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Tonkin E, Chan E, Deen C, Fredericks B, Dhurrkay M, Dissayanake HU, Dhurrkay J, Gurruwiwi G, Biggs BA, Brimblecombe J. The relative validity of the updated Menzies Remote Short-Item Dietary Assessment Tool (MRSDAT) for use with remote Aboriginal and Torres Strait Islander children and adults. BMC Public Health 2025; 25:1990. [PMID: 40442630 PMCID: PMC12121242 DOI: 10.1186/s12889-025-23233-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 05/19/2025] [Indexed: 06/02/2025] Open
Abstract
BACKGROUND This study aimed to determine the relative validity of dietary quality index scores estimated using the updated version of the Menzies Remote Short-item Dietary Assessment Tool (MRSDAT), a food frequency questionnaire developed for use with remote Indigenous communities in Australia. METHODS This validation study compares scores derived from the updated MRSDAT with those derived from 24-h recalls. Participants from nine remote communities across three discrete regions of Australia (Central Australia, North Northern Territory and Cape York) participated in June-September 2021, or May-July 2022. Participants were Indigenous children aged six months to five years, pregnant and/or breastfeeding Indigenous women, and overweight adult Indigenous males and females. The agreement between methods was explored using Lin's concordance correlation coefficient (CCC), Bland-Altman plots, weighted Cohen's kappa, paired samples t-tests and Wilcoxon signed-rank tests. Primary comparisons were completed for the whole sample, and primary and secondary comparisons for only participants with ≥ 2 × 24 h recalls. RESULTS Ninety-nine participants were recruited. The MRSDAT estimated dietary quality index scores 0.31/100 points higher than 24-h recall estimates for participants with ≥ 2 × 24-h recalls, and 0.18/100 points higher for all participants, with consistent results for adults and children (CCC = Rc 0.58, 95% CI 0.39, 0.72). CONCLUSIONS Updates to the MRSDAT have resulted in dietary quality index scores highly comparable to those derived from 24-h recalls. The MRSDAT has the practical advantages of speed and convenience for research purposes, and the built-in instant dietary feedback feature has application to service delivery settings given the robust results demonstrated in this validation study.
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Affiliation(s)
- Emma Tonkin
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, VIC, 3168, Australia.
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia.
| | - Ellie Chan
- Central Australian Aboriginal Congress, Alice Springs, NT, 0870, Australia
| | - Caroline Deen
- Apunipima Cape York Health Council, Bungalow, QLD, 4870, Australia
| | - Bronwyn Fredericks
- Office of the Deputy Vice-Chancellor, The University of Queensland, Herston, QLD, 4006, Australia
- Australian Research Council Centre of Excellence for Indigenous Futures, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Morag Dhurrkay
- Department of Infectious Diseases, The Doherty Institute, University of Melbourne, 3000, and Victorian Infectious Diseases, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - Hasthi U Dissayanake
- Department of Infectious Diseases, The Doherty Institute, University of Melbourne, 3000, and Victorian Infectious Diseases, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - J Dhurrkay
- Department of Infectious Diseases, The Doherty Institute, University of Melbourne, 3000, and Victorian Infectious Diseases, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - George Gurruwiwi
- Department of Infectious Diseases, The Doherty Institute, University of Melbourne, 3000, and Victorian Infectious Diseases, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - Beverley-Ann Biggs
- Department of Infectious Diseases, The Doherty Institute, University of Melbourne, 3000, and Victorian Infectious Diseases, Royal Melbourne Hospital, Melbourne, 3050, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill, VIC, 3168, Australia
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Casuarina, NT, 0810, Australia
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Khader Y, Abu Khudair S, Tanaka E, Kufoof L, Al Nsour M, Aqel A, Maayeh M, Kharabsha A. Psychosocial, emotional and behavioral problems, quality of life, and mental health care seeking behaviors among children and adolescents in Jordan: a national school-based survey. Front Public Health 2024; 12:1409158. [PMID: 39600408 PMCID: PMC11589819 DOI: 10.3389/fpubh.2024.1409158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 10/29/2024] [Indexed: 11/29/2024] Open
Abstract
Objectives This study aimed to estimate the prevalence of psychosocial, emotional, and behavioral problems and their symptoms among children and adolescents in Jordan, assess their quality of life, and examine mental health help-seeking behavior. Methods A large-scale school-based national survey was conducted in Jordan among children and adolescents aged 8 to 18 years (grades 3 to 12) from the host and refugee populations, utilizing a multi-stage stratified cluster sampling technique to select a nationally representative sample. Two versions of structured questionnaires were used: proxy parent version for students in grades 3 to 6 (8-11 years) and self-report version for students in grades 7 to 12 (12-18 years). The study questionnaires employed internationally recognized and validated tools in English, which were translated into Arabic. Results A total of 8,000 (3,433 (42.9%) boys, 4,567 (57.1%) girls) and (3,593 (44.9%) children, 4,407 (55.1%) adolescents) were included. About 24.5% of children had anxiety symptoms (18.0% of Jordanians, 34.5% of Syrian camp refugees, 33.7% of Syrian urban refugees, and 24.7% of Palestinian camp refugees) and 16.6% of children had major depressive disorder symptoms (11.0% of Jordanians, 25.4% of Syrian camp refugees, 25.0% of Syrian urban refugees, and 14.0% of Palestinian camp refugees). Almost 13.9% of children and 19.7% of adolescents had abnormal levels of total emotional and behavioral difficulties. Nearly 16.5% of children and 35.0% of adolescents had poor overall health-related quality of life. When experiencing a personal or emotional problem, only 28.1% of children's parents would seek help for their children and 19.7% of adolescents would seek help for themselves. Conclusion The study revealed a high prevalence of various mental health issues' symptoms, particularly among refugees and female adolescents. Intention to seek help is relatively low, suggesting that children and adolescents' mental health needs are not being widely met. It is crucial to implement integrated and coordinated plans and programs that effectively target multiple factors that impact children and adolescents' mental health, while also respecting the prevailing cultural context. A key aspect of promoting the mental well-being of children and adolescents in Jordan is the inclusive involvement of refugees and individuals from other nationalities.
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Affiliation(s)
- Yousef Khader
- Center of Excellence for Applied Epidemiology, The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sara Abu Khudair
- Center of Excellence for Applied Epidemiology, The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Eizaburo Tanaka
- College of Arts and Sciences, The University of Tokyo, Meguro, Tokyo, Japan
| | - Lara Kufoof
- Center of Excellence for Applied Epidemiology, The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - Mohannad Al Nsour
- Center of Excellence for Applied Epidemiology, The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | - Ashraf Aqel
- School Health Directorate, Jordan Ministry of Health, Amman, Jordan
| | - Mohammad Maayeh
- School Health Directorate, Jordan Ministry of Health, Amman, Jordan
| | - Ahmad Kharabsha
- School Environment Department, Jordan Ministry of Health, Amman, Jordan
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Ashton LM, Grounds JA, Barnes AT, Pollock ER, Young MD, Kennedy SL, Rayward AT, Lee DR, Morgan PJ. Replicability, adaptability and long-term impact of the 'Healthy Youngsters, Healthy Dads' program in Newcastle, Australia. Health Promot Int 2024; 39:daae095. [PMID: 39129343 PMCID: PMC11317530 DOI: 10.1093/heapro/daae095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024] Open
Abstract
'Healthy Youngsters, Healthy Dads' (HYHD) targets fathers to improve the health of their preschool-aged children. In a previous randomized trial, fathers and children experienced meaningful improvements in physical activity and eating behaviours. The next phase is to test the replicability and adaptability of HYHD when delivered in the community by trained facilitators. Fathers/father-figures and children aged 3-5 years were recruited from Newcastle, Australia into a 9-week, non-randomized trial with assessments at baseline, 10 weeks, and 12 months. The primary outcome was achievement of pre-registered targets for recruitment (≥ 96 dyads), attendance (≥ 70%), compliance (completing ≥ 70% of home-based tasks), fidelity (≥ 80% of content delivered as intended) and program satisfaction (≥ 4/5). Secondary outcomes included physical activity, nutrition, screen time and parenting measures. Process targets were surpassed for recruitment (140 fathers, 141 children), attendance (79% for fathers-only workshops, 81% for father-child sessions), compliance (80% of home-tasks completed), fidelity (99% for education, ≥ 97% for practical) and program satisfaction (4.8/5). Mixed effects regression models revealed significant effects in fathers for moderate-to-vigorous physical activity, co-physical activity, dietary intake and parenting practises, which were maintained at 12 months. Significant effects were also established for screen time at 10 weeks only. For children, significant effects were observed for screen time and dietary intake at 10 weeks, while effects on energy-dense, nutrient-poor foods and healthy, nutrient-dense core food intake were maintained at 12 months. Findings demonstrate the replicability and adaptability of HYHD when delivered in the community by local trained facilitators. Further investigation into how to optimally scale-up HYHD is warranted.
