Browsing by master's degree program "Master´s Programme in Human Nutrition and Food-Related Behaviour"

Background and aim: Formula fed (FF) infants show consistently higher rates of infections, and accelerated growth rate during the first year of life compared to breastfed (BF) infants. Lipid components of bovine origin, such as the lipid membrane structure, and phospholipids have been suggested as promising in narrowing the gap in health and development between FF and BF infants. The aim of this master’s thesis was to identify differences in the development and health of infants primarily fed with either milk-fat (MF) or vegetable-oil (VO) based formula, during the first year of life, and to elucidate the relativeness of lipid source and structure in currently commercially available formulas for infant growth and infectious morbidity. Methods: This study was a secondary analysis of the observational, longitudinal Health and Early Life Microbiota (HELMi) cohort data, collected among healthy, term infants and their families during 2016 and 2019 in the capital region of Finland. FF infants were divided into two groups (MF, VO), and observational BF group was included as a reference. Infant growth was analysed with general linear model for repeated measures of WHO z-scores: weight-for age (WFA), weight-for-length (WFL), BMI-for-age (BMIFA), and length-for-age (LFA). Infectious morbidity was assessed as the odds ratio (OR) with 95% confidence interval (CI) for doctor visit and antibiotics use during the first year of life based on parental reports and using binary logistic regression model. Results: Type of feeding (FF vs BF) was significantly (p<0.001) associated with the pattern of growth during the first year of life. FF groups showed slower weight gain for age during the first 3 months of life, but MF were then characterized with rapid catch-up growth (≥0.67 mean change in z-score) from 3 to 12 months of life, compared to BF infants. After inclusion of formula, the adjusted OR of doctor visit for respiratory infections was 2.58 (CI 1.14-5.86, p=0.024) from 3 to 6, and 3.25 (CI 1.46-7.25, p=0.004) from 6 to 9, among MF, compared to BF infants. For the antibiotics use the adjusted OR was 2.98 (CI 1.03-8.64, p=0.043) among MF infants from 6 to 9 months, compared to BF. No significant differences were detected between the two formula groups in any of the outcome parameters. Conclusions: Type of feeding is significantly associated with infant growth pattern and infectious morbidity during the first year of life, but no significant association could be determined with the lipid source of formula. Infant feeding is certainly an area of high importance and based on the current findings commercially available formulas are lacking in terms of health outcomes and growth compared to BF infants.

Introduction In addition to families and home environments, preschools can shape children’s eating habits. Children’s fruit and vegetable (FV) consumption remains below recommendations. Nutrition interventions should be aimed at young children when eating habits develop and be implemented in influential settings, like preschools. The preferred method to study and measure consumption is by weighing foods. However, weighing is hardly used in preschool-settings especially in group-level research. Aims The aim was to examine the effect of the DAGIS intervention on the consumption of FV in preschool meals. The secondary aim was to determine whether the results differed from the impact of DAGIS intervention on the FV consumption at group level when the amount of plate waste was considered. Materials and methods The DAGIS intervention was a randomized controlled trial (2017–2018) aiming to promote lifestyle and self-regulation skills affecting the energy-balance of Finnish 3–6-year-old. The 23-week intervention included 32 preschools. Vegetable consumption was measured at group level for three days in preschool before and after the intervention by weighing vegetables served, serving waste and plate waste. Data analyses were performed using Chi-square test, t-test, Wilcoxon signed-rank test and linear regression. Results In the follow-up, the median consumption of fresh FV, salad mixes, warm vegetables as a side dish and canned FV (25th; 75th quartile) per child was 81.3 g (55.2; 120.6) in the control group and 72.1 g (65.7; 119.3) in the intervention group. The total consumption of FV per child in the intervention group was not higher than in the control group after intervention. The inclusion of plate waste did not change the results adjusted by municipality. Conclusions There was no increase in FV consumption in the intervention group after intervention compared to the control group. Apart from highlighting FV consumption, future group-level interventions should be targeted at serving of vegetables. They should also critically consider the necessity of collecting plate-waste, especially if it increases research cost and burden.

