.earlhumdev.2016.01.021. Fulltekst i vitenarkiv
• Beek, Lies ter; Vanhauwaert, Erika; Slinde, Frode; Orrevall, Ylva; Henriksen, Christine & Johansson, Madelene [Vis alle 9 forfattere av denne artikkelen] (2016). Unsatisfactory knowledge and use of terminology regarding malnutrition, starvation, cachexia and sarcopenia among dietitians. Clinical Nutrition. ISSN 0261-5614. 35(6), s. 1450–1456. doi: 10.1016/j.clnu.2016.03.023. Fulltekst i vitenarkiv
• Thomassen, Rut Anne; Kvammen, Janne Anita; Eskerud, Mari Borge; Juliusson, Petur Benedikt; Henriksen, Christine & Rugtveit, Jarle (2016). Iodine status and growth in 0-2-year-old infants with cow's milk protein allergy. Journal of Pediatric Gastroenterology and Nutrition - JPGN. ISSN 0277-2116. 64(5), s. 806–811. doi: 10.1097/MPG.0000000000001434. Fulltekst i vitenarkiv
• Henriksen, Christine; Almaas, Astrid; Westerberg, Ane Cecilie; Drevon, Christian A; Iversen, Per Ole & Nakstad, Britt (2016). Growth, metabolic markers, and cognition in 8-year old children born prematurely, follow-up of a randomized controlled trial with essential fatty acids. European Journal of Pediatrics. ISSN 0340-6199. 175(9), s. 1165–1174. doi: 10.1007/s00431-016-2755-1. Fulltekst i vitenarkiv
• Volta, Umberto; Caio, G; Giorgio, R De; Henriksen, Christine; Skodje, Gry Irene & Lundin, Knut E A (2015). Non-celiac gluten sensitivity: a work-in-progress entity in the spectrum of wheat-related disorders. Baillière's Best Practice & Research Clinical Gastroenterology. ISSN 1521-6918. 29(3), s. 477–491. doi: 10.1016/j.bpg.2015.04.006. Fulltekst i vitenarkiv

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• Retterstøl, Kjetil; Henriksen, Christine & Borchenius, Cathrine (2019). Klinisk Ernæring. Gyldendal Norsk Forlag A/S. ISBN 9788205523937. 254 s. Fulltekst i vitenarkiv

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• Myrvoll, Eli Anne & Henriksen, Christine (2025). Dansk professor: – Ikke gi barna multivitamin. [Internet]. Forskning.no. doi: https:/www.forskning.no/barn-og-ungdom-vitaminer/dansk-professor-ikke-gi-barna-multivitamin/2584155. Fulltekst i vitenarkiv Vis sammendrag

  Foreldre risikerer å forgifte barna sine med multivitamin, ifølge Susanne Bügel. Nei, de gjør ikke det – men vær oppmerksom på at de ikke får i seg for mye, sier norsk forsker.

