Per Ole Iversen

• Gervin, Kristina; Kverneland, Magnhild; Nakken, Karl Otto; Rudi, Knut; Iversen, Per Ole & Selmer, Kaja Kristine (2026). Epigenetic ageing is accelerated in drug-resistant epilepsy and dynamically modulated during ketogenic diet therapy. EBioMedicine. 131. doi: 10.1016/j.ebiom.2026.106449.
• Daele, Wim Van; Tadeo, Raul Yhossef Tito; Perera, Jennifer; Tshokey, Tshokey; Iversen, Per Ole & Jayasinghe, Saroj [Vis alle 12 forfattere av denne artikkelen] (2026). Toward ethical human microbiome research: improving health through radical interdisciplinary and intercultural co-laboration. Microbiome. 14. doi: 10.1186/s40168-026-02340-w. Fulltekst i vitenarkiv Vis sammendrag

  Abstract As human microbiome research is globalizing, it raises ethical concerns regarding the European and North American dominance in the field, which may reproduce a colonial bias and perpetuate inequities in global health research and outcomes. We suggest disentangling this ethical quandary into three main concerns: 1) scientific bias toward European and North American populations; 2) limited meaningful community inclusion, participation, and ownership, and 3) scant significant inclusion of diverse global researchers. We then formulate three recommendations for their resolution, deploying co-laboration —joint labor of diverse partners in generating synergies between diverse disciplines, cultures, and knowledges around shared concerns—and co-laborative science —a form of citizen science based on such synergies between diverse partners—to guide meaningful inclusive, participatory, and ethical human microbiome research. To conclude, we promote a programmatic list for putting co-laborative ethical science into practice, benefiting global communities, individuals, and researchers alike and decolonizing and improving health worldwide.

• Kjendbakke, Ida; Selmer, Kaja Kristine; Nakken, Karl Otto; Hofoss, Dag; Iversen, Per Ole & Kverneland, Magnhild (2026). Micronutrient intake in adults with drug-resistant epilepsy treated with the modified Atkins diet needs monitoring. Frontiers in Nutrition. 13. doi: 10.3389/fnut.2026.1797011. Fulltekst i vitenarkiv
• Gervin, Kristina; Kverneland, Magnhild; Nakken, Karl Otto; Rudi, Knut; Iversen, Per Ole & Landmark, Cecilie Johannessen [Vis alle 7 forfattere av denne artikkelen] (2026). DNA methylation of antiseizure medication metabolism genes and pharmacokinetic changes in adult epilepsy patients treated with the modified Atkins diet. Genes & Nutrition. ISSN 1555-8932. 21. doi: 10.1186/s12263-026-00796-x. Fulltekst i vitenarkiv Vis sammendrag

  Background The modified Atkins diet is increasingly used as an adjunctive therapy for drug-resistant epilepsy. Recent evidence suggests that such dietary interventions may affect the pharmacokinetics of antiseizure medications and induce DNA methylation changes. However, it remains unclear whether epigenetic regulation of drug-metabolizing enzymes contributes to variability in medication serum levels. Results We analyzed 58 adults with drug-resistant epilepsy treated with a modified Atkins diet for 12 weeks. DNA methylation was profiled in peripheral blood before diet initiation (baseline) and after 4 weeks and 12 weeks using a genome-wide array. A total of 131 cytosine-phosphate-guanine (CpG) sites mapped to 13 candidate genes involved in antiseizure medication metabolism were assessed. One CpG in the CES1 gene showed significant methylation changes from baseline to 4 weeks, 12 weeks, and across all timepoints (FDR = 0.0018), indicating consistent longitudinal effects. Repeated measures correlation analyses were used to evaluate within-individual associations between DNA methylation and antiseizure medication serum concentrations. Two CpG–drug associations showed strong positive intra-individual correlations: CYP3A5 methylation was significantly associated with carbamazepine serum levels (repeated measures correlation coefficient = 0.81, FDR = 0.023), whereas CYP3A4 methylation showed a similarly strong but borderline association with topiramate (correlation coefficient = 0.76, FDR = 0.051). Conclusions This study finds that a modified Atkins diet may be associated with DNA methylation variation at genes involved in drug metabolism. Furthermore, DNA methylation levels were strongly associated with individual serum concentrations of certain antiseizure medications. These findings are consistent with the concept of a diet–epigenome–drug metabolism axis and warrant further investigation in larger studies to assess clinical implications for personalized dietary and pharmacological management in epilepsy.