Parkinson’s disease (PD) is a neurological disease impacting over six million people in the world. In addition to the motor symptoms of the disease, the disorder is accompanied with gastrointestinal problems. These include delayed transit time, disturbances in the microbial composition of the gut, inflammation in the intestine, structural changes in the epithelial lining and increased intestinal permeability. Paracellular permeability is regulated by tight junctions (TJ) which are complexes formed by proteins such as claudins, occludin and zonula occludens proteins. Probiotics are live microorganisms which when administered have beneficial effects on the host. Probiotic bacteria can modulate intestinal permeability and the expression of TJ proteins. These microbes are also able to improve the gastrointestinal symptoms, such as constipation, in PD patients. As a part of a larger study, the aim was to examine whether the expression of TJ proteins is altered in the lactacystin-induced mouse model of PD and to investigate whether probiotic supplementation elicits changes in their expression. The study was conducted in eight- to nine-week-old C57Bl/6JRccHsd mice, to which PD symptoms had been induced by lactacystin injection to the substantia nigra. Starting at one to two weeks after the injection, four groups of mice were treated with one out of four specific probiotic strains (A, B, C and D) for two weeks. At the end of the experiment, jejunal and colonic samples were collected from the mice. These samples were analyzed using Western Blot to determine the expression of TJ proteins claudin-1, claudin-4 and occludin. Based on the WB results, the jejunal gene level expression of these proteins in one probiotic group (D) was compared to the untreated group with reverse transcription quantitative polymerase chain reaction. The expression of TJ proteins was not altered as a result of the lactacystin injection in jejunum or colon, suggesting that lactacystin model is not optimal for investigating PD-related alterations in TJ proteins. Supplementation with microbe D increased the jejunal expression of claudin-1 on both protein and gene level, whereas in the colonic protein expression there was no change. Clear effects were not detected on claudin-4 or occludin nor when treated with microbes A, B or C. Therefore, microbe D might influence intestinal TJ function and permeability through regulating the expression of claudin-1.

Research shows that Finnish people could increase the consumption of some domestic fish species. Increased consumption has been calculated to have economic, social, and environmental benefits. The current situation of fish consumption is unsustainable. Academic literature on consumption and food systems emphasizes the importance of a holistic view to sustainability. Environmental sustainability has been emphasized and other dimensions of sustainability have been neglected, regarding policies and regulations of the fish industry. In this study, it is argued that observing the consumer perceptions of sustainability dimensions could help to develop a more sustainable fish industry and consumption patterns. The theoretical framework was formed based on literature review. A three-dimensional view to sustainability was used including social, economic, and environmental dimensions. The relevant factors to measure the importance of the dimensions were formed with previous studies on fish consumption. The research aims to reveal perceptions to sustainability dimensions importance from a consumer interface. The research questions are: Which dimensions of sustainability have importance to consumers regarding fish consumption? Are any of the dimensions and factors involved more important than the others? Are there differences between groups on the perception of the dimensions? The research was carried out as a quantitative online survey and shared on social media platforms. Data (N=107) was analysed with quantitative methods (descriptive statistics, crosstabulation and Kruskal-Wallis’s test). Most participants considered all sustainability dimensions important. Environmental dimension was the most important, and especially the factors of protecting the ecosystems, fish stocks and waterbodies. Between age groups a statistically significant difference was found in the importance of the environmental dimension. The results indicate that Finnish people are willing to consume more domestic fish, and care about the sustainability of fish consumption. This study contributes to the discussion of sustainable fish consumption and provides a new approach on developing more sustainable food systems.

