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Hoffmann L, Egert S, Allgaier J, Kohlenberg-Müller K. Review of Validated Methods to Evaluate Diet History in Diet Therapy and Counselling: An Overview and Analysis of Screeners Based on Food-Based Dietary Guidelines. Nutrients 2023; 15:4654. [PMID: 37960307 PMCID: PMC10647684 DOI: 10.3390/nu15214654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Evidence-based dietetic practice calls for systematically developed assessment methods for nutritional assessment in dietetic counselling and therapy (DCT). Screeners can provide a quick and easy way to determine a client's diet quality and contribute to quality assurance in DCT. The aim of this systematic review was to give a comparative overview of screeners based on national food-based dietary guidelines (FBDGs) and to derive recommendations for developing an FBDG-based screener for DCT. The literature search in PubMed (MEDLINE), embase and Web of Science was conducted between May and July 2022, and updated in March 2023, in accordance with the consensus-based standards for the selection of health measurement instruments (COSMIN). The analysis focused on characteristics of screener design and measurement properties for screener testing. In total, 13 studies on 11 screeners based on FBDGs were included; 7 screeners were targeted to DCT. The content and scoring of screeners were based on the corresponding national FBDGs. The validity and/or reliability of screeners were investigated in 11 studies; responsiveness was not tested for any screener and practicality was considered in all studies. Based on the screeners reviewed, a systematic rationale to develop, enhance and test screeners based on national FBDGs was established.
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Affiliation(s)
- Laura Hoffmann
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
| | - Sarah Egert
- Institute of Nutritional and Food Science, Nutritional Physiology, University of Bonn, 53115 Bonn, Germany;
| | - Joachim Allgaier
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
| | - Kathrin Kohlenberg-Müller
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, 36037 Fulda, Germany; (J.A.); (K.K.-M.)
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Herbert J, Schumacher T, Brown LJ, Collins CE. Developing a telehealth medical nutrition therapy (MNT) service for adults living in rural Australia at risk of cardiovascular disease: An intervention development study. J Hum Nutr Diet 2023; 36:1782-1794. [PMID: 37344944 PMCID: PMC10947187 DOI: 10.1111/jhn.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/26/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Receiving medical nutrition therapy (MNT) from an accredited practising dietitian (APD) can reduce diet-related cardiovascular disease (CVD) risk factors. However, people living in rural areas of Australia experience barriers to accessing dietitians because of their remote location. Telehealth has the potential to improve dietetic access in rural areas; however, there is limited research into the development and delivery of telehealth MNT interventions specific to these areas. The present study describes the development of the Healthy Rural Hearts (HealthyRHearts) telehealth MNT intervention, which was developed as a part of the HealthyRHearts randomised control trial, set in primary care practices in rural areas of the Hunter New England and Central Coast Primary Health Network. The aim of HealthyRHearts is to improve diet-related risk factors for CVD in rural adults at moderate to high CVD risk using a telehealth MNT intervention delivered by an APD. METHODS The study describes the development of the HealthyRHearts telehealth MNT intervention, using the 14-item GUIDance for rEporting of intervention Development (GUIDED) checklist and the Template for Intervention Description and Replication (TIDieR) framework to guide description. RESULTS HealthyRHearts is a complex intervention that aims to translate a telehealth MNT intervention for CVD prevention into rural and remote primary care settings. The intervention is designed to be implemented across multiple sites of varying characteristics and needs, with the ability to accommodate individual complexities within the rural context and target population. Participants are adults aged 45-75 years who are assessed as moderate to high risk of CVD by their general practitioner (GP). Consenting participants are referred to the intervention by their GPs and receive five telehealth MNT consultations with an APD over 6-months. APDs are trained in the intervention protocol including intervention materials, resources and behaviour change counselling strategies. CONCLUSION Using the GUIDED and TIDieR frameworks to guide description of the HealthyRHearts intervention development process facilitates detailed description of decision-making pathways for each element of the intervention design. The comprehensive description of the intervention development process for HealthyRHearts is intended to facilitate replication, iteration and optimisation of the intervention for rural contexts.