• Klevmoen, Marianne; Lennep, Jeanine Roeters van; Bogsrud, Martin Prøven; Vesterbekkmo, Elisabeth Kleivhaug; Pedersen, Eva Ringdal & Hovland, Anders Wilhelm [Vis alle 14 forfattere av denne artikkelen] (2026). Extensive pregnancy-related off-treatment time in women with familial hypercholesterolaemia. Atherosclerosis. ISSN 0021-9150. 415. doi: 10.1016/j.atherosclerosis.2026.120668. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims: Women with familial hypercholesterolaemia (FH) lose substantial treatment time during their reproductive years as most lipid-lowering therapies are contraindicated from the preconception through the end of breastfeeding. We examined the duration of real-life pregnancy-related off-treatment time in 27 women with FH in Norway. Methods: Women with FH in Norway who had completed the ongoing FH-FEMINA study (ClinicalTrials.gov ID NCT05367310) were included. Women were followed from 36th week of gestation and until one year after delivery or until end of breastfeeding. Information on use of medication before, during and after the current and previous pregnancies was collected. Pregnancy-related off-treatment time was calculated from discontinuation of lipid-lowering therapy when planning pregnancy, throughout pregnancy, and after delivery. Results: The total duration of pregnancy-related off-treatment time after all childbirths (median 1, range 1-3) per woman was a median of 2.9 years (25th-75th percentile; 1.6-4.0), ranging from 0.8 to 12 years. The pregnancy itself accounted for median of 42.1% of the pregnancy-related off-treatment time, whereas the time before and after pregnancy accounted for a median of 57.9% (range 11.4% to 91.2%). When including untreated years in childhood and/or prior to diagnosis, the lifelong off-treatment time represented a median of 66.3% (range 41.9 to 100%) of lifetime without treatment. Conclusion: Early diagnosis and initiation of treatment is essential in girls with FH to compensate for pregnancy-related off-treatment time later in life. To minimize these pregnancy-related off-treatment periods, healthcare professionals should support women with FH to resume lipid-lowering therapy immediately after breastfeeding and between pregnancies. In addition, more knowledge on the potential effects of statin use during pregnancy and breastfeeding on maternal and offspring health is urgently needed.