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Affiliation(s)
- Lee M Ashton
- Centre for Active Living and Learning, College of Human and Social Futures, School of Education, University of Newcastle, Awabakal Country, Callaghan, New South Wales, 2308, Australia
- Active Living and Learning Research Program, Hunter Medical Research Institute (HMRI), Lot 1 Kookaburra Circuit, Awabakal Country, New Lambton Heights, New South Wales 2305, Australia
| | - Jacqueline A Grounds
- Centre for Active Living and Learning, College of Human and Social Futures, School of Education, University of Newcastle, Awabakal Country, Callaghan, New South Wales, 2308, Australia
- Active Living and Learning Research Program, Hunter Medical Research Institute (HMRI), Lot 1 Kookaburra Circuit, Awabakal Country, New Lambton Heights, New South Wales 2305, Australia
| | - Alyce T Barnes
- College of Health, Medicine and Wellbeing, School of Medicine and Public Health, The University of Newcastle, Awabakal Country, Newcastle, New South Wales, 2308, Australia
- The National Centre of Implementation Science (NCOIS), The University of Newcastle, Awabakal Country, Newcastle, New South Wales, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, Awabakal Country, New Lambton Heights, New South Wales, 2305, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Awabakal Country, Newcastle, New South Wales, 2287, Australia
| | - Emma R Pollock
- College of Health, Medicine and Wellbeing, School of Medicine and Public Health, The University of Newcastle, Awabakal Country, Newcastle, New South Wales, 2308, Australia
- The National Centre of Implementation Science (NCOIS), The University of Newcastle, Awabakal Country, Newcastle, New South Wales, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, Awabakal Country, New Lambton Heights, New South Wales, 2305, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Awabakal Country, Newcastle, New South Wales, 2287, Australia
| | - Myles D Young
- Active Living and Learning Research Program, Hunter Medical Research Institute (HMRI), Lot 1 Kookaburra Circuit, Awabakal Country, New Lambton Heights, New South Wales 2305, Australia
- College of Engineering, Science and Environment, School of Psychology, University of Newcastle, Awabakal Country, Callaghan, New South Wales, 2308, Australia
| | - Stevie-Lee Kennedy
- Centre for Active Living and Learning, College of Human and Social Futures, School of Education, University of Newcastle, Awabakal Country, Callaghan, New South Wales, 2308, Australia
- Active Living and Learning Research Program, Hunter Medical Research Institute (HMRI), Lot 1 Kookaburra Circuit, Awabakal Country, New Lambton Heights, New South Wales 2305, Australia
| | - Anna T Rayward
- College of Health, Medicine and Wellbeing, School of Medicine and Public Health, The University of Newcastle, Awabakal Country, Newcastle, New South Wales, 2308, Australia
- The National Centre of Implementation Science (NCOIS), The University of Newcastle, Awabakal Country, Newcastle, New South Wales, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, Awabakal Country, New Lambton Heights, New South Wales, 2305, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Awabakal Country, Newcastle, New South Wales, 2287, Australia
| | - Daniel R Lee
- Centre for Active Living and Learning, College of Human and Social Futures, School of Education, University of Newcastle, Awabakal Country, Callaghan, New South Wales, 2308, Australia
- Active Living and Learning Research Program, Hunter Medical Research Institute (HMRI), Lot 1 Kookaburra Circuit, Awabakal Country, New Lambton Heights, New South Wales 2305, Australia
| | - Philip J Morgan
- Centre for Active Living and Learning, College of Human and Social Futures, School of Education, University of Newcastle, Awabakal Country, Callaghan, New South Wales, 2308, Australia
- Active Living and Learning Research Program, Hunter Medical Research Institute (HMRI), Lot 1 Kookaburra Circuit, Awabakal Country, New Lambton Heights, New South Wales 2305, Australia
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Abu-Saad K, Accos M, Ziv A, Collins F, Shepherd C, Eades S, Kalter-Leibovici O. Development and Functionality of a Parsimonious Digital Food Frequency Questionnaire for a Clinical Intervention among an Indigenous Population. Nutrients 2023; 15:5012. [PMID: 38068870 PMCID: PMC10707983 DOI: 10.3390/nu15235012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Nutrition-related chronic diseases are a major problem among Indigenous populations. Appropriate dietary intake assessment tools are needed for nutritional surveillance and intervention; however, tools designed to measure the habitual dietary intake of Indigenous persons are largely lacking. We developed a digital food frequency questionnaire (FFQ) to measure habitual consumption among Australian Aboriginal adults and support personalized nutrition counseling. The primary contributors to energy, select nutrients, and inter-person variation (83 food groups) were identified from nationally representative 24 h recall (24HR) data, and they accounted for >80% of the total intake and inter-person variation of the nutrients of interest. Based on community input, a meal-based FFQ format was adopted, with a main food/beverage list of 81 items and the capacity to report on >300 additional items via the digital platform. The nutrient database was based on the Australian Food and Nutrient Database. Data for the first 60 study participants (70% female; median age: 48 years) were used to assess the FFQ's utility. The participants' median [IQR] reported energy intake (10,042 [6968-12,175] kJ/day) was similar to their median [IQR] estimated energy expenditure (10,197 [8636-11,551] kJ/day). Foods/beverages on the main FFQ list accounted for between 66% and 90% of the participants' reported energy and nutrient intakes; the remainder came from participant-selected extra items. The digital FFQ platform provides a potentially valuable resource for monitoring habitual dietary intake among Aboriginal adults and supporting chronic disease prevention and management interventions.
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Affiliation(s)
- Kathleen Abu-Saad
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Moran Accos
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Arnona Ziv
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Fiona Collins
- South West Aboriginal Medical Service, Bunbury, WA 6230, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Carrington Shepherd
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Sandra Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Ofra Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
- Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Dedhia K, Li Y, Stallings VA, Germiller J, Giordano T, Dailey J, Kong M, Durkin A, Legg-Jack I, Nessen S, Schapira MM. Association of Diet Patterns and Post-Operative Tympanostomy Tube Otorrhea: A Pilot Study. Laryngoscope 2023; 133:3575-3581. [PMID: 36960887 DOI: 10.1002/lary.30672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/21/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE The objective of this study was to explore diet patterns in children with tympanostomy tube placement (TTP) complicated by postoperative tympanostomy tube otorrhea. STUDY DESIGN Cross-sectional survey and retrospective cohort study. METHODS Caregivers of children (0-12 years old), at a tertiary-care pediatric hospital who underwent TTP within 6 months to 2 years prior to enrollment were included. Children with a history of Down syndrome, cleft palate, craniofacial syndromes, known immunodeficiency, or a non-English-speaking family were excluded. Our primary outcome variable was the number of otorrhea episodes. The primary predictor was diet patterns, particularly dessert intake, which was captured through a short food questionnaire. RESULTS A total of 286 participants were included in this study. The median age was 1.8 years (IQR, 1.3, 2.9). A total of 174 (61%) participants reported at least one episode of otorrhea. Children who consumed dessert at least two times per week had a higher risk of otorrhea compared to children who consumed one time per week or less (odds ratio [OR], 3.22, 95% Confidence Interval [CI]: 1.69, 6.12). The odds ratio increase continued when considering more stringent criteria for otorrhea (multiple episodes or one episode occurring 4 weeks after surgery), with a 2.33 (95% CI: 1.24, 4.39) higher odds of otorrhea in children with dessert intake at least 2 times per week. CONCLUSIONS Our pilot data suggest that episodes of otorrhea among children with TTP were associated with more frequent dessert intake. Future studies using prospectively administered diet questionnaires are necessary to confirm these findings. LEVEL OF EVIDENCE 4 Laryngoscope, 133:3575-3581, 2023.
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Affiliation(s)
- Kavita Dedhia
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Yun Li
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
- University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Virginia A Stallings
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - John Germiller
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Terri Giordano
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
| | - Julia Dailey
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
| | - Maria Kong
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
| | - Alexandra Durkin
- Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A
| | - Ibikari Legg-Jack
- University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Sarah Nessen
- University of Pennsylvania Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Marilyn M Schapira
- Department of Internal Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
- Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, Pennsylvania, U.S.A
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Davies A, Coombes J, Wallace J, Glover K, Porykali B, Allman-Farinelli M, Kunzli-Rix T, Rangan A. Yarning about Diet: The Applicability of Dietary Assessment Methods in Aboriginal and Torres Strait Islander Australians-A Scoping Review. Nutrients 2023; 15:787. [PMID: 36771491 PMCID: PMC9919225 DOI: 10.3390/nu15030787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Conventional dietary assessment methods are based predominately on Western models which lack Aboriginal and Torres Strait Islander knowledges, methodologies, and social and cultural contextualisation. This review considered dietary assessment methods used with Aboriginal and Torres Strait Islander populations and assessed their applicability. Four electronic databases and grey literature were searched with no time limit applied to the results. Screening, data extraction and quality appraisal were undertaken independently by two reviewers. Out of 22 studies, 20 were conducted in rural/remote settings, one in an urban setting, and one at the national population level. The most frequently used and applicable dietary assessment method involved store data. Weighed food records and food frequency questionnaires had low applicability. Modifications of conventional methods were commonly used to adapt to Indigenous practices, but few studies incorporated Indigenous research methodologies such as yarning. This highlights an opportunity for further investigation to validate the accuracy of methods that incorporate qualitative yarning-based approaches, or other Indigenous research methodologies, into quantitative data collection. The importance of developing validated dietary assessment methods that are appropriate for this population cannot be understated considering the high susceptibility to nutrition-related health conditions such as malnutrition, overweight or obesity, diabetes, and cardiovascular disease.
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Affiliation(s)
- Alyse Davies
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Julieann Coombes
- Aboriginal and Torres Strait Islander Health Program, George Institute for Global Health, Sydney, NSW 2042, Australia
- Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jessica Wallace
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kimberly Glover
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Bobby Porykali
- Aboriginal and Torres Strait Islander Health Program, George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Margaret Allman-Farinelli
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | | | - Anna Rangan
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
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Galy O, Frayon S, Goldin M, Zongo P, Wattelez G, Lameta S, Quartermain A, Fotsing JM, Bouard S. Generational issues in linking family farming production, traditional food in diet, physical activity and obesity in Pacific Islands countries and territories: the case of the Melanesian population on Lifou Island. OPEN RESEARCH EUROPE 2022; 1:135. [PMID: 37645099 PMCID: PMC10446099 DOI: 10.12688/openreseurope.13705.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 08/31/2023]
Abstract
In the Melanesian culture, traditional activities are organized around family farming, although the lifestyle transition taking place over the last several decades has led to imbalances in diet and physical activity, with both leading to obesity. The aim of this interdisciplinary study was to understand the links between family farming (produced, exchanged, sold, and consumed food), diet (focused on produced, hunted, and caught food), physical activity (sedentary, light, and moderate-to-vigorous physical activity) and obesity in Melanesian Lifou Island families (parents and children). Forty families, including 142 adults and children, completed individual food frequency questionnaires, wore tri-axial accelerometers for seven continuous days, and had weight and height measured with a bio-impedance device. A family farming questionnaire was conducted at the household level concerning family farming practices and sociodemographic variables. Multinomial regression analyses and logistic regression models were used to analyze the data. Results showed that family farming production brings a modest contribution to diet and active lifestyles for the family farmers of Lifou Island. The drivers for obesity in these tribal communities were linked to diet in the adults, whereas parental socioeconomic status and moderate-to-vigorous physical activity were the main factors associated to being overweight and obesity in children. These differences in lifestyle behaviors within families suggest a transition in cultural practices at the intergenerational level. Future directions should consider seasonality and a more in-depth analysis of diet including macro- and micro- nutrients to acquire more accurate information on the intergenerational transition in cultural practices and its consequences on health outcomes in the Pacific region.
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Affiliation(s)
- Olivier Galy
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Stéphane Frayon
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Marco Goldin
- TERAU: Territoires, acteurs et usages, Institut Agronomique néo-Calédonien (IAC), Pouembout, New Caledonia
| | - Paul Zongo
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Guillaume Wattelez
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Sonny Lameta
- School of Agriculture and Food Technology, The University South Pacific, Samoa Campus, Fiji
| | - Alan Quartermain
- School of Science & Technology, The University of Goroka, Goroka, 1078, Papua New Guinea
| | - Jean Marie Fotsing
- ISEA, University of New Caledonia, Noumea, New Caledonia, 98800, New Caledonia
| | - Séverine Bouard
- TERAU: Territoires, acteurs et usages, Institut Agronomique néo-Calédonien (IAC), Pouembout, New Caledonia
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Mai TMT, Tran QC, Nambiar S, der Pols JCV, Gallegos D. Development and Validation of the Vietnamese Children’s Short Dietary Questionnaire to Evaluate Food Groups Intakes and Dietary Practices among 9–11-Year-Olds Children in Urban Vietnam. Nutrients 2022; 14:nu14193996. [PMID: 36235649 PMCID: PMC9570706 DOI: 10.3390/nu14193996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims to develop and assess the reproducibility and validity of the Vietnamese Children’s Short Dietary Questionnaire (VCSDQ) in evaluating food groups intakes and dietary practices among school-aged children 9–11 years old in urban Vietnam. A 26-item questionnaire covering frequency intakes of five core food groups, five non-core food groups, five dietary practices over a week, and daily intakes of fruits, vegetables, and water was developed. Children (n = 144) from four primary schools in four areas of Ho Chi Minh City, Vietnam completed the VCSDQ twice, as well as three consecutive 24 h recalls over a week. Intra-class correlation, Spearman correlation, weighted kappa, cross-classification, and Bland–Altman plots were used to evaluate the reproducibility and validity. The direct validity of food groups from VCSDQ against the 24 h recalls was examined using Wilcoxon-test for trend. The VCSDQ had good reproducibility in 12 out of 15 group items; the ICC ranged from 0.33 (grains) to 0.84 (eating while watching screens). This VCSDQ had low relative validity, two items (instant noodles, eating while watching screens) had a moderate to good agreement (k = 0.43, k = 0.84). There was good direct validity in three core-food groups (fruits, vegetables, dairy) and three non-core food groups (sweetened beverages, instant noodles, processed meat). In addition, the VCSDQ can also be used to classify daily intakes of fruits and vegetables from low to high.
