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Govindaraju T, Man M, Owen AJ, Carroll M, Borg BM, Smith CL, Gao CX, Brown D, Poland D, Allgood S, Ikin JF, Abramson MJ, McCaffrey TA, Lane TJ. Does diet quality moderate the long-term effects of discrete but extreme PM 2.5 exposure on respiratory symptoms? A study of the Hazelwood coalmine fire. ENVIRONMENTAL RESEARCH 2024; 252:119014. [PMID: 38685296 DOI: 10.1016/j.envres.2024.119014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024]
Abstract
In 2014, a fire at an open cut coalmine in regional Victoria, Australia burned for 6 weeks. Residents of the nearby town of Morwell were exposed to smoke, which included high levels of fine particulate matter (PM2.5). We investigated whether the long-term effects of PM2.5 on respiratory health were moderated by diet quality. A cross-sectional analysis was conducted of data collected 8.5 years after the mine fire from 282 residents of Morwell and 166 residents from the nearby unexposed town of Sale. Primary outcomes were respiratory symptoms. Exposure was coalmine fire-related PM2.5 and diet quality was assessed as Australian Recommended Food Score (ARFS) derived using the Australian Eating Survey (AES). The moderating effect of diet quality on respiratory outcomes associated with PM2.5 was assessed using logistic regression models, adjusting for potential confounders. Diet quality was poor in this sample, with 60% in the lowest category of overall diet quality. Overall diet quality and fruit and vegetable quality significantly attenuated the association between PM2.5 and prevalence of chronic cough and phlegm. Sauce/condiment intake was associated with a greater effect of PM2.5 on COPD prevalence. No other moderating effects were significant. The moderating effects of overall diet quality and vegetable and fruit intake aligned with a priori hypotheses, suggesting potential protective benefits. While more evidence is needed to confirm these findings, improving diets, especially fruit and vegetable intake, may provide some protection against the effects of smoke exposure from fire events.
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Affiliation(s)
- Thara Govindaraju
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Martin Man
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Alice J Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Matthew Carroll
- Monash Rural Health Churchill, Monash University, Churchill, Victoria, Australia
| | - Brigitte M Borg
- Respiratory Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - Catherine L Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Caroline X Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Orygen, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - David Brown
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - David Poland
- Monash Rural Health Churchill, Monash University, Churchill, Victoria, Australia
| | - Shantelle Allgood
- Monash Rural Health Churchill, Monash University, Churchill, Victoria, Australia
| | - Jillian F Ikin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Tyler J Lane
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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Leary M, Skinner JA, Pursey KM, Verdejo-Garcia A, Collins R, Collins C, Hay P, Burrows TL. The effectiveness of the TRACE online nutrition intervention in improving dietary intake, sleep quality and physical activity levels for Australian adults with food addiction: a randomised controlled trial. J Hum Nutr Diet 2024. [PMID: 38652589 DOI: 10.1111/jhn.13312] [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: 12/07/2023] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three-arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian-led telehealth intervention at 3 months. METHODS Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non-core foods were reported. RESULTS The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) -0.0 to 12.9], p = 0.049), non-core foods (-6.4%/day [95% CI -12.9 to 0.0], p = 0.049), sweetened drinks (-1.7%/day [95% CI -2.9 to -0.4], p = 0.013), takeaway foods (-2.3%/day [95% CI -4.5 to -0.1], p = 0.045) and sodium (-478 mg/day [95% CI -765 to -191 mg], p = 0.001). CONCLUSIONS A dietitian-led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change.
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Affiliation(s)
- Mark Leary
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Janelle A Skinner
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Rebecca Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Clare Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, NSW, Australia
- Mental Health Services, South Western Sydney Local Health District, Camden and Campbelltown Hospitals, NSW, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
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3
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Gallo LA, Steane SE, Young SL, de Jersey S, Schoenaker DAJM, Borg DJ, Lockett J, Collins CE, Perkins AV, Kumar S, Clifton VL, Wilkinson SA. Dietary supplements, guideline alignment and biochemical nutrient status in pregnancy: Findings from the Queensland Family Cohort pilot study. MATERNAL & CHILD NUTRITION 2024; 20:e13589. [PMID: 37947159 PMCID: PMC10750014 DOI: 10.1111/mcn.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
In high-income nations, multiple micronutrient (MMN) supplementation during pregnancy is a common practice. We aimed to describe maternal characteristics associated with supplement use and daily dose of supplemental nutrients consumed in pregnancy, and whether guideline alignment and nutrient status are related to supplement use. The Queensland Family Cohort is a prospective, Australian observational longitudinal study. Maternal characteristics, nutrient intake from food and supplements, and biochemical nutrient status were assessed in the second trimester (n = 127). Supplement use was reported by 89% of participants, of whom 91% reported taking an MMN supplement. Participants who received private obstetric care, had private health insurance and had greater alignment to meat/vegetarian alternatives recommendations were more likely to report MMN supplement use. Private obstetric care and general practitioner shared care were associated with higher daily dose of supplemental nutrients consumed compared with midwifery group practice. There was high reliance on supplements to meet nutrient reference values for folate, iodine and iron, but only plasma folate concentrations were higher in MMN supplement versus nonsupplement users. Exceeding the upper level of intake for folic acid and iron was more likely among combined MMN and individual supplement/s users, and associated with higher plasma concentrations of the respective nutrients. Given the low alignment with food group recommendations and potential risks associated with high MMN supplement use, whole food diets should be emphasized. This study confirms the need to define effective strategies for optimizing nutrient intake in pregnancy, especially among those most vulnerable where MMN supplement use may be appropriate.
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Affiliation(s)
- Linda A. Gallo
- School of HealthUniversity of the Sunshine CoastPetrieQLDAustralia
- School of Biomedical SciencesThe University of QueenslandSt LuciaQLDAustralia
| | - Sarah E. Steane
- School of Biomedical SciencesThe University of QueenslandSt LuciaQLDAustralia
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Sophia L. Young
- School of HealthUniversity of the Sunshine CoastPetrieQLDAustralia
| | - Susan de Jersey
- Department of Dietetics and Foodservices, Royal Brisbane and Women's HospitalMetro North Hospital and Health ServiceBrisbaneQLDAustralia
- Centre for Health Services ResearchThe University of QueenslandHerstonQLDAustralia
| | - Danielle A. J. M. Schoenaker
- School of Human Development and Health, Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- MRC Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHSSouthamptonUK
| | - Danielle J. Borg
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Jack Lockett
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNSWAustralia
- Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | | | - Sailesh Kumar
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Vicki L. Clifton
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQLDAustralia
| | - Shelley A. Wilkinson
- School of PharmacyThe University of QueenslandSt LuciaQLDAustralia
- Department of Obstetric MedicineMater Mothers HospitalSouth BrisbaneQLDAustralia
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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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5
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Maneschi K, Geller T, Collins CE, Gordon A, Grech A. Maternal diet quality and nutrient intakes across preconception and pregnancy are not consistent with Australian guidelines: Results from the pilot BABY1000 study. Food Sci Nutr 2023; 11:4113-4123. [PMID: 37457169 PMCID: PMC10345671 DOI: 10.1002/fsn3.3401] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/01/2023] [Accepted: 04/12/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Maternal nutrition has profound and lasting effects on growth and health from infancy into adulthood. The aim of this manuscript was to assess diet quality and nutrient adequacy in preconception and pregnancy in BABY1000 pilot study participants (n = 171). STUDY DESIGN AND METHODS The Australian Eating Survey (AES) Food Frequency Questionnaire was administered to women based in Sydney, Australia, at preconception or 12 weeks' gestation (n = 158), and again at 36 weeks' gestation (n = 99). Primary outcomes were diet quality and nutrient intake. Diet quality was evaluated using the AES diet quality subscale, the Australian Recommended Food Score (ARFS). Nutrient intakes were compared to Australian Nutrient Reference Values. Diet quality and nutrient intakes were not consistent with Australian recommendations. Over 83% of women exceeded the suggested target limits for percentage energy from saturated fat. Median ARFS was 37 at baseline, and 38 in late pregnancy (maximum score 73). Inadequate micronutrient intakes from food were common; no participants met the Estimated Average Requirement for iron, 76%-84% for iodine, 70%-78% for calcium and 44%-50% for folate. Maternal diet quality and nutrient intakes in the current sample are inconsistent with pregnancy recommendations and therefore may not be supporting optimal perinatal or long-term offspring health. Stronger messaging around the importance of prenatal nutrition, prevalence of dietary inadequacy, and availability of reliable support and information specific to nutrition in pregnancy is crucial in supporting women to improve their nutrition both before and during pregnancy.