• Iversen, Per Ole; Gedde-Dahl, Tobias; Tjønnfjord, Geir Erland & Ali, Maryan Mohamed (2025). Quality of life the first year after allogeneic haematopoietic stem cell transplantation—A randomized controlled trial examining extracorporeal photophoresis to prevent graft‐versus‐host disease. British Journal of Haematology. ISSN 0007-1048. 207(5), s. 2183–2186. doi: 10.1111/bjh.70119. Fulltekst i vitenarkiv
• Gudmundstuen, Anne Marte; Iversen, Per Ole; Pesonen, Maiju; Hjermstad, Marianne Jensen; Bye, Asta & Tjønnfjord, Geir Erland [Vis alle 7 forfattere av denne artikkelen] (2025). Comparing indirect calorimetry and predictive equations for energy expenditure - 1 year follow-up of adult hematopoietic stem cell transplanted recipients. Clinical Nutrition ESPEN. ISSN 2405-4577. 70, s. 218–226. doi: 10.1016/j.clnesp.2025.09.027. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims Recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT) often undergo body composition changes that may impact their energy expenditure (EE), however, the accurate energy requirements may be difficult to estimate. Indirect calorimetry (IC) is recommended as the gold standard to assess measured energy expenditure (mEE), but its use is resource-demanding and thus rarely applied compared to predictive energy equations. Here we evaluated the agreement between mEE by IC and EE estimated by several predictive energy equations, or the ESPEN recommendation, during 1-year follow-up of adult allo-HSCT recipients. Methods We examined 117 adult patients with hematological malignancies who received allo-HSCT. mEE was assessed by IC in non-fasting patients before transplantation, and at 3, 6, 9 and 12 months post-allo-HSCT. Agreement between mEE and predictive values using the Harris-Benedict-HB, Mifflin St. Jeor-MSJ, Ireton Jones-IJ equations and the fixed ESPEN recommendation of 25 kcal/kg/day was evaluated using Bland–Altman analysis and accuracy within ± 10 %. Changes in mEE over time were analyzed using linear mixed model with age as a covariate. Results A total of 509 mEE measurements by IC were obtained. HB and MSJ overestimated mEE on average (mean bias: + 2.9 and + 3.8 kcal/kg/day), while IJ, and the fixed ESPEN recommendation underestimated mEE (biases: – 0.7 and – 4.7 kcal/kg/day, respectively). None of the equations or the fixed ESPEN recommendation achieved > 50 % accuracy within ± 10 % of mEE by IC. IJ had the highest variability and widest limits of agreement. mEE changed significantly over time (p < 0.001), with no significant differences between the initially randomized intervention and control group (p = 0.982). Mean mREE was 24.74 ± 3.80 kcal/kg/day and 31.14 ± 4.91 kcal/kg/day when adjusted for FFM. Age was not significantly associated with mREE (p = 0.198). Conclusion Our findings indicate that commonly used predictive equations and the fixed ESPEN recommendation showed limited accuracy compared with mEE in allo-HSCT recipients. Only mEE obtained by IC captured longitudinal changes in EE during the first year post-transplantation. mEE by IC varied significantly the first year post-transplant. ClinicalTrials.gov, ID NCT01181076.

• Singh, Preet Bano; Singh, Simon Vivan; Iversen, Per Ole & Jensen, Janicke Liaaen (2025). Evaluation and management of chemosensory, trigeminal and salivary dysfunctions in patients with post coronavirus disease. Clinical Nutrition ESPEN. ISSN 2405-4577. 70(December 2025), s. 452–462. doi: 10.1016/j.clnesp.2025.10.018. Fulltekst i vitenarkiv Vis sammendrag

  Background & aims While the management of olfactory disorders among patients with post Coronavirus Disease (COVID-19) is well elucidated, treatment of taste dysfunction, oral burning, and oral dryness is less extensively studied among post-COVID-19 patients. This prospective study aimed (i) to assess the prevalence of chemosensory, trigeminal, and salivary dysfunctions in patients at two different time points following COVID-19 infection, and (ii) to evaluate the recovery process over time. Methods In this cross-sectional study, 54 Early-post-COVID-19 (3–11 months since COVID-19), 46 Late-post-COVID-19 (≥12 months since COVID-19) and 76 Non-COVID-19 controls were recruited. Participants’ olfactory, gustatory, trigeminal, and salivary status were investigated. Depending on the test outcomes, tailored treatments were administered, and patients were monitored every 3–6 months. Results The findings indicated that none of these dysfunctions improved on their own over time. Patients in both post-COVID-19 groups demonstrated significantly reduced smell, trigeminal and salivary functions compared to the control group. Taste impairment was significantly more severe in Late-post-COVID-19 patients compared to Early-post-COVID-19 patients. Follow-up evaluations revealed significant improvement in both smell and taste functions at each follow-up visit across both patient groups. Conclusion Chemosensory, trigeminal, and salivary disorders in post-COVID-19 patients may not resolve with time alone, underscoring the need for tailored treatments to achieve significant improvements.

• Skaarud, Kristin Aneta Joan; Gudmundstuen, Anne Marte; Pesonen, Maiju; Hjermstad, Marianne Jensen; Iversen, Per Ole & Tjønnfjord, Geir Erland (2025). The role of fat-soluble vitamins for graft-versus host disease after myeloablative conditioning in allogeneic stem cell transplanted patients. Scientific Reports. 15. doi: 10.1038/s41598-024-84805-2. Fulltekst i vitenarkiv Vis sammendrag