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Affiliation(s)
- Thi My Thien Mai
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Victoria Park Rd., Kelvin Grove, QLD 4059, Australia
- Ho Chi Minh City Center for Disease Control, Ho Chi Minh City 700000, Vietnam
- Correspondence:
| | - Quoc Cuong Tran
- Department of Nutrition and Food Safety, Faculty of Public Health, Pham Ngoc Thach Medical University, Ho Chi Minh City 700000, Vietnam
| | - Smita Nambiar
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Victoria Park Rd., Kelvin Grove, QLD 4059, Australia
| | - Jolieke C. Van der Pols
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Victoria Park Rd., Kelvin Grove, QLD 4059, Australia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Victoria Park Rd., Kelvin Grove, QLD 4059, Australia
- Woolworths Centre for Childhood Nutrition Research, Queensland University of Technology (QUT), Graham St., South Brisbane, QLD 4101, Australia
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Ilić A, Rumbak I, Brečić R, Colić Barić I, Bituh M. Relative validity and reproducibility of a semi-quantitative food frequency questionnaire to assess fruit and vegetable consumption in school-aged children. Front Nutr 2022; 9:934295. [PMID: 36061905 PMCID: PMC9428272 DOI: 10.3389/fnut.2022.934295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/19/2022] [Indexed: 12/28/2022] Open
Abstract
BackgroundSince the beneficial effects of fruit and vegetable (FV) consumption on health are well known due to the synergy of their nutrients and non-nutrients, it is crucial to have good tools to assess the FV intake. A food frequency questionnaire (FFQ) is an adequate method to estimate FV consumption, but it is necessary to relate this dietary method to the geographic and cultural environment. Therefore, this study presented the development of a semi-quantitative FFQ to estimate the FV intake in school-aged children who usually consume cooked homemade and school meals. It also aimed to evaluate the relative validity and reproducibility of the FFQ.MethodsSchool-aged children (baseline age 8 years) from 14 primary schools in the city of Zagreb participated in the study during the 2019/2020 school year. Parents/caregivers, together with the children, completed the FFQs and 3-day dietary records (3DDRs). The FFQ was designed to assess the consumption of eight food categories. The FFQ was validated using the 3DDR of 141 children (51.4% of boys), whereas the reproducibility test included the FFQ of 161 children (53.4% of boys).ResultsOf the eight food categories, FFQ overestimates the consumption of three and underestimates the consumption of three food categories (p < 0.05; Wilcoxon signed rank test) compared to the 3DDR. De-attenuated correlation coefficients estimated a significant relationship (0.217–0.384) between the FFQ and 3DDR. Cross-classification analysis revealed that overall, 28–41% of children were classified in the same quartile, whereas less than 10% of children were extremely misclassified for all food categories obtained from 3DDR and FFQ1. κw values showed fair agreement for all food categories. The Bland–Altman analysis results showed a relatively small bias for all food categories (median between -11.7 and -54.8 g), with no systematic patterns between the FFQ and 3DDR. No differences were found between food categories estimated with the FFQs on both occasions, and Spearman’s correlation coefficients ranged from 0.664 to 0.712 (p < 0.01). Cronbach’s alpha values (α > 0.700) indicate good internal consistency, and ICCs (range 0.724–0.826; p < 0.01) indicate good reproducibility of the FFQ.ConclusionThe results indicate reasonable relative validity and acceptable reproducibility of the FFQ for estimating FV consumption among school-aged children.
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Affiliation(s)
- Ana Ilić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Ivana Rumbak
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
- *Correspondence: Ivana Rumbak,
| | - Ružica Brečić
- Department of Marketing, Faculty of Economics and Business, University of Zagreb, Zagreb, Croatia
| | - Irena Colić Barić
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Martina Bituh
- Department of Food Quality Control, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
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Ghattas H, Jamaluddine Z, Semaan A, El-Helou N, Safadi G, Elghossain T, Akl C, Elbassuoni S, Chalak A, El Ati J, the SCALE Research Group. School and community drivers of child diets in two Arab cities: The SCALE protocol and innovative tools to assess children’s food environments. PLoS One 2022; 17:e0264963. [PMID: 35857785 PMCID: PMC9299321 DOI: 10.1371/journal.pone.0264963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background In the context of the rapid nutrition transition experienced by middle-income countries of the Arab region, children and adolescent’s food choices and dietary behaviors are early risk factors for the development of non-communicable diseases. Assessment of factors influencing food choices among this age group is challenging and is usually based on self-reported data, which are prone to information and recall bias. As the popularity of technologies and video gaming platforms increases, opportunities arise to use these tools to collect data on variables that affect food choice, dietary intake, and associated outcomes. This protocol paper describes the SCALE study (School and community drivers of child diets in Arab cities; identifying levers for intervention) which aims to explore the environments at the level of households, schools and communities in which children’s food choices are made and consequently identify barriers and enablers to healthy food choices within these environments. Methods Field studies are being conducted in primary schools, among children aged 9–12 years, in Greater Beirut, Lebanon and Greater Tunis, Tunisia. A stratified random sample of 50 primary schools (public and private) are selected and 50 children are randomly selected from grades 4-5-6 in each school. The study includes surveys with children, parents/caregivers, school directors, teachers, and nutrition/health educators to assess individual diets and the contextual factors that influence children’s food choices. Innovative locally adapted tools and methods such as game-based choice experiments, wearable cameras and neighborhood mapping are used to describe the environments in which children’s food choices are made. Discussion The SCALE study will generate contextual knowledge on factors in school and neighborhood environments that influence child dietary behaviors and will inform multi-level interventions and policies to address childhood malnutrition (under-and over-nutrition). By integrating methods from various disciplines, including economics, data science, nutrition, and public health and by considering factors at various levels (home, school, and neighborhood), the study will identify levers for intervention with the potential to improve children’s dietary behaviors. This will help fill existing gaps in research on food systems and consequently guide positive change in Lebanon and Tunisia, with the potential for replicability in other contexts.
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Affiliation(s)
- Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- * E-mail:
| | - Zeina Jamaluddine
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Aline Semaan
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Nehmat El-Helou
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gloria Safadi
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Tatiana Elghossain
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Christelle Akl
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Shady Elbassuoni
- Department of Computer Science, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Ali Chalak
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Jalila El Ati
- INNTA (National Institute of Nutrition and Food Technology), SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, Tunis, Tunisia
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Nuss T, Morley B, Scully M, Wakefield M. Energy drink consumption among Australian adolescents associated with a cluster of unhealthy dietary behaviours and short sleep duration. Nutr J 2021; 20:64. [PMID: 34225738 PMCID: PMC8259213 DOI: 10.1186/s12937-021-00719-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-alcoholic energy drinks ('energy drinks') are high in sugar, as well as caffeine, leading to concerns regarding their suitability for children and adolescents. Despite this, marketing of energy drinks is often directed at adolescents, and there are no age restrictions on the sale of these products in Australia. The current study aimed to examine patterns in consumption of energy drinks among Australian secondary school students and identify sociodemographic and behavioural correlates associated with regular consumption. METHODS Participants were 8942 students in Years 8 to 11 (aged 12 to 17 years) who participated in the 2018 National Secondary Students' Diet and Activity (NaSSDA) cross-sectional survey. A multistage stratified random sampling procedure was used. Within the school setting, students self-completed an online questionnaire assessing their dietary, physical activity and sedentary behaviours. A multilevel logistic regression model was used to examine associations between energy drink consumption and sociodemographic and behavioural factors. RESULTS Overall, 8% of students reported consuming energy drinks on a weekly basis ('regular consumers'). A further 16% indicated they consume less than one cup per week of these types of drinks, while around three-quarters (76%) reported they do not consume energy drinks. Regular consumption of energy drinks was independently associated with being male, having greater weekly spending money, high intakes of snack foods, fast food, other sugar-sweetened beverages and fruit juice, as well as short sleep duration. There was no independent association with other sociodemographic characteristics (i.e., year level, level of disadvantage, geographic location), consumption of vegetables and fruit, physical activity level, or sedentary recreational screen time. CONCLUSIONS While most Australian adolescents do not consume energy drinks, regular consumption is more prevalent among males, and consumption appears to cluster with other unhealthy dietary behaviours and short sleep duration. Findings support the need for policies that will reach identified at-risk groups (e.g., increased regulation of the marketing and sale of energy drinks), as well as suggest opportunities for interventions targeting energy drink consumption alongside other unhealthy dietary behaviours.
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Affiliation(s)
- Tegan Nuss
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004 Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC 3010 Australia
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12
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Karpouzis F, Lindberg R, Walsh A, Shah S, Abbott G, Lai J, Berner A, Ball K. Evaluating OzHarvest's primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia: protocol for a pragmatic cluster non-randomized controlled trial. BMC Public Health 2021; 21:967. [PMID: 34022839 PMCID: PMC8140478 DOI: 10.1186/s12889-021-10302-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The promotion of healthy eating is a public health priority. Poor dietary behaviours, including low fruit and vegetable (F&V) consumption are of particular concern among children. Novel nutrition promotion strategies are needed to improve F&V consumption. Sustainability education could be used to support nutrition education within the school context. The purpose of this paper is to report the protocol for impact and process evaluation of the school-based Food Education and Sustainability Training (FEAST) program, designed to educate children about sustainability, food waste and nutrition, using hands-on cooking activities. METHODS A pragmatic, parallel, cluster non-randomized controlled trial with pre- and post-measures, will be implemented among 20 primary schools (10 intervention vs 10 wait-list-control) within NSW, Australia, involving children in Grades 5-6. FEAST is a curriculum-aligned program, delivered as a 1.5-h lesson/week, for a 10-week unit of inquiry, incorporating theory and cooking. FEAST was developed using theoretical frameworks which included Social Cognitive Theory and the Precede-Proceed Planning model. Primary outcomes include children's self-reported F&V intakes (serves/day). Food literacy constructs such as: nutrition knowledge, food preparation and cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours and food production knowledge, will be assessed as secondary outcomes. Process evaluation will assess program reach, adoption, implementation, maintenance, satisfaction and perceived benefits by teachers and students. An online survey (including quantitative and qualitative questions) was developed for administration at baseline (impact evaluation) and immediately post-intervention (impact and process evaluation). Intervention effects on quantitative study outcomes will be estimated with generalised linear mixed models, including random effects and will follow the intention-to-treat principles. Open-ended questions embedded within the surveys will be analysed qualitatively using content and thematic analyses. DISCUSSION Results from this trial will provide valuable information on the value of adding environmental sustainability strategies to nutrition education in schools. Results will inform the design of future research and programs focused on primary-school children's nutrition, sustainability-related behaviours and experiential school-based interventions. TRIAL REGISTRATION Trial registered 14th December 2020 with the Australian and New Zealand Clinical Trials Registry ( ACTRN12620001347954 ).