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Affiliation(s)
- Katie Maneschi
- School of Life and Environmental Sciences, Faculty of ScienceUniversity of SydneyCamperdownNew South WalesAustralia
| | - Taryn Geller
- School of Life and Environmental Sciences, Faculty of ScienceUniversity of SydneyCamperdownNew South WalesAustralia
| | - Clare E. Collins
- School of Health Sciences, Faculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Adrienne Gordon
- Central Clinical School, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
- Charles Perkins CentreUniversity of SydneyCamperdownNew South WalesAustralia
| | - Allison Grech
- Central Clinical School, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
- Charles Perkins CentreUniversity of SydneyCamperdownNew South WalesAustralia
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6
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Ferguson JJA, Austin G, Oldmeadow C, Garg ML. Plant-Based Dietary Patterns and Cardiovascular Disease Risk in Australians: Protocol for a Cross-Sectional Study. Nutrients 2023; 15:2850. [PMID: 37447176 DOI: 10.3390/nu15132850] [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: 06/05/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Plant-based diets (PBDs) emphasise higher intakes of plant foods and lower intakes of animal foods, and they have been associated with reduced cardiovascular morbidity/mortality and lower cardiovascular disease (CVD) risk factors. Evidence is limited regarding the dietary profile, diet quality, and nutritional adequacy of PBDs, including their impact on CVD risk compared with traditional meat-eating diets in Australians. The PBD Study (PBDS) is a cross-sectional study that will recruit 240 adults from the Hunter region (NSW) without known CVD who are habitually consuming vegan (no animal flesh/animal products), lacto-ovo vegetarian (dairy and/or eggs only), pesco-vegetarian (fish/seafood only), or semi-vegetarian (minimal animal flesh) diets or are a regular meat-eater. To investigate dietary profile, diet quality, nutritional adequacy, and CVD risk, questionnaires (medical history, demographics, and physical activity), blood samples (biomarkers), physical measures (anthropometry, blood pressure, body composition, and bone density), and dietary intake (food frequency questionnaire and diet history) will be collected. One-way ANOVA and Kruskal-Wallis tests will compare the CVD risk and other quantitative measures, and Chi-square or Fisher's Exact tests will be used for qualitative data. Directed acyclic graphs will determine the confounding variables, and linear regression and mediation analyses will account for the confounders and estimate the effect of dietary patterns on CVD risk. p-values will be adjusted using the Benjamini-Hochberg method to control the False Discovery Rate to 5%.
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Affiliation(s)
- Jessica J A Ferguson
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
| | - Grace Austin
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW 2308, Australia
| | - Manohar L Garg
- Nutraceuticals Research Program, School of Biomedical Sciences & Pharmacy, University of Newcastle, 305C Medical Science Building, Callaghan, NSW 2308, Australia
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Grech AM, Kizirian N, Lal R, Zankl A, Birkner K, Nasir R, Muirhead R, Sau-Harvey R, Haghighi MM, Collins C, Holmes A, Skilton M, Simpson S, Gordon A. Cohort profile: the BABY1000 pilot prospective longitudinal birth cohort study based in Sydney, Australia. BMJ Open 2023; 13:e068275. [PMID: 37290940 PMCID: PMC10255277 DOI: 10.1136/bmjopen-2022-068275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 05/23/2023] [Indexed: 06/10/2023] Open
Abstract
PURPOSE The health of parents prior to conception, a woman's health during pregnancy and the infant's environment across their first months and years collectively have profound effects on the child's health across the lifespan. Since there are very few cohort studies in early pregnancy, gaps remain in our understanding of the mechanisms underpinning these relationships, and how health may be optimised. 'BABY1000', a pilot prospective longitudinal birth cohort study, aims to (1) identify factors before and during pregnancy and early life that impact longer-term health and (2) assess the feasibility and acceptability of study design to inform future research. PARTICIPANTS Participants were based in Sydney, Australia. Women were recruited at preconception or 12 weeks' gestation, and data were collected from them throughout pregnancy and postpartum, their children until the age of 2 years, and dietary information from a partner (if able) at the last study visit. The pilot aimed to recruit 250 women. However, recruitment ceased earlier than planned secondary to limitations from the COVID-19 pandemic and the final number of subjects was 225. FINDINGS TO DATE Biosamples, clinical measurements and sociodemographic/psychosocial measures were collected using validated tools and questionnaires. Data analysis and 24-month follow-up assessments for children are ongoing. Key early findings presented include participant demographics and dietary adequacy during pregnancy. The COVID-19 pandemic and associated public health and research restrictions affected recruitment of participants, follow-up assessments and data completeness. FUTURE PLANS The BABY1000 study will provide further insight into the developmental origins of health and disease and inform design and implementation of future cohort and intervention studies in the field. Since the BABY1000 pilot was conducted across the COVID-19 pandemic, it also provides unique insight into the early impacts of the pandemic on families, which may have effects on health across the lifespan.
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Affiliation(s)
- Allison Marie Grech
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Nathalie Kizirian
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Ravin Lal
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Angelika Zankl
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Karin Birkner
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Reeja Nasir
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Roslyn Muirhead
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Rachelle Sau-Harvey
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Marjan Mosalman Haghighi
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Clare Collins
- The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, The University of Newcastle, New Lambton, New South Wales, Australia
| | - Andrew Holmes
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
- Faculty of Science, School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Skilton
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Stephen Simpson
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
| | - Adrienne Gordon
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
- The University of Sydney Charles Perkins Centre, Sydney, New South Wales, Australia
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8
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Asher RC, Clarke ED, Bucher T, Shrewsbury VA, Roberts S, Collins CE. Impact and evaluation of an online culinary nutrition course for health, education and industry professionals to promote vegetable knowledge and consumption. J Hum Nutr Diet 2023; 36:967-980. [PMID: 36321462 PMCID: PMC10947242 DOI: 10.1111/jhn.13109] [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: 06/29/2022] [Accepted: 10/16/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Poor diet, including inadequate vegetable intake, is a leading risk factor for noncommunicable disease. Culinary and nutrition education provided to trainee and practising health and education professionals is an emerging strategy to promote improved dietary intake, including vegetable consumption. We evaluated the impact and feasibility of an online culinary medicine and nutrition (CM/CN) short course for health, education and vegetable industry professionals. The course aimed to improve participants' skills and confidence to prepare vegetables, knowledge of evidence-based nutrition information and recommendations for improving vegetable consumption and diet quality. METHODS A pre-post study consisting of two separate groups participating in two course rounds recruited practising professionals (n = 30) working in health; community, adult and/or culinary education; and the vegetable industry. Evaluation assessed diet quality, vegetable consumption barriers, cooking and food skill confidence, nutrition knowledge and process measures. RESULTS Seventeen participants (68%) completed the programme. Pre- to postintervention statistically significant increases in vegetables (M 1.3, SD 2.2), fruit (M 1.6, SD 3.1), and breads and cereal (M 1.1, SD 1.7) intakes were observed. Statistically significant increases and large effect sizes for mean food skill confidence scores (M 8.9, SD 15.4, Cohen's d 0.56) and nutrition knowledge scores (M 6.2, SD 15.4, Cohen's d 0.83) were also observed pre- to postintervention. CONCLUSIONS The short online course was feasible and improved diet quality, food skill confidence and nutrition knowledge. Online CM/CN education for practising professionals represents a promising area of research. Future research involving a larger study sample and a more rigorous study design such as a randomised control trial is warranted.