  Whether the fat-soluble vitamins A, D, E, and K are associated with development of graft-versus-host disease (GvHD) after allogeneic stem cell transplantation, is unclear. We assessed if the levels of these vitamins were associated with development of GvHD during the first year after transplantation using data from a two-armed randomized nutritional intervention trial. Changes in plasma levels during 1-year follow-up were analyzed using a linear mixed model for repeated measurements. Vitamin A, D, E, and K levels changed significantly the first year in both study arms (p < 0.001). Higher levels of vitamin E over time were associated with less acute GvHD grades 3–4 (OR = 0.997, 95% CI: (0.994, 0.999), p = 0.017). No associations were found with vitamin A, D, E and K levels and chronic GvHD. Multivariable analysis adjusted for treatment group, age, pre-transplant vitamin level and risk factors for GvHD did not change the results. Six weeks post-transplantation, higher levels of vitamin E were associated with less acute GvHD grades 3–4, (p = 0.012). In conclusion, we found an association between higher levels of vitamin E over time and less severe acute GvHD. Whether this reflects a causal relationship warrants further study. ClinicalTrials.gov (NCT01181076).

• Tushabe, Gerald; Rukundo, Peter Milton; Kaaya, Archileo Natigo; Nahalomo, Aziiza; Nateme, NC & Iversen, Per Ole [Vis alle 8 forfattere av denne artikkelen] (2025). Retrogressive or misplaced priorities? An assessment of public expenditure for food security and disaster risk reduction in Uganda. International Journal of Disaster Risk Management (IJDRM). ISSN 2620-2662. 7, s. 15–38. doi: 10.18485/ijdrm.2025.7.1.2. Fulltekst i vitenarkiv Vis sammendrag

  The article argues that a rights-based approach to public investment and expenditure in agriculture and disaster risk management is a viable pathway for Uganda to realise the right to adequate food and sustainable development in line with the government’s national and international human rights commitments. This study employed a qualitative research paradigm to examine both primary and secondary data on public investment and expenditure in food security and disaster risk reduction in Uganda. Fifty-six key informant interviews were conducted with purposively selected officials at national and Local Government levels. Data and insights obtained were analysed using thematic and rights-based budget analyses. There is minimal application of rights-based approach principles in the budgeting for food security or disaster risk reduction in Uganda. Public expenditure in the agriculture sector and disaster risk management is inadequate to meet the increasing disasters in the country or to effectively protect the right to adequate food of vulnerable communities in disaster-prone regions. As a State Party to the International Covenant on Economic, Social and Cultural Rights and a signatory to the Sendai Framework for Disaster Risk Reduction, Uganda is obligated to protect and fulfil the right to adequate food for vulnerable communities in the event of disasters. This will require increased public and private investment in the agriculture sector and strengthening the disaster risk financing mechanisms at both national and Local Government levels.

• Hjertholm, Katrine; Iversen, Per Ole; Holmboe-Ottesen, Gerd & Jepsen, Randi (2025). Risk factors for undernutrition and poor growth during the first 6 months of life in sub-Saharan Africa: A scoping review. Clinical Nutrition ESPEN. ISSN 2405-4577. 68, s. 309–318. doi: 10.1016/j.clnesp.2025.05.019. Fulltekst i vitenarkiv Vis sammendrag

  Background & aims Early infant undernutrition and suboptimal growth represent significant public health challenges in many low- and middle-income countries, yet information regarding the risk factors for poor growth remains limited. A scoping review was conducted to map the existing evidence on indicators of undernutrition and poor growth and related risk factors among infants aged 0–6 months in sub-Saharan Africa. Methods This scoping review was conducted in accordance with the Joanna Briggs Institute framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. MEDLINE, Embase, and Scopus were systematically searched for eligible studies, with no restrictions on time or language. Results A total of 50 studies met the inclusion criteria for this review. The most frequently reported indicator of undernutrition was stunting, followed by underweight and wasting. Sex, feeding, illness, and birth size were the most studied infant risk factors for poor growth. The maternal risk factors most frequently investigated included age, education, human immunodeficiency virus infection, and occupation. Socioeconomic status and factors related to water, sanitation, and hygiene were the most studied household risk factors. Conclusions Several indicators of undernutrition and poor growth were identified, with stunting being the most frequently reported. Associated risk factors included multiple infant-, maternal-, and household factors, highlighting the need for complex multilayered interventions to address undernutrition and poor growth among these vulnerable infants.