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Affiliation(s)
- F Karpouzis
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia.
| | - R Lindberg
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - A Walsh
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - S Shah
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - G Abbott
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - J Lai
- eResearch, Deakin University, Melbourne, VIC, Australia
- Intersect Australia, Sydney, NSW, Australia
| | - A Berner
- OzHarvest, Sydney, NSW, Australia
| | - K Ball
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
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Frayon S, Wattelez G, Paufique E, Nedjar-Guerre A, Serra-Mallol C, Galy O. Overweight in the pluri-ethnic adolescent population of New Caledonia: Dietary patterns, sleep duration and screen time. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2020; 2:100025. [PMID: 34327376 PMCID: PMC8315340 DOI: 10.1016/j.lanwpc.2020.100025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/19/2020] [Accepted: 09/02/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND A high prevalence of overweight and obesity has been found in adolescents of New Caledonia and other Pacific Island Countries and Territories. Although Westernization may contribute to the weight gain in populations of Oceanian, Non-European, Non-Asian ancestry (ONENA), little is known about the sociodemographic and lifestyle factors associated with overweight in the Melanesian and Polynesian adolescents of New Caledonia. METHODS In this cross-sectional study, a pluri-ethnic sample of New Caledonian adolescents (N = 954; age M = 13.2 years) completed a survey to estimate sleep duration, screen time, and dietary pattern using a food frequency questionnaire. Demographic data (gender, ethnicity, socioeconomic status: SES, area of residence) were collected, and anthropometric measures were used to compute weight status. FINDINGS We found a higher risk for being overweight in Melanesian (OR = 1.67) and Polynesian (OR = 5.40) adolescents compared with European adolescents, even after controlling for age, SES, area of residence, dietary pattern, sleep duration and screen time. We also found that low SES (OR = 3.43) and sleep duration (OR = 0.65 per hour) were independently associated with overweight status in the European but not in ONENA adolescents. INTERPRETATION In this study, the main contribution to being overweight was ethnic background, i.e. being Melanesian or Polynesian. The hypothesis of a genetic influence thus seems attractive and merits further analyses. FUNDING This project was funded by the University of New Caledonia and the Fondation Nestlé France.
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Affiliation(s)
- Stéphane Frayon
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
| | - Guillaume Wattelez
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
| | - Emilie Paufique
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
| | - Akila Nedjar-Guerre
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
| | - Christophe Serra-Mallol
- Centre on Work Organizations and Policies (CERTOP), UMR 5044 CNRS, University of Toulouse Jean Jaurès, 5 allées Antonio Machado, 31058 Toulouse cedex 9, France
| | - Olivier Galy
- Interdisciplinary Laboratory for Research in Education, EA 7483, School of Education, University of New Caledonia, BP R4, Avenue James Cook, Noumea Cedex 98851, New Caledonia
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Galy O, Paufique E, Nedjar-Guerre A, Wacalie F, Wattelez G, Le Roux PY, Ponidja S, Zongo P, Serra-Mallol C, Allman-Farinelli M, Frayon S. Living in Rural and Urban Areas of New Caledonia: Impact on Food Consumption, Sleep Duration and Anthropometric Parameters Among Melanesian Adolescents. Nutrients 2020; 12:nu12072047. [PMID: 32664246 PMCID: PMC7400928 DOI: 10.3390/nu12072047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Food consumption, sleep duration and overweight were assessed in rural and urban Melanesian adolescents. METHODS A cross-sectional survey of 312 rural and 104 urban adolescents (11-16 years old) was conducted. Food intakes were assessed by a 26-item food frequency questionnaire and then categorised into the number of serves from each of the three recommended Pacific food groups (energy foods, protective foods, bodybuilding foods), with two additional categories for foods and drinks to be avoided i.e., processed foods and sugary drinks. Number of food serves were compared with the guidelines of 50% serves from energy foods, 35% serves from protective foods and 15% serves from bodybuilding foods. Sleep duration as hours per day was self-reported and body mass index (BMI) was calculated from measured weight and height. RESULTS Approximately 17.9% of rural and 26.9% of urban adolescents met the guidelines for energy foods; 61.5% rural and 69.2% urban met the serves for protective foods and 88.5% and 94.2% met the serves for bodybuilding foods. Less than 6.4% rural and 1.9% urban adolescents avoided processed foods but 61.5% rural and 56.7% urban avoided sugary beverages. Sleep duration for school days was below the international recommendations and did not significantly differ between rural and urban groups: respectively, 8.16 ± 1.10 and 8.31 ± 1.29 h. Overweight/obesity percentage was 38.1% for rural and 31.7% for urban adolescents. CONCLUSIONS Although traditional foods, including protective food, are still part of the adolescents' diet, low consumption of the energy food group and high consumption of processed food occurs regardless of location. As poor eating habits and insufficient sleep may contribute to overweight/obesity, educational nutrition programs should target these lifestyle variables.
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Affiliation(s)
- Olivier Galy
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
- Correspondence: ; Tel.: +687-290-545
| | - Emilie Paufique
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
| | - Akila Nedjar-Guerre
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
| | - Fabrice Wacalie
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
| | - Guillaume Wattelez
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
| | - Pierre-Yves Le Roux
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
| | - Solange Ponidja
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
| | - Paul Zongo
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
| | | | | | - Stéphane Frayon
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800 Nouméa, New Caledonia; (E.P.); (A.N.-G.); (F.W.); (G.W.); (P.-Y.L.R.); (S.P.); (P.Z.); (S.F.)
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Factors associated with frequent consumption of fast food among Australian secondary school students. Public Health Nutr 2020; 23:1340-1349. [PMID: 32172726 DOI: 10.1017/s1368980019004208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine demographic and behavioural correlates of frequent consumption of fast food among Australian secondary school students and explore the associations between fast food consumption and social/environmental factors. DESIGN Cross-sectional survey using a web-based self-report questionnaire. SETTING Secondary schools across all Australian states and territories. PARTICIPANTS Students aged 12-17 years participating in the 2012-2013 National Secondary Students' Diet and Activity survey (n 8392). RESULTS Overall, 38 % of students surveyed reported consuming fast food at least weekly. Being male, residing in lower socio-economic areas and metropolitan locations, having more weekly spending money and working at a fast food outlet were all independently associated with consuming fast food once a week or more, as were several unhealthy eating (low vegetable intake and high sugary drink and snack food intake) and leisure (low physical activity and higher commercial television viewing) behaviours and short sleep duration. Frequent fast food consumption and measured weight status were unrelated. Students who agreed they go to fast food outlets with their family and friends were more likely to report consuming fast food at least weekly, as were those who usually 'upsize' their fast food meals and believe fast food is good value for money. CONCLUSIONS These results suggest that frequent fast food consumption clusters with other unhealthy behaviours. Policy and educational interventions that reach identified at-risk groups are needed to reduce adolescent fast food consumption at the population level. Policies placing restrictions on the portion sizes of fast food may also help adolescents limit their intake.
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Anastasiou CA, Fappa E, Zachari K, Mavrogianni C, Van Stappen V, Kivelä J, Virtanen E, González-Gil EM, Flores-Barrantes P, Nánási A, Semánová C, Dimova R, Usheva N, Iotova V, Cardon G, Manios Y, Makrilakis K, Feel4Diabetes-study group LindströmJaanaSchwarzPeterAnnemansLievenGaramendiIgnacioKontogianniMeropiAndroutsosOdysseasTsoutsoulopoulouKonstantinaKatsarouChristinaKaraglaniEvaQiraIriniSkoufasEfstathiosMaragkopoulouKonstantinaTsiafitsaAntigoneSotiropoulouIriniTsolakosMichalisArgyriEffieNikolaouMaryVampouliEleni-AnnaFilippouChristinaGatsiouKaterinaDimitriadisEfstratiosLaatikainenTiinaWikströmKatjaKiveläJeminaValvePäiviLevälahtiEskoCardonGreetVan StappenVickyHuysNeleWillemsRubenShadidSamyahSchwarzPeterPanchyrzIvonneHollandMaxiTimpelPatrickLiatisStavrosDafoulasGeorgeLambrinouChristina-PaulinaGiannopoulouAngelikiTsirigotiLydiaFappaEviAnastasiouCostasRabemananjaraLalade SabataMaria StellaKoWinneMorenoLuisCiveiraFernandoBuenoGloriaDe Miguel-EtayoPilarGonzalez-GilEsther M.MesanaMaria I.Vicente-RodriguezGermánRodriguezGerardoBaila-RuedaLuciaCenarroAnaJarautaEstíbalizMateo-GallegoRocíoIotovaVioletaTankovaTsvetalinaUshevaNataliaTsochevKaloyanChakarovaNevenaGalchevaSonyaDimovaRumyanaBochevaYanaRadkovaZhanetaMarinovaVanyaBazdarskaYuliyaStefanovaTanyaRurikImreUngvariTimeaJancsóZoltánNánásiAnnaKolozsváriLászlóSemánovaCsillaMartinezRembertoTongMarcosJoutsenniemiKaislaWendel-MitorajKatrina. Development and reliability of questionnaires for the assessment of diet and physical activity behaviors in a multi-country sample in Europe the Feel4Diabetes Study. BMC Endocr Disord 2020; 20:135. [PMID: 32164677 PMCID: PMC7066729 DOI: 10.1186/s12902-019-0469-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Assessment of diet and physical activity and their determinants still remains a demanding task, especially when the objective is to evaluate the efficacy of lifestyle interventions. In the context of the Feel4Diabetes study (a European community based intervention study in families with school aged children and at high risk of developing diabetes), we aimed to develop questionnaires for the assessment of food-frequency and eating behaviors, and physical activity and sedentary behaviors in both parents and school-aged children and a questionnaire for overall family's energy balance-related behaviors. METHODS Questionnaires were developed to be used in 6 countries under standardized harmonization procedures and included questions regarding not only food intake and physical activity, but also questions of their determinants. A reliability study was conducted in 191 pairs of parents and their children (N = 191). Parents completed the questionnaires on two occasions, within a 1-2 week interval. Reliability was tested by the intra-class correlation coefficients (ICC) of test-retest. RESULTS Most of the questions in all questionnaires had excellent reliability, assessed as an ICC of > 0.810. Mean ICCs for food-frequency and eating behaviors questionnaires were 0.838 and 0.787, and for physical activity and sedentary behaviors questionnaires were 0.734 and 0.793, in adults and children respectively. Mean ICC for overall family's energy balance-related behaviors and their determinants was 0.659. CONCLUSION The developed questionnaires showed acceptable reliability and may be valuable tools in the assessment of children's and parents' behaviors related to diet, physical activity, sedentary behavior and overall energy balance in school- and community-based interventions.
