Browsing by master's degree program "Magisterprogrammet i human nutrition och matbeteende"

Background: The effects of vegan and vegetarian diets on children's health are not yet well-understood due to limited research, and the relationship between plant-based diets and children's serum amino acid levels remains unclear. Amino acids play a vital role in growth and well-being, particularly for children. Objectives: The primary objective of this study is to investigate potential differences in serum amino acid concentrations among children following vegan, vegetarian, and omnivorous diets. The secondary objective is to explore whether the diet of a child can be inferred based on their serum amino acid profiles. Methods: Conducted as part of the MIRA2 research, the study involved 69 children from Helsinki day care centers, following vegan, vegetarian, or omnivore diets, with dietary data gathered from parents and validated by 3-day food diaries. Serum amino acid concentrations were analyzed using UHPLC in a laboratory, and group comparisons were conducted using Kruskal-Wallis tests with post-hoc analyses. A decision tree model was constructed based on amino acid concentrations to classify children as vegan or non-vegan. Results: Serum amino acid median concentrations of glycine, arginine, cysteine, conditionally indispensable amino acids, sulfur amino acids and amino acids participating in urea cycle were higher in vegans compared to omnivores. Concentrations of lysine were lower in vegans and vegetarians compared to omnivores. The decision tree model, based on amino acid concentrations, successfully classified 70,3% of children as vegan or non-vegan. Conclusions: Plant-based diets appeared to influence serum amino acid concentrations of children to some extent. Further research, especially regarding the health implications and reference values for amino acid levels, particularly in children on plant-based diets, is still needed. Tausta: Vegaani- ja kasvisruokavalioiden vaikutukset lasten terveyteen eivät ole vielä täysin ymmärrettyjä rajallisen tutkimustiedon vuoksi, ja yhteys kasvipohjaisten ruokavalioiden ja lasten seerumin aminohappopitoisuuksien välillä on epäselvä. Aminohapot ovat keskeisiä kasvun ja hyvinvoinnin kannalta, erityisesti lapsille. Tavoitteet: Tutkimuksen ensisijainen tavoite oli selvittää mahdollisia eroja seerumin aminohappopitoisuuksissa lapsilla, jotka noudattavat vegaani-, kasvis- tai sekasyöntiruokavaliota. Lisäksi tutkittiin, voiko lasten ruokavalion päätellä heidän seerumin aminohappoprofiilinsa perusteella. Menetelmät: Tutkimus tehtiin osana MIRA2-tutkimusta, ja siihen osallistui Helsingin päiväkodeissta yhteensä 69 lasta, jotka noudattivat vegaani-, kasvis- tai sekaruokavaliota. Tieto ruokavaliosta kerättiin vanhemmilta ja validioitiin 3 päivän ruokapäiväkirjoilla. Seerumin aminohappopitoisuudet analysoitiin laboratoriossa UHPLC-menetelmällä, ja ryhmävertailut suoritettiin Kruskal-Wallis -testeillä post-hoc-analyyseineen. Päätöspuumalli luotiin aminohappopitoisuuksien perusteella lasten luokittelemiseksi vegaaneiksi tai ei-vegaaneiksi. Tulokset: Vegaaneilla glysiinin, arginiinin, kysteiinin, ehdollisesti välttämättömien aminohappojen, rikkipitoisten aminohappojen ja ureasykliin osallistuvien aminohappojen mediaanipitosuudet olivat korkeammat verrattuna sekasyöjiin. Lysiinin pitoisuudet olivat alhaisemmat vegaaneilla ja kasvissyöjillä verrattuna sekasyöjiin. Aminohappopitoisuuksiin perustuva päätöspuumalli luokitteli onnistuneesti 70,3 % lapsista vegaaneiksi tai ei-vegaaneiksi. Johtopäätökset: Kasvipohjaiset ruokavaliot vaikuttivat jossain määrin lasten seerumin aminohappopitoisuuksiin. Lisätutkimusta tarvitaan erityisesti terveysvaikutusten ja aminohappopitoisuuksien viitearvojen suhteen, erityisesti kasvipohjaisilla ruokavaliolla olevilla lapsilla.

