Paulina Nowicka
Professor at Department of food studies, nutrition and dietetics
- Telephone:
- +46 18 471 34 31
- Fax:
- +46 18 471 22 61
- E-mail:
- paulina.nowicka@ikv.uu.se
- Visiting address:
- BMC
Husargatan 3
752 37 Uppsala - Postal address:
- Box 560
751 22 UPPSALA
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Short presentation
Professor (Chair) in Food Studies, Nutrition and Dietetics, esp Communication of Dietetics
With over two decades of obesity research, I integrate medical and social sciences to address a key health challenge. My journey spans leading institutions—Lund, Yale, Oregon, Oxford, and Karolinska—culminating at Uppsala University. I innovate in early family-based interventions and explore how lifestyle patterns evolve across generations. Currently, I am on sabbatical at Stanford.
Keywords
- barnnutrition
- behandling
- childhood obesity
- familj
- livsstil
- pediatrik
- prevention
- psykometri
Biography
For complete list of my activities and funding, please see my CV.
The projects I lead are inspired by my experiences at the Childhood Obesity Unit at the Pediatric Hospital in Malmö, Sweden, where I worked for almost a decade as a clinician. In my doctoral thesis, in the discipline of Pediatrics (2009, Faculty of Medicine, Lund University, Sweden), I examined different methods of multidisciplinary treatment of obesity in children and adolescents, with particular attention to possibilities for family therapy. This is still the main focus of my team, together we develop and evaluate childhood obesity interventions, for example the More and Less Study and the More and Less Study Europe (part of the STOP project).
My postdoctoral education (2009-2014) included research at Yale University, USA (Yale Pediatric Obesity/Diabetes Research Program), University of Oregon, USA (Department of Psychology) and University of Oxford, UK (Institute of Social and Cultural Anthropology). I am associated with Unit for Biocultural Variation and Obesity at the University of Oxford .
I have served on numerous expert committees and boards such as Childhood Obesity Task Force of the European Association for the Study on Obesity (EASO), European Childhood Obesity Group (ECOG) and Swedish Association for the Study on Obesity (SFO) and the expert group for nutrition and publlic health at the National Food Agency.
I lecture about body weight, food and eating practices of children and adolescents, and I supervise students on the bachelor, master, doctoral and postdoctoral levels. I have supervised three doctoral students: Anna Ek, who defended her thesis "Early obesity: family-based risk factors and treatment interventions" in 2016, Karolin Bergman, who defended her thesis Negotiating healthy eating: Lay, stakeholder and government constructions of official dietary guidance in Sweden in 2019, and Maria Somaraki who defended her thesis Parent-child feeding dynamics and childhood obesity: The importance of foreign background and effects of early obesity treatment in 2020. I have been a postdoctoral mentor for Elin Lövestam who is now Associate Professor at Uppsala University, Pernilla Sandvik, who is now Associate Senior Lecturer at Uppsala University, and Anna Ek who is now senior researcher at Karolinska Institutet.
Research
As many as 20% of children in Sweden develop overweight or obesity during childhood and adolescence. While obesity is difficult to treat in adolescence, early childhood presents a unique opportunity to provide effective treatment through lifestyle changes alone. However, the effects of treatment interventions early in life need to be further examined, paying particular attention to how parents can be best supported when implementing lifestyle changes for their families. To do so, I lead several projects using both quantitative and qualitative methods. A particular highlight is the More and Less Study, a randomized controlled trial aiming to test different treatment options for preschoolers with obesity. To further understand the broader context behind the development of eating habits in families with young children, my publications focus on obesity through the prism of social inequality, sense of coherence and intergenerational perspectives on body weight, food and eating. My research has been funded funded by Swedish Research Council, VINNOVA, EU HORIZON 2020, Swedish Medical Association, FORTE, the Jerring Foundation, among others.