• Song, Peige; Adeloye, Davies; Acharya, Yubraj; Bojude, Danladi Adamu; Ali, Sajjad & Alibudbud, Rowalt [Vis alle 59 forfattere av denne artikkelen] (2024). Setting research priorities for global pandemic preparedness: An international consensus and comparison with ChatGPT's output. Journal of Global Health. ISSN 2047-2978. 14. doi: 10.7189/jogh.14.04054. Fulltekst i vitenarkiv
• Kakwangire, Paul; Ngari, Moses; Muhoozi, Grace Kyamazima Mehangye; Westerberg, Ane Cecilie; Friberg, Prudence Atukunda & Iversen, Per Ole (2024). Associations between sociodemographic exposures, growth and development during infancy with development at the age of eight years among children: Analysis of a maternal education trial in rural Uganda. Journal of Global Health. ISSN 2047-2978. 14. doi: 10.7189/jogh.14.04228. Fulltekst i vitenarkiv Vis sammendrag

  Background Links between early life exposures and child development later in life are not sufficiently explored in low- and middle-income countries. We studied associations between sociodemographic variables, growth and development at six to eight months with developmental outcomes at eight years. Methods We used data from a maternal education trial which included 511 mother-infant pairs at children’s age of six to eight months (baseline). In this follow-up study, data from 361 mother-child pairs were available. Questionnaires were used to collect sociodemographic variables. Growth (anthropometry) was measured by study personnel and converted to z-scores according to the World Health Organization (WHO) growth reference. Child development (cognitive, motor and language) at baseline was assessed using Bayley Scales of Infant and Todler Development, third edition (BSID-III). Development at eight years was measured using two neuropsychological tools: Kaufman Assessment Battery for Children Second Edition (KABC-II) and Test of Variables of Attention (TOVA). Results Higher weight-for-age z-scores (adjusted odds ratio (aOR) = 0.74; 95% confidence interval (CI) = 0.53, 0.98; P = 0.04), better maternal education (aOR = 0.86; 95% CI = 0.78, 0.96; P = 0.03). and better household head education (aOR = 0.86; 95% CI = 0.78, 0.96; P = 0.03) at six to eight months of age were associated with lower odds of scoring below average on KABC-II categorical scores at eight years of age. Motor composite scores and maternal parity at six to eight months of age were positively associated with auditory and visual TOVA scores (all P-values <0.05) at eight years. Cognitive composite scores at six to eight months of age were positively associated with visual TOVA scores (P < 0.05). In contrast, weight-for-length z-scores and household head age were negatively associated with both auditory and visual TOVA scores (P < 0.05). Being a female child was associated with lower auditory and visual TOVA scores (P < 0.05). Conclusions At six to eight months of age, growth and development, gender, maternal education and parity, and household head age and education were associated with child development at eight years. Interventions emphasising improved growth and development in infancy, as well as parental educational attainment, may improve long-term developmental outcomes.

• Brevik, Oda Kallevig; Kaaya, A.N. & Iversen, Per Ole (2024). AFLATOXIN EXPOSURE IN CHILDREN AGED 4 MONTHS TO 5 YEARS FROM SUB-SAHARAN AFRICA AND ITS EFFECT ON STUNTED CHILD GROWTH – A TOPICAL REVIEW. African Journal of Food, Agriculture, Nutrition and Development. ISSN 1684-5358. 24(11), s. 25121–25142. doi: 10.18697/AJFAND.136.25060. Fulltekst i vitenarkiv Vis sammendrag

