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  • 1.
    Lennernäs, Maria
    et al.
    Department of Nutrition, University of Uppsala.
    Åkerstedt, Torbjörn
    National Institute for Psychosocial Factors and Health, Karolinska Institutet, Avdelningen för stressforskning, Karolinska institutet, Department of Nutrition, University of Uppsala.
    Hagman, Ulla
    Department of Nutrition, University of Uppsala.
    Bruce, Åke
    Department of Nutrition, University of Uppsala.
    Hambræus, Leif M.
    Department of Biosciences, Unit for Preventive Nutrition, Karolinska Institute, Department of Nutrition, University of Uppsala.
    A new approach for evaluation of meal quality and meal patterns1993In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 6, no 3, p. 261-273Article in journal (Refereed)
    Abstract [en]

    An objective, nutritionally orientated classification system is necessary to evaluate the frequency, nutritional quality and temporal distribution of eating events in dietary surveys. In this paper a system to classify eating events qualitatively with regard to the types of food items consumed is described and demonstrated. It comprises eight food categories and criteria for their combination into four types of meals and three types of snacks of various nutrient composition. The food categories represent food items of animal and plant origin, and also food products containing sucrose and beverages containing alcohol or lacking energy and nutrients. Classification requires individual data collected by established food-record or recall methods. Data on consumed amounts is not required to classify qualitatively the eating events per se, but is required for quantitative calculations of their content, composition and relative contribution to total intakes. The application of the system to dietary data (80 repeated 24-h recalls, 517 eating events) of 16 male three-shift workers showed that classification of eating events was easy and largely unequivocal compared to traditional methods. Subsequent calculations showed expected differences between eating types with regard to content and relative quality. The meal-classification system might be used as a cost-effective method to evaluate the nutritional profile of meal patterns in surveys.

  • 2.
    Sidenvall, Birgitta
    et al.
    Department of Caring Sciences, Faculty of Health Sciences, University of Linköping; Uppsala University, College of Health and Caring Sciences, Department of Nursing, Uppsala, Sweden.
    Lennernäs, Maria A. C.
    Department of Home Economics, University of Uppsala, National Food Administration.
    Ek, Anna-Christina
    Linköping University, Campus Norrköping, Faculty of Health Sciences, Department of Caring Sciences, Faculty of Health Sciences, University of Linköping.
    Elderly patients' meal patterns: A retrospective study1996In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 9, no 4, p. 263-272Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine possible causes of malnutrition in geriatric patients on admission to hospital by evaluation and comparison of their meal pattern between periods of working, retirement and hospitalization, respectively. Forty-five consecutive patients aged 60 years or older participated. By use of modified dietary history interviews, a retrospective assessment of food intake was carried out. A qualitative system for meal classification was then applied. In the retirement period there was a strong reduction in daily eating frequency when compared to working and hospital periods. Thus, the daily intake and also distribution of energy and nutrients seem to be reduced during retirement, which might lead to nutritional deficiency.

  • 3.
    Wallin, Gisela van der Ster
    et al.
    Department of Nutrition, University of Uppsala; Department of Psychiatry, Uppsala University, Sweden.
    Lennernäs, Maria A. C.
    National Food Administration, Uppsala, Sweden.
    Andersson, Michael I.
    Department of Statistics, Stockholm School of Economics, Sweden.
    Comparisons between recalled and observed dietary intake in anorectics and bulimics: A validation study1995In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 8, no 3, p. 201-208Article in journal (Refereed)
    Abstract [en]

    A validation study was performed in order to compare the observed versus the self-reported food consumption in anorectics (n = 9), anorectic bulimics (n = 6) and bulimics (n = 10). The observed meals (breakfast, lunch and/or dinner) were served in a hospital setting. Foods on plates were unobtrusively weighed before and after serving to each subject, and the foods consumed were compared with data from a 24-hour recall the subsequent day. Data analyses via a nutrient database comprised amounts of food items from seven food groups as well as energy, macro nutrients, vitamin C, calcium and iron. Analyses of recalled intakes showed consistently high correlations with observed intakes, suggesting that the 24-hour recall gives valid results, and could thus be suitable for this category of patients. This notion contrasts with previous statements, although no validation studies have been undertaken in order to support this view