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Affiliation(s)
- Roberta C. Asher
- School of Health Sciences, College of HealthMedicine and WellbeingCallaghanAustralia
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | - Erin D. Clarke
- School of Health Sciences, College of HealthMedicine and WellbeingCallaghanAustralia
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | - Tamara Bucher
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
- School of Environmental and Life Sciences, College of EngineeringScience and EnvironmentCallaghanAustralia
| | - Vanessa A. Shrewsbury
- School of Health Sciences, College of HealthMedicine and WellbeingCallaghanAustralia
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | | | - Clare E. Collins
- School of Health Sciences, College of HealthMedicine and WellbeingCallaghanAustralia
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
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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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10
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Tehan PE, Burrows T, Hawes MB, Linton C, Norbury K, Peterson B, Walsh A, White D, Chuter VH. Factors influencing diabetes-related foot ulcer healing in Australian adults: A prospective cohort study. Diabet Med 2023; 40:e14951. [PMID: 36054775 PMCID: PMC10087534 DOI: 10.1111/dme.14951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Diabetes-related foot ulceration (DFU) is a common limb-threatening condition, which is complex and subsequently challenging to manage. The aim of this study was to determine the contribution of a range of clinical and social factors to the healing of diabetes-related foot ulceration in an Australian population. RESEARCH DESIGN AND METHODS This was a prospective cohort study of individuals with diabetes-related foot ulceration (DFU). Age, sex, medical history, medications, dietary supplementation (e.g. vitamin C intake) and smoking history were elicited at baseline. The index of relative socio-economic disadvantage (IRSD) was calculated. The Australian Eating Survey and International Physical Activity Questionnaire-short were administered. Wound history, size, grade, time to healing and infection were captured and monitored over 6 months. Logistic regression was performed to determine the relationship between healing and diet quality, toe systolic pressure, wound size at, IRSD, infection and previous amputation. RESULTS A total of 117 participants were included. The majority were male n = 96 (82%), socio-economically disadvantaged (mean IRSD 965, SD 60), and obese (BMI 36 kg/m2 , SD 11) with a long history of diabetes (20 years, SD 11). Wounds were predominantly neuropathic (n = 85, 73%) and classified 1A (n = 63, 54%) on the University of Texas wound classification system with few infections (n = 23, 16%). Dietary supplementation was associated with 4.36 increased odds of healing (95% 1.28-14.84, p = 0.02), and greater levels of socio-economic advantage were also associated with increased odds of healing (OR 1.01, 95% CI 1.01-1.02, p = 0.03). CONCLUSIONS In this cohort study of predominantly neuropathic, non-infected DFU, individuals who had greater levels of socio-economic advantage had significantly greater odds of DFU healing. Diet quality was poor in most participants, with individuals taking supplementation significantly more likely to heal.
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Affiliation(s)
- Peta Ellen Tehan
- Department of Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Allied Health, Monash University, Clayton, Victoria, Australia
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Morgan Brian Hawes
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare Linton
- Gosford Hospital High Risk Foot Clinic, Central Coast Local Health District, Gosford, UK
| | - Kate Norbury
- Wyong Hospital High Risk Foot Clinic, Central Coast Local Health District, Gosford, New South Wales, Australia
| | - Benjamin Peterson
- School of Health, Medical and Applied Sciences, CQUniversity Australia, North Rockhampton, Queensland, Australia
| | - Annie Walsh
- Liverpool High Risk Foot Clinic, South Western Sydney Local health District, Kogarah, New South Wales, Australia
| | - Diane White
- John Hunter Hospital High Risk Foot Clinic, Hunter New England Local health District, New Lambton, New South Wales, Australia
| | - Vivienne Helaine Chuter
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
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11
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Wilkinson SA, Schoenaker DAJM, de Jersey S, Collins CE, Gallo L, Rollo M, Borg D, Dekker Nitert M, Truby H, Barrett HL, Kumar S, Clifton V. Exploring the diets of mothers and their partners during pregnancy: Findings from the Queensland Family Cohort pilot study. Nutr Diet 2022; 79:602-615. [PMID: 35355379 PMCID: PMC9790493 DOI: 10.1111/1747-0080.12733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 12/30/2022]
Abstract
AIM Modifiable behaviours during the first 1000 days of life influence developmental trajectories of adult chronic diseases. Despite this, sub-optimal dietary intakes during pregnancy and excessive gestational weight gain are common. Very little is known about partners' dietary patterns and the influence on women's pregnancy dietary patterns. We aimed to examine dietary intake during pregnancy among women and their partners, and gestational weight gain patterns in the Queensland Family Cohort pilot study. METHODS The Queensland Family Cohort is a prospective, observational study piloted at a Brisbane (Australia) tertiary maternity hospital from 2018 to 2021. Participant characteristics, weight gain, dietary and nutrient intake were assessed. RESULTS Data were available for 194 pregnant women and their partners. Poor alignment with Australian Guide to Healthy Eating recommendations was observed. Highest alignment was for fruit (40% women) and meat/alternatives (38% partners) and lowest for breads/cereals (<1% women) and milk/alternatives (13% partners). Fewer women (4.4%-60.3%) than their partners (5.4%-92.3%) met guidelines for all micronutrient intakes from food alone, particularly folic acid, iodine, and iron. Women were more likely to meet daily recommendations for fruit, vegetables, dairy, bread/cereals, and meat/alternatives when their partners also met recommendations. Women with a higher pre-pregnancy body mass index were more likely to gain above recommended weight gain ranges. CONCLUSIONS In this contemporary cohort of pregnant women and their partners, sub-optimal dietary patterns and deficits in some nutrients were common. There is an urgent need for evidence-informed public health policy and programs to improve diet quality during pregnancy due to intergenerational effects.
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Affiliation(s)
- Shelley A. Wilkinson
- Faculty of Health and Behavioural Sciences, School of Human Movements and Nutrition SciencesThe University of QueenslandSt LuciaQueensland
| | - Danielle A. J. M. Schoenaker
- Faculty of Medicine, School of Primary Care, Population Sciences and Medical EducationUniversity of SouthamptonSouthamptonUK,NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK,School of Medical, Indigenous and Health SciencesUniversity of WollongongWollongongNew South WalesAustralia
| | - Susan de Jersey
- Faculty of Medicine, Centre for Clinical Research and Perinatal Research CentreThe University of QueenslandHerstonQueenslandAustralia,Department of Nutrition and Dietetics, Royal Brisbane and Women's HospitalMetro North Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia,Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Linda Gallo
- School of Biomedical SciencesThe University of QueenslandSt LuciaQueenslandAustralia
| | - Megan Rollo
- Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleNewcastleAustralia,Faculty of Health and Medicine, School of Health SciencesUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Danielle Borg
- Queensland Family Cohort, Mater Research InstituteThe University of QueenslandSouth BrisbaneQueenslandAustralia
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular BiosciencesThe University of QueenslandSt LuciaQueenslandAustralia
| | - Helen Truby
- Faculty of Health and Behavioural Sciences, School of Human Movements and Nutrition SciencesThe University of QueenslandSt LuciaQueensland
| | - Helen L. Barrett
- Department of Endocrinology, Mater Health, South Brisbane, Australia; Mater Research InstituteThe University of QueenslandSouth BrisbaneQueenslandAustralia
| | - Sailesh Kumar
- Mater Centre for Maternal Fetal MedicineMater Mothers HospitalBrisbaneQueenslandAustralia,Mater Research InstituteThe University of QueenslandSouth BrisbaneQueenslandAustralia,Faculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Vicki Clifton
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQueenslandAustralia
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12
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Whatnall M, Clarke ED, Adam MTP, Ashton LM, Burrows T, Hutchesson M, Collins CE. Diet Quality of Adolescents and Adults Who Completed the Australian Healthy Eating Quiz: An Analysis of Data over Six Years (2016-2022). Nutrients 2022; 14:nu14194072. [PMID: 36235723 PMCID: PMC9570644 DOI: 10.3390/nu14194072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Diet quality is influenced by demographics and can change over time. This study aimed to (1) compare diet quality among adolescents/adults who completed the online Healthy Eating Quiz (HEQ) by demographic characteristics, and (2) to evaluate change in score over time for repeat completers. HEQ data collected between July 2016 and May 2022 were analysed, including demographics (age, gender, vegetarian status, socio-economic status, number of people main meals are shared with, country), and diet quality calculated using the Australian Recommended Food Score (ARFS) (range 0−73) for respondents aged ≥ 16 years. Differences in ARFS by demographic characteristics and change in score over time, adjusted for age, gender and vegetarian status, were tested by linear regression. The participants (n = 176,075) were predominantly female (70.4%), Australian (62.8%), and aged 18−24 years (27.7%), with 4.0% (n = 7087) repeat completers. Mean ± SD ARFS was 33.9 ± 9.4/73. Results indicate that ARFS was significantly lower among males and significantly higher with increasing age group, higher socio-economic status, in vegetarians, those who shared main meals with others, and those living in Australia (p-values < 0.001). Mean change in ARFS over time (2.3 ± 6.9) was significantly higher for those with lower baseline scores (p < 0.001). Publicly available, brief dietary assessment tools have the potential to improve diet quality at the population level.
