A school based study of time trends in food habits and their relation to socio-economic status among Norwegian adolescents, 2001–2009

Background: In recent years, adolescents’ food habits have become a major source of concern, and substantial policy and intervention efforts have been made to influence adolescents to consume more fruit and vegetables and less sweets and soft drink. Particular attention has been devoted to the social gradient in food habits, aiming to reduce dietary inequality. However, few internationally published studies have evaluated trends in teenagers’ food habits, or investigated how dietary inequalities develop. Methods: We used Norwegian cross-sectional data from the international Health Behaviour in School-Aged Children (HBSC) study, collected via three nationally representative and comparable questionnaire surveys in 2001, 2005 and 2009. Food habits were identified by students’ consumption of fruit, vegetables, sweets and sugar rich soft drink. Socio-economic status (SES) was measured with the Family Affluence Scale (FAS). Multilevel logistic regression was used to analyze the data. Results: The analyses indicated an overall positive trend in food habits among adolescents in Norway. Students were more likely to consume fruit (OR 1.76, CI 1.61-1.92) and vegetables (OR 1.51, CI 1.37-1.66) daily in 2005 as compared to 2001, and were less likely to consume sweets (OR 0.58, CI 0.51-0.66 resp. OR 0.77, CI 0.67-0.90) and soft drink (OR 0.55, CI 0.49-0.62 resp. OR 0.84, CI 0.73-0.96) daily when comparing, respectively, 2005 with 2001 and 2009 with 2005. Across all survey years, students with higher SES were more likely to eat fruit (OR 1.47, CI 1.32-1.65) and vegetables (OR 1.40, CI 1.24-1.58) daily than did students with lower SES. Our analyses indicated that the socio-economic differences were stable in the period 2002 - 2010, with uniform improvement in fruit and vegetable consumption across all SES levels. No significant associations between SES and intake of sweets and sugar-added soft drink were found. Conclusion: The study identifies an overall improvement in diet among adolescents over a period characterized by onset of as well as ongoing initiatives targeting young people’s food habits. However, the observed socio-economic gradient in fruit and vegetable consumption remained unchanged

Physical environmental characteristics and individual interests as correlates of physical activity in Norwegian secondary schools: The health behaviour in school-aged children study

<p>Abstract</p> <p>Background</p> <p>The school has been identified as a key arena for physical activity promotion for young people. Effective change of physical activity behaviour requires identification of consistent and modifiable correlates. The study explores students' interests in school physical activity and facilities in the school environment and examines their associations with students' participation in physical activity during recess and their cross-level interaction effect.</p> <p>Methods</p> <p>This cross-sectional study was based on a national representative sample of Norwegian secondary schools and grade 8 students who participated in the Health Behaviour in School-aged Children (HBSC) 2005/06 study. The final sample comprised 68 schools and 1347 students. Physical environment characteristics were assessed through questionnaires completed by the principals, and students' physical activity and interests in physical activity were assessed through student self-completion questionnaires.</p> <p>Results</p> <p>Most students were interested in more opportunities for physical activity in school. Multilevel logistic regression models demonstrated that students attending schools with many facilities had 4.49 times (95% Confidence Interval (CI) = 1.93–10.44) higher odds of being physically active compared to students in schools with fewer facilities when adjusting for socio-economic status, sex and interests in school physical activity. Also open fields (Odds Ratio (OR) = 4.31, 95% CI = 1.65–11.28), outdoor obstacle course (OR = 1.78, 95% CI = 1.32–2.40), playground equipment (OR = 1.73, 95% CI = 1.24–2.42) and room with cardio and weightlifting equipment (OR = 1.58, 95%CI = 1.18–2.10) were associated with increased participation in physical activity. Both students' overall interests and the physical facilitation of the school environment significantly contributed to the prediction of recess physical activity. The interaction term demonstrated that students' interests might moderate the effect of facilities on recess physical activity.</p> <p>Conclusion</p> <p>The findings support the use of an ecological approach and multilevel analyses in the investigation of correlates of physical activity that allows for a broader understanding of the influence of and interaction between factors at multiple levels on physical activity behaviour. In the promotion of physical activity in lower secondary schools, the study suggests that programmes should include a focus on environmental facilitation and incorporate strategies to increase students' interests for school physical activity.</p

Gendered leisure activity behavior among Norwegian adolescents across different socio-economic status groups

