ORCID Profile
0000-0001-8805-385X
Current Organisation
University of Tasmania
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Publisher: MDPI AG
Date: 21-09-2023
Publisher: MDPI AG
Date: 28-07-2023
DOI: 10.3390/NU15153370
Abstract: Despite widespread acknowledgement of the multifarious health benefits of physical activity (PA), including prevention and control of obesity, an overwhelming majority of children and adolescents are not sufficiently active to realise such benefits. Concurrently, young people are significantly impacted by the rapid global rise of sedentarism, and suboptimal dietary patterns during key phases of development. Regrettably, the cumulative effects of unhealthy behaviours during the growing years predisposes young people to the early stages of several chronic conditions, including obesity. Clear and consistent approaches are urgently needed to improve eating and activity behaviours of children and adolescents. Based on existing evidence of “best bets” to prevent and control obesity and its comorbidities, we present a set of non-negotiable strategies as a ‘road map’ to achieving prevention and improving the health of children and adolescents.
Publisher: MDPI AG
Date: 08-09-2023
DOI: 10.3390/NU15183908
Publisher: Wiley
Date: 18-06-2023
DOI: 10.1002/HPJA.763
Abstract: The capacity of communities to develop effective obesity prevention initiatives varies and should be a focus for obesity prevention intervention planning and investment. This research aimed at engaging and consulting local community stakeholders to identify determinants, needs, strategic priorities and capacity to act on overweight and obesity prevention in North‐West (NW) Tasmania. A series of semi‐structured interviews and thematic analyses was implemented to explore the knowledge, insights, experiences and attitudes of stakeholders. Mental health and obesity were identified as major concerns and were often reported to share similar determinants. This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information). This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information). Broad upstream socio‐economic, cultural and environmental determinants underpin the conditions by which the local community develops overweight/obesity and/or health and wellbeing outcomes. Including stakeholder consultations as a significant technique within a comprehensive plan of action aimed at achieving a sustainable, long‐term strategy for obesity prevention and/or health promotion, should be considered in future programs.
Publisher: Elsevier BV
Date: 11-2022
Publisher: Elsevier BV
Date: 2022
Publisher: MDPI AG
Date: 16-10-2023
Publisher: Public Library of Science (PLoS)
Date: 22-03-2022
DOI: 10.1371/JOURNAL.PONE.0264744
Abstract: Many factors can negatively impact perinatal outcomes, including inappropriate gestational weight gain (GWG). Despite having the greatest potential to influence maternal and infant health, there is a lack of consensus regarding the GWG consistent with a healthy pregnancy. To date, GWG in Northern Tasmania remains understudied. We investigated how maternal pre-pregnancy body mass index (BMI) is related to weight gain during pregnancy and weight retention post-partum, and how maternal pre-pregnancy BMI is related to the mode of delivery. Approximately 300 Tasmanian mothers (n = 291 for mode of delivery and n = 282 for GWG) were included in this study. Analysis of variance and chi square tests were conducted to assess differences in BW of mothers across BMI categories and differences between categorical variables respectively. Based on pre-pregnancy BMI, mothers were assigned to one of three groups, with healthy weight ( kg m -2 ), with overweight (25–29.9 kg m -2 ), or with obesity ( kg m -2 ). Pre-pregnancy BMI and body weight (BW) were significantly associated (p .001) with post-partum BW at 3 and 6 months. Only 25% of mothers with a normal weight BMI, 34% with overweight and 13% with obesity, achieved the Institute of Medicine (IOM) recommendation for GWG. Interestingly, a number of women in our cohort lost weight during gestation (1.5, 9 and 37% in , 25–29.9 and kg m -2 groups, respectively). Further, women with obesity showed the lowest level of BW fluctuation and retained less weight post-partum. The highest number of caesarean sections were observed in mothers who exceeded GWG recommendations. Most mothers either exceeded or failed to achieve IOM recommendations for GWG. To improve the generalisability of these findings, this study should be replicated in a larger representative s le of the Tasmanian maternal population.