The current definition for dietary fibre was adopted by the Codex Alimentarius Commission (CAC) in 2009, but implementation still requires updating food composition databases with values based on appropriate analysis methods. The Finnish National Food Composition Database Fineli is among the first to be updated with CODEX-compliant values of total dietary fibre (TDF), insoluble dietary fibre (IDF), dietary fibre soluble in water but precipitated in 78 % aqueous ethanol (SDFP) and dietary fibre soluble in water and not precipitated in 78 % aqueous ethanol (SDFS). Previous data on population intakes of dietary fibre fractions is sparse. The aim of this study was to assess intakes and sources of dietary fibre and dietary fibre fractions in Finnish children based on updated values of the national food composition database Fineli. In addition, associations of sociodemographic factors with energy adjusted total dietary fibre intake were assessed. Our sample included 5206 children at increased genetic risk of type 1 diabetes from the Type 1 Diabetes Prediction and Prevention birth-cohort, born between 1996 and 2004. We assessed the intakes and sources based on 3-day food records collected at the ages of 6 months, 1, 3, and 6 years. Associations of child’s age, sex, breastfeeding status and sociodemographic factors were assessed with independent samples t-test, Mann-Whitney U-test, and univariate analysis of variance. Food sources of dietary fibre were assessed with source analysis. Older children and boys had higher intakes of absolute dietary fibre. The highest energy-adjusted intake of TDF was however observed in 1-year-olds (2.85 g/MJ in boys; 2.77 g/MJ in girls). At the age of 6 months, non-breastfed girls and boys had higher energy-adjusted intake of TDF than their breastfed counterparts, while at the age of one the setting reversed. Children of older parents, parents with a higher level of education, non-smoking mothers, and children with no older siblings had higher energy-adjusted intakes of total dietary fibre. Cereal products, fruits and berries, potatoes, and vegetables were the major food sources of total dietary fibre as well as the dietary fibre fractions. IDF was the major dietary fibre fraction followed by SDFP and SDFS. Proportions of IDF and SDFP decreased with age, while the proportion of SDFS increased. Our study based on updated CODEX-compliant food database values found that on average the TDF intake of Finnish children met the recommendations. The proportions of dietary fibre fractions as well as the roles of different foods as dietary fibre sources shifted with the child’s age, reflecting age related changes in the child’s diet.

Many athletes, goal-oriented exercisers, and normal-weight adults are interested in pursuing weight loss and a more aesthetic appearance. However, research on the association between body composition changes and cardiometabolic health is relatively scarce in metabolically healthy adults, whose body mass index is below 30. Thus, the current study observed, how the serum cardiometabolic profile of fitness competitors changes in response to an intensive weight loss period prior to competitions, and whether these changes persist during competition week and a post-competition recovery period. In addition, the association between android fat mass and serum cardiometabolic profile was investigated. The study was part of University of Jyväskylä and National Institute for Health and Welfare’s study that followed the competition preparation of 23 fitness athletes (13 men, 10 women) prior to the Finnish National Championships and their subsequent recovery from the pre-competition weight loss. The results of the competitor group were compared to a control group (10 men, 12 women) that strived to maintain their baseline body composition, energy intake, and exercise levels throughout the study period. Participants’ serum cardiometabolic profile (250 serum metabolites), body composition, energy intake, and energy expenditure of weekly exercise were measured in four time points: six months pre-competition (PRE), one week pre-competition (MID), one day post-competition (COMP), and six months post-competition (POST). Changes in the serum cardiometabolic profile and their associations with android fat mass, energy intake, and exercise levels were analyzed with Generalized Estimation Equations models. During the weight loss period (PRE-MID), the competitors’ body weight decreased by 8,0 ± 3,5 kg (false discovery rate, FDR = 0,02) and 12,0 ± 3,4 kg (FDR < 0,001), and total fat mass decreased by 10,7 ± 2,1 kg and 9,7 ± 1,5 kg (FDR < 0,001) in women and men, respectively. The competitors’ serum HDL-cholesterol, HDL-phospholipid and apoA-1 concentrations, and HDL particle size and number increased (FDR < 0,01), while serum total and VLDL-triglyceride concentrations, VLDL particle size, and concentrations of glucose and glycoprotein acetyls decreased (FDR < 0,001). Decreased android fat mass (~-79%, FDR < 0,001) explained the majority of the metabolic changes during the weight loss period. Increased energy intake during the competition week (women: ~18%, FDR = 0,19; men: ~41%, FDR < 0,001) was associated with increases in serum HDL- and VLDL-triglyceride concentrations (FDR < 0,05). In the end of the recovery period (POST), the competitors’ body composition and most (n = 64) of the serum metabolite concentrations had reverted back to baseline levels (FDR > 0,05), except for lipids in large VLDL particles and a few (n = 7) HDL-related metabolites (FDR < 0,05). The current results suggest that weight loss and loss of android fat mass are associated with anti-atherogenic changes in fitness competitors’ HDL and VLDL particle composition and in concentrations of serum glucose and inflammation markers. Increased energy intake after weight loss may lead to acute increases in HDL- and VLDL-triglyceride concentrations, but weight-loss-related changes in the serum cardiometabolic profile are not substantially dissipated until body weight and fat mass are regained. Further longitudinal research with larger sample sizes is warranted to confirm potential causal relationships.