Background: Preschoolers suffer frequently from infections. Large group sizes and varying hygiene practices may enhance pathogen transmission within preschool settings. Preschool-attributable infections cause economic consequences for society, which is why identifying the related risk factors is of importance. One such may be diet. Appropriate immune defence requires sufficient intakes of energy, protein, polyunsaturated fat, dietary fibre, and numerous micronutrients, whereas excess sugar and saturated fat may be harmful. However, previous nutritional research examining preschoolers’ infections has mainly focused on probiotics. Little research has been done on the role of whole-diet in preschoolers’ susceptibility to infections. Aim: The present study aimed to investigate the associations of dietary patterns with common colds, gastroenteritis, and antibiotic courses among Finnish preschoolers. Methods: The study sample included 721 children aged 3-6 years attending the cross-sectional DAGIS survey. The parents reported retrospectively how many common colds, gastroenteritis, and antibiotic courses their children had experienced during the past year. Children’s food consumption was recorded using a 47-item food frequency questionnaire filled in by the parents. The parents also reported background factors of their children and family. The following three dietary patterns were identified based on the food consumption frequencies using principal component analysis: 1) sweets-and-treats pattern (high loadings of e.g. biscuits, chocolate, and ice cream); 2) health-conscious pattern (high loadings of e.g. nuts, natural yoghurt, and berries); and 3) vegetables-and-processed meats pattern (high loadings of e.g. vegetables, colds cuts, and fruits). Dietary pattern scores were calculated for each child to describe the strength of adherence to each identified dietary pattern. The distributions of the dietary pattern scores were divided into thirds that were labelled low, moderate, and high adherence groups. Negative binomial regression analysis was used to examine the associations between thirds of the dietary pattern scores and the prevalence of common colds and antibiotic courses. Logistic regression analysis was used to investigate the associations between thirds of the dietary pattern scores and a chance of experiencing at least one gastroenteritis. Results: Prevalence of common colds was lower in moderate and high adherences to the sweets-and-treats pattern compared to low adherence (PR=0.89, 95% CI=0.80-1.00; and PR=0.88, 95% CI=0.79-0.99, respectively) and higher in high adherence to the health-conscious pattern compared to low adherence (PR=1.13, 95% CI=1.01-1.27) after adjusting for age, sex, number of children living in the same household, frequency of preschool attendance, probiotic use, and the highest educational level in the family. Moderate adherence to the sweets-and-treats pattern was associated with a lower chance of at least one gastroenteritis (OR=0.63, 95% CI=0.44-0.92) and lower prevalence of antibiotic courses (PR=0.77, 95% CI= 0.59-1.00) compared to low adherence. No significant associations were observed between the vegetables-and-processed meats pattern and the infectious outcomes. Adjustments for the background factors did not modify the associations. Conclusion: The results were unexpected. The associations observed would suggest that favouring unhealthier foods but avoiding healthier foods was linked to better immunity, which is difficult to accept as true. Parents who were most health-conscious of their children’s diet might also have been more conscious of their children’s illness conditions than less health-conscious parents, which may explain the results. Further research with longitudinal designs is needed to determine whether dietary habits play a role in preschoolers’ susceptibility to infections.

BACKGROUND: Diet has a major influence on the human gut microbiome, which has been linked to health and disease. However, epidemiological studies on the association of a healthy diet with the gut microbiome utilizing a whole-diet approach are still scant. OBJECTIVES: To assess associations between healthy food choices and human gut microbiome composition, and to determine the strength of association with the functional potential of the microbiome. DESIGN: The study sample consisted of 4,930 participants in the FINRISK 2002 study. Food intake was assessed using a food propensity questionnaire. Intake of food items recommended to be part of a healthy diet in the Nordic Nutrition Recommendations were transformed into a healthy food choices (HFC) score. Microbial diversity (alpha diversity) and compositional differences (beta diversity) and their associations with the HFC score and its components were assessed using linear regression and permutational multivariate analysis of variance (PERMANOVA). Associations between specific taxa and HFC were analyzed using multivariate associations with linear models (MaAsLin). Functional associations were derived from KEGG orthologies (KO) with linear regression models. RESULTS: Both microbial alpha (p = 1.90x10-4) and beta diversity (p ≤ 0.001) associated with HFC score. For alpha diversity, the strongest associations were observed for fiber-rich breads, poultry, fruits, and low-fat cheeses. For beta diversity, most prominent associations were observed for vegetables followed by berries and fruits. Genera with fiber-degrading and short-chain fatty acids (SCFA) producing capacity were positively associated with the HFC score. HFC associated positively with KO-based functions such as vitamin biosynthesis and SCFA metabolism, and inversely with fatty acid biosynthesis and the sulfur relay system. CONCLUSIONS: These results from a large and representative population-based survey confirm and extend findings of other smaller-scale studies that plant and fiber-rich dietary choices are associated with a more diverse and compositionally distinct microbiome, and with a greater potential to produce SCFAs.