  • 4.
    Wissing, Ulla E.
    et al.
    Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Lennernäs, Maria A.-C.
    Department of Medical Sciences, Nutrition Unit, Uppsala University, Sweden.
    Ek, Anna-Christina
    Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Unosson, Mitra
    Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Meal patterns and meal quality in patients with leg ulcers2000In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 13, no 1, p. 3-12Article in journal (Refereed)
    Abstract [en]

    Background. Wound healing is a complex process, which requires adequate energy sources, proteins, and specific minerals and vitamins. If an individual is unable to get or to eat the nutrients required, the wound healing process might be disrupted. The aim of this study was to investigate food-related factors, meal patterns and meal quality in relation to nutritional status in elderly out-patients with leg ulcers. Methods. Nutritional status was assessed by use of the Mini Nutritional Assessment in 70 patients living in their own homes. Fifty-six of the patients recorded actual meals and snacks over four consecutive days. Meal patterns and meal quality were evaluated with the help of a qualitative classification system, the Food Based Concept for Classification of Eating Episodes. Results. Thirty-six patients were classified as well-nourished, 32 were at risk of malnutrition and two were malnourished. More patients in the risk group for malnutrition did not buy their own food, and usually ate alone. Incomplete Meals and Low Quality Snacks were the most common eating types. The patients at risk of malnutrition had significantly fewer prepared Complete Meals than the well-nourished patients. Conclusion. The results show a diet and meal quality which hardly meets the requirements for nutrients that are important in wound healing, especially for those patients assessed at risk of malnutrition.

  • 5.
    Wissing, Ulla E.
    et al.
    Linköping University, Campus Norrköping, Faculty of Health Sciences, Department of Medicine and Care, Faculty of Health Sciences, Linköping University.
    Lennernäs, Maria
    National Institute of Public Health.
    Ek, Anna-Christina
    Linköping University, Campus Norrköping, Faculty of Health Sciences, Department of Medicine and Care, Faculty of Health Sciences, Linköping University.
    Unosson, Mitra
    Linköping University, Campus Norrköping, Faculty of Health Sciences, Department of Medicine and Care, Faculty of Health Sciences, Linköping University.
    Monitoring of dietary quality in outpatients by qualitative meal classification method1998In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 11, no 2, p. 125-133Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to evaluate whether qualitative meal-classification used as a dietary evaluation tool reflects eating frequency and key nutrients in the diet, and whether it could be used to monitor the dietary quality in elderly outpatients. The qualitative meal-classification tool used was based on eight food categories combined into four types of meals: Complete, Incomplete, Less Balanced and Vegetarian Meals, and three types of snacks: High-, Mixed- and Low-Quality Snacks. Methods: Dietary intake was assessed during 7 consecutive days by use of an estimated food record in nine elderly women with leg ulcers. Mean 7-day dietary intakes of energy, macronutrients, beta-carotene, retinol, vitamin E, ascorbic acid, calcium, iron, zinc and dietary fibre were calculated. Each eating event was classified in accordance with the food-based classification method. The frequency of the four types of meals and three types of snacks, their energy content and nutrients, and their contribution to total intake were subsequently analysed. Results: Meals were associated with a higher energy, vitamin and mineral content than were snacks. Complete Meals were the major source for beta-carotene and ascorbic acid. Intakes from Low-Quality Snacks were relatively high in energy fat and sucrose. Conclusion: The qualitative meal-classification tool was found to be simple to use and useful for reflecting meal order and the nutritional roles of different types of meals and snacks in the diet. This method is recommended for dietary monitoring.

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