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Affiliation(s)
- Costas A. Anastasiou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evaggelia Fappa
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantina Zachari
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Vicky Van Stappen
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jemina Kivelä
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Eeva Virtanen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Esther M. González-Gil
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Paloma Flores-Barrantes
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Madrid, Spain
| | - Anna Nánási
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Csilla Semánová
- Department of Family and Occupational Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Roumyana Dimova
- Department of Diabetology, Clinical, Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Natalya Usheva
- Department of Social Sciences and Public Health, Medical University of Varna, Varna, Bulgaria
| | - Violeta Iotova
- Department of Pediatrics, Clinic of Pediatric Endocrinology, Medical University of Varna, Varna, Bulgaria
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Konstantinos Makrilakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Internal Medicine, National and Kapodistrian University of Athens Medical School, Laiko General Hospital, 17 Ag. Thoma St, 11527 Athens, Greece
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17
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The Role of Recreational Online Activities in School-Based Screen Time Sedentary Behaviour Interventions for Adolescents: A Systematic and Critical Literature Review. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00213-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AbstractSedentary behaviours are highly associated with obesity and other important health outcomes in adolescence. This paper reviews screen time and its role within school-based behavioural interventions targeting adolescents between the years 2007 and 2019. A systematic literature review following PRISMA guidelines was conducted across five major databases to identify interventions targeting screen time—in addition to TV/DVD viewing. The review identified a total of 30 papers analysing 15 studies across 16 countries aiming at addressing reduction of recreational screen time (internet use and gaming) in addition to television/DVD viewing. All of the interventions focused exclusively on behaviour change, targeting in the majority both reduction of sedentary behaviours along with strategies to increase physical activity levels. A mix of intervention effects were found in the reviewed studies. Findings suggest aiming only for reduction in time spent on screen-based behaviour within interventions could be a limited strategy in ameliorating excessive screen use, if not targeted, in parallel, with strategies to address other developmental, contextual and motivational factors that are key components in driving the occurrence and maintenance of adolescent online behaviours. Additionally, it raises the need for a differential treatment and assessment of each online activity within the interventions due to the heterogeneity of the construct of screen time. Recommendations for enhancing the effectiveness of school-based sedentary behaviour interventions and implications for public policy are discussed.
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Abstract
OBJECTIVE The present study aimed to evaluate the validity and reproducibility of a thirteen-item FFQ regarding identification of dietary conditions in a rural population in China. DESIGN A reproducibility study repeated the first FFQ (FFQ1) approximately 4 weeks later (FFQ2). A validity study evaluated the mean of three consecutive 24 h diet recalls as the reference measure. SETTING Cross-sectional study. PARTICIPANTS Residents of a rural area in Henan Province, which is located in the central region of China. RESULTS A total of 295 individuals participated in the reproducibility study. In addition, 123 people agreed to participate in the validity study. Spearman's correlation coefficients between the two FFQ ranged from 0·06 (vegetables) to 0·58 (eggs). Spearman's correlation coefficients between the two methods of collection ranged from 0·01 for cereal to 0·49 for staple foods. The mean of the intraclass correlation coefficients of the two FFQ (FFQ1 v. FFQ2) was 0·19. Bland-Altman analysis indicated good agreement for most food groups across the range of intake for the two studies. CONCLUSIONS The study demonstrated that our FFQ design could be used as a representative tool to conduct a dietary evaluation of a rural population.
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Lee IL, Purbrick B, Barzi F, Brown A, Connors C, Whitbread C, Moore E, Kirkwood M, Simmonds A, van Dokkum P, Death E, Svenson S, Graham S, Hampton V, Kelaart J, Longmore D, Titmuss A, Boyle J, Brimblecombe J, Saffery R, D'Aprano A, Skilton MR, Ward LC, Corpus S, Chitturi S, Thomas S, Eades S, Inglis C, Dempsey K, Dowden M, Lynch M, Oats J, McIntyre HD, Zimmet P, O'Dea K, Shaw JE, Maple-Brown LJ. Cohort Profile: The Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) Study. Int J Epidemiol 2019; 47:1045-1046h. [PMID: 29618003 DOI: 10.1093/ije/dyy046] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- I-Lynn Lee
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Brydie Purbrick
- Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, NT, Australia
| | - Federica Barzi
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Sansom Institute of Health Research, University of South Australia, Adelaide, SA, Australia
| | | | - Cherie Whitbread
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia.,Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Elizabeth Moore
- Public Health Unit, Aboriginal Medical Services Alliance of Northern Territory, Darwin, NT, Australia
| | - Marie Kirkwood
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Alison Simmonds
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Paula van Dokkum
- Aboriginal Health Domain, Baker Heart and Diabetes Institute, Alice Springs, NT, Australia
| | - Elizabeth Death
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Stacey Svenson
- Aboriginal Health Domain, Baker Heart and Diabetes Institute, Alice Springs, NT, Australia
| | - Sian Graham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Vanya Hampton
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Joanna Kelaart
- Aboriginal Health Domain, Baker Heart and Diabetes Institute, Alice Springs, NT, Australia
| | - Danielle Longmore
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Angela Titmuss
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Jacqueline Boyle
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia.,Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Richard Saffery
- Cancer and Disease Epigenetics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Anita D'Aprano
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
| | - Michael R Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, QLD, Australia
| | - Sumaria Corpus
- Clinical Services, Danila Dilba Health Service, Darwin, NT, Australia
| | - Shridhar Chitturi
- Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Sujatha Thomas
- Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, NT, Australia
| | - Sandra Eades
- Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | | | - Karen Dempsey
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | | | - Michael Lynch
- Pathology Network, Top End Health and Hospital Services, Darwin, NT, Australia
| | - Jeremy Oats
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Harold D McIntyre
- Faculty of Medicine, Mater Medical Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Paul Zimmet
- Monash University, Medicine, Nursing and Health Sciences, Melbourne, VIC, Australia
| | - Kerin O'Dea
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia.,Sansom Institute of Health Research, University of South Australia, Adelaide, SA, Australia
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Louise J Maple-Brown
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia.,Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
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20
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Wright KM, Dono J, Brownbill AL, Pearson Nee Gibson O, Bowden J, Wycherley TP, Keech W, O'Dea K, Roder D, Avery JC, Miller CL. Sugar-sweetened beverage (SSB) consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review. BMJ Open 2019; 9:e023630. [PMID: 30819702 PMCID: PMC6398687 DOI: 10.1136/bmjopen-2018-023630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/18/2018] [Accepted: 11/20/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES Sugar-sweetened beverage (SSB) consumption in Australian Aboriginal and Torres Strait Islander people is reported to be disproportionally high compared with the general Australian population. This review aimed to scope the literature documenting SSB consumption and interventions to reduce SSB consumption among Australian Aboriginal and Torres Strait Islander people. Findings will inform strategies to address SSB consumption in Aboriginal and Torres Strait Islander communities. METHODS PubMed, SCOPUS, CINAHL, Informit, Joanna Briggs Institute EBP, Mura databases and grey literature were searched for articles published between January 1980 and June 2018. Studies were included if providing data specific to an Australian Aboriginal and/or Torres Strait Islander population's SSB consumption or an intervention that focused on reducing SSB consumption in this population. DESIGN Systematic scoping review. RESULTS 59 articles were included (1846 screened). While reported SSB consumption was high, there were age-related and community-related differences observed in some studies. Most studies were conducted in remote or rural settings. Implementation of nutrition interventions that included an SSB component has built progressively in remote communities since the 1980s with a growing focus on community-driven, culturally sensitive approaches. More recent studies have focused exclusively on SSB consumption. Key SSB-related intervention elements included incentivising healthier options; reducing availability of less-healthy options; nutrition education; multifaceted or policy implementation (store nutrition or government policy). CONCLUSIONS There was a relatively large number of studies reporting data on SSB consumption and/or sales, predominantly from remote and rural settings. During analysis it was subjectively clear that the more impactful studies were those which were community driven or involved extensive community consultation and collaboration. Extracting additional SSB-specific consumption data from an existing nationally representative survey of Aboriginal and Torres Strait Islander people could provide detailed information for demographic subgroups and benchmarks for future interventions. It is recommended that a consistent, culturally appropriate, set of consumption measures be developed.
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Affiliation(s)
- Kathleen M Wright
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne Dono
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Aimee L Brownbill
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Odette Pearson Nee Gibson
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Sansom Institute, University of South Australia, Adelaide, South Australia, Australia
| | - Jacqueline Bowden
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Thomas P Wycherley
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Wendy Keech
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Health Translation SA, Adelaide, South Australia, Australia
| | - Kerin O'Dea
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - David Roder
- School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Jodie C Avery
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Caroline L Miller
- Population Health Research Group, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
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21
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Gifford JA, Gwynn JD, Hardy LL, Turner N, Henderson LC, Innes-Hughes C, Flood VM. Review of Short-Form Questions for the Evaluation of a Diet, Physical Activity, and Sedentary Behaviour Intervention in a Community Program Targeting Vulnerable Australian Children. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E95. [PMID: 30011873 PMCID: PMC6069381 DOI: 10.3390/children5070095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 01/06/2023]
Abstract
Childhood obesity is associated with low socioeconomic status in developed countries, and community programs can deliver cost-effective obesity interventions to vulnerable children and adolescents at scale. Evaluating these programs in a low-cost, time-efficient, and culturally appropriate way with valid and reliable measures is essential to determining their effectiveness. We aimed to identify existing valid and reliable short-form instruments (≤50 items for diet, ≤15 items for physical activity) suitable for the assessment of change in diet, physical activity, and sedentary behaviour in an Australian obesity intervention program for children and adolescents aged 7⁻13 years from low socioeconomic groups, with a focus on Aboriginal and Torres Strait Islander children. Relevant electronic databases were searched, with a focus on Australian literature. Validity and/or reliability studies using diet instruments (5), physical activity/sedentary behaviour instruments (12), and diet and physical activity/sedentary behaviour instruments used with Aboriginal and Torres Strait Islander (3) children were identified. Seven questions on diet, one question on physical activity, and no questions on sedentary behaviour were recommended. These questions can be used for evaluation in community-based obesity programs among Australian children and adolescents, including those from low socioeconomic groups and Aboriginal and Torres Strait Islander children.
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Affiliation(s)
- Janelle A Gifford
- Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW 2141, Australia.
| | - Josephine D Gwynn
- Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW 2141, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2005, Australia.
| | - Louise L Hardy
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Nicole Turner
- Centre for Rural and Remote Mental Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
- Hunter New England Local Health District, Locked Bag 1, New Lambton, NSW 2305, Australia.
| | - Lily C Henderson
- NSW Office of Preventive Health, Liverpool, NSW 1871, Australia.
| | | | - Victoria M Flood
- Faculty of Health Sciences, The University of Sydney, 75 East St, Lidcombe, NSW 2141, Australia.
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2005, Australia.
- Western Sydney Local Health District, Westmead, NSW 2145, Australia.