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Affiliation(s)
- Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Erin D. Clarke
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Marc T. P. Adam
- School of Information and Physical Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
| | - Lee M. Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Melinda Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
- Correspondence:
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13
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Reay WR, Haslam R, Cairns MJ, Moschonis G, Clarke E, Attia J, Collins CE. Variation in cardiovascular disease risk factors among older adults in the Hunter Community Study cohort; a comparison of diet quality versus polygenic risk score. J Hum Nutr Diet 2022; 35:675-688. [PMID: 35560851 PMCID: PMC9542949 DOI: 10.1111/jhn.13031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/16/2022] [Indexed: 11/29/2022]
Abstract
Background The interplay between cardiovascular disease (CVD) genetic risk indexed by a polygenic risk score (PRS) and diet quality still requires further investigation amongst older adults or those with established or treated CVD. The present study aimed to evaluate the relative contribution of diet quality, measured using the Australian Recommended Food Score (ARFS) and PRS, with respect to explaining variation in plasma lipids CVD outcomes in the Hunter Cohort. Methods The study comprised a secondary analysis of cross‐sectional data from the Hunter Cohort study. Single‐nucleotide polymorphisms from previously derived polygenic scores (PGSs) for three lipid classes were obtained: low‐density lipoprotein, high‐density lipoprotein and triglycerides, as well as PRS for coronary artery disease (CAD) from the PGS catalogue. Regression modelling and odds ratios were used to determine associations between PRS, ARFS and CVD risk. Results In total, 1703 participants were included: mean ± SD age 66 ± 7.4 years, 51% female, mean ± SD total ARFS 28.1 ± 8 (out of 74). Total diet quality and vegetable subscale were not significantly associated with measured lipids. By contrast, PGS for each lipid demonstrated a markedly strong, statistically significant correlation with its respective measured lipid. There was a significant association between CAD PRS and 5/6 CVD phenotypes (all except atrial fibrillation), with the largest effect size shown with coronary bypass. Adding dietary intake as a covariate did not change this relationship. Conclusions Lipid PGS explained more variance in measured lipids than diet quality. However, the poor diet quality observed in the current cohort may have limited the ability to observe any beneficial effects. Future research should investigate whether the diet quality of older adults can be improved and also the effect of these improvements on changes in polygenic risk. The Australian Recommended Food Score (ARFS) had little association with lipid and cardiovascular disease (CVD) endpoints. Lipid polygenic score (PGS) explained more variance in measured lipids than diet quality. The lipid PGS was associated with all three lipid parameters and some CVD endpoints, especially high cholesterol. Coronary artery disease polygenic risk score was associated with CVD endpoints angina, coronary bypass, heart attack, high cholesterol and hypertension and some lipid parameters (high‐density lipoprotein cholesterol).
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Affiliation(s)
- William R Reay
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Rebecca Haslam
- Hunter Medical Research Institute, New Lambton, NSW, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle Callaghan, NSW, Australia
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Erin Clarke
- Hunter Medical Research Institute, New Lambton, NSW, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle Callaghan, NSW, Australia
| | - John Attia
- Hunter Medical Research Institute, New Lambton, NSW, Australia.,School of Population Health and Medical Practice, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Clare Elizabeth Collins
- Hunter Medical Research Institute, New Lambton, NSW, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle Callaghan, NSW, Australia
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14
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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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15
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Taylor R, Rollo ME, Baldwin JN, Hutchesson M, Aguiar EJ, Wynne K, Young A, Callister R, Collins CE. Evaluation of a Type 2 diabetes risk reduction online program for women with recent gestational diabetes: a randomised trial. Int J Behav Nutr Phys Act 2022; 19:35. [PMID: 35346229 PMCID: PMC8962548 DOI: 10.1186/s12966-022-01275-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/01/2022] [Indexed: 11/28/2022] Open
Abstract
Background To evaluate the preliminary efficacy, feasibility and acceptability of the 3-month Body Balance Beyond (BBB) online program among Australian women with overweight/obesity and recent gestational diabetes mellitus. Methods Women were randomised into either: 1) High Personalisation (HP) (access to ‘BBB’ website, video coaching sessions, text message support); 2) Medium Personalisation (MP) (website and text message support); or 3) Low Personalisation (LP) (website only). Generalised linear mixed models were used to evaluate preliminary efficacy, weight, diet quality, physical activity levels, self-efficacy and quality of life (QoL) at baseline and 3-months. Feasibility was assessed by recruitment and retention metrics and acceptability determined via online process evaluation survey at 3-months. Results Eighty three women were randomised, with 76 completing the study. Self-efficacy scores showed significant improvements in confidence to resist eating in a variety of situations from baseline to 3-months in HP compared to MP and LP groups (P=.03). The difference in mean QoL scores favoured the HP compared to MP and LP groups (P=.03). Half of the women (HP n=17[81%], MP n=12[75%], LP n=9[56%]) lost weight at 3-months. No significant group-by-time effect were reported for other outcomes. Two-thirds of women in the HP group were satisfied with the program overall and 86% would recommend it to others, compared with 25% and 44% in the MP group, and 14% and 36% in the LP group, respectively. Conclusions Video coaching sessions were associated with improvements in QoL scores and self-efficacy, however further refinement of the BBB website and text messages support could improve program acceptability. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000162112, registered 5 February 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01275-3.
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16
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Bullock SL, Miller HM, Ammerman AS, Viera AJ. Comparisons of Four Diet Quality Indexes to Define Single Meal Healthfulness. J Acad Nutr Diet 2022; 122:149-158. [PMID: 34303634 PMCID: PMC8688208 DOI: 10.1016/j.jand.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 05/28/2021] [Accepted: 06/10/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Many dietary indexes exist to evaluate nutrition quality, but few specifically assess the quality of a single meal. OBJECTIVE Our aim was to compare 4 different diet quality indexes in their ability to assess the nutrition quality of single meals. DESIGN This was a secondary analysis of data from the PACE (Effects of Physical Activity Calorie Expenditure) food labeling study (2015-2017). Data were collected in business cafeterias in North Carolina and included photos of lunch trays before consumption from an adult population and serving sizes of each food item. Additional nutrient analysis was conducted to compile macro- and micronutrient data for each food item, in addition to servings provided from each food group. MAIN OUTCOME MEASURES The main outcome was individual meal nutrition quality. Data from the PACE study were used to calculate the scores of the following diet quality indexes: Healthy Eating Index 2015, Dietary Approaches to Stop Hypertension accordance score, Main Meal Quality Index, and Nutrient Rich Foods Index. STATISTICAL ANALYSIS PERFORMED To score the meals, algorithms were created in SAS software, version 9.4, to combine individual foods and beverages into meals and calculate scores according to the individual index components. The total scores for each of the indexes were compared using Spearman correlation coefficients. RESULTS A total of 8,070 observations or "meals" from 379 participants were scored for this study. The scores for each observation varied by index. The Spearman correlation coefficients between the indexes for the total score for all observations ranged from 0.26 to 0.68. The correlation coefficients did not change equally among the indexes when observations were excluded based on predefined criteria for what constitutes a meal. CONCLUSIONS There is wide variability in scores of the 4 diet quality indexes analyzed in this study. In addition, the indexes show weak to moderate correlation, indicating that the appropriateness of the index will depend greatly on the study questions and objectives.
