Margaretha Nydahl

The meal as a gift : the meaning of cooking among retired women

The aim of this qualitative interview study was to delineate the meaning of preparing, cooking, and serving meals among retired single living and cohabiting women. Sixty-three women living in two Swedish cities and their rural surroundings participated. The findings showed that the profound meaning was to do something for others. The whole procedure of preparing a meal could be seen as preparing a gift. Four phases were identified: finding out what to serve, cooking with fresh ingredients, presenting the gift in a beautiful manner, and enjoying the gift in commensality. Cohabiting women went on cooking with duty and joy as they had done before retirement as long as their power was maintained. For widows, especially those who had recently lost their spouse, the whole meaning of cooking and eating was lost, and among these women there is a risk of poor nutritional intake.

Managing food shopping and cooking : The experiences of older Swedish women

The aim of the research reported in this paper was to study older Swedish womens experiences of managing food shopping and cooking as part of an independent life in different family situations. The research approach was qualitative, using informal ethnographic interviews and thematic analysis. Twenty-three single-living and 18 cohabiting Swedish women, aged 64–67, 74–77 and 84–87, participated. They valued being active through continuing with familiar routines whereby they could live independently. They gained physical exercise and social contacts when they went shopping. Well-known foods and traditional dishes were preferred as they enabled them to proceed from familiar routines. Economical thinking related to money and their own work guided their choice of food. Lack of strength made some, particularly the older informants and those living alone, dependent on local shops, and they simplified their cooking, while others had more freedom of choice when they shopped together with their husbands. The implications of the research for services which help older women, particularly those who live alone or who have been recently bereaved, are discussed.

Comparison between optical readable and open-ended weighed food records

Background A simplified optically readable food record (ORFR) was developed and compared with an open-ended weighed record (WR). Objective To compare intake of nutrients and foods using a seven-day ORFR with intake estimated using a seven-day WR. The results from each method were validated against 24-h urinary nitrogen excretion and energy intake (EI)/estimated basal metabolic rate (BMR) cut-off values. Design The study comprised 73 free-living, healthy 70-year-old Swedish men. Dietary data were collected during seven consecutive days, starting either with WR or ORFR. Results Average intakes of energy and several nutrients were significantly lower when estimated using ORFR than when using WR. However, when adjusted for nutrient density, only a few nutrients were still lower with ORFR. Spearman correlation coefficients between the two methods regarding intakes of energy and energy-yielding nutrients were moderate to high, i.e. 0.4–0.6, while figures for most micro-nutrients were in the range 0.3–0.5. A large proportion of subjects under-reported their EIs, a higher proportion doing so when using ORFR. Protein intake obtained using ORFR was 31% lower than the values calculated from the 24-h urine nitrogen excretion, and 22% lower than those obtained from WR. Average intakes of milk, cheese and other milk products as well as coffee, tea and alcohol were significantly higher when estimated using ORFR than when using WR, while intakes of vegetables, meat and meat products, fish, bread and cereal products as well as number of sweet foods were significantly lower with ORFR. Conclusions Based on these results, adjustments of some portion sizes in ORFR are suggested. In view of the advantages of ORFR with respect to lower response burden and rapid processing of data, such adjustments would make ORFR a suitable dietary assessment tool for use in dietary surveys, including larger resource-demanding epidemiological investigations.

Meals and snacks among elderly self-managing and disabled women.

AIM The aim of this study was to describe the frequency and distribution of self-managing and disabled elderly womens eating events, as well as to investigate which definition/names the women had given their different eating events and to categorise these into meals and snacks. An additional aim was to study the composition of meals and snacks, and analyse the nutritional significance of these eating events in terms of energy and macronutrients. SUBJECTS Elderly women, both self-managing (n=139) and disabled (n=63; with Parkinsons disease, rheumatoid arthritis or stroke), aged 64-88 years, and living at home participated. METHODS A repeated 24 h recall and an estimated food diary for three consecutive days were used. RESULTS The eating events defined by the women that were categorised as meals contributed 74% of the total daily energy intake, while snacks contributed 22-23%. The meals that the women had defined as dinner, was the most energy dense meal. The frequency of eating events not defined by the women, was 30-34%, but contributed only 3-4% of the total daily energy intake. The disabled women had a significantly lower energy content in meals and most snacks, compared to the self-managing women. CONCLUSION The main conclusion was that elderly women still living at home had their meals distributed during the day and that these meals were characterised by individuality and flexibility.