Alcohol policy, alcohol legislation and alcohol consumption have a long history in Finland. For long, Finnish people have been seen as binge drinkers and harms caused by alcohol have been a true problem and burden for the public health. Still, alcohol is present in our everyday life. Therefore, there needs to be different ways to limit the consumption and related harms. This is where alcohol policy comes into action; its long history and the quite restrictive methods used in Finland have been generated for the welfare of the Finnish people and public health. Alcohol policy entails many aspects to consider. Discussing alcohol policy without taking into account such factors as self-regulation, alcohol culture and consumer practices leaves the discussion unilateral. The aim of this thesis is to identify what kind of policy measures were targeted when discussing the alcohol Act 2018 in the plenary session before voting about the Act. Also, the aim is to identify whether there was prejudice or stigma present in the discussion and how was alcohol culture taken into consideration when discussing the new act. In this study the focus is on alcohol culture and politics and therefore the research design of this study is qualitative. The material used in this research is a transcript of a plenary session held the day before the new Act was voted on. The method of analysis used to analyse the research material is directed content analysis. Still, it should be recognized, that this research is strongly related to rhetoric analyses as well. The debate in the plenary session was intense and strongly emphasized by personal opinions and arguments. The discussion many times shifted away from health policy to industrial policy which leaves open a question about the justification of alcohol policy in general. Stigma was present in the discussion and alcohol culture was referred to in a negative and positive sense. The nine target areas of alcohol policy were addressed, pricing and availability being emphasized more than other. The topic in general is part of a wider societal discussion and should be addressed from a wider perspective than alcohol policy alone.

Abstract Background: Irritable bowel syndrome is a common functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits. More than 60% of IBS patients report that certain foods, such as legumes, trigger intestinal symptoms. Legumes contain α-galacto-oligosaccharides (α-GOS), which belong to FODMAP-carbohydrates, that are not absorbed in the small intestine. When they pass to large intestine, α-GOS are fermented by gut microbiota, causing abdominal bloating and aggravated intestinal symptoms in IBS patients. Enzymatic processing could reduce the amount of α-GOS in food. Oral α-galactosidase enzyme has been reported to effectively reduce gas production and relieve gas-related symptoms in healthy individuals and pediatric IBS patients. The effects of enzymatic treatment of foods on gastrointestinal (GI) symptoms have not been previously studied. Aim: The aim of the study was to investigate whether α-galactosidase treated pea-based crackers, compared to control crackers, will reduce GI symptoms in people suffering from irritable bowel syndrome (IBS) or functional bloating (FB). The second aim of the study was to investigate the associations between nutrient and food intake and GI symptoms. Methods: This was a randomized, double-blinded, placebo-controlled two-period crossover study. Participants, were aged 22 -– 57 years. who suffered from irritable bowel syndrome or functional bloating based on the Rome IV criteria (n=24). Each participant received a three-day portion of either α-galactosidase-treated or control, pea-based crackers on each study week. The participants reported their GI symptoms throughout the study weeks and kept a food diary on the cracker eating days and during the run-in period. Maximum values of symptoms, symptom sum scores, as well as the average intake of nutrients and foods were analyzed. Statistical analyses were performed with the Wilcoxon signed rank test, Friedman's dependent samples test, correlation analyzes and linear regression. Results: No significant statistical difference was seen in between the maximum values of the symptoms during the study weeks. However, maximum values of abdominal bloating, flatulence, stomach noise, nausea and heartburn were consistently higher during the control week. Several nutrients and foods such as fiber, fat, glucose, fructose, and maltose, were significantly related to the GI symptoms during the study weeks. Conclusions: Since the enzyme-treated product was not better tolerated than the control product, it is possible that other components in the crackers or diet have overshadowed the possible benefits of α-galactosidase treatment. There is some evidence of beneficial effects ofSupplementation with α-galactosidase supplementation, but has shown some beneficial effects, however the results of α-galactosidase in alleviating GI symptoms in adult patients suffering from IBS are inconclusive. More studies on the effects of enzyme-treated food are needed in people suffering from IBS and FB are needed.