The present paper explores gendered behavior based on participation patterns of leisure activities among adolescents across socio-economic status (SES) groups, aiming to increase knowledge and understanding of how gender socialization processes are expressed through boys’ and girls’ participation in leisure activities. Furthermore, the aim is to investigate whether such gendered behavior is associated with general levels of participation, and if there may be differences between low, middle, and high SES groups. The study used Norwegian nationally representative data of 15- and 16-year-olds from the World Health Organization's cross-sectional survey, Health Behaviour in School-aged Children 2005/06 (n = 3,273). Logistic regression analysis and propensity scores showed that adolescent boys and girls had clear gendered behavior patterns based on leisure activity participation in 27 different activities, and that boys and girls had about equal distributions on what was classified as typical (“boyish” or “girlish”), atypical, and neutral gender behavior. Furthermore, gendered behavior was correlated with higher levels of participation for both sexes, and it was more or less similar for boys and girls and for different socio-economic status groups. However, when investigating differences in distributions between SES groups, high SES girls were found to have a significantly higher prevalence of both “boyish” and “girlish” activity behavior, but less “gender-neutral” compared with girls in medium and low SES groups. There were no such differences for boys.publishedVersio

Gaming Behaviors and the Association with Sleep Duration, Social Jetlag, and Difficulties Falling Asleep among Norwegian Adolescents

The relationship between gaming and sleep is mostly informed by studies of addictive gaming behavior, thus limiting our understanding of sleep in the context of nonproblematic engaged gaming. The present study investigated whether addicted, problem, and engaged gaming behavior was associated with sleep duration, social jetlag, and difficulties falling asleep. The sample consisted of 13- and 16-year-old Norwegian adolescents (n = 3228) participating in the Health Behavior in School-Aged Children (HBSC) survey in 2018. Participants were categorized into addicted, problem, engaged, and normal/non-gaming behavior groups according to which GAS-7 criteria they fulfilled. Robust generalized linear mixed models with a random intercept for class ID were used to examine the association between the sleep variables and gaming behavior. Addicted gaming behavior was unfavorably associated with all sleep parameters. The findings for engaged gaming and problem gaming behavior were somewhat mixed. Engaged gamers slept less on weekends, less on weekdays for those aged 16, and experienced greater social jetlag compared to the normal/non-gaming group. Problem gamers experienced greater social jetlag and had higher odds of experiencing difficulties falling asleep. Overall, the results suggest that all types of gaming behaviors might harm sleep health, but to a greater extent for the addicted gamers.publishedVersio

A school based study of time trends in food habits and their relation to socio-economic status among Norwegian adolescents, 2001–2009

Background: In recent years, adolescents&rsquo; food habits have become a major source of concern, and substantial policy and intervention efforts have been made to influence adolescents to consume more fruit and vegetables and less sweets and soft drink. Particular attention has been devoted to the social gradient in food habits, aiming to reduce dietary inequality. However, few internationally published studies have evaluated trends in teenagers&rsquo; food habits, or investigated how dietary inequalities develop. Methods: We used Norwegian cross-sectional data from the international Health Behaviour in School-Aged Children (HBSC) study, collected via three nationally representative and comparable questionnaire surveys in 2001, 2005 and 2009. Food habits were identified by students&rsquo; consumption of fruit, vegetables, sweets and sugar rich soft drink. Socio-economic status (SES) was measured with the Family Affluence Scale (FAS). Multilevel logistic regression was used to analyze the data. Results: The analyses indicated an overall positive trend in food habits among adolescents in Norway. Students were more likely to consume fruit (OR 1.76, CI 1.61-1.92) and vegetables (OR 1.51, CI 1.37-1.66) daily in 2005 as compared to 2001, and were less likely to consume sweets (OR 0.58, CI 0.51-0.66 resp. OR 0.77, CI 0.67-0.90) and soft drink (OR 0.55, CI 0.49-0.62 resp. OR 0.84, CI 0.73-0.96) daily when comparing, respectively, 2005 with 2001 and 2009 with 2005. Across all survey years, students with higher SES were more likely to eat fruit (OR 1.47, CI 1.32-1.65) and vegetables (OR 1.40, CI 1.24-1.58) daily than did students with lower SES. Our analyses indicated that the socio-economic differences were stable in the period 2002 - 2010, with uniform improvement in fruit and vegetable consumption across all SES levels. No significant associations between SES and intake of sweets and sugar-added soft drink were found. Conclusion: The study identifies an overall improvement in diet among adolescents over a period characterized by onset of as well as ongoing initiatives targeting young people&rsquo;s food habits. However, the observed socio-economic gradient in fruit and vegetable consumption remained unchanged.publishedVersio