  The mould species fungi encompass among others the family of Aspergillus which produce and secrete a number of compounds toxic to human health, namely the aflatoxins. These mycotoxins are converted to secondary metabolites that exert the often detrimental biological effect, and they are commonly found in various foods such as fruits, nuts, seeds, and grains. Members of the Aspergillus family thrive in wet and humid conditions, so they are particularly prevalent in regions with a tropical climate, for example in countries in sub-Saharan Africa. Aflatoxins are a type of mycotoxins considered to be among the most known potent mutagenic and carcinogenic substances. For example, it can cause liver cancer. Importantly, aflatoxins often contaminate weaning foods consumed by small children. This topical review outlines the evidence on the associations between aflatoxin exposure and impaired linear growth (stunting, that is low height/length for age) in small children (aged 4 months to 5 years) from sub-Saharan Africa. Ten studies were retrieved from the database PubMed after considering predefined inclusion and exclusion criteria. Six out of the ten studies found a significant inverse association between increased aflatoxin exposure and stunted child growth. Although aflatoxin exposure and stunting prevalence were high and widespread in most of the included studies, in general, studies conducted in Western Africa had the highest aflatoxin exposure and stunting prevalence. The only included randomized controlled trial found that a diet aimed at reducing aflatoxin exposure significantly improved linear growth in children at 13, but not at 22, months of age. The evidence suggests that aflatoxins have an impact on linear growth among children aged 4 months to five years. Possibly there is a threshold value for aflatoxin exposure before a significant impact on growth can be identified. Raised awareness and management strategies for the high aflatoxin exposure rates in sub-Saharan Africa and its negative health effects, in particular stunted child growth, are warranted.

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• Sundsbarm, Sebastian; Bye, Asta; Tjønnfjord, Geir Erland; Iversen, Per Ole & Skaarud, Kristin Aneta Joan (2026). NP077 Nutrition impact symptoms and nutritional status in adult allo-HSCT recipients during 1-year follow-up. Bone Marrow Transplantation. ISSN 0268-3369. 61(S1), s. 1041–1098. doi: 10.1038/s41409-026-02887-0. Fulltekst i vitenarkiv Vis sammendrag

  Background: Nutrition impact symptoms (NIS) are contributors to impaired nutritional status in allo-HSCT patients. However, the impact of patients’ reported NIS on nutritional status are poorly described. This study investigated changes in NIS and nutritional status, and associations between NIS and nutritional status during a 1-year follow-up of allo-HSCT patients. Methods: We used data from 117 patients (57 intervention, 60 control) who participated in a randomized controlled nutritional intervention trial. Linear mixed models were used to analyse changes in NIS over time. Ordinal logistic regressions were used to analyse associations between NIS and nutritional status. Results: Nausea and vomiting and constipation were significantly lower in the intervention group than the control group during 1-year follow-up (p = 0.015 and p < 0.001, respectively). Initially, nutritional status declined in both study groups post-allo-HSCT but improved over time. Significantly fewer patients in the intervention group were malnourished at 3 weeks (p = 0.020) and 6 weeks post-transplantation (p = 0.028). Associations between NIS and nutritional status varied over time and differed between the study groups at 6 weeks post-transplantation (OR 3.702, 95% CI: (1.355, 10.100), p = 0.011). Conclusions: In conclusion, our findings emphasize the need for long term monitoring of symptoms and nutritional status in allo-HSCT patients, supporting individualized nutritional assessments as part of long-term care strategies. Disclosure: Geir Erland Tjønnfjord has received research grants from Mundipharma and Alexion Pharmaceuticals, advisory board honoraria from Alexion Pharmaceuticals and Johnson & Johnson, and lecture honoraria from Novartis, Johnson & Johnson, Alexion Pharmaceuticals, and Mundipharma. The other authors declare no competing interest.

• Klevmoen, Marianne; Mulder, Janneke W.C.M.; Bogsrud, Martin Prøven; Retterstøl, Kjetil; Vesterbekkmo, Elisabeth Kleivhaug & Pedersen, Eva Ringdal [Vis alle 16 forfattere av denne artikkelen] (2025). Prospective study on breastfeeding, lipid profile and cardiovascular risk markers in women with familial hypercholesterolaemia: study protocol for the FH-FEMINA study. doi: 10.1136/bmjopen-2024-092208. Fulltekst i vitenarkiv
• Kardel, Kristin Reimers; Iversen, Per Ole; Kaaya, Archileo Natigo; Muhoozi, Grace Kyamazima Mehangye; Veierød, Marit Bragelien & Wangen, Knut Reidar [Vis alle 8 forfattere av denne artikkelen] (2024). A pragmatic randomized trial to examine the effect of combining healthy diet with mindfulness cognitive therapy to reduce depressive symptoms among university students in a low-resource setting: protocol for the NutriMind Project. BMC Psychiatry. 24, s. 1–8. doi: 10.1186/s12888-024-06056-9. Fulltekst i vitenarkiv Vis sammendrag