Effects of lipid-lowering diets enriched with monounsaturated and polyunsaturated fatty acids on serum lipoprotein composition in patients with hyperlipoproteinaemia.

Controlled comparisons of the effects of monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) as a part of lipid-lowering diets in persons with hyperlipoproteinaemia are sparse. The present study was carried out at a metabolic ward. Forty hyperlipidaemic patients (25 hypercholesterolaemic and 15 hypertriglyceridaemic) were given a 3-week diet rich in either MUFA (saturated fatty acids 7.3 energy% (E%), MUFA 14.6 E%, PUFA 4.8 E%) or PUFA (saturated fatty acids 7.8 E%, MUFA 8.4 E%, PUFA 10.4 E%), but otherwise with an identical composition. The mean serum cholesterol reduction on the MUFA diet was 12% (P < 0.001), with a low density lipoprotein cholesterol reduction of 11% (P < 0.001). The corresponding reductions on the PUFA diet were 15% (P < 0.001) and 16% (P < 0.001). The serum apolipoprotein B and A-I concentrations decreased highly significantly by 13% and 11% on the MUFA diet and by 14% and 11% on the PUFA diet. None of these changes differed between the two diets. Neither were there any differences between the diets regarding the effects on blood glucose, serum insulin and plasma fibrinogen, but there was a significant decrease in serum insulin with a significant reduction of the insulin/glucose ratio after the MUFA diet. The results of this study indicate that MUFA and PUFA are interchangeable within the given frames in lipid lowering diets even in patients with hyperlipidaemia.

Food Intake and the Elderly — Social Aspects

In the beginning of the 21st century most countries in the World are facing tremendous demographic changes in which the elderly are the fastest growing segment of the population. Between 1980 and 2020 the number of elderly (over age 64) in westernised countries will grow 66%, while in Asia the population will grow more than 200% (Senauer et al. 1991). At the same time, the younger segment of the population will decrease, leaving a gap between those elderly people in society who might need help and those who, in terms of employed workers or relatives, need to provide this help. Every facet of society will be affected, including food consumed in everyday life. Some researchers predict that society in the near future will be unable to satisfactorily meet or deal with the needs and requirements of elderly households. Others stress that a new social trend, such as rising living standards among the population as a whole, will be positive in terms of society overall, including its elderly members (Senauer et al. 1991; Fenell et al. 1994). Older persons will be able to buy whatever services or commodities they need, but nonetheless they may experience other problems associated with foods for example. Several studies have reported insufficient energy and nutrient intake among the elderly living at home (Wylie et al. 1999; Tierney 1996). Many factors might explain this phenomenon, such as; loss of appetite after becoming a widow/widower, resulting from social isolation, physical disability, economic problems, poor access to shops and difficulties undertaking the shopping, inadequate food storage facilities, subjective experience of the “Meals on Wheels” as non-tasty or culturally unfamiliar, and so on (Wylie et al. 1999; Wolfe et al. 1996; Rolls 1994). The necessity of comprehending social and cultural meanings of food and food-related behaviours is important when studying food in relation to health as well as the role of food in life. Food research among the elderly has, however, focused more upon nutritional factors, one example being the so-called Euronut SENECA-study published in 1991 on nutrition and the elderly (n=2600, respondents 70–75 years of age), than on studies that emphasise cultural and social aspects of elderly food intake (Euronut SENECA study 1991). As new social developments emerge, associated with the demographic changes described above, research into cultural and social aspects of ageing will become more important.

Associations between perceived cooking ability, dietary intake and meal patterns among older women

Iron-deficiency anaemia (IDA) is a global public health problem, affecting an estimated 51% of children below 4 years of age in developing countries and 12% in developed countries. Owing to rapid body growth and a depletion of neonatal iron stores, iron requirements during late infancy are higher than during any other period of life. There is a well-known association between IDA and delayed neurodevelopment in infants and young children. Early weaning to cow’s milk or formula unfortified with iron is known to increase the risk for IDA in this age group. Iron fortification of common infant foods is recommended in many countries. Iron supplements are often recommended for infants who are breast-fed for longer than 4–6 months and who do not consume adequate amounts of iron-fortified complementary foods. The scientific bases for these recommendations are discussed in this review, as are safety aspects, and the diagnostic criteria for IDA in infants and young child ren are critically examined. Keywords: Human infant, infant nutrition, iron-deficiency anaemia, iron status, iron supplementation, nutritional requirements

Fruit and vegetable consumption close to recommendations. A partly web-based nationwide dietary survey in Swedish adults