• Hay, Gry; Fadnes, Lars T.; Meltzer, Helle Margrete; Arnesen, Erik Kristoffer & Henriksen, Christine (2022). Oppfølging av gravide, ammende og spedbarn med vegetarisk eller vegansk kosthold. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 142. doi: 10.4045/tidsskr.21.0847. Fulltekst i vitenarkiv
• Paur, Ingvild; Henriksen, Christine; Kværner, Ane Sørlie; Bøhn, Siv Kjølsrud & Blomhoff, Rune (2022). Reply – Letter to the Editor by FM Silva on “Agreement between GLIM and PG-SGA for diagnosis of malnutrition depends on the screening tool used in GLIM”. Clinical Nutrition. ISSN 0261-5614. 41(10), s. 2414–2415. doi: 10.1016/j.clnu.2022.07.019. Fulltekst i vitenarkiv
• Henriksen, Christine; Thomassen, Rut Anne; Kvammen, Janne Anita & Størdal, Ketil (2022). Fullamming til 6 måneder er ikke det beste for barnet. Fulltekst i vitenarkiv
• Størdal, Ketil; Henriksen, Christine; Kvammen, Janne Anita & Thomassen, Rut Anne (2022). Gi babyer fast føde. Fulltekst i vitenarkiv
• Fadnes, Lars T.; Meltzer, Helle Margrete; Henriksen, Christine; Arnesen, Erik Kristoffer & Hay, Gry (2022). Hvordan kan vegetar og vegankost gjøres helsefremmende? 142. doi: 10.4045/tidsskr.21.0846. Fulltekst i vitenarkiv
• Telle-Hansen, Vibeke; Myhrstad, Mari; Slydahl, Marlene; Hellmann, Monica; Garnweidner-Holme, Lisa & Lundin, Knut Erik Aslaksen [Vis alle 7 forfattere av denne artikkelen] (2021). Næringsinnhold og pris i glutenfrie produkter. glutenFRI. ISSN 1893-5419. 2, s. 12–15. Fulltekst i vitenarkiv
• Herfindal, Anne Mari; Megen, Frida van; Gilde, Mari Christine Overvik; Valeur, Jørgen; Rudi, Knut & Skodje, Gry Irene [Vis alle 9 forfattere av denne artikkelen] (2021). Effects of low-FODMAP diet on gut microbiota in individuals with treated celiac disease having persistent gastrointestinal symptoms. Fulltekst i vitenarkiv
• Thomassen, Rut Anne; Kvammen, Janne Anita & Henriksen, Christine (2021). Ernæringsstatus ved parenteral ernæring. Paidos: Tidsskrift for Norsk barnelegeforening. ISSN 1503-5360. Fulltekst i vitenarkiv
• Telle-Hansen, Vibeke; Henriksen, Christine; Hellmann, Monica; Garnweidner-Holme, Lisa; Lundin, Knut & Myhrstad, Mari (2021). Kartlegging av utgifter ved inkludering av glutenfrieprodukter sammenlignet med tilsvarende glutenholdigeprodukter i et norsk kosthold. OsloMet Skriftserie. ISSN 2535-6984. Fulltekst i vitenarkiv
• Myhrstad, Mari; Slydahl, Marlene; Hellmann, Monica; Garnweidner-Holme, Lisa; Lundin, Knut Erik Aslaksen & Henriksen, Christine [Vis alle 7 forfattere av denne artikkelen] (2020). Nutritional and costs aspects of gluten-free products, a case control study of products on the Norwegian marked. Fulltekst i vitenarkiv
• Kvammen, Janne Anita; Thomassen, Rut Anne; Kjeserud, Christina; Sæland, Camilla; Godang, Kristin & Thorsby, Per Medbøe [Vis alle 10 forfattere av denne artikkelen] (2019). Bone health and vitamin D in paediatric intestinal failure patients receiving home parenteral nutrition. Fulltekst i vitenarkiv
• Henriksen, Christine; Thoresen, Lene; Fjøseide, Berit; Lorentzen, Sissi C. Stove; Ottery, Faith & Jager-Wittenaar, Harriet (2018). LINGUISTIC AND CONTENT VALIDITY OF THE NORWEGIAN PATIENTGENERATED SUBJECTIVE GLOBAL ASSESSMENT. Fulltekst i vitenarkiv
• Tangvik, Randi Julie; Torheim, Liv Elin & Henriksen, Christine (2018). Bedre ernæringspraksis - til det beste for pasientene. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 138(7), s. 628–629. doi: 10.4045/tidsskr.18.0159. Fulltekst i vitenarkiv
• Malvik, Stine; Bjørkhaug, Steinar Traae; Valeur, Jørgen & Henriksen, Christine (2018). Ernæringsstatus hos personer med høyt alkoholinntak. Fulltekst i vitenarkiv
• Skodje, Gry Irene; Henriksen, Christine; Veierød, Marit Bragelien; Gibson, Peter R. & Lundin, Knut Erik Aslaksen (2018). Reply. Gastroenterology. ISSN 0016-5085. 155(1), s. 228–228. doi: 10.1053/j.gastro.2018.06.032. Fulltekst i vitenarkiv
• Bjørkhaug, Steinar Traae; Aanes, Håvard; Medhus, Asle Wilhelm; Skar, Viggo Øystein; Malvik, Stine & Henriksen, Christine [Vis alle 9 forfattere av denne artikkelen] (2018). Tarmfloraendringer hos pasienter med forhøyet alkoholkonsum. Fulltekst i vitenarkiv
• Kværner, Ane Sørlie; Sunde, Elena; Paur, Ingvild & Henriksen, Christine (2017). Høydepunkter fra ESPEN. Fulltekst i vitenarkiv
• Kvammen, Janne Anita; Thomassen, Rut Anne; Rugtveit, Jarle; eskerud, mari borge & Henriksen, Christine (2017). Diet and micronutrient status in 0-2 years old children with cow`s milk protein allergy. Fulltekst i vitenarkiv
• Henriksen, Christine; Almaas, Astrid; Westerberg, Ane Cecilie; Drevon, Christian A; Iversen, Per Ole & Nakstad, Britt (2017). Growth, metabolic profile and IQ in 8 years old children born preterm: Follow-up of an RCT with essential fatty acids (foredraget ble holdt på norsk). Fulltekst i vitenarkiv
• Kværner, Ane Sørlie; Minaguchi, Jun; Yamani, Naouale El; Henriksen, Christine; Ræder, Hanna & Paur, Ingvild [Vis alle 12 forfattere av denne artikkelen] (2017). DNA damage in blood cells in relation to chemotherapy and nutritional status in colorectal cancer patients. Fulltekst i vitenarkiv
• Ræder, Hanna; Henriksen, Christine; Bøhn, Siv Kjølsrud; Vilbo, Anne Rikke O`de Fey; Henriksen, Hege & Kværner, Ane Sørlie [Vis alle 9 forfattere av denne artikkelen] (2016). A high proportion of cachectic cancer patients are not identified by the Patient-Generated Subjective Global Assessment tool. Fulltekst i vitenarkiv
• Henriksen, Christine (2016). Kostvejledning. Teorier, metoder og perspektiver. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. s. 32–32. Fulltekst i vitenarkiv
• Skodje, Gry Irene; Sarna, Vikas Kumar; Rolfsen, Kjersti Langballe; Minelle, Ingunn Hillestad; Muir, JG & Gibson, Peter R. [Vis alle 9 forfattere av denne artikkelen] (2016). A double-blind cross-over challenge in individuals with self-reported gluten sensitivity points towards fructans as symptom trigger. Fulltekst i vitenarkiv
• Kværner, Ane Sørlie; Ræder, Hanna & Henriksen, Christine (2016). Bioimpedans -et nytting redskap i ernæringsvurderingen? Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. s. 22–24. Fulltekst i vitenarkiv
• Henriksen, Christine (2016). Årets KEF - Tonje Mellin Olsen. [Journal]. Norsk tidsskrift for ernæring (NTFE). Fulltekst i vitenarkiv
• Alhaug, Johanne; Gay, Caryl; Henriksen, Christine & Lerdal, Anners (2016). Nutritional risk screening (NRS 2002) is associated with pressure ulcer in a hospital population. Fulltekst i vitenarkiv Vis sammendrag