Publisher: JMIR Publications Inc.
Date: 17-02-2023
DOI: 10.2196/41280
Abstract: Social and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management, and public health. Accordingly, social prescribing (SP) has received increased attention in recent times. The r ant global prevalence of obesity indicates that the customary, reductionistic, and disease-oriented biomedical approach to health service delivery is inadequate/ineffective at arresting the spread and mitigating the damaging consequences of the condition. There is an urgent need to shift the focus from reactive downstream disease-based treatments to more proactive, upstream, preventive action. In essence, this requires more effort to affect the paradigm shift from the traditional “biomedical approach of care” to a “biopsychosocial model” required to arrest the increasing prevalence of obesity. To this end, an SP approach, anchored in systems thinking, could be an effective means of moderating prevalence and consequences of obesity at a community level. The proposed SP intervention has the following three key objectives: (1) build a sustainable program for Circular Head based on SP, peer education, and health screening to minimize the incidence of obesity and related lifestyle diseases (2) increase service and workforce connectivity and collaboration and initiate the introduction of new services and activities for obesity prevention and community health promotion and (3) enhance health and well-being and minimize preventable adverse health outcomes of obesity and related lifestyle diseases through enhancement of food literacy and better nutrition, enhancement of physical literacy and habitual personal activity levels, and improvement of mental health, community connectedness, and reduction of social isolation. This paper describes a prospective SP strategy aimed at obesity prevention in Circular Head, a local government area in Northwest (NW) Tasmania. SP is a prominent strategy used in the Critical Age Periods Impacting the Trajectory of Obesogenic Lifestyles Project, which is an initiative based in NW Tasmania focused on assessing obesity prevention capacity. A social prescription model that facilitates the linkage of primary health screening with essential health care, education, and community resources through a dedicated “navigator” will be implemented. Four interlinked work packages will be implemented as part of the initial plan with each either building on existing resources or developing new initiatives. A multimethod approach to triangulate insights from quantitative and qualitative research that enables the assessment of impact on in iduals, community groups, and the health care system will be implemented within the initial pilot phase of the project. Literature is replete with rhetoric advocating complex system approaches to curtail obesity. However, real-life ex les of whole-of-systems interventions operationalized in ways that generate relevant evidence or effective policies are rare. The erse approach for primary prevention of obesity-related lifestyle diseases and strategies for improvement of health and well-being described in this instance will contribute toward closing this evidence gap. PRR1-10.2196/41280
Publisher: Elsevier BV
Date: 04-2023
Publisher: MDPI AG
Date: 27-02-2023
DOI: 10.3390/NU15051190
Abstract: School environments can create healthy settings to foster children’s health and well-being. School gardening is gaining popularity as an intervention for healthier eating and increased physical activity. We used a systematic realist approach to investigate how school gardens improve health and well-being outcomes for school-aged children, why, and in what circumstances. The context and mechanisms of the specific school gardening interventions (n = 24) leading to positive health and well-being outcomes for school-aged children were assessed. The impetus of many interventions was to increase fruit and vegetable intake and address the prevention of childhood obesity. Most interventions were conducted at primary schools with participating children in Grades 2 through 6. Types of positive outcomes included increased fruit and vegetable consumption, dietary fiber and vitamins A and C, improved body mass index, and improved well-being of children. Key mechanisms included embedding nutrition-based and garden-based education in the curriculum experiential learning opportunities family engagement and participation authority figure engagement cultural context use of multi-prong approaches and reinforcement of activities during implementation. This review shows that a combination of mechanisms works mutually through school gardening programs leading to improved health and well-being outcomes for school-aged children.
Publisher: JMIR Publications Inc.