Background: Adults’ obesity prevalence has become threefold world widely during the last 50 years, and the rate is estimated to continue to increase in the future. Overweight and obesity are a health challenge, as they create health problems to persons and load the health care. Both obesity prevention and treatment are a constituent of health care. Updated Obesity Current Care Guideline (2020) has been created to support the work of health professionals. It has not been previously studied nationally, how the obesity guideline is known, and how the prevention and treatment are handled in different health care sectors, areas, and occupational groups in Finland. Aims: This thesis aimed to find out, who of the health professionals had familiarized with the updated obesity guideline and how they perceive it has affected their work. Additionally, the prevention and treatment methods, procedures of the health care, and attitudes of the health professionals were studied. Methods: The used material was part of the questionnaire regarding the Obesity Current Care Guideline. Electronic questionnaire was sent with an open link to the professionals and supervisors working in primary health care, special health care and public and private occupational health care. 760 professionals responded to the questionnaire. Here, 447 responses from professionals, who mainly work in the prevention and treatment of adults’ obesity, are used as data. Microsoft Excel 2208 -program and IBM SPSS Statistics 29.0 -program’s cross-tabulation and Chi-square test were used to analyze the results. Results: Half (52 %) of the professionals, who participated in the study, were familiarized with the updated obesity guideline. Nutritional therapists and doctors were familiarized more than other occupational groups (p<0,001). Of those, who had familiarized with the guideline, 45 % considered that the guideline has affected to the procedures of their work. The methods of the guideline were used in the health care to some degree, especially professionals brought up obesity topic into discussion and used lifestyle treatment. Professionals working mainly with adults estimated that health care procedures do not follow completely the guideline, and many professionals were not aware of the obesity prevention and treatment procedures of their organization and area. The attitudes of the professionals were mainly positive. One fourth of the responders did not consider that bringing up obesity topic into discussion is natural. Conclusions: The Obesity Current Care Guideline implementation should be improved, so that all health professionals would know the content of the guideline and take advantage it in their work. The procedures of the obesity prevention and treatment must be developed, since they were not in line with the guideline and many professionals were not aware of the procedures of their own organization, like weight management groups. Professionals’ attitudes were mainly positive indicating high interest towards obesity prevention and treatment. Some professionals considered bringing up obesity topic into discussion not being natural, which indicates the need for education and communication about already existing materials. These could help the work of the professionals and lead to better support of the patients. When examining the results of this thesis, it is essential to keep in mind the option of biased results, because of the small number of answers – the results cannot be generalized to total health care of Finland. However, the results can be used in developing the Obesity Current Care Guideline work and adults’ obesity prevention and treatment in the health care. The topic should be studied more with advanced methods and with a representative sample.

A healthy and balanced diet is essential for healthy growth and nutrition during childhood and youth has permanent and long-term effects for an individual’s health status. However, in contrast to other Nordic countries and most other European countries, there is no national data on adolescents’ food consumption and nutrient intake available in Finland. The Finnish Institute for Health and Welfare conducted a pilot study on nutrition monitoring in adolescents during Autumn 2021. The study was conducted altogether in six schools in Helsinki and Tampere and the study group consisted of 110 ninth graders. The data on the adolescents’ food consumption and nutrient intake was collected with two 24-h dietary recalls. The first recall was conducted face to face and the second by phone. Based on this pilot study, the goal is to develop a national study protocol for examining the food consumption and nutrient intake of 12-18-year-old adolescents. The aim of this master’s thesis is to find out if the study protocol of the pilot study is suitable for a larger national study. In addition, the aim is to find out how was the food consumption and nutrient intake of the ninth graders from Helsinki and Tampere who participated in the study. The statistical tests and graphs were made using IBM SPSS Statistics 29 -software and Microsoft Excel - program. Non-parametric Mann-Whitney U -test was used to compare groups. The participation rate of the study was good. 73% of the invited adolescents participated in the first recall, from which 98% participated also in the second recall. Based on the results of this pilot study, 24-h dietary recalls conducted face to face and by phone are a practical and reliable study method when examining adolescents’ food consumption and nutrient intake. Adolescents’ mean intake of vegetables, fruits, berries, and dietary fibre was below the recommended amount, while the mean intake of salt and saturated fatty acids exceeded the recommended level. Based on the results, the study protocol is suitable for a larger national study. A national study is needed to better understand adolescents’ food consumption and nutrient intake from the point of view of health and environmental sustainability, and to see if there are differences by region, age, or sociodemographic factors. In addition, the national study would help to improve adolescents’ health and to prevent, for example, overweight, obesity and chronic diseases.