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Affiliation(s)
- Sally L Bullock
- Department of Public Health, Davidson College, Davidson, NC.
| | | | - Alice S Ammerman
- Department of Nutrition, Gillings School of Global Public Health, and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Anthony J Viera
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC
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17
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A Comparison of Diet Quality in a Sample of Rural and Urban Australian Adults. Nutrients 2021; 13:nu13114130. [PMID: 34836385 PMCID: PMC8624345 DOI: 10.3390/nu13114130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 01/22/2023] Open
Abstract
The diet quality of rural Australians is under researched. Characterising disparities in diet quality between rural and urban populations may inform targeted interventions in at- risk groups. A cross-sectional study aimed to determine the relationship between diet quality, rurality and sociodemographic characteristics in a sample of Australian adults. Participants were recruited at rural and regional events between 2017 and 2020, in New South Wales, Australia. Diet quality was measured using the Healthy Eating Quiz or Australian Eating Survey to generate an Australian Recommended Food Score (ARFS). ARFS was compared by rurality and sociodemographic characteristics using multivariate regression. Participants (n = 247; 53% female) had a mean ± SD ARFS of 34.5 ± 9.0. There was no significant effect of rurality on ARFS (β-coefficient = −0.4; 95%CI −3.0, 2.3). Compared to participants aged 18–30 years, higher ARFS was evident for those aged 31–50 (β = 5.4; 95%CI 0.3, 10.4), 51–70 (β = 4.4; 95%CI 0.3, 8.5) and >71 years (β = 6.5; 95% CI 1.6–11.4). Compared to those living alone, participants living with a partner (β = 5.2; 95%CI 2.0, 8.4) and families with children (β = 5.6; 95%CI 1.4, 9.8) had significantly higher ARFS. ARFS was significantly lower with each additional self-reported chronic health condition (β = −1.4; 95%CI −2.3, −0.4). Our results indicate that diet quality as defined by the ARFS was classified as ‘getting there’ and that age, living arrangements and chronic health conditions, but not rurality, influenced diet quality in a sample of Australian adults.
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Ashton LM, Morgan PJ, Grounds JA, Young MD, Rayward AT, Barnes AT, Pollock ER, Kennedy SL, Saunders KL, Collins CE. Dietary Outcomes of the 'Healthy Youngsters, Healthy Dads' Randomised Controlled Trial. Nutrients 2021; 13:3306. [PMID: 34684307 PMCID: PMC8541030 DOI: 10.3390/nu13103306] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/10/2021] [Accepted: 09/20/2021] [Indexed: 11/24/2022] Open
Abstract
(1) Background: The effect of fathers on dietary intake in preschool-aged children is under-explored. The aims were to: (i) evaluate the efficacy of a family-based lifestyle intervention, Healthy Youngsters, Healthy Dads, on change in dietary intake in fathers and their preschool-aged children post-intervention (10 weeks) and at 9 months follow-up compared to a waitlist control group and (ii) investigate associations in father-child dietary intakes. (2) Methods: Linear mixed models estimated group-by-time effects for all dietary outcomes, measured by food frequency questionnaires. Cohen's d determined effect sizes, while correlation tests determined associations in father-child dietary intakes. (3) Results: For children, medium group-by-time effects sizes were identified at 10 weeks for sodium intake (d = 0.38) and percentage energy from core foods (d = 0.43), energy-dense, nutrient-poor (EDNP) foods (d = 0.43) and prepacked snacks (d = 0.45). These findings were sustained at 9 months follow-up. For fathers, medium to large, group-by-time effect sizes were identified at 10 weeks for energy intake (d = 0.55), sodium intake (d = 0.64) and percentage energy from core foods (d = 0.49), EDNP foods (d = 0.49), and confectionary (d = 0.36). For all of these dietary variables, except sodium, effects were sustained at 9 months. Moderate to strong associations existed in father-child dietary intakes for some of the dietary variables. (4) Conclusions: Although further research is required, this study provides preliminary support for targeting fathers as agents of change to improve dietary intakes in their preschool-aged children.
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Affiliation(s)
- Lee M. Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (L.M.A.); (C.E.C.)
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- School of Psychology, College of Engineering, Science and Environment, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Philip J. Morgan
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Jacqueline A. Grounds
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Myles D. Young
- School of Psychology, College of Engineering, Science and Environment, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia;
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Anna T. Rayward
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Alyce T. Barnes
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Emma R. Pollock
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Stevie-Lee Kennedy
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Kristen L. Saunders
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.G.); (A.T.R.); (A.T.B.); (E.R.P.); (S.-L.K.); (K.L.S.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia; (L.M.A.); (C.E.C.)
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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Harper CA, Smythe K, Wong VW, Rollo ME, Collins CE. Comparison of pre-diagnosis dietary intake of women with gestational diabetes mellitus to dietary recommendations. Midwifery 2021; 100:103032. [PMID: 34034114 DOI: 10.1016/j.midw.2021.103032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 04/22/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
The prevalence of Gestational Diabetes Mellitus (GDM) increased from 7% to 13.1% between 2013 and 2017 in NSW, Australia. Limited detail has been reported on dietary patterns prior to GDM diagnosis. AIM To evaluate adequacy of micronutrient intakes and contribution of nutrient-dense versus energy-dense, nutrient-poor food groups to total energy. METHOD Dietary intake of women with GDM was assessed over the six months prior to attending the first outpatient nutrition education group using the Australian Eating Survey: food frequency questionnaire with food group serves compared to the Australian Guide to Healthy Eating recommendations. Nutrient intakes compared to Estimated Average Requirements (EARs). Diet quality was evaluated using the Australian Recommended Food Score diet quality index. RESULTS Fifty women with a mean age of 30.8±4.6 years completed the Australian Eating Survey. Mean percentage (SD) energy intake derived from nutrient-dense versus energy-dense, nutrient-poor foods was 66.6% (12.4) and 33.4% (12.4); respectively. Median intakes of iron, calcium, fibre, iodine and folate were below EARs. Median (IQR) total Australian Recommended Food Score was 31(15) from a maximum 73 points. Adherence to the Australian Guide to Healthy Eating recommendations was low, with no participants meeting recommendations for serves of bread and cereals, 92% below dairy and dairy alternatives and 82% below vegetable intake recommendations. CONCLUSIONS Before being diagnosed with GDM, women derive a high percentage of total energy from energy-dense, nutrient-poor foods, have low dietary variety amongst nutrient-dense foods, and sub-optimal intakes of key pregnancy micronutrients. Poor dietary patterns require attention within medical nutrition therapy for GDM in order to optimise nutrition-related health outcomes.
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Affiliation(s)
- Claire A Harper
- Department of Dietetics, Liverpool Hospital, Locked Bag 7103, Liverpool BC, New South Wales 2170, Australia; Diabetes and Endocrine Service, Liverpool Hospital, New South Wales 2170, Australia.
| | - Kylie Smythe
- Department of Dietetics, Liverpool Hospital, Locked Bag 7103, Liverpool BC, New South Wales 2170, Australia; Diabetes and Endocrine Service, Liverpool Hospital, New South Wales 2170, Australia
| | - Vincent W Wong
- Diabetes and Endocrine Service, Liverpool Hospital, New South Wales 2170, Australia
| | - Megan E Rollo
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308, Australia; Priority Research Centre in Physical Activity and Nutrition, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308, Australia; Priority Research Centre in Physical Activity and Nutrition, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308, Australia
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Fenton S, Burrows TL, Collins CE, Holliday EG, Kolt GS, Murawski B, Rayward AT, Stamatakis E, Vandelanotte C, Duncan MJ. Behavioural mediators of reduced energy intake in a physical activity, diet, and sleep behaviour weight loss intervention in adults. Appetite 2021; 165:105273. [PMID: 33945842 DOI: 10.1016/j.appet.2021.105273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/29/2021] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
Reduced energy intake is a major driver of weight loss and evidence suggests that physical activity, dietary, and sleep behaviours interact to influence energy intake. Energy restriction can be challenging to sustain. Therefore to improve intervention efficacy, evaluation of how changes in physical activity, diet, and sleep behaviours mediate reduced energy intake in adults with overweight/obesity who participated in a six-month multiple-behaviour-change weight loss intervention was undertaken. This was a secondary analysis of a 3-arm randomised controlled trial. Adults with body mass index (BMI) 25-40 kg/m2 were randomised to either: a physical activity and diet intervention; physical activity, diet, and sleep intervention; or wait-list control. Physical activity, dietary intake, and sleep was measured at baseline and six-months using validated measures. The two intervention groups were pooled and compared to the control. Structural equation modelling was used to estimate the mediated effects (AB Coefficient) of the intervention on total energy intake. One hundred and sixteen adults (70% female, 44.5y, BMI 31.7 kg/m2) were enrolled and 70% (n = 81) completed the six-month assessment. The significant intervention effect on energy intake at six-months (-1011 kJ/day, 95% CI -1922, -101) was partially mediated by reduced fat intake (AB = -761.12, 95% CI -1564.25, -53.74) and reduced consumption of energy-dense, nutrient-poor foods (AB = -576.19, 95% CI -1189.23, -97.26). In this study, reducing fat intake and consumption of energy-dense, nutrient-poor foods was an effective strategy for reducing daily energy intake in adults with overweight/obesity at six-months. These strategies should be explicitly targeted in future weight loss interventions.