  Background Mental health disorders still rank as leading causes of morbidity worldwide despite increasing awareness and improvements in treatment. Notably, low- and middle-income countries like Uganda, are disproportionately affected by such disorders. The burden of depressive symptoms in these countries is particularly high among students, aggravated by poverty, malnutrition, and inadequate public health governance, yet it is clearly under-researched, making it hard to achieve several of UN Sustainability Development Goals. Current treatment options are insufficient to tackle the increased burden of depressive disease. This is more challenging for low-resource regions especially in Sub-Saharan Africa, suggesting the need for alternative treatments that can swiftly be applied if proven effective. The main aim of this randomized controlled trial (RCT) is therefore to examine if a low-cost healthy diet (based on local Ugandan foods) combined with easy-to access mindfulness cognitive therapy can reduce depressive symptoms among university students in Uganda. Methods We will recruit female and male students at Makerere University, the largest public university in Uganda, to an open, intention-to-treat, two-armed RCT. Those who score above a predefined threshold on a self-reported assessment of depressive symptoms, measured by the Center for Epidemiological Studies – Depression score (CES-D), are eligible for study inclusion and will be randomized to either an intervention (n = 125) or a control (n = 125) group. The intervention group will receive educational group-based sessions on how to prepare a Mediterranean-type of healthy diet and how to adhere to the principles of mindfulness-based cognitive therapy. Outcome measures include self-reported depression symptoms, quality of life, and dietary intakes. In addition we will perform a cost-effectiveness analysis. The RCT intervention will last 9 months, followed by additional 15 months with regular data collections. Discussion We here describe a novel approach to treat depressive symptoms among university students living in resource constraint settings, by combining a healthy diet with low threshold psychotherapy. If this intervention succeeds, our project can be viewed as a step towards evidence-based behavior practices for young adults with a common mental disorder (depression) that are beneficial to public mental health initiatives and management. Trial registration The RCT is registered in ClinicalTrials.gov (ID: NCT05848973). The date of registration was August 14, 2023.

• Singh, Preet Bano; Nazar, Mahnoor; Rogn, Åsmund & Iversen, Per Ole (2024). Dental caries and other oral complications in patients after hematopoietic stem cell transplantation. Fulltekst i vitenarkiv
• Kakwangire, Paul; Friberg, Prudence Atukunda; Muhoozi, Grace Kyamazima Mehangye & Iversen, Per Ole (2025). Effects of a maternal education intervention on child development and maternal depression: Long-term follow-up of a cluster-randomized trial in rural Uganda. Universitetet i Oslo. ISSN 9788234806902. Fulltekst i vitenarkiv Vis sammendrag

  Early childhood represents a pivotal phase for cognitive, emotional, and physical development. However, children residing in low-resource rural environments face an elevated risk of undernutrition and associated developmental delays. Few studies have examined whether maternal education interventions can produce long-term benefits for child development and maternal mental health. The aim of this thesis was to assess the long-term effects of a maternal education intervention on child development (cognition and attention) eight years later, identify early-life predictors of developmental outcomes, and evaluate maternal depressive symptoms six years after the intervention. The original CHNUDEV trial was a cluster-randomized controlled study conducted in rural southwestern Uganda between 2013 and 2014, enrolling 511 mother-child pairs. The intervention provided education sessions on nutrition, hygiene, oral health, and child stimulation when children were 6-8 months old. Follow-up assessments were conducted at six and eight years post-intervention. Child cognition and attention were measured using the Kaufman Assessment Battery for Children, Second Edition and the Test of Variables of Attention. Maternal depressive symptoms were assessed using the Beck Depression Inventory-II and the Center for Epidemiological Studies Depression Scale. Children in the intervention group had significantly higher scores on short-term memory, visual processing, fluid reasoning, and overall cognitive ability compared to children in the control group. Intervention group children also showed better attention performance. Baseline factors such as maternal education, child sex, and nutritional and developmental status were significantly associated with cognitive outcomes at eight years. Mothers in the intervention group reported fewer depressive symptoms at six years, although differences were borderline statistically significant. Overall, the study demonstrates that a low-cost maternal education intervention can lead to sustained improvements in child development and may support better maternal mental health in low-resource settings. These findings highlight the value of integrating nutrition, hygiene, and child stimulation education into community based health programs to promote long-term benefits for both children and caregivers.