Background Fruit and vegetables (F&V) are strongly associated with health. The latest Swedish national dietary survey from a decade ago showed that consumption of F&V was below recommended levels. However, current consumption in different subgroups is not well known. Objective To investigate the consumption of various F&V types in Swedish adults grouped according to sociodemographic factors and self-reported physical activity (PA). Design A cross-sectional survey using a quantitative pen-and-paper or web-based questionnaire in a population-based random sample of adults 18–84 years (final n=1,304; 51%). A self-administered 24-h recall and a food frequency questionnaire (FFQ) were used to measure F&V consumption. Data on gender, age, education level, country of birth, and PA (hours/week) were included as grouping variables. Besides descriptive data, two-sample t-tests and non-parametric tests were performed. A P-value <0.01 was regarded as significant. Results Mean F&V consumption based on the self-administered 24-h recall was close to the recommended five portions/day: 5.4 (99% CI 5.1–5.6) portions/day among women and 4.7 (4.4–5.0) portions/day among men (P<0.001). Also the FFQ showed that women generally consumed more F&V than men did. Consumption was lowest among respondents with ≤ 0.5 h self-reported PA/week (P≤0.001), as well as among men born in Sweden (P=0.006). F&V were consumed in almost equal amounts, and fresh F&V were most popular. Intake of berries and cooked F&V was relatively low. Conclusion The present study shows a relatively high F&V consumption close to the recommended five portions per day. Gender differences still exist. Also PA and country of birth were significantly associated with F&V consumption.

Reasons among older Swedish women of not participating in a food survey.

Objectives: To (a) examine participation rate as a function of municipality, age group and living status; and (b) investigate the main reasons for exclusion and declining as stated by the women themselves.Design: Analysis of participation rate and content analysis of statements given in phone calls explaining exclusion or declination from a project in which 24 h recalls and food-diaries were used.Subjects: Self-managing Swedish women (n=505) were systematically selected from a stratified random sample covering single living and cohabiting women aged 64–68, 74–78 and 84–88 y living in three municipalities.Results: No significant differences were found among included and declining women when municipalities and living status was analysed, but significantly more women in the oldest group were excluded (P>0.01). Among those in their 80s living at home, the usual reasons for exclusion were illness, disability or dementia, and many lived in institutions for old people. The four most used explanations to decline participation were ‘lack of time’, ‘tired, fragile, sick or having bad memory’, ‘not willing to participate in scientific studies’ and ‘too old and nothing to contribute’.Conclusions: The participation rate was, compared with other food surveys in the older generation, fairly good, especially among those in their 80s. However, the most active and the very ill and disabled did not participate.Sponsorship: The Swedish Council for Social Research, the Swedish Council for Forestry and Agricultural Research, the Swedish Foundation for Health and Care Sciences and Allergy Research and Uppsala University.

Bread consumption patterns in a Swedish national dietary survey focusing particularly on whole-grain and rye bread

Background Bread types with high contents of whole grains and rye are associated with beneficial health effects. Consumer characteristics of different bread consumption patterns are however not well known. Objective To compare bread consumption patterns among Swedish adults in relation to selected socio-demographic, geographic, and lifestyle-related factors. For selected consumer groups, the further aim is to investigate the intake of whole grains and the context of bread consumption, that is, where and when it is consumed. Design Secondary analysis was performed on bread consumption data from a national dietary survey (n=1,435). Respondents were segmented into consumer groups according to the type and amount of bread consumed. Multiple logistic regressions were performed to study how selected socio-demographic, geographic, and lifestyle-related factors were associated with the consumer groups. Selected consumption groups were compared in terms of whole-grain intake and consumption context. Consumption in different age groups was analysed more in detail. Results One-third of the respondents consumed mainly white bread. Socio-demographic, geographic, and healthy-lifestyle-related factors were associated with the bread type consumed. White bread consumption was associated with younger age groups, less education, children in the family, eating less fruit and vegetables, and more candy and snacks; the opposite was seen for mainly whole-grain bread consumers. Older age groups more often reported eating dry crisp bread, whole-grain bread, and whole-grain rye bread with sourdough whereas younger respondents reported eating bread outside the home, something that also mainly white bread eaters did. Low consumers of bread also consumed less whole grain in total. Conclusions Traditional bread consumption structures were observed, as was a transition among young consumers who more often consumed fast food bread and bread outside the home, as well as less rye and whole-grain bread. Target groups for communication strategies and product development of more sensorily attractive rye or whole-grain-rich bread should be younger age groups (18–30 years), families with children, and groups with lower educational levels.