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Affiliation(s)
- Sasha Fenton
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; School of Medicine & Public Health, College of Health, Medicine & Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Tracy L Burrows
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; School of Health Sciences, College of Health, Medicine & Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Elizabeth G Holliday
- School of Medicine & Public Health, College of Health, Medicine & Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Gregory S Kolt
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Beatrice Murawski
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; School of Medicine & Public Health, College of Health, Medicine & Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Anna T Rayward
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; School of Education, College of Human and Social Futures, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Emmanuel Stamatakis
- University of Sydney, Faculty of Medicine and Health, Charles Perkins Centre, School of Health Sciences, New South Wales, Australia.
| | - Corneel Vandelanotte
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Bruce Highway, Rockhampton, QLD, 4702, Australia.
| | - Mitch J Duncan
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; School of Medicine & Public Health, College of Health, Medicine & Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW, 2308, 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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Ashton LM, Rollo ME, Adam M, Burrows T, Shrewsbury VA, Collins CE. Process Evaluation of the 'No Money No Time' Healthy Eating Website Promoted Using Social Marketing Principles. A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073589. [PMID: 33808432 PMCID: PMC8038032 DOI: 10.3390/ijerph18073589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
Background: Reaching and engaging individuals, especially young adults, in web-based prevention programs is challenging. ‘No Money No Time’ (NMNT) is a purpose built, healthy eating website with content and a social marketing strategy designed to reach and engage a young adult (18–34 year olds) target group. The aim of the current study was to conduct a process evaluation of the 12-month social marketing strategy to acquire and engage NMNT users, particularly young adults. Methods: a process evaluation framework for complex interventions was applied to investigate the implementation of the social marketing strategy component, mechanisms of impact and contextual factors. Google Analytics data for the first 12 months of operation (17 July 2019 to 17 July 2020) was evaluated. Results: in year one, 42,413 users from 150+ countries accessed NMNT, with 47.6% aged 18–34 years. The most successful channel for acquiring total users, young adults and return users was via organic search, demonstrating success of our marketing strategies that included a Search Engine Optimisation audit, a content strategy, a backlink strategy and regular promotional activities. For engagement, there was a mean of 4.46 pages viewed per session and mean session duration of 3 min, 35 s. Users clicked a ‘call-to-action’ button to commence the embedded diet quality tool in 25.1% of sessions. The most common device used to access NMNT (63.9%) was smartphone/mobile. Engagement with ‘quick, cheap and healthy recipes’ had the highest page views. Conclusions: findings can inform online nutrition programs, particularly for young adults, and can apply to other digital health programs.
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Affiliation(s)
- Lee M. Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia
- Correspondence: ; Tel.: +61-(2)-4913-8034
| | - Megan E. Rollo
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Marc Adam
- School of Electrical Engineering and Computing, College of Engineering, Science and Environment, University of Newcastle, Callaghan, 2308 Newcastle, Australia;
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Vanessa A. Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
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Maternal Diet Influences Fetal Growth but Not Fetal Kidney Volume in an Australian Indigenous Pregnancy Cohort. Nutrients 2021; 13:nu13020569. [PMID: 33572217 PMCID: PMC7914647 DOI: 10.3390/nu13020569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/15/2022] Open
Abstract
Suboptimal nutrition during pregnancy is recognised as a significant modifiable determinant in the development of chronic disease in offspring in later life. The current study aimed: (i) to assess the dietary intakes of pregnant Indigenous Australian women against national recommendations and (ii) to investigate the associations between maternal nutrition during pregnancy and the growth of the offspring, including kidney development in late gestation in the Gomeroi gaaynggal cohort (n = 103). Maternal dietary intake in the third trimester was assessed using the Australian Eating Survey Food Frequency Questionnaire. Estimated fetal weight (EFW) and kidney size were obtained by ultrasound. Birth weight was retrieved from hospital birth records. Of the five key nutrients for optimal reproductive health (folate, iron, calcium, zinc and fibre), the nutrients with the highest percentage of pregnant women achieving the nutrient reference values (NRVs) were zinc (75.7%) and folate (57.3%), whereas iron was the lowest. Only four people achieved all NRVs (folate, iron, calcium, zinc and fibre) important in pregnancy. Sodium and saturated fat intake exceeded recommended levels and diet quality was low, with a median score of 28 out of 73 points. After adjusting for smoking and pre-pregnancy body mass index, only maternal intake of retinol equivalents and the proportion of energy from nutrient-dense or energy-dense, nutrient-poor (EDNP) foods were associated with fetal growth. EFW decreased by 0.13 g and birth weight decreased by 0.24 g for every µg increase in maternal dietary retinol intake. Interestingly, EFW, but not actual birth weight, was positively associated with percentage energy from nutrient dense foods and negatively associated with percentage energy from EDNP foods. Dietary supplement usage was associated with increased birthweight, most significantly iron and folate supplementation. Current dietary intakes of pregnant Australian women from this cohort do not align with national guidelines. Furthermore, current findings show that maternal retinol intake and diet composition during pregnancy can influence fetal growth, but not fetal kidney growth in late gestation. Strategies that aim to support and optimise nutrient intakes of Indigenous pregnant women are urgently needed. Future studies with long-term follow-up of the children in the current cohort to assess renal damage and blood pressure are imperative.
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Lower Vegetable Variety and Worsening Diet Quality Over Time Are Associated With Higher 15-Year Health Care Claims and Costs Among Australian Women. J Acad Nutr Diet 2021; 121:655-668. [PMID: 33487591 DOI: 10.1016/j.jand.2020.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 11/30/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The relationship between diet quality and health care costs is unclear. OBJECTIVE The aim of this study was to investigate the relationship between baseline diet quality and change in diet quality over time, with 15-year cumulative health care claims/costs. DESIGN Data from a longitudinal cohort study were analyzed. PARTICIPANTS/SETTING Data for survey 3 (2001) (n = 7,868) and survey 7 (2013) (n = 6,349 both time points) from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health were analyzed. MAIN OUTCOME MEASURES Diet quality was assessed using the Australian Recommended Food Score (ARFS). Fifteen-year cumulative Medicare Benefits Schedule (Australia's universal health care coverage) data were reported by baseline ARFS quintile and category of diet quality change ("diet quality worsened" [ARFS change ≤ -4 points], "remained stable" [-3 ≤ change in ARFS ≤3 points], or "improved" [ARFS change ≥4 points]). STATISTICAL ANALYSES Linear regression analyses were conducted adjusting for area of residence, socioeconomic status, lifestyle factors, and private health insurance status. RESULTS Consuming a greater variety of vegetables at baseline but fewer fruit and dairy products was associated with lower health care costs. For every 1-point increment in the ARFS vegetable subscale, women made 3.3 (95% CI, 1.6-5.0) fewer claims and incurred AU$227 (95% CI, AU$104-350 [US$158; 95% CI, US$72-243]) less in costs. Women whose diet quality worsened over time made more claims (median, 251 claims; quintile 1, quintile 3 [Q1; Q3], 168; 368 claims) and incurred higher costs (AU$15,519; Q1; Q3, AU$9,226; AU$24,847 [US$10,793; Q1; Q3, US$6,417; US$17,281]) compared with those whose diet quality remained stable (median, 236 claims [Q1; Q3, 158; 346 claims], AU$14,515; Q1; Q3, AU$8,539; AU$23,378 [US$10,095; Q1; Q3, US$5,939; US$16,259]). CONCLUSIONS Greater vegetable variety was associated with fewer health care claims and costs; however, this trend was not consistent across other subscales. Worsening diet quality over 12 years was linked with higher health care claims and costs.