Aims: There is no information on changes in body mass index (BMI) due to the COVID-19 pandemic among persons of migrant origin. The aim of the present study was to examine the impact of the COVID-19 pandemic on BMI and factors associated with changes in BMI among the general- and migrant-origin populations in Finland. Methods: Individual-level changes in self-reported BMI among migrant origin persons (n=3313) were obtained from the FinMonik Survey conducted in 2018 and MigCOVID Survey conducted 2020-2021. Data for the general population reference group was obtained from the FinHealth 2017 Study conducted 2017-2018 and the FinHealth 2017 follow-up Study (n= 2982). Logistic regression was applied to examine the association between changes in BMI and age, sex, education, economic activity, length of residence in Finland, language skills, smoking, alcohol usage, sleep, physical activity, snacking, and fruit and vegetable consumption. A significant change in BMI was defined as a 5% or greater change. Results: 40.8 percent of the migrant-origin population and 41.2 percent of the general population in Finland experienced at least a five percent change in BMI. Persons of migrant origin who were other than students or employed (OR=1.71, 95% CI 1.18, 2.48) faced an increased risk for an increase in BMI of at least 5%, while being between 35-49 (OR=0.69, 95% CI 0.49, 0.98) and between 50-66 (OR=0.55, 95% CI 0.36, 0.83) had a significantly decreased risk. In the general population, an increase in BMI of at least 5% was more likely to occur among women (OR=1.61, 95% CI 1.26, 2.07), those who were other than students or employed (OR=1.68, 95% CI 1.26, 2.25), those who increased their alcohol intake (OR=1.64, 95% CI 1.06, 2.54), those who increased their snacking (OR=1.40, 95% CI 1.04, 1.90) and decreased their fruit and vegetable intake (OR=1.85 , 95% CI 1.18, 2.90). An increase of at least 5% in BMI was inversely related with being between the ages of 50 and 66 (OR=0.39, 95% CI 0.27, 0.57), having secondary education or higher (OR=0.61, 95% CI 0.43, 0.86), and even among those who smoked more during the pandemic (OR=0.50, 95% CI 0.26, 0.96). Conclusions: Although economic activity was determined to be a significant predictor of increases in BMI among both general- and migrant-origin populations, most examined factors applied differently to each population. These differences must be considered when planning future public health promotion efforts, particularly those during crisis situations.

Legumes are a good source of protein, and they have recently grown in popularity as a substitute for meat due to their lower environmental impact. Reducing meat consumption and replacing it with plant-based foods, such as legumes, is also known to be beneficial for health. Nevertheless, legume consumption in Finland is relatively low, and they are not yet a part of the typical diet for adults or children. Food education and role modeling play an important role in encouraging children towards healthy and sustainable food choices. This thesis investigated whether different food education methods can increase the acceptability of legumes in early childhood education. The thesis is part of the "Food Step" research project, and the data was collected from intervention daycares. The study surveyed early childhood education professionals' attitudes towards legumes using questionnaires. The questionnaires aimed to determine the acceptability of legumes before the intervention and how the food education materials used during the intervention affected it. Among early childhood educators, the use of legumes and related attitudes varied greatly. Most respondents reported using legumes in both the baseline and follow-up surveys, but they showed varying prejudices towards their nutritional properties, structure, and taste. Only attitudes towards the nutritional content of legumes changed significantly between the time points. In summary, the study did not observe significant positive changes in adult attitudes towards legumes. Food behavior begins to form in early childhood, and these patterns are known to be relatively stable. Food behavior-related patterns are learned, for example, in early childhood education. Therefore, it would be important to consider in the future how the attitudes of adults working in early childhood education could be positively changed for them to be better role models.