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22
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Tonkin E, Kennedy D, Golley R, Byrne R, Rohit A, Kearns T, Hanieh S, Biggs BA, Brimblecombe J. The Relative Validity of the Menzies Remote Short-Item Dietary Assessment Tool (MRSDAT) in Aboriginal Australian Children Aged 6⁻36 Months. Nutrients 2018; 10:E590. [PMID: 29748493 PMCID: PMC5986470 DOI: 10.3390/nu10050590] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 01/21/2023] Open
Abstract
The Menzies Remote Short-item Dietary Assessment Tool (MRSDAT) can be used to derive a dietary index score, which measures the degree of compliance with the Australian Dietary Guidelines. This study aimed to determine the relative validity of a dietary index score for children aged 6⁻24 months, living in a Remote Aboriginal Community (RAC), derived using MRSDAT. This validation study compared dietary index scores derived using MRSDAT with those derived from the average of three 24-h recalls. Participants were aged 6⁻36 months at the first dietary assessment and were living in a RAC. The level of agreement between the two methods was explored using Lin’s concordance correlation coefficient (CCC), Bland-Altman plots, weighted Cohen’s kappa, and Fischer’s exact and paired t-tests. Forty participants were recruited. The CCC was poor between methods (R = 0.35, 95% CI 0.06, 0.58), with MRSDAT estimating higher dietary intake scores for all food groups except fruit, and higher dietary quality scores by an average of 4.78 points/100. Community-based Aboriginal researchers were central to this validation study. MRSDAT was within the performance range of other short-item dietary assessment tools developed for young children, and shows promise for use with very young children in RACs.
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Affiliation(s)
- Emma Tonkin
- Nutrition Program, Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Casuarina 0810, Northern Territory, Australia.
| | - Dani Kennedy
- Nutrition Program, Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Casuarina 0810, Northern Territory, Australia.
| | - Rebecca Golley
- Nutrition and Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park 5042, Australia.
| | - Rebecca Byrne
- Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane 4101, Australia.
| | - Athira Rohit
- Nutrition Program, Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Casuarina 0810, Northern Territory, Australia.
| | - Therese Kearns
- Child Health, Menzies School of Health Research, Casuarina 0810, Northern Territory, Australia.
| | - Sarah Hanieh
- Department of Medicine at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Victoria 3010, Australia.
| | - Beverley-Ann Biggs
- Department of Medicine at the Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Victoria 3010, Australia.
| | - Julie Brimblecombe
- Nutrition Program, Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Casuarina 0810, Northern Territory, Australia.
- Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria 3168, Australia.
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23
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Rohit A, Brimblecombe J, O'Dea K, Tonkin E, Maypilama Ḻ, Maple-Brown L. Development of a short-item diet quality questionnaire for Indigenous mothers and their young children: The Menzies remote short-item dietary assessment tool. Aust J Rural Health 2018; 26:220-224. [PMID: 29672986 DOI: 10.1111/ajr.12412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Athira Rohit
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Julie Brimblecombe
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Kerin O'Dea
- Menzies School of Health Research, Darwin, Northern Territory, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| | - Emma Tonkin
- Menzies School of Health Research, Darwin, Northern Territory, Australia
| | | | - Louise Maple-Brown
- Menzies School of Health Research, Darwin, Northern Territory, Australia
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24
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Whalan S, Farnbach S, Volk L, Gwynn J, Lock M, Trieu K, Brimblecombe J, Webster J. What do we know about the diets of Aboriginal and Torres Strait Islander peoples in Australia? A systematic literature review. Aust N Z J Public Health 2017; 41:579-584. [PMID: 28898509 DOI: 10.1111/1753-6405.12721] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/01/2017] [Accepted: 07/01/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To provide an overview of published research on the dietary intake of Aboriginal and Torres Strait Islander peoples. METHODS Peer-reviewed literature from 1990 to October 2016 was searched to identify studies that measured the dietary intake of Australian Aboriginal and Torres Strait Islander populations. Study quality was assessed using a purposely devised quality appraisal tool. Meta-analysis was not possible due to the heterogeneity in dietary intake assessment methods. A narrative synthesis of study findings, where key themes were compared and contrasted was completed. RESULTS Twenty-five articles from twenty studies with outcome measures related to dietary intake were included. Dietary intake was assessed by electronic store sales, store turnover method, 24-hour dietary recall, food frequency questionnaire and short questions. Consistent findings were low reported intakes of fruit and vegetables and high intakes of total sugar and energy-dense, nutrient-poor food and beverages. CONCLUSIONS While differences between studies and study quality limit the generalisability of the findings, most studies suggest that the diets of Aboriginal and Torres Strait Islander peoples are inadequate. Implications for public health: A more concerted approach to understanding dietary patterns of Aboriginal and Torres Strait Islander peoples is required to inform policy and practice to improve diet and nutrition.
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Affiliation(s)
- Sarah Whalan
- Menzies School of Health Research, Northern Territory
| | - Sara Farnbach
- The George Institute for Global Health, New South Wales
| | - Lena Volk
- The George Institute for Global Health, New South Wales
| | - Josephine Gwynn
- Faculty of Health Sciences, University of Sydney, New South Wales
| | - Mark Lock
- School of Medicine and Public Health, University of Newcastle, New South Wales
| | - Kathy Trieu
- The George Institute for Global Health, New South Wales
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25
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Foley BC, Shrewsbury VA, Hardy LL, Flood VM, Byth K, Shah S. Evaluation of a peer education program on student leaders' energy balance-related behaviors. BMC Public Health 2017; 17:695. [PMID: 28882121 PMCID: PMC5590169 DOI: 10.1186/s12889-017-4707-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 09/04/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Few studies have reported energy balance-related behavior (EBRB) change for peer leaders delivering health promotion programs to younger students in secondary schools. Our study assessed the impact of the Students As LifeStyle Activists (SALSA) program on SALSA peer leaders' EBRBs, and their intentions regarding these behaviors. METHODS We used a pre-post study design to assess changes in EBRBs and intentions of Year 10 secondary school students (15-16 year olds) who volunteered to be peer leaders to deliver the SALSA program to Year 8 students (13-14 year olds). This research is part of a larger study conducted during 2014 and 2015 in 23 secondary schools in Sydney, Australia. We used an online questionnaire before and after program participation to assess Year 10 peer leaders' fruit and vegetable intake, daily breakfast eating, sugar sweetened beverage (SSB) intake, moderate-to-vigorous physical activity (MVPA) participation and school-day recreational screen time behaviors and intentions regarding these EBRBs. Generalized estimating equations with a robust variance structure and exchangeable correlation structure were used to estimate the individual-level summary statistics and their 95% CIs, adjusted for clustering. We further assessed the effect of covariates on EBRB changes. RESULTS There were significant increases in the proportion of Year 10 peer leaders (n = 415) who reported eating ≥2 serves fruit/day fruit from 54 to 63% (P < 0.01); eating ≥5 serves vegetables/day from 8 to 12% (P < 0.01); and drinking <1 cup/day of SSBs from 56 to 62% (P < 0.01). Change in ≥60 min MVPA participation/day depended on gender (P < 0.01): Boys increased 14% while girls decreased -2%. Changes in eating breakfast daily also depended on gender (P < 0.004): Boys increased 13% while girls decreased -0.4%. The change in peer leaders recreational screen time differed by socio-economic status (P < 0.05): above average communities decreased by -2.9% while below average communities increased 6.0%. Significant shifts were seen in peer leaders' intentions, except MVPA which remained stable. CONCLUSIONS The SALSA program had a positive impact on peer leaders' EBRBs, with gender and socio-economic status moderating some outcomes. TRIAL REGISTRATION ACTRN12617000712303 retrospectively registered.
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Affiliation(s)
- B. C. Foley
- Western Sydney Local Health District, Westmead, NSW Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW Australia
| | - V. A. Shrewsbury
- Sydney Medical School, The University of Sydney, Sydney, NSW Australia
| | - L. L. Hardy
- Sydney Medical School, The University of Sydney, Sydney, NSW Australia
| | - V. M. Flood
- Western Sydney Local Health District, Westmead, NSW Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia
| | - K. Byth
- Sydney Medical School, The University of Sydney, Sydney, NSW Australia
| | - S. Shah
- Western Sydney Local Health District, Westmead, NSW Australia
- Sydney Medical School, The University of Sydney, Sydney, NSW Australia
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Frequency of takeaway food consumption and its association with major food group consumption, anthropometric measures and blood pressure during adolescence. Br J Nutr 2017; 115:2025-30. [PMID: 27046032 DOI: 10.1017/s000711451600101x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We prospectively assessed the (1) frequency and socio-economic correlates of takeaway food consumption during adolescence; and (2) association between frequent takeaway food consumption with intakes of major food groups and anthropometric measures and blood pressure (BP). In total, 699 Sydney schoolchildren (380 girls and 319 boys) who had dietary data at both 12 and 17 years of age were included for analyses. Takeaway food consumption was self-reported and based on a single question. Anthropometric measures and BP were collected. The proportion of participants who ate takeaway foods once per week or more increased significantly over 5 years from the age of 12 to 17 years: 35·5-44·1 % (P<0·0001). In total, 12-year-old girls compared with boys had reduced odds of takeaway foods once per week or more at the age of 17 years (P=0·01), multivariable-adjusted OR 0·63 (95 % CI 0·44, 0·90). In total, 12-year-old children who ate takeaway foods once per week or more had significantly lower mean fruit (220·3 v. 253·0 g/d; P=0·03) and vegetable consumption (213·2 v. 247·7 g/d; P=0·004), 5 years later (at 17 years of age). Frequent takeaway food consumption at the age of 12 years was not associated with anthropometric indices and BP at the age of 17 years. Consumption of takeaway foods became more frequent during adolescence, particularly among boys, and it was associated with reduced intake of fruits and vegetables.
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Factors associated with high consumption of soft drinks among Australian secondary-school students. Public Health Nutr 2017; 20:2340-2348. [DOI: 10.1017/s1368980017000118] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveTo examine demographic and behavioural correlates of high consumption of soft drinks (non-alcoholic sugar-sweetened carbonated drinks excluding energy drinks) among Australian adolescents and to explore the associations between high consumption and soft drink perceptions and accessibility.DesignCross-sectional self-completion survey and height and weight measurements.SettingAustralian secondary schools.SubjectsStudents aged 12–17 years participating in the 2012–13 National Secondary Students’ Diet and Activity (NaSSDA) survey (n 7835).ResultsOverall, 14 % of students reported consuming four or more cups (≥1 litres) of soft drinks each week (‘high soft drink consumers’). Demographic factors associated with high soft drink consumption were being male and having at least $AU 40 in weekly spending money. Behavioural factors associated with high soft drink consumption were low fruit intake, consuming energy drinks on a weekly basis, eating fast foods at least once weekly, eating snack foods ≥14 times/week, watching television for >2 h/d and sleeping for <8 h/school night. Students who perceived soft drinks to be usually available in their home, convenient to buy and good value for money were more likely to be high soft drink consumers, as were students who reported usually buying these drinks when making a beverage purchase from the school canteen/vending machine.ConclusionsHigh soft drink consumption clusters with other unhealthy lifestyle behaviours among Australian secondary-school students. Interventions focused on reducing the availability of soft drinks (e.g. increased taxes, restricting their sale in schools) as well as improved education on their harms are needed to lower adolescents’ soft drink intake.