Research on parental support
The More and Less Study was started in 2011 when I chose to carry out my postdoctoral research at the renowned research institute Oregon Social Learning Center (OSLC), in Eugene, Oregon, USA. The researchers at OSLC have long studied how and what kind of parenting promotes healthy development in children; their studies have informed many established parental support programs such as KOMET, Triple P and The incredible years. I got especially inspired by KEEP, a program developed by OSLC, which introduces parents in a systematic way to behaviors that strengthen a positive interaction with the child and facilitate changes in habits and routines. Together with my team, first at Karolinska Institutet and later at Uppsala University, I have developed the parental support program, The More and Less, which is specifically designed for families of preschoolers, 2–6 years old, with overweight or obesity.
What is More and Less
In the More and Less program, parents attend group sessions to learn about and try different tools that promote healthy habits in the family. Participants have said that meeting parents who are in the same situation is a highlight of the program. More and Less was first evaluated in a randomized controlled trial in collaboration with child health care and pediatric and adolescent medicine clinics in Stockholm 2012–2016. The study showed that More and Less was effective in improving several health outcomes in children 4–6 years old with obesity one year and four years after the program (Ek et al 2019, Ek et al 2022). As a next step, the program has been included in the EU project STOP (2018–2022) and has been evaluated in Spain, Romania and Sweden. In this study, families of children from the age of two and children with overweight were included.
Close dialogue with parents has been crucial for the development of the program, and we have conducted interviews with parents exploring their experiences of the program. This has led to several qualitative publications (Ek et al., Appetite 2020, Nowicka et al. 2022a, Nowicka et al. 2022b). Overall, the program has been described and evaluated in more than twenty scientific publications and two doctoral theses (Anna Ek, Karolinska Institutet 2016 and Maria Somaraki, Uppsala University 2019). Both the group leaders’ and parents’ manuals have been translated into five languages.
How the ML program works
• The More and Less program consists of 10 group meetings of 1.5 hours once a week. Each meeting is based on a specific theme.
• Parents and group leaders (two per group) discuss strategies and concrete tips, for example:
o how much food is adequate and how to limit the child's screen time.
o how habits can be changed and how parents can best encourage children to learn new, slightly more difficult things.
o how parents can deal with tantrums, why it is important to be able to say no, how conflict situations can be avoided, and other important aspects of parenting, for example, how to be a “fair” parent.
The aim of the program is to empower parents in adopting new parenting tools and supporting their child's health, healthy eating habits and physical activity. It's about finding solutions that suit each family.
The group meetings are led by two group leaders who have health care background and additional education in the More and Less program. The group leaders first train by leading a group under supervision and then lead groups independently. Each group consists of 6–10 families where both parents are invited, and groups can be held both digitally and face-to-face. In the case of face-to-face groups, childcare can be offered to those who need it.
All parents receive written materials related to each group meeting. These materials include many tips on healthy habits, portion sizes, drinks, cooking and exercise, as well as guidance on how to keep motivated, on both weekdays and weekends.
Ongoing research
We are currently evaluating long-term effects of obesity treatment started at the preschool age, using the data from the randomized controlled trial, the More and Less study. We do this with quantitative studies (with a focus on weight status, children's metabolic health and eating behavior and parents' psychosocial health) and qualitative studies, exploring the experiences of both children and parents. The doctoral student My Sjunnestrand specifically studies parents' experiences of weight talk and body image in children who have participated in treatment at the preschool age.
We are also evaluating the effects of the More and Less program implemented in Spain and Romania as part of the EU project STOP.
Finally, we have started a new study (led by Anna Ek and Markus Brissman at KI) which aims to adapt More and Less to families with children who have both obesity and ADHD. It is an unexplored group of children who have both diagnoses, which can have a major impact on the everyday lives of many families.