Abstract Background Household food insecurity and hunger are associated with undernutrition of children under five years of age. Stunted, wasted and underweight young children are often living in food insecure households in low- and lower-middle-income countries. Low socioeconomic status is associated with both, food insecurity and malnutrition. Interestingly, children’ undernourishment and adults’ overweight occur sometimes in the same family. Aims The purpose was to investigate the prevalence of food insecurity, by two different assessment scales, among households with children at the age of 6–23 months in Nairobi and Chuka in Kenya. Differences in household food insecurity between the two living areas and households’ wealth, and an association between household food insecurity and nutritional status of mothers and children were examined. Methods The data from households (n=412) was cross-sectional and a part of InnoFood Africa project in 2021. Household Food Insecurity Access Scale (HFIAS) and Household Hunger Scale (HHS) were used for analysing the prevalence of food insecurity. Sociodemographic background, housing characteristics, nutritional status indicators and HHS were used for the Chi2 -test and linear regression analysis. Results The prevalence of food insecurity by HFIAS and HHS were 63% and 15.5%, respectively. No difference in HHS was found between the living areas. The least wealthy households were more often moderately or severely hungry than the wealthiest households. Statistically significant association was found between HHS and lower maternal MUAC. No association was found between HHS and maternal BMI and any of child’s nutritional status indicators. Conclusion Household hunger was not associated with nutritional status of mothers and children. Further studies are needed to examine the prevalence of double burden of malnutrition in households living in urban and developing societies to understand better the causes for malnutrition.

Background: Recent findings in adults and children suggest that vegetarians, and particularly vegans, are at risk of iodine deficiency. As an increasing number of individuals adhere to plant-based diets, it is important to investigate the current iodine nutrition in children and adults. Aim: The aim was to examine whether iodine intake from food and supplements differs in children and adults who follow vegan, vegetarian, or omnivore diets, and to describe the main sources of iodine in these diets. Furthermore, the objective was to investigate the median urinary iodine concentration and determine whether these diets are associated with inadequate iodine status. Materials and methods: Cross-sectional data for children (n=73) and adults (n=79) were drawn from participants in the MIRA2 study. Iodine intake from food and supplements was assessed using a 3-day food record and a background questionnaire. The iodine status was assessed using spot urine samples. Results: Among children, there were no between-group differences in total iodine intake from food and supplements. In adults, vegetarians had a significantly lower total iodine intake than vegans and omnivores, but only vegan adults had a median urinary iodine concentration below 100 μg/L. Iodine supplements were the main sources of iodine in the vegan diet for both children and adults, whereas grain products were an important source of iodine regardless of diet. No association was found between plant-based diets and inadequate iodine status, defined as a median urinary iodine concentration below 100 μg/L. Conclusions: This study found no association between plant-based diets and inadequate iodine status. However, sufficient iodine intake may be compromised in adults who follow vegan and vegetarian diets. These results highlight the importance of iodine supplementation in the vegan diet.

Background and aim Limited global research is available on the nutritional status of preschool-aged children following a vegan diet. Significant disparities in the absorption of animal and plant-based iron call for an investigation into the iron status of vegan children. The aim of the study was to assess the iron status of preschool-aged children and their caregivers following vegan or vegetarian diets compared to their omnivorous counterparts using multiple iron biomarkers. An additional aim was to capture the variation of dietary intake within the diet groups by constructing a dietary variable and exploring its association with iron biomarkers. Methods In a cross-sectional MIRA 2 study 2-6-year-old children following either a vegan, vegetarian or mixed diet, and their family members, were recruited from daycare centres in Helsinki. Parents reported their own and their children's diets and completed a short screener of dietary intake. Haemoglobin, transferrin receptor and ferritin concentrations were analysed from blood samples. The data used in this study included children (N=61) and parents (N=72) who provided a blood sample and answered the background questionnaire. Diet groups were formed based on the screener. Iron biomarker distributions were examined by diet groups with the Kruskal-Wallis test and iron deficiency prevalence was examined using the Fisher’s exact test. Dietary variables were constructed by principal component analysis and linear regression models were used to assess the association between the variables and iron biomarkers. Results Compared to omnivorous children, children following a vegan diet had lower haemoglobin concentrations (median -7 g/L), and children following a vegetarian diet were found to have haemoglobin values below the reference value (<112 g/L) more often. Vegan men had lower ferritin concentrations compared to omnivorous men (median -55 µg/l). Animal-based dietary pattern was associated with higher haemoglobin concentrations in children and ferritin concentrations in men. In women, a negative linear association was found between animal-based dietary pattern and ferritin concentrations. Of all children and women, 26% and 28 % had ferritin concentrations below the reference value (<12/15 µg/L). Conclusions Iron biomarker concentrations of vegetarians and vegans were lower compared to omnivores. While the popularity of plant-based diets is increasing, studies assessing the long-term effects of childhood vegetarian diets are warranted.