Date: 20-07-2022
Abstract: ocial and behavioral determinants of health are increasingly recognized as central to effective person-centered intervention in clinical practice, disease management, and public health. Accordingly, social prescribing (SP) has received increased attention in recent times. The r ant global prevalence of obesity indicates that the customary, reductionistic, and disease-oriented biomedical approach to health service delivery is inadequate/ineffective at arresting the spread and mitigating the damaging consequences of the condition. There is an urgent need to shift the focus from reactive downstream disease-based treatments to more proactive, upstream, preventive action. In essence, this requires more effort to affect the paradigm shift from the traditional “biomedical approach of care” to a “biopsychosocial model” required to arrest the increasing prevalence of obesity. To this end, an SP approach, anchored in systems thinking, could be an effective means of moderating prevalence and consequences of obesity at a community level. he proposed SP intervention has the following three key objectives: (1) build a sustainable program for Circular Head based on SP, peer education, and health screening to minimize the incidence of obesity and related lifestyle diseases (2) increase service and workforce connectivity and collaboration and initiate the introduction of new services and activities for obesity prevention and community health promotion and (3) enhance health and well-being and minimize preventable adverse health outcomes of obesity and related lifestyle diseases through enhancement of food literacy and better nutrition, enhancement of physical literacy and habitual personal activity levels, and improvement of mental health, community connectedness, and reduction of social isolation. his paper describes a prospective SP strategy aimed at obesity prevention in Circular Head, a local government area in Northwest (NW) Tasmania. SP is a prominent strategy used in the Critical Age Periods Impacting the Trajectory of Obesogenic Lifestyles Project, which is an initiative based in NW Tasmania focused on assessing obesity prevention capacity. A social prescription model that facilitates the linkage of primary health screening with essential health care, education, and community resources through a dedicated “navigator” will be implemented. Four interlinked work packages will be implemented as part of the initial plan with each either building on existing resources or developing new initiatives. multimethod approach to triangulate insights from quantitative and qualitative research that enables the assessment of impact on in iduals, community groups, and the health care system will be implemented within the initial pilot phase of the project. iterature is replete with rhetoric advocating complex system approaches to curtail obesity. However, real-life ex les of whole-of-systems interventions operationalized in ways that generate relevant evidence or effective policies are rare. The erse approach for primary prevention of obesity-related lifestyle diseases and strategies for improvement of health and well-being described in this instance will contribute toward closing this evidence gap. > RR1-10.2196/41280
Publisher: Research Square Platform LLC
Date: 20-03-2023
DOI: 10.21203/RS.3.RS-2648249/V1
Abstract: Background Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically erse countries. Methods We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1176 (49% female) infants from birth to 6-mo-of-age (Australia, India, and South Africa n = 468), 3 to 24-mo-of-age (Brazil, Pakistan, South Africa, and Sri Lanka n = 925), and derived fat mass (FM), fat mass (FMI), and fat-free mass (FFMI) indices. Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WFLZ) z-scores were computed. Sex differences were assessed using a t-test, and country differences using a one-way analysis of variance. We further compared subs les of children who tracked the median for HAZ (-0.25 HAZ + 0.25), and those who did not. Results HAZ tracked well between 0 and 6-mo, but less so between 3 and 24-mo. The stunting prevalence peaked at 10.3% for males and 7.8% for females, at 24-mo. By 24-mo, girls had greater FMI (10%) than boys. There were significant differences in FFM (South African and Sri Lankan males) and FM (South African females and Sri Lankan males) by 24-mo-of-age, between infants whose length tracked the WHO median and those that did not. Conclusion In a multi-country s le representing more ideal maternal conditions, body composition was heterogeneous, potentially due to ethnic, breastfeeding, and dietary-pattern differences. Tracking the median of the WHO standard reduced FFM heterogeneity but not FM, suggesting that other factors may influence adiposity.