Publications
Selection of publications
- A long-term follow-up of treatment for young children with obesity (2023)
- The social origins of obesity within and across generations (2023)
- A randomized controlled trial for overweight and obesity in preschoolers (2019)
- A Parent Treatment Program for Preschoolers With Obesity (2019)
Recent publications
- Time for a new framework that treats obesity in children as an adiposity-based chronic disease (2024)
- Systematic Development of National Guidelines for Obesity Care (2024)
- The prevalence of overweight among 4-year-olds during and after the COVID-19 pandemic was associated with socioeconomic burden. (2024)
- "A balancing act" (2024)
- Obesity treatment in adolescents and adults in the era of personalized medicine. (2024)
All publications
Articles
- Time for a new framework that treats obesity in children as an adiposity-based chronic disease (2024)
- Systematic Development of National Guidelines for Obesity Care (2024)
- The prevalence of overweight among 4-year-olds during and after the COVID-19 pandemic was associated with socioeconomic burden. (2024)
- "A balancing act" (2024)
- Obesity treatment in adolescents and adults in the era of personalized medicine. (2024)
- Diet quality and cardiovascular outcomes (2024)
- A long-term follow-up of treatment for young children with obesity (2023)
- The social origins of obesity within and across generations (2023)
- National data showed an increased prevalence of overweight and obesity among four-year-old Swedish children during the first year of COVID-19. (2023)
- Cost-Effectiveness and Long-Term Savings of the Bright Bodies Intervention for Childhood Obesity (2023)
- 'Writing nutritionistically' (2022)
- Children's experiences of meals after obesity treatment (2022)
- Explaining the complex impact of the Covid-19 pandemic on children with overweight and obesity (2022)
- How Do Interpersonal Relationships Affect Children's Weight Management? (2022)
- How active can preschoolers be at home? (2022)
- Associations of preschoolers' dietary patterns with eating behaviors and parental feeding practices at a 12-month follow-up of obesity treatment (2022)
- How do young children eat after an obesity intervention? (2022)
- Addressing Weight Stigma and Weight-Based Discrimination in Children (2022)
- Impact of weight management nutrition interventions on dietary outcomes in children and adolescents with overweight or obesity (2021)
- The role of parental depression during early childhood obesity treatment (2021)
- Social disparities in obesity treatment for children age 3-10 years (2021)
- Childhood memories of food and eating in lower-income families in the United States (2021)
- Changing the Home Food Environment (2021)
- Making Childhood Obesity a Priority (2021)
- Parenting and childhood obesity (2021)
- ‘A holistic approach’ (2020)
- Responding positively to "children who like to eat" (2020)
- Body mass index and gestational weight gain in migrant women by birth regions compared with Swedish-born women (2020)
- Self-rated health in migrant and non-migrant women before, during and after pregnancy (2020)
- Changes in parental feeding practices and preschoolers' food intake following a randomized controlled childhood obesity trial (2020)
- Public expressions of trust and distrust in governmental dietary advice in Sweden (2019)
- The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes (2019)
- A randomized controlled trial for overweight and obesity in preschoolers (2019)
- A Parent Treatment Program for Preschoolers With Obesity (2019)
- Feeding the extended family (2019)
- Picky eating in an obesity intervention for preschool-aged children (2019)
- Planting a seed - child health care nurses' perceptions of speaking to parents about overweight and obesity (2019)
- Stakeholder responses to governmental dietary guidelines (2018)
- Kritisk dietetik (2018)
- Reviewing and addressing the link between mass media and the increase in obesity among European children (2018)
- Picky eating in Swedish preschoolers of different weight status (2018)
- Update of the best practice dietetic management of overweight and obese children and adolescents: a systematic review protocol (2018)
- Perceived child eating behaviours and maternal migrant background (2018)
- Water, juice, or soda? (2017)
- Dietisters erfarenhet av motiverande samtal inom öppenvård (2017)
- Kritisk dietetik (2017)
- Physical Activity and Physical Fitness in Pediatric Obesity (2017)
- Controlling feeding practices and maternal migrant background (2017)
- Psychosocial predictors and moderators of weight management programme outcomes in ethnically diverse obese youth (2017)
- Inequality and childhood overweight and obesity (2017)
- Associations between Parental Concerns about Preschoolers' Weight and Eating and Parental Feeding Practices (2016)
- A question of balance (2016)
- Associations between maternal sense of coherence and controlling feeding practices (2016)