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Affiliation(s)
- Jaimee Herbert
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, Callaghan, NSW, Australia
- Department of Rural Health, University of Newcastle, North Tamworth, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Tracy Schumacher
- Department of Rural Health, University of Newcastle, North Tamworth, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Leanne J Brown
- Department of Rural Health, University of Newcastle, North Tamworth, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Callaghan, NSW, Australia
| | - Clare E Collins
- School of Health Sciences (Nutrition and Dietetics), University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, Callaghan, NSW, Australia
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Schumacher TL, Herbert J, May J, Ramanathan S, Brown LJ, Guppy M, Williams A, Rollo ME, Attia J, Collins CE. HealthyRHearts - reducing cholesterol in rural adults via telehealth-based medical nutrition therapy: protocol for a cluster randomised controlled trial. BMC Cardiovasc Disord 2023; 23:297. [PMID: 37308886 DOI: 10.1186/s12872-023-03306-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/16/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Few randomised controlled trials specifically focus on prevention in rural populations. Cardiovascular disease (CVD) contributes to approximately one quarter of deaths in Australia. Nutrition is a key component affecting many risk factors associated with CVD, including hypercholesterolaemia. However, access to medical nutrition therapy (MNT) is limited for people living in rural areas, potentially exacerbating inequities related to health outcomes. Telehealth services present an opportunity to improve MNT access and address healthcare disparities for rural populations. The present study aims to evaluate feasibility, acceptability, and cost-effectiveness of a telehealth MNT CVD intervention program in lowering CVD risk over 12-months in regional and rural primary health care settings. METHODS/DESIGN A cluster randomised controlled trial set in rural and regional general practices in NSW, Australia, and their consenting patients (n = 300 participants). Practices will be randomised to either control (usual care from their General Practitioner (GP) + low level individualised dietetic feedback) or intervention groups (usual care from their GP + low level individualised dietetic feedback + telehealth MNT intervention). Telehealth consultations will be delivered by an Accredited Practising Dietitian (APD), with each intervention participant scheduled to receive five consultations over a 6-month period. System-generated generic personalised nutrition feedback reports are provided based on completion of the Australian Eating Survey - Heart version (AES-Heart), a food frequency questionnaire. Eligible participants must be assessed by their GP as at moderate (≥ 10%) to high (> 15%) risk of a CVD event within the next five years using the CVD Check calculator and reside in a regional or rural area within the Hunter New England Central Coast Primary Health Network (HNECC PHN) to be eligible for inclusion. Outcome measures are assessed at baseline, 3, 6 and 12 months. The primary outcome is reduction in total serum cholesterol. Evaluation of the intervention feasibility, acceptability and cost-effective will incorporate quantitative, economic and qualitative methodologies. DISCUSSION Research outcomes will provide knowledge on effectiveness of MNT provision in reducing serum cholesterol, and feasibility, acceptability, and cost-effectiveness of delivering MNT via telehealth to address CVD risk in rural regions. Results will inform translation to health policy and practice for improving access to clinical care in rural Australia. TRIAL REGISTRATION This trial is registered at anzctr.org.au under the acronym HealthyRHearts (Healthy Rural Hearts), registration number ACTRN12621001495819.
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Affiliation(s)
- Tracy L Schumacher
- Department of Rural Health, University of Newcastle, Newcastle, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jaimee Herbert
- Department of Rural Health, University of Newcastle, Newcastle, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Jennifer May
- Department of Rural Health, University of Newcastle, Newcastle, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Shanthi Ramanathan
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Health Economics and Impact, Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Leanne J Brown
- Department of Rural Health, University of Newcastle, Newcastle, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Michelle Guppy
- School of Rural Medicine, University of New England, Armidale, Australia
| | - Annabelle Williams
- Hunter New England Central Coast Primary Health Network, Broadmeadow, Australia
| | - Megan E Rollo
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
- Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Clare E Collins
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia.
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia.