Publisher: Springer Science and Business Media LLC
Date: 14-10-2021
Publisher: Springer Science and Business Media LLC
Date: 19-05-2021
DOI: 10.1186/S13006-021-00389-X
Abstract: This report evaluated the breastfeeding status in a Tasmanian cohort and its effects on infant and maternal anthropometry and body composition. An observational-cohort analysis of self-reported feeding data from 175 Tasmanian mother-baby dyads (recruited via in-person contact between September 2017 and October 2019), was executed. Only mothers who were ≥ 18 years of age, who had a singleton pregnancy and were able to speak and understand English, were included in the study. Infants outside a gestational age range between 37 + 0 and 41 + 6 weeks were excluded. Infant (using Air Displacement Plethysmography) and maternal body composition was assessed at 0, 3 and 6 months. Analysis of variance with relevant statistical corrections were utilised for cross-sectional and longitudinal comparisons between non-exclusively breastfed (neBF) and exclusively breastfed (eBF) groups. Fat-free mass was significantly higher [ t = 2.27, df = 98, P = 0.03, confidence interval (CI) 0.03, 0.48] in neBF infants at 6 months (5.59 ± 0.59 vs 5.33 ± 0.50 kg) despite a higher mean fat-free mass in eBF infants at birth (2.89 ± 0.34 vs 3.01 ± 0.35 kg). Weak evidence for different fat mass index trajectories was observed for eBF and neBF infants in the first 6 months of life (ANOVA, F = 2.42, df = 1.9, P = 0.09) with an inversion in fat mass index levels between 3 and 6 months. Body Mass Index (BMI) trajectories were significantly different in eBF and neBF mothers through pregnancy and the first 6 months postpartum (ANOVA, F = 5.56, df = 30.14, P = 0.01). Compared with eBF mothers, neBF mothers retained significantly less weight (t = − 2.754, df = 158, P = 0.02, CI -6.64, − 1.09) at 3 months (0.68 ± 11.69 vs 4.55 ± 6.08 kg) postpartum. Prevalence for neBF was incrementally higher in mothers with a normal BMI compared to mothers with obesity, and mothers who underwent surgical or medical intervention during birth were less likely to exclusively breastfeed. Infants with different feeding patterns may display varying growth patterns in early life and sustained breastfeeding can contribute to greater postpartum maternal weight loss.
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJPO-2021-001123
Abstract: This research evaluated (1) differences in body size and composition of Tasmanian infants at birth and 3 and 6 months postpartum compared with WHO child growth standards and (2) body composition changes in Tasmanian infants at the extremes of the weight-for-length (WFL) spectrum. Observational study. A hospital in Northern Tasmania, Australia. 315 healthy infants (~90% Caucasian) born between 2017 and 2019 in Tasmania. Body composition and anthropometric measures at 0, 3 and 6 months. Growth characteristics at birth and growth trajectories from 0 to 6 months were compared against WHO child growth standards for 0–2 years. Overall, growth of Tasmanian infants in the first 6 months of life was similar to the global prescriptive standards. Trajectories of fat mass (FM) and fat-free mass (FFM) accrual in infants from the extremes of the size spectrum appear to converge at the 6-month time point. Infants in the lower extremity demonstrated the most precipitous accrual in percentage FM (and the steepest decline in percentage FFM), compared with all other infants. No significant deviations of growth were observed in Tasmanian infants from 0 to 6 months in comparison to the WHO prescriptive growth standards. Infants below the third percentile WFL showed the most precipitous increase in FM accretion. Periodic comparisons local infants with global standards will enable identification of significant deviations from optimal growth patterns.
