To investigate the association between food insecurity (FI) and diet quality in private sector service workers.

Data were collected via electronic questionnaires (2019) and the national register data (2018–2019). FI was measured using the Household Food Insecurity Access Scale (HFIAS) and diet quality using an FFQ and a modified Healthy Food Intake Index (mHFII). The associations between HFIAS and mHFII were studied using ANOVA and ordinal regression analysis.

Cross-sectional survey and register data for all municipalities in Finland in 2018–2019.

Individuals (n 6435) belonging to the Finnish Service Union United. The members are predominantly women and work mainly in retail trade, tourism, restaurant and leisure services, property maintenance and security services.

Overall diet quality, measured by mHFII, was significantly lower in those experiencing severe FI than in those who were food secure (8·0 v. 9·1). Additionally, those with severe FI were less likely to have higher (more optimal) scores in sugar-sweetened beverages (OR: 0·67), fibre-rich grains (OR: 0·79), vegetables (OR: 0·54), fruits and berries (OR: 0·61), vegetable oil (OR: 0·80), fish (OR: 0·65), milk (OR: 0·89) and nuts and seeds (OR: 0·66) than food-secure participants. Severe FI was associated with higher odds for less frequent consumption of red and processed meat (OR: 1·15, a higher score represents less frequent consumption).

Severe FI was linked to both lower overall diet quality and suboptimal consumption of several food groups. Individuals experiencing severe FI may be predisposed to accumulating dietary risk factors for chronic diseases.

This study aimed to (1) examine the clustering of energy balance-related behaviours (EBRB) and (2) investigate whether EBRB clusters, temperament and hair cortisol concentration (HCC) associate with overweight.

We assessed food consumption using food records, screen time (ST) using sedentary behaviour diaries, sleep consistency and temperament (negative affectivity, surgency, effortful control) using questionnaires and HCC using hair samples. Accelerometers were used to assess physical activity (PA) intensities, sleep duration and sleep efficiency. Researchers measured each child’s weight and height. We used finite mixture models to identify EBRB clusters and multilevel logistic regression models to examine the associations between EBRB clusters, temperament, HCC and overweight.

The cross-sectional DAGIS survey, data collected in 2015–2016.

Finnish 3–6-year-olds (n 864) recruited through preschools.

One-third of the participants were categorised into the cluster labelled ‘Unhealthy diet, excessive screen time’, characterised by unhealthy dietary choices (e.g. greater consumption of high-fat, high-sugar dairy products) and longer ST. Two-thirds were categorised into the second cluster, labelled ‘Healthy diet, moderate screen time’. PA and sleep were irrelevant for clustering. Higher negative affectivity and lower effortful control associated with the ‘Unhealthy diet, excessive screen time’ cluster. EBRB clusters and HCC did not associate with overweight, but surgency was positively associated with overweight (OR = 1·63, 95 % CI 1·17, 2·25).

Of the EBRB, food consumption and ST seem to associate. As temperament associates with EBRB clusters and overweight, tailored support acknowledging the child’s temperament could be profitable in maintaining a healthy weight.

To identify food purchase patterns and to assess their carbon footprint and expenditure.

Cross-sectional.

Purchase patterns were identified by factor analysis from the annual purchases of 3435 product groups. The associations between purchase patterns and the total purchases’ carbon footprints (based on life-cycle assessment) and expenditure were analysed using linear regression and adjusted for nutritional energy content of the purchases.

Loyalty card holders (n 22 860) of the largest food retailer in Finland.

Eight patterns explained 55 % of the variation in food purchases. The Animal-based pattern made the greatest contribution to the annual carbon footprint, followed by the Easy-cooking, and Ready-to-eat patterns. High-energy, Traditional and Plant-based patterns made the smallest contribution to the carbon footprint of the purchases. Animal-based, Ready-to-eat, Plant-based and High-energy patterns made the greatest contribution, whereas the Traditional and Easy-cooking patterns made the smallest contribution to food expenditure. Carbon footprint per euros spent increased with stronger adherence to the Traditional, Animal-based and Easy-cooking patterns.

The Animal-based, Ready-to-eat and High-energy patterns were associated with relatively high expenditure on food, suggesting no economic barrier to a potential shift towards a plant-based diet for consumers adherent to those patterns. Strong adherence to the Traditional pattern resulted in a low energy-adjusted carbon footprint but high carbon footprint per euro. This suggests a preference for cheap nutritional energy rather than environment-conscious purchase behaviour. Whether a shift towards a plant-based pattern would be affordable for those with more traditional and cheaper purchase patterns requires more research.

To examine the prevalence and determinants of food insecurity among private sector service workers in Finland and assess validity of the Household Food Insecurity Access Scale (HFIAS) tool.

In this cross-sectional study, food insecurity and background characteristics were collected from Finnish private service workers via electronic questionnaires (2019) and national register data (2018–2019). We conducted univariate and multivariate logistic regression analyses to determine the variables explaining food insecurity. Validity of HFIAS was assessed with rotated principal component analysis and Cronbach’s α.