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Haslam RL, Baldwin JN, Pezdirc K, Truby H, Attia J, Hutchesson MJ, Burrows T, Callister R, Hides L, Bonevski B, Kerr DA, Kirkpatrick SI, Rollo ME, McCaffrey TA, Collins CE. Efficacy of technology-based personalised feedback on diet quality in young Australian adults: results for the advice, ideas and motivation for my eating (Aim4Me) randomised controlled trial. Public Health Nutr 2023; 26:1293-1305. [PMID: 36755380 PMCID: PMC10346011 DOI: 10.1017/s1368980023000253] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/01/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Web-based dietary interventions could support healthy eating. The Advice, Ideas and Motivation for My Eating (Aim4Me) trial investigated the impact of three levels of personalised web-based dietary feedback on diet quality in young adults. Secondary aims were to investigate participant retention, engagement and satisfaction. DESIGN Randomised controlled trial. SETTING Web-based intervention for young adults living in Australia. PARTICIPANTS 18-24-year-olds recruited across Australia were randomised to Group 1 (control: brief diet quality feedback), Group 2 (comprehensive feedback on nutritional adequacy + website nutrition resources) or Group 3 (30-min dietitian consultation + Group 2 elements). Australian Recommended Food Score (ARFS) was the primary outcome. The ARFS subscales and percentage energy from nutrient-rich foods (secondary outcomes) were analysed at 3, 6 and 12 months using generalised linear mixed models. Engagement was measured with usage statistics and satisfaction with a process evaluation questionnaire. RESULTS Participants (n 1005, 85 % female, mean age 21·7 ± 2·0 years) were randomised to Group 1 (n 343), Group 2 (n 325) and Group 3 (n 337). Overall, 32 (3 %), 88 (9 %) and 141 (14 %) participants were retained at 3, 6 and 12 months, respectively. Only fifty-two participants (15 % of Group 3) completed the dietitian consultation. No significant group-by-time interactions were observed (P > 0·05). The proportion of participants who visited the thirteen website pages ranged from 0·6 % to 75 %. Half (Group 2 = 53 %, Group 3 = 52 %) of participants who completed the process evaluation (Group 2, n 111; Group 3, n 90) were satisfied with the programme. CONCLUSION Recruiting and retaining young adults in web-based dietary interventions are challenging. Future research should consider ways to optimise these interventions, including co-design methods.
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Affiliation(s)
- Rebecca L Haslam
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jennifer N Baldwin
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Kristine Pezdirc
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Deborah A Kerr
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, Australia
| | | | - Megan E Rollo
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
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Tang JS, Haslam RL, Ashton LM, Fenton S, Collins CE. Gender differences in social desirability and approval biases, and associations with diet quality in young adults. Appetite 2022; 175:106035. [PMID: 35405222 DOI: 10.1016/j.appet.2022.106035] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 01/05/2023]
Abstract
Social desirability and approval biases can influence self-report of diet, contributing to inaccurate assessment. Biases may be influenced by sex. This study examined gender differences in social desirability and approval, and diet quality in young adults, and relationships between social biases and diet quality. Data from 1003 young adults participating in the Advice, Ideas and Motivation for My Eating trial, median age 21.7 years, BMI 24.7 kg/m2 were included. Biases were measured using Marlowe-Crowne Social Desirability Scale Short-Form, Martin Larsen Approval Motivation Scale, and diet quality using the Australian Recommended Food Score. Pearson chi-square, t-test and Wilcoxon tests evaluated gender differences and Spearman's rank-order tested strengths of correlations between biases and diet quality. Social desirability did not differ by gender, however females reported higher social approval scores than males (p = 0.009). Among females, there was a positive correlation between social desirability and diet quality (p = 0.002), and between social approval and dairy sub-scale (p < 0.001); and a negative correlation between social approval and vegetable subscale (p = 0.045). Among males there were no correlations between social desirability or social approval and overall diet quality. Social approval may be more common in females and influence self-reported diet. To address bias and mis-reporting errors, future studies should account for participants' social desirability and/or social approval status, especially among young adult females. Further research is needed to explore gender differences in social desirability and approval in young adults, and associations between social biases and diet quality.