  Nutritional Risk Screening (NRS 2002) is associated with pressure ulcer in a hospital population Rationale: The objective in this study was to describe the prevalence of pressure ulcer (PU) and risk of malnutrition in a hospital population, in addition to examine whether Nutritional Risk Screening 2002 (NRS 2002) would be associated with the presence of PU in hospitalized patients. Methods: A cross-sectional study was conducted on 10 screening days (2012-2014) in a Norwegian hospital. Including patients (≥18 years) admitted to medical or elective orthopedic surgical wards and excluding patients admitted to Hospice, intensive care unit, cognitively impaired and patients not able to read Norwegian. Initial NRS 2002 and skin examinations were conducted by ward nurses and nursing students, using European Pressure Ulcer Advisory Panel classification (Stage I-IV). A registered clinical dietician conducted all final NRS 2002 screenings. SPSS version 22.0 and p<0.05 was used for all statistical analyses. Results: Study population included 651 patients, with complete NRS 2002 screening data and skin examinations. The NRS 2002 screening identified 34% at risk of malnutrition. PU prevalence was 8% and associated with age ≥70 years, body mass index (BMI) below 20 and hospitalization in the medical department. Both initial and final NRS 2002 revealed higher presence of PU (OR=2.58 and 2.55, respectively) than low nutritional risk. The initial screening items “Is BMI<20?” (OR= 2.73) and “Reduced dietary intake past week?” (OR=1.91) were strongly associated to PU, as was a composite item of “Reduced dietary intake past week OR Weight loss past 3 months”(OR= 2.75). Conclusion: This study shows that NRS 2002 (initial and final screening) was associated with PU in hospitalized patients. Initial screening items were strongly associated with PU and might be used for detecting patients at risk of malnutrition and PU. Conflict of interest: None.