• Koroma, Aminata Shamit; Manary, Mark & Iversen, Per Ole (2025). Integrated Nutritional and Healthcare Interventions to Combat Maternal Undernutrition and Enhance Infant Birth Outcomes in Resource-Limited Rural Sierra Leone. Universitetet i Oslo. ISSN 9788234806575. Fulltekst i vitenarkiv Vis sammendrag

  Background Undernutrition remains a leading cause of poor maternal and neonatal health outcomes, with severe implications for growth, development, and survival. Addressing this challenge is particularly pressing in countries like Sierra Leone, where limited resources and high rates of malnutrition, infections, and inadequate healthcare pose significant barriers to maternal and child health. This thesis explores the impact of integrated nutritional and anti-infective interventions on maternal and child undernutrition in resource-constrained, malaria-endemic rural settings, mainly focusing on the child’s first 1,000 days of life. The research aimed to assess the effectiveness of innovative interventions designed to improve health outcomes for these undernourished populations, emphasizing sustainability and scalability. Study Populations and Methodology The thesis is based on a series of randomized controlled trials and secondary analyses conducted across 43 health clinics in Sierra Leone. The first study evaluated the effects of providing Ready-to-Use Supplementary Food (RUSF) enriched with long-chain fatty acids and choline, combined with anti-infective measures, on maternal and neonatal health outcomes. A secondary analysis examined differences in birth outcomes among younger adolescent mothers (<18 years), older adolescents (18–19 years), and adult mothers (≥20 years). Another study assessed the utility of Mid Upper Arm Circumference (MUAC) for identifying low-birth-weight infants and neonatal mortality risk in settings without weighing facilities. Additional studies evaluated the impact of exclusive breastfeeding practices on infant growth and survival and the effectiveness of Ready-to-Use Therapeutic Food (RUTF) and antibiotics in treating High-Risk Moderate Acute Malnutrition (HR-MAM) in children. The acceptability and feasibility of an enriched maternalRUSF formulation were also tested through a 2x2 crossover design. Main Results Enriched RUSF and anti-infective treatments improved maternal weight gain, newborn birth outcomes, and child survival rates. Younger adolescent mothers faced poorer birth outcomes compared to older mothers, underlining the need for targeted interventions for this vulnerable group. MUAC proved to be an effective tool for identifying low-birth-weight infants and those at risk of neonatal mortality. Exclusive breastfeeding was confirmed as a life-saving practice, significantly improving infant growth and survival. For children with HR-MAM, treatment with RUTF and antibiotics enhanced short-term recovery, but required longer-term solutions for sustained benefits. Enriched RUSF with long-chain fatty acids and choline showed high acceptability, potentially improving maternal and fetal health. Conclusion This thesis highlights the effectiveness of integrated nutritional and anti-infective interventions in improving maternal and child health outcomes in resource-limited settings. Combining enriched RUSF and targeted anti-infective measures led to better maternal weight gain, enhanced newborn growth metrics, and increased survival rates. Adolescent mothers were identified as a particularly vulnerable group, emphasizing the need for customized interventions to tackle their specific challenges. MUAC was validated as a practical and dependable tool for identifying at-risk newborns in low-resource environments. Exclusive breastfeeding was confirmed as a life-saving practice, significantly improving infant health and survival. While utilizing RUTF and antibiotics for HR-MAM resulted in short-term recovery improvements, the findings stress the need for sustainable, long-term interventions. The high acceptance of enriched RUSF showcases its potential as a scalable solution to combat maternal and child undernutrition. It provides valuable insights for future policies and programs to break the malnutrition cycle.

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