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Affiliation(s)
- Jei Sey Tang
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Rebecca L Haslam
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Lee M Ashton
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; College of Human and Social Futures, School of Education, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Sasha Fenton
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Clare E Collins
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
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Baldwin JN, Haslam RL, Clarke E, Attia J, Hutchesson MJ, Rollo ME, Callister R, Burrows T, Truby H, McCaffrey TA, Hides L, Bonevski B, Kerr DA, Kirkpatrick SI, Collins CE. Eating Behaviors and Diet Quality: A National Survey of Australian Young Adults. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:397-405. [PMID: 35534098 DOI: 10.1016/j.jneb.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate associations between eating behavior constructs (social eating, perceived competence, habit automaticity, self-determined motivation) and diet quality among young adults. DESIGN Cross-sectional analysis. PARTICIPANTS Young adults (n = 1,005; mean age, 21.7 ± 2.0 years; 85% female) enrolled in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study. MAIN OUTCOME MEASURES Four eating behavior measures collected via online surveys: Social Eating Scale, Perceived Competence in Healthy Eating Scale, Self-Report Behavioral Automaticity Index, and Regulation of Eating Behaviors scales. Diet quality was assessed using the Australian Recommended Food Score (ARFS) and percentage energy from energy-dense, nutrient-poor (EDNP) foods. ANALYSIS Multivariate linear regression investigating associations between eating behavior measures (independent variables) and ARFS and EDNP foods (dependent variables), adjusting for sociodemographic and lifestyle confounders. RESULTS Greater perceived competence in healthy eating and behavioral automaticity for consuming healthy foods, limiting EDNP food intake, and higher intrinsic motivation, integrated regulation, and identified regulation of eating behaviors were associated with higher ARFS and lower percentage energy EDNP foods (P < 0.001). Greater self-reported social influence on eating behaviors was associated with higher ARFS (P = 0.01). Higher amotivation was associated with greater % energy from EDNP foods (P < 0.001). CONCLUSIONS AND IMPLICATIONS Perceived competence, habit automaticity, and self-determined motivation are determinants of diet quality in young adults. These findings support the development of interventions that promote healthy eating habits by focusing on eating behavior constructs and evaluating their use in improving diet quality.
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Affiliation(s)
- Jennifer N Baldwin
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Rebecca L Haslam
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Erin Clarke
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Megan E Rollo
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia; School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics & Food, Monash University, Clayton, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Billie Bonevski
- Discipline of Public Health, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia
| | - Deborah A Kerr
- Curtin School of Population Health and Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON. Canada
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia.
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Taylor RM, Haslam RL, Truby H, Attia J, Hutchesson MJ, Burrows T, Callister R, Hides L, Bonevski B, Kirkpatrick S, Ashton L, Collins CE. Do disparities exist between national food group recommendations and the dietary intakes of contemporary young adults? Nutr Diet 2021; 78:524-534. [PMID: 34169615 DOI: 10.1111/1747-0080.12694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 11/25/2022]
Abstract
AIM The aim of this study was to compare food and nutrient intakes of young Australian adults (18-24 years) to national recommendations as per the Australian Guide to Healthy Eating and Nutrient Reference Values. METHODS Dietary intake of 18 to 24 year olds (n = 1005) participating in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study was self-reported using the 120-item Australian Eating Survey Food Frequency Questionnaire. Median daily servings of Australian Guide to Healthy Eating food groups, macronutrients and micronutrients were compared to recommendations in the Australian Guide to Healthy Eating and Nutrient Reference Values using t-tests or Kruskal-Wallis tests (P < .05). RESULTS None of the young adults met all Australian Guide to Healthy Eating recommendations. The highest adherence [% meeting recommendations, median (IQR)] was for meat/alternatives [38%, 2.1(1.8)] and fruit [32%, 1.5(1.6)], with <25% meeting remaining food-group recommendations. The majority (76%) exceeded recommendations for the consumption of discretionary foods [4.0(3.3) vs 0-3 serves] and 81% had excessive saturated fat intakes. Young adults who met all key Nutrient Reference Values (dietary fibre, folate, iodine, iron, calcium and zinc) (18%) consumed a higher number of serves of all food groups, including discretionary foods. CONCLUSIONS Dietary intakes of contemporary young adults do not align with Australian Guide to Healthy Eating targets, while meeting Nutrient Reference Values is achieved by a higher consumption of all food groups, including discretionary foods. Strategies to increase consumption of nutrient-dense foods in young adults to achieve the Nutrient Reference Values are warranted.