• Slettahjell, Hanne Bjørg & Henriksen, Christine (2026). Managing Nutritional Risks in Spinal Cord Injury Rehabilitation: From Malnutrition to Obesity Prevention. Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  Traumatic spinal cord injury (SCI) induces rapid changes in body composition, energy metabolism, and nutritional requirements. Substantial skeletal muscle loss and reduced energy expenditure occur early after injury, while adipose tissue may accumulate even in the absence of weight gain. At the same time, weight loss and malnutrition are common during the acute and subacute phases, creating challenges for nutritional assessment and care. This thesis investigated nutritional challenges and changes in body composition during the first year after traumatic SCI. Three complementary studies examined longitudinal changes in body composition using neck-to-knee magnetic resonance imaging (MRI), the prevalence of malnutrition and applicability of the Global Leadership Initiative on Malnutrition (GLIM) criteria, and the effect of a structured, individualized dietitian-led nutritional intervention compared with usual care. Longitudinal MRI demonstrated substantial loss of skeletal muscle and accumulation of adipose tissue during the first year post-SCI, with more pronounced changes among individuals with motor complete injuries. Malnutrition was highly prevalent during subacute rehabilitation, while injury-related changes in body composition complicated the interpretation of reduced muscle mass as a criterion for malnutrition. In the randomized controlled trial, the intervention did not significantly affect the primary outcome, total fat mass. However, favorable between-group differences were observed for waist circumference and estimated visceral adipose tissue, suggesting that individualized dietitian-led nutritional care may attenuate adverse adiposity trajectories during the first year after SCI. Together, the findings demonstrate the complexity of nutritional risk following SCI and highlight the limitations of relying on body weight alone. Assessment of body composition, dietary intake, and individual energy requirements may provide a more comprehensive basis for tailored nutritional care. The findings highlight the potential value of structured, individualized dietitian-led nutritional follow-up as part of SCI rehabilitation and continued care after discharge.

• Thomassen, Rut Anne; Henriksen, Christine & Brun, Anne Charlotte (2026). Effect of prebiotics in children with intestinal failure. Gut feeling or evidence-based practice? Universitetet i Oslo. ISSN 9788234808289. Fulltekst i vitenarkiv Vis sammendrag

  Intestinal failure is a rare but severe condition in which the gut cannot absorb enough nutrients and fluids to sustain health and growth, necessitating long term parenteral nutrition. While lifesaving, parenteral nutrition carries medical risks and places a substantial burden on children and their families. Gastrointestinal symptoms are common and may limit progression toward enteral nutrition and independence from parenteral support. These symptoms may be linked to dysbiosis of the gut microbiota. Antibiotics are commonly used as treatment, but alternative strategies are needed. Prebiotics, nondigestible food components that selectively stimulate beneficial gut bacteria, may improve microbiota balance, reduce gastrointestinal symptoms, and potentially enhance health related quality of life. This thesis investigates how nutritional support and gastrointestinal symptoms influence health related quality of life in children with intestinal failure and their families and evaluates prebiotic supplementation as a potential therapeutic approach. Using baseline data from a cross sectional analysis, health related quality of life was assessed. Parent reported quality of life was markedly reduced compared with healthy peers, whereas children’s self reports did not differ significantly. The need for parenteral nutrition placed a substantial burden on parents and impaired family functioning. Gastrointestinal symptoms were strongly associated with reduced quality of life. In a randomized controlled trial, prebiotic supplementation resulted in a significant reduction in gastrointestinal symptoms. Microbiota composition was altered, including increases in selected beneficial taxa and transient reductions in potentially pro inflammatory bacteria. Responses varied according to baseline microbiota composition and intestinal anatomy. Prebiotics may therefore benefit a subset of children with intestinal failure and highlight the importance of individualised care.

• Tangvik, Randi Julie & Henriksen, Christine (2017). Sykdomsrelatert underernæring. Urfordringer, muligheter og anbefalinger. Helsedirektoratet. Fulltekst i vitenarkiv

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