Norkost 4 is a nationally representative dietary survey among people aged 18-80. This report takes a closer look at methodological aspects of conducting the survey among participants born outside Norway. In addition, some results about the participants' diet are presented. The sample consisted of people born outside Norway in the main sample in Norkost 4 and an additional sample consisting only of people born outside Norway. A total of 290 men and 327 women born outside Norway participated (33% participation).
Data collection took place between September 2022 and October 2023. The participants completed two 24-hour dietary recalls in which they were asked about their food and drink intake the previous day. They then answered a questionnaire about how often they ate different types of food. The study was conducted by the Department of Nutrition at the University of Oslo in collaboration with the Norwegian Institute of Public Health and the Norwegian Directorate of Health.
The participation rate varied according to country of birth. While 47% of the contactable sample of people born in the Nordic countries (excluding Norway) participated, only 27% of the contactable sample from Eastern Europe and Asia excluding South Asia participated. Underreporting of energy intake was widespread, and the proportion of participants reporting an energy intake that could not be considered to be within the normal day-to-day variation, ranged from 14% to 37% according to the participant's region of birth.
On average, participants obtained 17-19% of their energy from protein, 34-38% from fat, and 40-44% from carbohydrate. Added sugars contributed 5-7% of the energy and free sugars 7-9% of the energy. Fiber contributed around 2% of the energy and alcohol 0.7-2.5%. The average percentage of energy from saturated fat ranged from 10 to 14%. Compared to the recommendations, the intake of saturated fat was too high and the intake of carbohydrates was too low or in the lower range of the recommended intake.
It is important to be aware of the limitations of the collected data. The number of participants from the different regions is low, and participation and the degree of underreporting of energy intake varied between regions. The division into regions is also very rough, so that one region contains many different food cultures. In addition, the proportion of participants with a university/college education is significantly higher among the participants in the survey than among immigrants in general in Norway.
The survey shows that it is possible to conduct dietary surveys among people born outside Norway with the methodology used in this survey, but that the feasibility depends on good language skills among the interviewers and that extra attention should be paid to the challenge of underreporting of energy intake in certain population groups.