Members of the trade union for private sector service workers, Service Union United (PAM), from all municipalities in Finland participated in the study in 2019.

The subjects were 6435 private sector workers that were members of the Service Union United (PAM) in Finland. Mean age of participants was 44 years (sd 12·7 years).

Two-thirds of the participants (65 %) were food insecure with over a third (36 %) reporting severe food insecurity. Reporting great difficulties in covering household expenses and young age markedly increased the risk of severe food insecurity (OR 15·05; 95 % CI 10·60, 21·38 and OR 5·07; 95 % CI 3·94, 6·52, respectively). Not being married, low education, working in the hospitality industry, being male and living in rented housing also increased the probability of severe food insecurity. The HFIAS tool demonstrated acceptable construct and criterion validity.

Severe food insecurity was widespread and associated with low socio-economic status, young age and being male among Finnish private sector service workers, emphasising the need for regular monitoring of food insecurity in Finland.

Many pre-schoolers in Finland eat too little vegetables, fruits and berries. Compared to fruits, vegetables are in general less well accepted. Since most of the Finnish 4–6-year-olds attend pre-schools, they are an ideal setting for promoting vegetable consumption. However, early educators in the pre-schools need engaging methods for food education. The aim of this project is to develop a mobile application that can be used in pre-schools to improve vegetable acceptance among pre-schoolers. An additional aim of the application is to increase self-regulation skills, i.e., we aimed to build the application in a way that, instead of immediate reward and impulsivity encourages self-regulation and delayed gratification.

We organized workshops in three pre-schools in order to collect ideas and experiences from pre-schoolers and early childhood professionals. Based on the workshops, a Finnish educational game company NordicEdu designed the first version of the prototype. A multi-professional team with expertise in early childhood education and pre-schoolers’ health behaviours commented the prototype, which was then updated and uploaded to application stores. The prototype consisted of two sections: a teacher-led ‘Learn’ section that encourages a group of children to share their knowledge and feelings about vegetables and fruits with each other and mini-games as well as physical exercises that can be played in a group. The application also allows the group to record which vegetables they have tasted. The feasibility of the prototype was tested in the three pre-schools. We collected feedback from the early childhood professionals and children with video-recordings and interviews.

Based on the feasibility tests, the children enjoyed using the application and they also gave positive feedback about the visual identity of the application. However, the early childhood professionals thought that the application could be a bit more challenging. Additional contents as well as tasks requiring more self-regulation and patience were also hoped for.

In 2019, the prototype will be further developed into a full demo. Additional vegetables will be added to the ‘Learn’ sections and organized into seasons. The application will be accompanied by a teacher's guide containing more information about the vegetables and fruits. The full demo will be completed in spring 2019 and translated into English and Polish. The effectiveness of the application to increase the acceptability of vegetables will be tested in a randomized intervention in pre-schools in Finland, Poland and the UK.

Studying the link between children's stress and diet is crucial, as early childhood is an important period for the development of eating habits as well as other health behaviours. Among adults, studies have shown that elevated cortisol levels (indicator of long-term stress) might be associated with overweight and a preference for energy-dense foods. However, the association between hair cortisol concentration (HCC) and diet among pre-school-aged children is poorly understood. The aim of this study was to investigate whether HCC, a measure of long-term stress, is associated with diet among 3–6-year-old Finnish children.

The current cross-sectional study is a part of the DAGIS study conducted in 66 Finnish pre-schools in 2015–2016. Of the 864 participating pre-schoolers, 578 (67%) provided the information needed to examine the association between HCC and diet. HCC was measured from 4-cm hair samples using a chemiluminescence immunoassay, and the HCCs were categorized into fifths. The parents of the participating children filled in a food frequency questionnaire (FFQ) assessing the child's food consumption outside preschool hours. The FFQ items (n = 47) were used as inputs in principal component analysis to derive dietary patterns. The associations between HCC and food group consumption frequencies as well as dietary pattern scores for ‘sweets-and-treats’, ‘health-conscious’ and ‘vegetables-and-processed meats’ patterns were examined with multilevel linear mixed models and adjusted for age, gender and parental education.

The median HCC was 11.7 pg/mg (min 0.24, max 879.6). Compared to the children who had the lowest HCCs, the children with the highest HCCs consumed vegetables as well as fruits and berries less frequently (β = -1.62, 95% CI -3.14, -0.09; β = -1.49, 95% CI -2.95, -0.04) and scored lower on the ‘health-conscious’ dietary pattern (β = -0.31, 95% CI -0.51, -0.11). After adjustments, the associations between HCC and fruit and berry and sugary beverage consumption as well as ‘health-conscious’ pattern were significant (β = -1.62, 95% CI -3.09, -0.16; β = 1.30, 95% CI 0.06, 2.54; β = -0.33, 95% CI -0.53, -0.14).