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Comparative validity and repeatability of a single question, a twenty-eight-item FFQ and estimated food records to assess takeaway meal intake. Br J Nutr 2016; 116:1582-1591. [PMID: 27767000 DOI: 10.1017/s000711451600310x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A single question (SQ) and a twenty-eight-item FFQ to measure takeaway meal intake were compared with two 7-d estimated food records (EFR; reference method). Test methods were completed after the reference period and repeated 6-8 d later for repeatability. The SQ asked about intake of high-SFA takeaway meals. FFQ items included low- and high-SFA meals. Test methods were compared with EFR for sensitivity, specificity, and positive and negative predictive values, using a goal of ≤1 high-SFA weekly takeaway meals. Bland-Altman analyses were used to check agreement between measurement approaches, the κ coefficient was used to summarise the observed level of agreement, and Spearman's correlation was used to assess the degree to which instruments ranked individuals. Young adults were recruited from two universities, and 109 participants (61 % female) completed the study. The mean age was 24·4 (sd 4·9) years, and the mean BMI was 23·5 (sd 3·7) kg/m2. The SQ and the FFQ had a sensitivity of 97 and 83 % and a specificity of 46 and 92 %, respectively. Both methods exhibited moderate correlation for measuring total and high-SFA takeaway meal intakes (r s ranging from 0·64 to 0·80). Neither instrument could measure precise, absolute intake at the group or individual level. Test methods ranged from fair (κ w =0·24) to moderate agreement (κ w =0·59). The repeatability for all was acceptable. The FFQ identified excessive high-SFA takeaway meal intake and measured individuals' category for total and high-SFA takeaway intakes. Both methods are suitable for ranking individuals for total or high-SFA takeaway meal intakes.
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Golley RK, Bell LK, Hendrie GA, Rangan AM, Spence A, McNaughton SA, Carpenter L, Allman-Farinelli M, de Silva A, Gill T, Collins CE, Truby H, Flood VM, Burrows T. Validity of short food questionnaire items to measure intake in children and adolescents: a systematic review. J Hum Nutr Diet 2016; 30:36-50. [PMID: 27561947 DOI: 10.1111/jhn.12399] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Short food questions are appealing to measure dietary intakes. METHODS A review of studies published between 2004 and 2016 was undertaken and these were included in the present study if they reported on a question or short item questionnaire (≤50 items, data presented as ≤30 food groups) measuring food intake or food-related habits, in children (aged 6 months to 18 years), and reported question validity or reliability. Thirty studies met the inclusion criteria. RESULTS Most questions assessed foods or food groups (n = 29), with the most commonly assessed being fruit (n = 22) or vegetable intake (n = 23), dairy foods and discretionary foods (n = 20 studies each). Four studies assessed food habits, with the most common being breakfast and meal frequency (n = 4 studies). Twenty studies assessed reliability, and 25 studies determined accuracy and were most commonly compared against food records. Evaluation of question performance relied on statistical tests such as correlation. CONCLUSIONS The present study has identified valid and reliable questions for the range of key food groups of interest to public health nutrition. Questions were more likely to be reliable than accurate, and relatively few questions were both reliable and accurate. Gaps in repeatable and valid short food questions have been identified that will provide direction for future tool development.
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Affiliation(s)
- R K Golley
- University of South Australia, Adelaide, SA, Australia
| | - L K Bell
- Flinders University, Adelaide, SA, Australia
| | | | - A M Rangan
- University of Sydney, Sydney, NSW, Australia
| | - A Spence
- Deakin University, Melbourne, VIC, Australia
| | | | - L Carpenter
- University of Melbourne, Melbourne, VIC, Australia
| | | | - A de Silva
- University of Melbourne, Melbourne, VIC, Australia
| | - T Gill
- University of Sydney, Sydney, NSW, Australia
| | - C E Collins
- University of Newcastle, Newcastle, NSW, Australia
| | - H Truby
- Monash University, Melbourne, VIC, Australia
| | - V M Flood
- University of Sydney, Sydney, NSW, Australia
| | - T Burrows
- University of Newcastle, Newcastle, NSW, Australia
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Niven P, Scully M, Morley B, Crawford D, Baur LA, Wakefield M. Socio-economic disparities in Australian adolescents' eating behaviours. Public Health Nutr 2014; 17:2753-8. [PMID: 24152543 PMCID: PMC10282261 DOI: 10.1017/s1368980013002784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 09/02/2013] [Accepted: 09/04/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess the association between socio-economic position (SEP) and poor eating behaviours in a large representative sample of Australian secondary-school students. DESIGN Cross-sectional survey of students' vegetable, fruit, sugar-sweetened beverage and fast-food consumption assessed using validated instruments and collected via a web-based self-report format. SETTING Secondary schools across all Australian states and territories. SUBJECTS Secondary-school students (n 12 188; response rate: 54 %) aged 12-17 years participating in the 2009-10 National Secondary Students' Diet and Activity (NaSSDA) survey. RESULTS Overall, 25 % of students reported consuming ≤1 serving of vegetables/d and 29 % reported eating ≤1 serving of fruit/d. Fourteen per cent of students reported drinking at least 1-2 cups of sugar-sweetened beverages/d while 9 % reported eating fast food ≥3 times/week. After adjusting for other demographic factors, students of lower-SEP areas were more likely to report low intake of vegetables (F(4, 231) = 3·61, P = 0·007) and high frequency of consumption of sugar-sweetened beverages (F(4, 231) = 8·41, P < 0·001) and fast food (F(4, 231) = 4·59, P = 0·001) compared with students of high-SEP neighbourhoods. A positive SEP association was found for fruit consumption among female students only (F(4, 231) = 4·20, P = 0·003). Those from lower-SEP areas were also more likely to engage in multiple poor eating behaviours (F(4, 231)=5·80, P < 0·001). CONCLUSIONS Results suggest that socio-economic disparities in Australian adolescents' eating behaviours do exist, with students residing in lower-SEP neighbourhoods faring less well than those from high-SEP neighbourhoods. Reducing social inequalities in eating behaviours among young people should be a key consideration of future preventive strategies.
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Affiliation(s)
- Philippa Niven
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
| | - David Crawford
- Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Victoria, Australia
| | - Louise A Baur
- Discipline of Paediatrics & Child Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
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Flood VM, Wen LM, Hardy LL, Rissel C, Simpson JM, Baur LA. Reliability and validity of a short FFQ for assessing the dietary habits of 2-5-year-old children, Sydney, Australia. Public Health Nutr 2014; 17:498-509. [PMID: 23632037 PMCID: PMC10282393 DOI: 10.1017/s1368980013000414] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 01/04/2013] [Accepted: 01/22/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A simple FFQ which ranks young children's dietary habits is necessary for population-based monitoring and intervention programmes. The aim of the present study was to determine the reliability and validity of a short FFQ to assess the dietary habits of young children aged 2-5 years. DESIGN Parents completed a seventeen-item FFQ for their children by telephone on two occasions, two weeks apart. Sixty-four parents also completed 3 d food records for their children. The FFQ included daily servings of fruit and vegetables, frequency of eating lean meat, processed meats, take-away food, snack foods (biscuits, cakes, doughnuts, muesli bars), potato crisps and confectionery, and cups of soft drinks/cordials, juice, milk and water. Weighted kappa and intra-class correlation coefficients were used to assess FFQ reliability and the Bland-Altman method was used to assess validity of the FFQ compared with the 3 d food record. SETTING Seven pre-school centres in metropolitan Sydney, Australia. SUBJECTS Seventy-seven children aged 2-5 years. RESULTS The majority of questions had moderate to good reliability: κ w ranged from 0·37 (lean meat) to 0·85 (take-away food consumption). Validity analysis showed a significant increase in mean values from the food record with increasing ordered categories from the FFQ for servings of vegetables and fruit and cups of drinks (all trend P ≤ 0·01). Spearman rank correlation coefficient was >0·5 for vegetables, fruit, diet soft drinks and fruit juice. CONCLUSIONS The FFQ provides reliable and moderately valid information about the dietary intakes and habits of children aged 2-5 years, in particular for fruit, vegetables and beverages.
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Affiliation(s)
- Victoria M Flood
- School of Health Sciences, Faculty of Health and Behavioural Sciences, University of Wollongong, NSW 2455, Australia
| | - Li Min Wen
- Health Promotion Service, Sydney South West Area Health Service, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
| | - Louise L Hardy
- School of Public Health, University of Sydney, Sydney, Australia
| | - Chris Rissel
- Health Promotion Service, Sydney South West Area Health Service, Sydney, Australia
- School of Public Health, University of Sydney, Sydney, Australia
| | - Judy M Simpson
- School of Public Health, University of Sydney, Sydney, Australia
| | - Louise A Baur
- School of Public Health, University of Sydney, Sydney, Australia
- Discipline of Paediatrics & Child Health, University of Sydney, Sydney, Australia
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Performance of short food questions to assess aspects of the dietary intake of Australian children. Nutrients 2013; 5:4822-35. [PMID: 24288023 PMCID: PMC3875929 DOI: 10.3390/nu5124822] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/12/2013] [Accepted: 10/28/2013] [Indexed: 11/17/2022] Open
Abstract
Single dietary questions are used as a rapid method of monitoring diet. The aim of this investigation was to assess the performance of questions to measure population group intake compared to the mean of two 24-h recalls. Data from the Australian National Children's Nutrition and Physical Activity Survey 2007 was used (n = 4487). Children reported their intake on three questions relating to usual serves of fruit, vegetables and type of milk. Age, gender and body weight status were assessed as modifiers of the relationship between methods. There was a stepwise increase in fruit and vegetable intake (p < 0.001) measured by recall when grouped by response category of the short question. By recall, fruit consumption decreased with age (F = 12.92, p < 0.001) but this trend was not detectable from the short question (F = 2.31, p = 0.075). The difference in fruit intake between methods was greatest for obese children. Almost 85% of children who consumed whole milk by short question consumed mainly whole fat milk by recall, but agreement was lower for other milk types. Saturated fat and volume of milk was highest in whole milk consumers. Ease of administration suggests that short questions, at least for some aspects of diet, are a useful method to monitor population intakes for children.
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Hebden L, Cook A, van der Ploeg HP, King L, Bauman A, Allman-Farinelli M. A mobile health intervention for weight management among young adults: a pilot randomised controlled trial. J Hum Nutr Diet 2013; 27:322-32. [PMID: 23992038 DOI: 10.1111/jhn.12155] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Today's generation of young adults are gaining weight faster than their parents; however, there remains insufficient evidence to inform interventions to prevent this weight gain. Mobile phones are a popular means of communication that may provide a convenient, inexpensive means to deliver health intervention programmes. This pilot study aimed to measure the effect of a 12-week mobile health (mHealth) intervention on body weight, body mass index and specific lifestyle behaviours addressed by the programme. METHODS University students and staff aged 18-35 years (n = 51) were randomised (ratio 1 : 1, intervention : control). Both groups received a printed diet booklet with instructions prepared by a dietitian. The intervention group also received Short Message Service (SMS) text messages (four per week), e-mails (four per week), and had access to smartphone applications and Internet forums. RESULTS Pre- to post-intervention, participants in the intervention group decreased their body weight [mean (SD)] [-1.6 (2.6) kg], increased their light intensity activity [34 (35) min day(-1)] and reported an increased vegetable (1.0 median serving day(-1)) and decreased sugar-sweetened beverage intake [-355 (836) mL week(-1)]. Despite this, post-intervention changes in outcomes were not significantly different from controls. CONCLUSIONS The piloted mHealth programme provided some short-term positive changes in weight, nutrition and physical activity using a low cost, convenient delivery method for this population. However, changes were no different from those observed among controls. This might partly be explained by intervention participants' low engagement with the programme, which is likely to require further modification to provide more regular, personalised, monitored support.