Good nutritional status contributes to health, functional capacity, and quality of life. The food provided to patients in hospitals is formulated to contribute to their recovery and is an integral part of their care. For nutritional care to be successful, it is important that patients eat the food they are offered, so both the food and the dining environment should be pleasing to patients. Personal habits have a big influence on what kind of food and eating situation each person finds pleasurable. The data analysed in this study were collected by interviewing patients. The interviews were conducted at a stage when the interviewees had at least two days of experience of patient dining. For this study, a thematic interview was chosen as the research method, as the phenomena and issues to be surveyed are not yet very well-known and the interviewees themselves wanted to be given the opportunity to raise issues that were relevant to them. The supervisors of this thesis were Heini Karp, PhD, licensed dietician, and Anu Joki, PhD. The interviews revealed that patients were quite satisfied with the hospital meals, both in terms of food and organisation. The size of portions was the single most important issue that all interviewees highlighted as a factor affecting satisfaction and which they would like to influence themselves. The interviews also showed that the possibility to make choices - even small ones - improves the dining experience in hospital. As there are already several portion sizes available and the aim is to provide the right size portion for each patient, changes to these practices could be implemented relatively easily and at low cost. A typical way to find out patients' satisfaction with hospital food is through form-based surveys. They may not reveal all the underlying reasons for the results obtained, making it difficult to correct the situation and improve hospital catering based on the results. Interview-based research on patient satisfaction with the food service experience is relatively scarce. More research would be needed to assess the transferability of the results. In particular, there is a need for a study that takes into account the age distribution and the different needs of patients of different ages.

Tausta ja tavoitteet: Punaisen lihan kulutus on maailmanlaajuisesti liian runsasta, millä on merkittäviä epäsuotuisia ympäristö- ja terveysvaikutuksia. Suomessa erityisesti miehet syövät merkittävästi enemmän punaista lihaa kuin ravitsemussuosituksissa suositellaan. Punainen liha on kuitenkin suomalaisten miesten ruokavalioissa merkittävä B12-vitamiinin ja hyvin imeytyvän raudan lähde. Työn tavoitteena oli tutkia punaisen ja prosessoidun lihan osittaisen korvaamisen palkokasveilla vaikutuksia suomalaisten miesten B12-vitamiinin ja raudan saantiin sekä niiden biomarkkereihin. Menetelmät: Tutkimusjaksoa edeltävän seulonnan läpäisyn jälkeen osallistujat (n=102) jaettiin kahteen rinnakkaisryhmään, liharyhmään ja palkokasviryhmään. Liharyhmä sisällytti ruokavalioonsa 760 grammaa punaista lihaa viikossa, kun palkokasviryhmä puolestaan sisällytti ruokavalioonsa 200 grammaa punaista lihaa ja loput punaisesta lihasta (560 g/vk) saatavasta proteiinimäärästä korvattiin palkokasveja sisältävillä elintarvikkeilla. Muu ruokavalio pyydettiin pitämään tavanomaisena, mutta muiden kuin tutkimuksessa jaettujen punaisen lihan ja palkokasvien käyttö kiellettiin. Tulokset: B12 vitamiinin saanti oli suurempaa (p<0,001) liharyhmässä (7,7±4,0 μg/vrk) kuin palkokasviryhmässä (5,0±2,7 μg/vrk). Raudan saanti oli puolestaan pienempää (p<0,001) liharyhmässä (14,0±3,1 mg/vrk) kuin palkokasviryhmässä (21,9±5,7 mg/vrk). Transkobalamiini II sitoutuneen B12-vitamiinin (holoTC) pitoisuus oli suurempi (p=0,022) liharyhmässä (120,4±47,3 pmol/l) kuin palkokasviryhmässä (107,1±45,1 pmol/l). Interventioryhmien välillä ei havaittu eroja veren hemoglobiinissa ja hematokriitissa sekä plasman transferriinireseptorissa, raudassa, ferritiinissä, transferriinissä eikä transferriinin rautakyllästeisyydessä. Johtopäätökset: Punaisen lihan osittainen korvaaminen palkokasveilla vähensi B12-vitamiinin saantia ja johti pienempään veren holoTC-pitoisuuteen. Raudan saanti puolestaan kasvoi palkokasviryhmässä mutta raudan biomarkkereissa ei ollut eroja interventioryhmien välillä.