Mette Rosenlund Sørensen

Evaluation of dietary intake in Danish adults by means of an index based on food-based dietary guidelines

Background Data on dietary intake and physical activity has been collected from a representative sample of the Danish population from 2003–2008. Objectives The aim of the present study was to describe the habitual diet in Denmark and to evaluate the overall diet quality using a diet quality index based on the National Food-Based Dietary Guidelines (FBDG), which consists of seven guidelines regarding diet and one regarding physical activity. Design Data from the Danish National Survey of Diet and Physical Activity 2003–2008 (n=3354) were included. The diet quality index was constructed based on five of the seven dietary guidelines. Individuals were categorised according to quartiles of the diet quality index, and food and nutrient intakes were estimated in each of the groups. Results Macronutrient distribution did not meet recommendations in any of the groups, as energy from total fat and especially saturated fat was too high. A high intake of high-fat milk products, fat on bread and processed meat contributed to a high intake of total fat and saturated fat, and sugar-sweetened soft drinks contributed to a high intake of added sugars in the group below the lowest quartile of the diet quality index. Individuals above in the highest quartile had higher intakes of ‘healthy foods’ such as fish, fruit and vegetables, rye bread, and also a higher consumption of water and wine. Overall, intakes of micronutrients were sufficient in all groups. Conclusions The diet quality index is a useful tool in assessing food and nutrient intake in individuals with high vs. low degree of compliance towards the dietary guidelines, and provides a valuable tool in future studies investigating variations in dietary intakes with respect to lifestyle, demographic and regional differences in Denmark.

Reduction in pedometer-determined physical activity in the adult Danish population from 2007 to 2012.

Aims: To examine the development in pedometer-determined physical activity from 2007–2008 to 2011–2012 in the adult Danish population. Methods: The study population comprised two random samples of 18–75-year-old individuals who took part in cross-sectional studies in 2007–2008 (n=224) and 2011–2012 (n=1515). Pedometer data (sealed Yamax SW 200) were obtained for seven consecutive days. Data for 1624 participants (48.2% men) were included in the analysis. An overall step-defined activity level was examined based on a graduated step index (sedentary, low active, somewhat active, active, highly active). The pedometer-determined outcomes were analysed using regression models. Results: A borderline significant decline (p=0.077) from 8788 to 8341 steps/day (−446 (95% confidence intervals −50, 943)) was found between 2007–2008 and 2011–2012. Furthermore, a 23.7% (95% confidence intervals −41.7%, −0.1%) lower overall step-defined activity level was observed in 2011–2012 compared to 2007–2008. These changes were primarily due to a reduced level of activity among women. The proportion of individuals taking ⩾10,000 steps/day decreased non-significantly from 34.8% to 29.3%, whereas the proportion taking <5000 steps/day did not differ between survey periods. Conclusions: This nationally representative survey suggests an overall reduction in the physical activity level among Danish adults. The reduction was due to a shift in the population distribution from higher to lower levels of activity. If this shift is true, it is worrying from a public health perspective. Our study result needs, however, to be confirmed by other population studies.

Disparities in dietary habits and physical activity in Denmark and trends from 1995 to 2008

Aims: To examine social disparities in dietary-, alcohol- and leisure-time physical activity habits in Danish adults from 1995 to 2008 and to test the hypothesis of widening disparities. Methods: Four cross-sectional surveys of representative samples of the Danish population aged 20–75 years were analysed, a total of 7900 respondents. Dietary and alcohol habits were measured by a 7-day pre-coded food diary and physical activity and education by a face-to-face interview. Multivariate analyses were used to test associations between explanatory variables and response variables and the hypothesis of widening disparities. Results: In all analyses, both diet quality and physical inactivity differed systematically with educational group and with healthier habits for the group with long education. Only for alcohol habits was an opposite social gradient seen. Disparities persisted over all time periods. The analyses using “The Concentration Index” did not change any of the conclusions. Gender also influenced diet quality. Men had dietary and alcohol habits furthest away from the guidelines. A trend of healthier habits was also found over the time period. Conclusions: Social disparities in diet quality and leisure-time physical activity were seen for all examined time periods and with no significant change. Therefore, there is no support to the hypothesis of widening social disparities. In all educational groups some improvement of dietary habits was found, especially for those foods where comprehensive initiatives had taken place. However, social disparities still exist. There is an ongoing need to address these disparities in order to reduce social inequality in health.