- Obesogenic dietary intake in families with 1-year-old infants at high and low obesity risk based on parental weight status (2016)
- The More and Less Study (2015)
- Child behaviors associated with childhood obesity and parents’ self-efficacy to handle them (2015)
- Childhood Obesity Is a Chronic Disease Demanding Specific Health Care - a Position Statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO) (2015)
- Low grandparental social support combined with low parental socioeconomic status is closely associated with obesity in preschool-aged children: a pilot study (2015)
- The Assessment of Eating Behaviour in Children Who Are Obese: A Psychological Approach. A Position Paper from the European Childhood Obesity Group (2014)
- ‘‘Those Comments Last Forever’’: Parents and Grandparents of Preschoolers Recount How They Became Aware of Their Own Body Weights as Children (2014)
- “A little on the heavy side”: a qualitative analysis of parents’ and grandparents’ perceptions of preschoolers' body weights (2014)
- The Ethics of Childhood Obesity Treatment – from the Childhood Obesity Task Force (COTF) of European Association for the Study of Obesity (EASO) (2014)
- Föräldratekniker mot fetma hos förskolebarn (2014)
- Assessment of parental overt and covert control of child's food intake: A population-based validation study with mothers of preschoolers (2014)
- Parental feeding practices and associations with child weight status. Swedish validation of the Child Feeding Questionnaire finds parents of 4-year-olds less restrictive (2014)
- Reversal of Early Abnormalities in Glucose Metabolism in Obese Youth: Results of an Intensive Lifestyle Randomized Controlled Trial (2014)
- Infant growth is associated with parental education but not with parental adiposity – Early Stockholm Obesity Prevention Project (2014)
- Parental Monitoring of Children’s Media Consumption: The Long-term Influences on Body Mass Index in Children (2014)
- Moving from Knowledge to Action: A Qualitative Study of Elite Coaches’ Capacity for Early Intervention in Cases of Eating Disorders (2013)
- Direct and Indirect Effects of a Family-Based Intervention in Early Adolescence on Parent-Youth Relationship Quality, Late Adolescent Health, and Early Adult Obesity (2013)
- Beteendemodifikation och barnfetma. Vart står vi idag? (2012)
- Family therapy as a model for treating childhood obesity: Useful tools for clinicians (2011)
- Beteendemodifikation – enda rimliga terapin vid fetma hos barn och vuxna (2011)
- Utility of Hemoglobin A1c for Diagnosing Prediabetes and Diabetes in Obese Children and Adolescents (2011)
- Which psychological method is most effective for group treatment? (2011)
- Long-term Results of an Obesity Program in an Ethnically Diverse Pediatric Population (2011)
- Obesity related eating behaviour patterns in Swedish preschool children and association with age, gender, relative weight and parental weight - factorial validation of the Children’s Eating Behaviour Questionnaire (2011)
- Hur kan vi ta vara på föräldrar i behandlingen? (2009)
- Self-esteem in a clinical sample of morbidly obese children and adolescents (2009)
- Sports camp with six months of support from a local sports club as a treatment for childhood obesity (2009)
- Family in pediatric obesity management. A literature review. (2008)
- Family Weight School treatment: 1-year results in obese adolescents. (2008)
- Physical activity - key issues in treatment of childhood obesity. (2007)
- Low-intensity family therapy intervention is useful in a clinical setting to treat obese and extremely obese children. (2007)
- Sugars or sweeteners: Towards guidelines for their use in practice report from an expert consultation (2006)
- Dietitians and exercise professionals in a childhood obesity treatment team. (2005)
Books
Conferences
- Memories of meals in the Grandparents Study (2019)
- Prevalence of picky eating in children of different weight status (2018)
- Picky eating - An analysis of concerns and support in an online family forum (2018)
- Healthy eating as conceptualized in referral responses to Sweden’s updated dietary guidelines: excluding the complexity of everyday life (2017)
- Family members perceptions of “healthy” vs “unhealthy” practices andways to preserve familial homeostasis in making lifestyle decisions. (2016)
- Early obesity treatment: Motivational work with the parents of the youngest. Current evidence of effectiveness and practical examples. (2016)
- Maternal sense of coherence and controlling feeding practices: The importance of resilience and support for families with preschoolers. (2016)
- Controlling feeding practices are strongly associated with maternal migrant background: An analysis of a multi-cultural sample (2016)
- Parental concern about child weight is an important mediator of the effect of child eating behaviors on parental feeding practices (2015)
- "What happens at Grandma's stays at Grandma's" (2015)
- Familial practices, attitudes and knowledge related to the child’s beverage consumption (2015)
- Föräldraskap och fetma (2015)