This study supports the link between long-term stress and lower-quality diet, as it showed that elevated HCCs and less healthful diets were connected already in the early childhood. However, because of the cross-sectional design of the study, we are not able to conclude whether stress affects diet or vice versa. Nevertheless, these results give reason to further investigate the relationship between stress and children's eating habits as well as health in general.

We investigated the determinants of serum 25-hydroxyvitamin D [S-25(OH)D] and dietary vitamin D sources among three immigrant groups in Finland and compared their S-25(OH)D to the general Finnish population.

Cross-sectional population-based Migrant Health and Wellbeing Study and the nationally representative Finnish Health 2011 Survey. S-25(OH)D was standardised according to the Vitamin D Standardisation Program. Vitamin D sources were assessed by interview.

Six different municipalities in Finland (60°–63°N).

Immigrants aged 18–64 years (446 Russians, 346 Somalis, 500 Kurds), 798 Finns aged 30–64 years.

The mean of S-25(OH)D was 64 (95 % CI 62, 66), 44 (95 % CI 41, 46), 35 (95 % CI 34, 37) and 64 (95 % CI 62, 66) nmol/l for Russians, Somalis, Kurds and Finns, respectively. S-25(OH)D among Somalis and Kurds was lower compared with Finns (P < 0·001). The prevalence of vitamin D deficiency (S-25(OH)D <30 nmol/l) and insufficiency (S-25(OH)D <50 nmol/l) was higher among immigrants than Finns (P < 0·001). Vitamin D-rich foods differed between the groups; vitamin D-fortified fat spread consumption was higher among Somalis (91 %) than among Russians (73 %) and Kurds (60 %); fish was less consumed among Kurds (17 %) than among Russians (43 %) and Somalis (38 %); and 57 % Russians, 56 % Kurds and 36 % Somalis consumed vitamin D-fortified dairy daily (P < 0·001 for all). Daily smoking, alcohol consumption and winter blood sampling were determinants of vitamin D insufficiency (P ≤ 0·03). Older age, physical activity, fish and vitamin D-fortified dairy consumption were associated with lower odds of insufficiency (P ≤ 0·04).

Vitamin D status differed among immigrant groups and the determinants are, to some degree, associated with learned or existing cultural behaviours.

We aimed to examine associations between early educators’ feeding practices and opinions and children’s dietary intake at pre-school, in a context where uniform meals are served and pre-schools are highly regulated.

Cross-sectional study. Food consumption data of the children consisted of two-day food records from pre-school kept by early educators. Early educators also reported their feeding practices and opinions on pre-school food. Serving style was observed.

Municipal pre-schools in Southern and Western Finland.

Pre-schoolers (n 586) aged 3–6 years and early educators (n 378).

Early educators’ positive opinion of the food served at pre-school and the opinion that sufficient vegetables were available for the children were positively associated with children’s vegetable consumption. Early educators’ role modelling and a positive opinion of the food were negatively associated with children’s energy intake. Encouragement to eat fruit and vegetables was associated with higher fibre intake. Intake of added sugar was low (4·4 % of energy).

Some of the feeding practices and opinions of early educators were related to healthier dietary intake (higher vegetable consumption and fibre intake) among the children. However, in some respects, the results contradicted previous findings. Overall, early educators’ feeding practices and opinions contribute to children’s dietary intake and should be taken into account when promoting healthy food intake among pre-school children.

To study the associations between home food availability and dietary patterns among pre-school children.

Cross-sectional study in which parents of the participating children filled in an FFQ and reported how often they had certain foods in their homes. We derived dietary pattern scores using principal component analysis, and composite scores describing the availability of fruits and vegetables as well as sugar-enriched foods in the home were created for each participant. We used multilevel models to investigate the associations between availability and dietary pattern scores.

The DAGIS study, Finland.

The participants were 864 Finnish 3–6-year-old children recruited from sixty-six pre-schools. The analyses included 711 children with sufficient data.

We identified three dietary patterns explaining 16·7 % of the variance. The patterns were named ‘sweets-and-treats’ (high loadings of e.g. sweet biscuits, chocolate, ice cream), ‘health-conscious’ (high loadings of e.g. nuts, natural yoghurt, berries) and ‘vegetables-and-processed meats’ (high loadings of e.g. vegetables, cold cuts, fruit). In multivariate models, the availability of fruits and vegetables was inversely associated with the sweets-and-treats pattern (β=−0·05, P<0·01) and positively associated with the health-conscious (β=0·07, P<0·01) and vegetables-and-processed meats patterns (β=0·06, P<0·01). The availability of sugar-enriched foods was positively associated with the sweets-and-treats pattern (β=0·10, P<0·01) and inversely associated with the health-conscious pattern (β=−0·03, P<0·01).

Considering dietary patterns, the availability of sugar-enriched foods in the home seems to have a stronger role than that of fruits and vegetables. Parents should restrict the availability of unhealthy foods in the home.