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Diet Quality Indices Used in Australian and New Zealand Adults: A Systematic Review and Critical Appraisal. Nutrients 2020; 12:nu12123777. [PMID: 33317123 PMCID: PMC7763901 DOI: 10.3390/nu12123777] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022] Open
Abstract
Distilling the complexity of overall diet into a simple measure or summative score by data reduction methods has become a common practice in nutritional epidemiology. Recent reviews on diet quality indices (DQI) have highlighted the importance of sound construction criteria and validation. The aim of this current review was to identify and critically appraise all DQI used within Australian and New Zealand adult populations. Twenty-five existing DQI were identified by electronic searching in Medline and hand searching of reference lists. DQI were constructed based on the respective national dietary guidelines and condition-specific recommendations. For preferable features of DQI, six captured the dimensions of adequacy, moderation and balance; five had a nested structure; 12 consisted of foods, food groups and nutrients; 11 used metric scoring systems and most of those with metric scales used normative cutoff points. Food frequency questionnaires, either alone or with other methods, were the most common dietary assessment method used in 20 DQI. For evaluation of DQI, construct validity and relative validity are reported. Based on our critical appraisal, Dietary Guideline Index (DGI), Dietary Guideline Index-2013 (DGI-2013), Total Diet Score (TDS), Healthy Eating Index for Australian Adults-2013 (HEIFA-2013), and Aussie-Diet Quality Index (Aussie-DQI) were the preferred DQI used in Australian adults according to dimension, indicator selection, scoring criteria and evaluation. Further work is needed to enhance the construction of all Australian and New Zealand DQI, especially in terms of dimension and structure, for alignment with recommended construction criteria.
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Szewczyk Z, Weaver N, Rollo M, Deeming S, Holliday E, Reeves P, Collins C. Maternal Diet Quality, Body Mass Index and Resource Use in the Perinatal Period: An Observational Study. Nutrients 2020; 12:nu12113532. [PMID: 33213030 PMCID: PMC7698580 DOI: 10.3390/nu12113532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022] Open
Abstract
The impact of pre-pregnancy obesity and maternal diet quality on the use of healthcare resources during the perinatal period is underexplored. We assessed the effects of body mass index (BMI) and diet quality on the use of healthcare resources, to identify whether maternal diet quality may be effectively targeted to reduce antenatal heath care resource use, independent of women’s BMI. Cross-sectional data and inpatient medical records were gathered from pregnant women attending publicly funded antenatal outpatient clinics in Newcastle, Australia. Dietary intake was self-reported, using the Australian Eating Survey (AES) food frequency questionnaire, and diet quality was quantified from the AES subscale, the Australian Recommended Food Score (ARFS). Mean pre-pregnancy BMI was 28.8 kg/m2 (range: 14.7 kg/m2–64 kg/m2). Mean ARFS was 28.8 (SD = 13.1). Higher BMI was associated with increased odds of caesarean delivery; women in obese class II (35.0–39.9 kg/m2) had significantly higher odds of caesarean delivery compared to women of normal weight, (OR = 2.13, 95% CI 1.03 to 4.39; p = 0.04). Using Australian Refined Diagnosis Related Group categories for birth admission, the average cost of the birth admission was $1348 more for women in the obese class II, and $1952 more for women in the obese class III, compared to women in a normal BMI weight class. Higher ARFS was associated with a small statistically significant reduction in maternal length of stay (RR = 1.24, 95% CI 1.00, 1.54; p = 0.05). There was no evidence of an association between ARFS and mode of delivery or “midwifery-in-the-home-visits”.
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Affiliation(s)
- Zoe Szewczyk
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (N.W.); (S.D.); (E.H.); (P.R.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Correspondence: (Z.S.); (C.C.)
| | - Natasha Weaver
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (N.W.); (S.D.); (E.H.); (P.R.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Megan Rollo
- School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Simon Deeming
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (N.W.); (S.D.); (E.H.); (P.R.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Elizabeth Holliday
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (N.W.); (S.D.); (E.H.); (P.R.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Penny Reeves
- Hunter Medical Research Institute (HMRI) Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (N.W.); (S.D.); (E.H.); (P.R.)
- School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Clare Collins
- School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Correspondence: (Z.S.); (C.C.)
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Clarke ED, Rollo ME, Collins CE, Wood L, Callister R, Philo M, Kroon PA, Haslam RL. The Relationship between Dietary Polyphenol Intakes and Urinary Polyphenol Concentrations in Adults Prescribed a High Vegetable and Fruit Diet. Nutrients 2020; 12:nu12113431. [PMID: 33182344 PMCID: PMC7695339 DOI: 10.3390/nu12113431] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/12/2022] Open
Abstract
Urinary polyphenol metabolites are potential biomarkers of dietary polyphenol intake. The current study aims to evaluate associations between total diet, vegetable and fruit polyphenol intakes with urinary polyphenol metabolite concentrations in a sample of adults prescribed a diet rich in vegetables and fruit. Thirty-four participants completed a 10-week pre-post study. Participants were asked to consume Australian recommended daily vegetable and fruit serves and attend measurement sessions at baseline and at weeks 2 and 10. Two 24-h diet recalls were collected at each time-point and polyphenol intakes were calculated using the Phenol-Explorer database. Spot urine samples, collected at each time-point, were analyzed for 15 polyphenol metabolites using liquid chromatography-mass spectroscopy. Spearman’s correlation analyzes assessed the strength of relationships between urinary and dietary polyphenols. Linear mixed models were used to investigate relationships between polyphenol excretion and intake. Total urinary polyphenols were significantly correlated with total polyphenol intakes at week 10 (rs = 0.47) and fruit polyphenols at week 2 (rs = 0.38). Hippuric acid was significantly correlated with vegetable polyphenols at baseline (rs = 0.39). Relationships were identified between individual polyphenol metabolites and vegetable and fruit polyphenols. Linear mixed model analyzes identified that for every 1 mg increase in polyphenol intakes, urinary polyphenol excretion increased by 16.3 nmol/g creatinine. Although the majority of relationships were not sufficiently strong or consistent at different time-points, promising relationships were observed between total urinary polyphenols and total polyphenol intakes, and hippuric acid and vegetable polyphenols.
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Affiliation(s)
- Erin D. Clarke
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (E.D.C.); (M.E.R.); (C.E.C.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Megan E. Rollo
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (E.D.C.); (M.E.R.); (C.E.C.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Clare E. Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (E.D.C.); (M.E.R.); (C.E.C.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Lisa Wood
- Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, Rankin Park, NSW 2287, Australia;
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Mark Philo
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UQ, UK; (M.P.); (P.A.K.)
| | - Paul A. Kroon
- Quadram Institute Bioscience, Norwich Research Park, Norwich NR4 7UQ, UK; (M.P.); (P.A.K.)
| | - Rebecca L. Haslam
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (E.D.C.); (M.E.R.); (C.E.C.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW 2308, Australia;
- Correspondence:
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The Feasibility and Preliminary Efficacy of an eHealth Lifestyle Program in Women with Recent Gestational Diabetes Mellitus: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197115. [PMID: 32998401 PMCID: PMC7579575 DOI: 10.3390/ijerph17197115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 01/04/2023]
Abstract
Self-administered eHealth interventions provide a potential low-cost solution for reducing diabetes risk. The aim of this pilot randomised controlled trial (RCT) was to evaluate the feasibility, including recruitment, retention, preliminary efficacy (primary outcome) and acceptability (secondary outcome) of the "Body Balance Beyond" eHealth intervention in women with previous gestational diabetes mellitus (GDM). Women with overweight/obesity who had recent GDM (previous 24 months) were randomised into one of three groups: 1) high personalisation (access to "Body Balance Beyond" website, individual telehealth coaching via video call by a dietitian and exercise physiologist, and text message support); 2) low personalisation (website only); or 3) waitlist control. To evaluate preliminary efficacy, weight (kg), glycosylated hemoglobin, type A1C (HbA1c), cholesterol (total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL)), diet quality and moderate-vigorous physical activity were analysed at baseline and at 3 and 6 months using generalised linear mixed models. To investigate acceptability, process evaluation was conducted at 3 and 6 months. Of the 327 potential participants screened, 42 women (mean age 33.5 ± 4.0 years and BMI 32.4 ± 4.3 kg/m2) were randomised, with 30 (71%) completing the study. Retention at 6 months was 80%, 54% and 79% for high personalisation, low personalisation and waitlist control, respectively (reasons: personal/work commitments, n = 4; started weight-loss diet, n = 1; pregnant, n = 1; resources not useful, n = 1; and not contactable, n = 5). No significant group-by-time interactions were observed for preliminary efficacy outcomes, with the exception of HDL cholesterol, where a difference favoured the low personalisation group relative to the control (p = 0.028). The majority (91%) of women accessed the website in the first 3 months and 57% from 4-6 months. The website provided useful information for 95% and 92% of women at 3 and 6 months, respectively, although only a third of women found it motivating (30% and 25% at 3 and 6 months, respectively). Most women agreed that the telehealth coaching increased their confidence for improving diet (85%) and physical activity (92%) behaviours, although fewer women regarded the text messages as positive (22% and 31% for improving diet and physical activity, respectively). The majority of women (82% at 3 months and 87% at 6 months) in the high personalisation group would recommend the program to other women with GDM. Recruiting and retaining women with a recent diagnosis of GDM is challenging. The "Body Balance Beyond" website combined with telehealth coaching via video call is largely acceptable and useful for women with recent GDM. Further analysis of the effect on diabetes risk reduction in a larger study is needed.