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Affiliation(s)
- Rachael M Taylor
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Rebecca L Haslam
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - John Attia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Melinda J Hutchesson
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Tracy Burrows
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, School of Biomedical Sciences and Pharmacy, Callaghan, New South Wales, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Sharon Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Lee Ashton
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
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The relationship between urinary polyphenol metabolites and dietary polyphenol intakes in young adults. Br J Nutr 2021; 127:589-598. [PMID: 33899720 DOI: 10.1017/s0007114521001343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Spot urinary polyphenols have potential as a biomarker of polyphenol-rich food intakes. The aim of this study is to explore the relationship between spot urinary polyphenols and polyphenol intakes from polyphenol-rich food sources. Young adults (18-24 years old) were recruited into a sub-study of an online intervention aimed at improving diet quality. Participants' intake of polyphenols and polyphenol-rich foods was assessed at baseline and 3 months using repeated 24-h recalls. A spot urine sample was collected at each session, with samples analysed for polyphenol metabolites using LC-MS. To assess the strength of the relationship between urinary polyphenols and dietary polyphenols, Spearman correlations were used. Linear mixed models further evaluated the relationship between polyphenol intakes and urinary excretion. Total urinary polyphenols and hippuric acid (HA) demonstrated moderate correlation with total polyphenol intakes (rs = 0·29-0·47). HA and caffeic acid were moderately correlated with polyphenols from tea/coffee (rs = 0·26-0·46). Using linear mixed models, increases in intakes of total polyphenols or polyphenols from tea/coffee or oil resulted in a greater excretion of HA, whereas a negative relationship was observed between soya polyphenols and HA, suggesting that participants with higher intakes of soya polyphenols had a lower excretion of HA. Findings suggest that total urinary polyphenols may be a promising biomarker of total polyphenol intakes foods and drinks and that HA may be a biomarker of total polyphenol intakes and polyphenols from tea/coffee. Caffeic acid warrants further investigation as a potential biomarker of polyphenols from tea/coffee.
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Rollo ME, Haslam RL, Collins CE. Impact on Dietary Intake of Two Levels of Technology-Assisted Personalized Nutrition: A Randomized Trial. Nutrients 2020; 12:E3334. [PMID: 33138210 PMCID: PMC7693517 DOI: 10.3390/nu12113334] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023] Open
Abstract
Advances in web and mobile technologies have created efficiencies relating to collection, analysis and interpretation of dietary intake data. This study compared the impact of two levels of nutrition support: (1) low personalization, comprising a web-based personalized nutrition feedback report generated using the Australian Eating Survey® (AES) food frequency questionnaire data; and (2) high personalization, involving structured video calls with a dietitian using the AES report plus dietary self-monitoring with text message feedback. Intake was measured at baseline and 12 weeks using the AES and diet quality using the Australian Recommended Food Score (ARFS). Fifty participants (aged 39.2 ± 12.5 years; Body Mass Index 26.4 ± 6.0 kg/m2; 86.0% female) completed baseline measures. Significant (p < 0.05) between-group differences in dietary changes favored the high personalization group for total ARFS (5.6 points (95% CI 1.3 to 10.0)) and ARFS sub-scales of meat (0.9 points (0.4 to 1.6)), vegetarian alternatives (0.8 points (0.1 to 1.4)), and dairy (1.3 points (0.3 to 2.3)). Additional significant changes in favor of the high personalization group occurred for proportion of energy intake derived from energy-dense, nutrient-poor foods (-7.2% (-13.8% to -0.5%)) and takeaway foods sub-group (-3.4% (-6.5% to 0.3%). Significant within-group changes were observed for 12 dietary variables in the high personalization group vs one variable for low personalization. A higher level of personalized support combining the AES report with one-on-one dietitian video calls and dietary self-monitoring resulted in greater dietary change compared to the AES report alone. These findings suggest nutrition-related web and mobile technologies in combination with personalized dietitian delivered advice have a greater impact compared to when used alone.
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Affiliation(s)
- Megan E. Rollo
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Rebecca L. Haslam
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Clare E. Collins
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
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