Sosial ulikhet og trender i subjektiv helse og livsstil blant norsk ungdom i perioden 1985-2001

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Associations between family structure and adolescents’ food habits

Objective: To investigate family structure differences in adolescents’ consumption of fruit, vegetables, sweets and sugar-added soft drinks with adjustments for socio-demographic and socio-economic variables. Design: Cross-sectional data from the Health Behaviour in School-aged Children survey. Setting: Norwegian primary and secondary schools. Participants: Adolescents (n 4475) aged 11, 13, 15 and 16 years. Results: After adjusting for covariates, living in a single-mother family was associated with lower vegetable consumption (OR 0·76, 95 % CI 0·63, 0·91) and higher soft drink consumption (OR 1·29, 95 % CI 1·06, 1·57). Living in a mother and stepfather family was negatively associated with fruit (OR 0·71, 95 % CI 0·54, 0·95) and vegetable (OR 0·72, 95 % CI 0·54, 0·97) consumption. Living in a single-father family was associated with lower sweets consumption (OR 0·48, 95 % CI 0·32, 0·72). No significant interactions were demonstrated between family structure and socio-demographic or socio-economic covariates. Conclusions: The study suggests that an independent association between family structure and adolescents’ food habits exists.publishedVersio

How to evaluate the effect of seven years of The Norwegian School Fruit Scheme (2007-14) on fruit, vegetables, snacks consumption and weight status- A natural experiment.

Aim: From August 2007 to June 2014, the Norwegian School Fruit Scheme (NSFS) legally established that all pupils in junior high and combined schools (275,000 pupils every year), but not those in primary schools (343,000 pupils every year), were entitled to a free piece of fruit or vegetable every school day. The NSFS is a natural experiment, unique in terms of scope and lengthiness. Such governmental efforts to improve the diet of the public are rarely evaluated. Thus, an evaluation of the comprehensive, well-designed NSFS is warranted. The aim was to describe how the NSFS can be evaluated using existing data sets. Methods: Four data sets have been identified for the evaluation of the NSFS: (a) the Nord-Trøndelag Health Study, (b) the Norwegian Mother and Child Cohort Study, (c) the Norwegian Child Growth Study/Growth in Teenagers and (d) Health Behaviour in School Aged Children. These comprehensive studies have collected cross-sectional or longitudinal data providing information about children’s dietary consumption and/or weight status, which can be utilised in the evaluation of the NSFS. Both short- and long-term effects of the NSFS related to dietary habits and weight status and the potential effect of moderators such as socio-economic status, sex, ethnicity and the age of children and adolescents can be studied. Conclusions: Worldwide, there is a lack of well-designed, long-term studies evaluating the impact of governmental efforts to improve public diet. The present study describes how the NSFS can be evaluated using data from four large data sets on eating habits and weight status.acceptedVersio

Examining the Psychometric Properties of the Family Affluence Scale in Norwegian Health Behaviour in School-Aged Children Surveys: Implications for Time Trend Analysis

This study assessed the applicability of the Family Affluence Scale II (FASII) for conducting time trend analysis within Norway's “Health Behaviour in School-Aged Children Study” (HBSC), spanning from 2002 to 2018. A dataset comprising 27,470 valid questionnaires was employed to assess the psychometric properties of the FASII with respect to validity and reliability for use at single- and multiple times points. The analytical approach encompassed a range of statistical techniques, including confirmatory factor analysis (CFA), multi-group CFA, polychoric correlation testing between FASII scores and perceived family wealth, a subjective measure of socioeconomic position (SEP), and an assessment of perceived family wealth and FASII scores across time. The results of the study revealed an overall good model fit in CFA and a positive correlation between FASII scores and perceived family wealth. However, the analysis uncovered measurement non-invariance across survey years, sex, and age groups. Measurement non-invariance hampers direct time-to-time comparisons of FASII scores, impeding the assessment of affluence development over time. Despite this limitation, FASII maintains its utility for ranking affluence and measuring health outcomes at single time points. As such, this study offers valuable insight into the suitability of FASII for time trend analysis within the Norwegian HBSC data and broader research on social inequality.publishedVersio