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Haslam RL, Pezdirc K, Truby H, Attia J, Hutchesson M, Burrows T, Callister R, Hides L, Bonevski B, Kerr DA, Lubans D, Kirkpatrick S, Rollo M, McCaffrey T, Collins CE. Investigating the Efficacy and Cost-Effectiveness of Technology-Delivered Personalized Feedback on Dietary Patterns in Young Australian Adults in the Advice, Ideas, and Motivation for My Eating (Aim4Me) Study: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e15999. [PMID: 32441659 PMCID: PMC7275255 DOI: 10.2196/15999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 01/17/2023] Open
Abstract
Background Web-based health interventions may be easier to access and time efficient relative to face-to-face interventions and therefore may be the most appropriate mode to engage young adults. Objective This study aims to investigate the impact of 3 different levels of personalized web-based dietary feedback and support on changes in diet quality. Methods The Advice, Ideas, and Motivation for My Eating (Aim4Me) study is a 12-month assessor-blinded, parallel-group randomized controlled trial evaluating the impact of 3 levels of web-based feedback on diet quality, measured using the Australian Recommended Food Score (ARFS). Participants (N=2570) will primarily be recruited via web-based methods and randomized to 1 of 3 groups. Group 1 (control) will receive the Healthy Eating Quiz, a web-based dietary assessment tool that generates a brief feedback report on diet quality. Individuals randomized to this group can use the brief feedback report to make positive dietary changes. Group 2 will receive the Australian Eating Survey, a web-based dietary assessment tool that generates a comprehensive feedback report on diet quality as well as macro- and micronutrient intake. Group 2 will use the comprehensive feedback report to assist in making positive dietary changes. They will also have access to the Aim4Me website with resources on healthy eating and tools to set goals and self-monitor progress. Group 3 will receive the same intervention as Group 2 (ie, the comprehensive feedback report) in addition to a tailored 30-min video consultation with an accredited practicing dietitian who will use the comprehensive feedback report to assist individuals in making positive dietary changes. The self-determination theory was used as the framework for selecting appropriate website features, including goal setting and self-monitoring. The primary outcome measure is change in diet quality. The completion of questionnaires at baseline and 3, 6, and 12 months will be incentivized with a monetary prize draw. Results As of December 2019, 1277 participants have been randomized. Conclusions The web-based delivery of nutrition interventions has the potential to improve dietary intake of young adults. However, the level of support required to improve intake is unknown. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618000325202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374420 International Registered Report Identifier (IRRID) DERR1-10.2196/15999
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Affiliation(s)
- Rebecca L Haslam
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Kristine Pezdirc
- Faculty of Health and Medicine, University of Newcastle, North Sydney, Australia
| | - Helen Truby
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - John Attia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Melinda Hutchesson
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Tracy Burrows
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Deborah A Kerr
- School of Public Health, Faculty of Health Sciences, Curtin Institute of Technology, Perth, Australia
| | - David Lubans
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, Australia
| | - Sharon Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Megan Rollo
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Tracy McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
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Skinner JA, Garg ML, Dayas CV, Burrows TL. Is weight status associated with peripheral levels of oxytocin? A pilot study in healthy women. Physiol Behav 2019; 212:112684. [PMID: 31629767 DOI: 10.1016/j.physbeh.2019.112684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 09/09/2019] [Accepted: 09/16/2019] [Indexed: 12/13/2022]
Abstract
The neuropeptide oxytocin is best known for its role during parturition and the milk-let down reflex. Recent evidence identifies a role for oxytocin in eating behaviour. After oxytocin administration, caloric intake is reduced with stronger inhibitory effects in individuals with obesity. Whether the experience of visual food cues affects secretion or circulating levels of oxytocin is unknown. This pilot study had three aims: 1) to measure fasting appetite hormones with a focus on plasma oxytocin concentrations; 2) determine whether healthy vs. hyperpalatable visual food cues differentially altered plasma oxytocin; and 3) assess whether appetite hormone responses to healthy vs. hyperpalatable food images depended on weight or food addiction status. Eighteen healthy women of varying weight status, with/without self-reported food addiction were recruited. Study participants completed a set of standardised questionnaires, including Yale Food Addiction Scale, and attended a one-off experimental session. Blood was collected before and after viewing two sets of food images (healthy and hyperpalatable foods). Participants were randomly allocated in a crossover design to view either healthy images or hyperpalatable foods first. A positive correlation between BMI and plasma oxytocin was found (r2 = 0.32, p = 0.021) at baseline. Oxytocin levels were higher, and cholecystokinin levels lower, in food addicted (n = 6) vs. non-food addicted females (p = 0.015 and p<0.001, respectively). There were no significant changes (p>0.05) in plasma oxytocin levels in response to either healthy or hyperpalatable food images. Given that endogenous oxytocin administration tends to suppress eating behaviour; these data indicate that oxytocin receptor desensitization or oxytocin resistance may be important factors in the pathogenesis of obesity and food addiction. However, further studies in larger samples are needed to determine if peripheral oxytocin is responsive to visual food cues.
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Affiliation(s)
- Janelle A Skinner
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan NSW 2308, Australia
| | - Manohar L Garg
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia
| | - Christopher V Dayas
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia
| | - Tracy L Burrows
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan NSW 2308, Australia; Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan NSW 2308, Australia.
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31
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Ashton LM, Pezdirc KB, Hutchesson MJ, Rollo ME, Collins CE. Is Skin Coloration Measured by Reflectance Spectroscopy Related to Intake of Nutrient-Dense Foods? A Cross-Sectional Evaluation in Australian Young Adults. Nutrients 2017; 10:nu10010011. [PMID: 29295504 PMCID: PMC5793239 DOI: 10.3390/nu10010011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 11/16/2022] Open
Abstract
The current study examines associations between the dietary intakes of nutrient-dense foods, measured using brief indices and skin coloration, measured using reflectance spectroscopy in young adults. This is a cross-sectional analysis of 148 young Australian males and females (55% female) aged 18 to 25 years. Dietary intake was assessed using a validated food frequency questionnaire, with responses used to calculate two dietary indices: (i) the Australian Recommended Food Score (ARFS); and (ii) the Fruit And Vegetable VAriety Score (FAVVA). Skin yellowness was measured at three body locations using reflectance spectroscopy. Associations were assessed using Spearman's correlation coefficients, regression analysis, and agreement using weighted kappa (Kw). Significant, moderate correlations were found between skin yellowness and diet index scores for the ARFS (ρ = 0.30, p < 0.001) and FAVVA score (ρ = 0.39, p < 0.001). These remained significant after adjustment for confounders (total fat intake, sex, skin lightness) and for agreement based on categorical rankings. Results suggest that measurement of skin coloration by reflectance spectroscopy can be used as an indicator of overall dietary quality and variety in young adults. Further exploration in diverse populations is required.
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Affiliation(s)
- Lee M Ashton
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Kristine B Pezdirc
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Megan E Rollo
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan 2308, Australia.
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