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Affiliation(s)
- L Hebden
- School of Molecular Bioscience, The University of Sydney, Sydney, NSW, Australia
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Brimblecombe JK, Ferguson MM, Liberato SC, O'Dea K. Characteristics of the community-level diet of Aboriginal people in remote northern Australia. Med J Aust 2013; 198:380-4. [PMID: 23581959 DOI: 10.5694/mja12.11407] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 03/04/2013] [Indexed: 11/28/2024]
Abstract
OBJECTIVE To describe the nutritional quality of community-level diets in remote northern Australian communities. DESIGN, SETTING AND PARTICIPANTS A multisite 12-04 assessment (July 2010 to June 2011) of community-level diet in three remote Aboriginal communities in the Northern Territory, linking data from food outlets and food services to the Australian Food and Nutrient Database. MAIN OUTCOME MEASURES Contribution of food groups to total food expenditure; macronutrient contribution to energy and nutrient density relative to requirements; and food sources of key nutrients. RESULTS One-quarter (24.8%; SD, 1.4%) of total food expenditure was on non-alcoholic beverages; 15.6% (SD, 1.2%) was on sugar-sweetened drinks. 2.2% (SD, 0.2%) was spent on fruit and 5.4% (SD, 0.4%) on vegetables. Sugars contributed 25.7%-34.3% of dietary energy, 71% of which was table sugar and sugar-sweetened beverages. Dietary protein contributed 12.5%-14.1% of energy, lower than the recommended 15%-25% optimum. Furthermore, white bread was a major source of energy and most nutrients in all three communities. CONCLUSION Very poor dietary quality continues to be a characteristic of remote Aboriginal community nutrition profiles since the earliest studies almost three decades ago. Significant proportions of key nutrients are provided from poor-quality nutrient-fortified processed foods. Further evidence regarding the impact of the cost of food on food purchasing in this context is urgently needed and should include cost-benefit analysis of improved dietary intake on health outcomes.
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Affiliation(s)
- Julie K Brimblecombe
- Wellbeing and Preventable Chronic Disease, Menzies School of Health Research, Darwin, NT.
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Dal Grande E, Fullerton S, Taylor AW. Reliability of self-reported health risk factors and chronic conditions questions collected using the telephone in South Australia, Australia. BMC Med Res Methodol 2012; 12:108. [PMID: 22834889 PMCID: PMC3441283 DOI: 10.1186/1471-2288-12-108] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 06/28/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accurate monitoring of health conditions and behaviours, and health service usage in the population, using an effective and economical method is important for planning and evaluation. This study examines the reliability of questions asked in a telephone survey by conducting a test/retest analysis of a range of questions covering demographic variables, health risk factors and self-reported chronic conditions among people aged 16 years and over. METHODS A Computer Assisted Telephone Interviewing (CATI) survey on health issues of South Australians was re-administered to a random sub-sample of 154 respondents between 13-35 days (mean 17) after the original survey. Reliability between questions was assessed using Cohen's kappa and intraclass correlation coefficients. RESULTS Demographic questions (age, gender, number of adults and children in the household, country of birth) showed extremely high reliability (0.97 to 1.00). Health service use (ICC = 0.90 95% CI 0.86-0.93) and overall health status (Kappa = 0.60 95% CI 0.46-0.75) displayed moderate agreement. Questions relating to self-reported risk factors such as smoking (Kappa = 0.81 95% CI 0.72-0.89) and alcohol drinking (ICC 0.75 = 95% CI 0.63-0.83) behaviour showed good to excellent agreement, while questions relating to self-reported risk factors such as time spent walking for physical activity (ICC 0.47 = 95% CI 0.27-0.61), fruit (Kappa(w) = 0.60 95% CI 0.45-0.76) and vegetable consumption (Kappa(w) = 0.50 95% CI 0.32-0.69) showed only moderate agreement. Self-reported chronic conditions displayed substantial to almost perfect agreement (0.72 to 1.00) with the exception of moderate agreement for heart disease (Kappa = 0.82 95% CI 0.57-0.99). CONCLUSION These results show the questions assessed to be reliable in South Australia for estimating health conditions and monitoring health related behaviours using a CATI survey.
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Affiliation(s)
- Eleonora Dal Grande
- Population Research and Outcome Studies, Department of Medicine, University of Adelaide, Level 3, 122 Frome St, Adelaide, South Australia 5000, Australia.
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Louie JCY, Gwynn J, Turner N, Cochrane J, Wiggers J, Flood V. Dietary glycemic index and glycemic load among Indigenous and non-Indigenous children aged 10-12 years. Nutrition 2012; 28:e14-22. [PMID: 22484006 DOI: 10.1016/j.nut.2011.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 12/13/2011] [Accepted: 12/15/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study aimed to estimate the dietary glycemic index (GI) and glycemic load (GL) of Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children and identify the main foods contributing to their GI and GL. METHODS A cross-sectional analysis of food intake of 215 children (38.1% were Aboriginal and Torres Strait Islanders) 10 to 12 y old obtained by three 24-h recalls was conducted. The foods were ranked according to their total contribution to total carbohydrates, GI, and GL. RESULTS Aboriginal and Torres Strait Islander participants had a significantly higher dietary GL (155.8 ± 46.8 versus 135.4 ± 31.2, P < 0.001) and GI (58.3 ± 3.9 versus 56.9 ± 3.8, P = 0.008) than the non-Indigenous participants. White breads were the main contributors of GI and GL in both groups and were a main driver for the increasing GI. Fiber was not associated with GI, whereas sugar and starch were positively associated. Subjects with a higher GI tended to be less physically active. CONCLUSION The quality of carbohydrates in the diets of the participants was low, with poorer dietary items contributing most of the GI and GL. Substituting white breads with low/lower GI alternatives may be a useful strategy.
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Khambalia A, Hardy LL, Bauman A. Accuracy of weight perception, life-style behaviours and psychological distress among overweight and obese adolescents. J Paediatr Child Health 2012; 48:220-7. [PMID: 22417463 DOI: 10.1111/j.1440-1754.2011.02258.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To compare overweight and obese adolescents with accurate and inaccurate self-reported weight perception across a range of behaviours and measures of psychological well-being. METHODS This study uses a cross-sectional survey of grade 7-12 high school students in New South Wales, Australia, conducted in 2008 (n= 7553). Overweight and obese students based on body mass index were classified as accurate perceivers (weight perception was 'too fat') or inaccurate perceivers (weight perception was 'about right'). RESULTS Nearly a third of adolescents had incongruity between self-perceived body weight status and body mass index-determined weight category. Compared with boys, girls were less likely to underestimate their body weight (odds ratio: 0.26; 95% confidence interval: 0.25, 0.27) and more likely to overestimate their body weight (odds ratio: 3.4; 95% confidence interval: 3.3, 3.5). Accurate body weight perception was higher in obese adolescents compared with overweight adolescents (69.5% vs. 44.0%). Compared with mis-perceivers, accurate overweight and obese perceivers had significantly higher odds of trying to lose weight and being more physically active; however, they showed a combination of unhealthy and healthy behaviours (i.e. dietary patterns and sedentary activities). Accurate weight perception among overweight and obese adolescents was associated with increased odds of feeling sad or depressed in the past 6 months. CONCLUSIONS Further research on social, familial and psychological factors that predict or mediate healthy and unhealthy weight-related behaviours among adolescents by accuracy of weight perception is needed. Accurate weight perception should be considered in counselling and behavioural interventions.
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Affiliation(s)
- Amina Khambalia
- Preventive Research Collaboration, School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
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Gwynn JD, Flood VM, D'Este CA, Attia JR, Turner N, Cochrane J, Louie JCY, Wiggers JH. Poor food and nutrient intake among Indigenous and non-Indigenous rural Australian children. BMC Pediatr 2012; 12:12. [PMID: 22304829 PMCID: PMC3308924 DOI: 10.1186/1471-2431-12-12] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 02/04/2012] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The purpose of this study was to describe the food and nutrient intake of a population of rural Australian children particularly Indigenous children. Participants were aged 10 to 12 years, and living in areas of relative socio-economic disadvantage on the north coast of New South Wales. METHODS In this descriptive cross-sectional study 215 children with a mean age of 11.30 (SD 0.04) years (including 82 Indigenous children and 93 boys) completed three 24-hour food recalls (including 1 weekend day), over an average of two weeks in the Australian summer of late 2005. RESULTS A high proportion of children consumed less than the Australian Nutrient Reference Values for fibre (74-84% less than Adequate Intake (AI)), calcium (54-86% less than Estimated Average Requirement (EAR)), folate and magnesium (36% and 28% respectively less than EAR among girls), and the majority of children exceeded the upper limit for sodium (68-76% greater than Upper Limit (UL)). Energy-dense nutrient-poor (EDNP) food consumption contributed between 45% and 49% to energy. Hot chips, sugary drinks, high-fat processed meats, salty snacks and white bread were the highest contributors to key nutrients and sugary drinks were the greatest per capita contributor to daily food intake for all. Per capita intake differences were apparent by Indigenous status. Consumption of fruit and vegetables was low for all children. Indigenous boys had a higher intake of energy, macronutrients and sodium than non-Indigenous boys. CONCLUSIONS The nutrient intake and excessive EDNP food consumption levels of Australian rural children from disadvantaged areas are cause for concern regarding their future health and wellbeing, particularly for Indigenous boys. Targeted intervention strategies should address the high consumption of these foods.
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Affiliation(s)
- Josephine D Gwynn
- Faculty of Health, University of Newcastle, Callaghan 2308 NSW Australia
| | - Victoria M Flood
- Cluster for Public Health Nutrition, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW 2006, Australia
- School of Health Sciences, Faculty of Health and Behavioural Sciences, The University of Wollongong NSW 2522, Australia
| | - Catherine A D'Este
- Faculty of Health, University of Newcastle, Callaghan 2308 NSW Australia
| | - John R Attia
- Faculty of Health, University of Newcastle, Callaghan 2308 NSW Australia
| | - Nicole Turner
- Durri Aboriginal Medical Service Corporation, Kempsey, NSW 2440, Australia
| | - Janine Cochrane
- Biripi Aboriginal Medical Service, Taree, NSW 2430, Australia
| | - Jimmy Chun-Yu Louie
- Cluster for Public Health Nutrition, Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW 2006, Australia
| | - John H Wiggers
- Faculty of Health, University of Newcastle, Callaghan 2308 NSW Australia
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Scully M, Wakefield M, Niven P, Chapman K, Crawford D, Pratt IS, Baur LA, Flood V, Morley B. Association between food marketing exposure and adolescents’ food choices and eating behaviors. Appetite 2012; 58:1-5. [DOI: 10.1016/j.appet.2011.09.020] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 09/13/2011] [Accepted: 09/29/2011] [Indexed: 10/17/2022]
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Assessment of diet and physical activity: new tools; old challenges. Public Health Nutr 2011; 14:377-8. [DOI: 10.1017/s1368980011000218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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