Publisher: American Physiological Society
Date: 02-2022
DOI: 10.1152/AJPREGU.00276.2021
Abstract: Although the patterns of response within the sympathoadrenal medullary (SAM) system and hypothalamo-pituitary adrenal (HPA) axis are interesting and important in their own accord, the overall response to acute psychological stress involves reactivity of both pathways. We tested the hypothesis that consideration of the integrated response of these pathways may reveal dysregulation of the stress systems, which is not evident when considering either system alone. Age-matched lean and overweight/obese men were subjected to a Trier Social Stress Test and reactivity of the SAM system (salivary α-amylase, systolic blood pressure, diastolic blood pressure, and heart rate) and the HPA axis (salivary cortisol) were measured. Relative reactivity of SAM system and HPA axis was calculated as the ratio between the measures from each pathway. Although analysis of reactivity of in idual stress pathways showed no evidence of dysfunction in overweight/obese compared with lean men, analysis of HPA/SAM reactivity revealed significantly lower cortisol over systolic blood pressure (CoSBP) and cortisol over diastolic blood pressure (CoDBP) reactivity in overweight/obese compared with lean men. Other measures of HPA/SAM reactivity and all measures of SAM/HPA reactivity were unaltered in overweight/obese compared with lean men. These findings suggest that the cortisol response per unit of blood pressure response is blunted in men with elevated adiposity. Furthermore, these findings support a notion of a coordinated overall approach to activation of the stress pathways with the degree of activation in one pathway being related to the degree of activation in the other.
Publisher: Springer Science and Business Media LLC
Date: 10-08-2023
DOI: 10.1038/S41430-023-01322-7
Abstract: Providing all infants with the best start to life is a universal but challenging goal for the global community. Historically, the size and shape of infants, quantified by anthropometry and commencing with birthweight, has been the common yardstick for physical growth and development. Anthropometry has long been considered a proxy for nutritional status during infancy when, under ideal circumstances, changes in size and shape are most rapid. Developed from data collected in the Multicentre Growth Reference Study (MGRS), WHO Child Growth Standards for healthy infants and children have been widely accepted and progressively adopted. In contrast, and somewhat surprisingly, much less is understood about the ‘quality’ of growth as reflected by body composition during infancy. Recent advances in body composition assessment, including the more widespread use of air displacement plethysmography (ADP) across the first months of life, have contributed to a progressive increase in our knowledge and understanding of growth and development. Along with stable isotope approaches, most commonly the deuterium dilution (DD) technique, the criterion measure of total body water (TBW), our ability to quantify lean and fat tissue using a two-compartment model, has been greatly enhanced. However, until now, global reference charts for the body composition of healthy infants have been lacking. This paper details some of the historical challenges associated with the assessment of body composition across the first two years of life, and references the logical next steps in growth assessments, including reference charts.
Publisher: Research Square Platform LLC
Date: 26-06-2023
DOI: 10.21203/RS.3.RS-3018527/V1
Abstract: Background Accurate assessment of body composition during infancy is important, especially for understanding the effects of early growth on later health. This study aimed to develop an anthropometry-based approach to predict body composition in 3–24 month old infants from erse socioeconomic settings and ethnic groups. Methods An observational, longitudinal, prospective, multinational study of infants from birth to 24 months. Body composition was assessed at 3, 6, 9, 12, 18, and 24 months using deuterium dilution (DD) and anthropometry. Linear mixed modelling was utilized to generate sex-specific fat mass(FM) and fat-free mass(FFM) prediction equations. Length(m), weight-for-length(kg/m), triceps and subscapular skinfolds and Asian ethnicity were used as predictor variables. The study s le consisted of 1896(942 measurements from 310 girls) training data sets, 941(441 measurements from 154 girls) validation data sets from Brazil, Pakistan, South Africa and Sri Lanka, and 349(185 measurements from 124 girls) data sets of infants at 6 months from South Africa, Australia and India of external validation group. Results Sex-specific equations for three age categories (3-9 months 10-18 months 19-24 months) were developed and validated and an external validation was performed on the test group. The root mean squared error(RMSE) was similar between validation and test data for assessment of FM and FFM. Root mean squared percentage error(RMSPE) and mean absolute percentage error(MAPE) in validation data were higher for predicting FM but lower for FFM compared to test data. Conclusions Anthropometry-based FFM prediction equations provide acceptable results which have the potential to be developed as a field tool.
No related grants have been discovered for Sisitha Jayasinghe.