Sarah A McNaughton

Understanding the Eating Behaviors of Adolescents: Application of Dietary Patterns Methodology to Behavioral Nutrition Research

Publisher: Elsevier BV

Date: 02-2011

DOI: 10.1016/J.JADA.2010.10.041

Energy intake and dietary patterns in childhood and throughout adulthood and mammographic density: results from a British prospective cohort

Publisher: Springer Science and Business Media LLC

Date: 28-11-2010

DOI: 10.1007/S10552-010-9690-7

A Parent-Focused Intervention to Reduce Infant Obesity Risk Behaviors: A Randomized Trial

Publisher: American Academy of Pediatrics (AAP)

Date: 04-2013

DOI: 10.1542/PEDS.2012-2576

Abstract: To assess the effectiveness of a parent-focused intervention on infants’ obesity-risk behaviors and BMI. This cluster randomized controlled trial recruited 542 parents and their infants (mean age 3.8 months at baseline) from 62 first-time parent groups. Parents were offered six 2-hour dietitian-delivered sessions over 15 months focusing on parental knowledge, skills, and social support around infant feeding, diet, physical activity, and television viewing. Control group parents received 6 newsletters on nonobesity-focused themes all parents received usual care from child health nurses. The primary outcomes of interest were child diet (3 × 24-hour diet recalls), child physical activity (accelerometry), and child TV viewing (parent report). Secondary outcomes included BMI z-scores (measured). Data were collected when children were 4, 9, and 20 months of age. Unadjusted analyses showed that, compared with controls, intervention group children consumed fewer grams of noncore drinks (mean difference = –4.45 95% confidence interval [CI]: –7.92 to –0.99 P = .01) and were less likely to consume any noncore drinks (odds ratio = 0.48 95% CI: 0.24 to 0.95 P = .034) midintervention (mean age 9 months). At intervention conclusion (mean age 19.8 months), intervention group children consumed fewer grams of sweet snacks (mean difference = –3.69 95% CI: –6.41 to –0.96 P = .008) and viewed fewer daily minutes of television (mean difference = –15.97: 95% CI: –25.97 to –5.96 P = .002). There was little statistical evidence of differences in fruit, vegetable, savory snack, or water consumption or in BMI z-scores or physical activity. This intervention resulted in reductions in sweet snack consumption and television viewing in 20-month-old children.

Assessing dietary intake in children and adolescents: Considerations and recommendations for obesity research

Publisher: Informa UK Limited

Date: 02-2011

DOI: 10.3109/17477161003728469

Abstract: Abstract Dietary intake and food habits are important contributors to the obesity epidemic. They are highly modifiable components of energy balance and are usually targeted in both obesity prevention and treatment programs. However, measurement of total diet creates challenges and can convey a large burden in terms of cost, technical expertise, impact on respondents and time. It is not surprising therefore that comprehensive reports of dietary intake in children are uncommon and, when reported, have limitations. The aim of this paper is to guide researchers and practitioners in selecting the most appropriate dietary assessment method for situations involving children and adolescents. This paper presents a summary of the issues to consider when choosing a method, a description of some of the more commonly used dietary assessment methods for young people and a series of case-studies to illustrate the range of circumstances faced when measuring dietary intake. We recommend that researchers consider the specific components of dietary intake addressed in their research and practice, and whether diet should be reported comprehensively or as targeted components. Other considerations include age, cognitive ability, weight status, physical activity level, respondent burden, and reliability and validity in the context of program goals and research questions. A checklist for selecting the appropriate dietary methodology is provided. This guide aims to facilitate the reporting of dietary intake and food habits in the context of obesity using valid and reliable measures, thus contributing to the evidence-base for nutrition policies and programs relating to obesity.

Dietary silicon intake in post-menopausal women

Publisher: Cambridge University Press (CUP)

Date: 11-2005

DOI: 10.1079/BJN20051548

Abstract: Si has been suggested as an essential element, and may be important in optimal bone, skin and cardiovascular health. However, there are few estimates of dietary Si intakes in man, especially in a UK population. Following the development of a UK food composition database for Si, the aim of the present study was to investigate dietary intakes of Si amongst healthy women aged over 60 years and to identify important food sources of Si in their diet. Healthy, post-menopausal female subjects ( years of age n 209) were recruited from the general population around Dundee, Scotland as part of an unrelated randomised controlled intervention study where dietary intake was assessed using a self-administered, semi-quantitative food-frequency questionnaire at five time-points over a 2-year period. Food composition data on the Si content of UK foods was used to determine the Si content of food items on the food-frequency questionnaire. Mean Si intake was 18·6 (sd 4·6) mg and did not vary significantly across the 2 years of investigation. Cereals provided the greatest amount of Si in the diet (about 30%), followed by fruit, beverages (hot, cold and alcoholic beverages combined) and vegetables together these foods provided over 75% about Si intake. Si intakes in the UK appear consistent with those reported previously for elderly women in Western populations, but lower than those reported for younger women or for men.

Role of Dietary Factors in the Development of Basal Cell Cancer and Squamous Cell Cancer of the Skin

Publisher: American Association for Cancer Research (AACR)

Date: 07-2005

DOI: 10.1158/1055-9965.EPI-05-0026

Abstract: The role of dietary factors in the development of skin cancer has been investigated for many years however, the results of epidemiologic studies have not been systematically reviewed. This article reviews human studies of basal cell cancer (BCC) and squamous cell cancer (SCC) and includes all studies identified in the published scientific literature investigating dietary exposure to fats, retinol, carotenoids, vitamin E, vitamin C, and selenium. A total of 26 studies were critically reviewed according to study design and quality of the epidemiologic evidence. Overall, the evidence suggests a positive relationship between fat intake and BCC and SCC, an inconsistent association for retinol, and little relation between β-carotene and BCC or SCC development. There is insufficient evidence on which to make a judgment about an association of other carotenoids with skin cancer. The evidence for associations between vitamin E, vitamin C, and selenium and both BCC and SCC is weak. Many of the existing studies contain limitations, however, and further well-designed and implemented studies are required to clarify the role of diet in skin cancer. Additionally, the role of other dietary factors, such as flavonoids and other polyphenols, which have been implicated in skin cancer development in animal models, needs to be investigated.

Iron status and dietary iron intake of female blood donors

Publisher: Wiley

Date: 22-07-2013

DOI: 10.1111/TRF.12347

Abstract: The aim was to assess iron status and dietary iron intake in a s le of premenopausal female regular and new blood donors. Premenopausal women blood donors were invited to participate. Blood s les were analyzed for serum ferritin and hemoglobin. An iron checklist assessed dietary iron intake. Donors were classified as regular donors or new donors. Twenty-one new donors (mean [SD] age, 28.6 [6.0] years body mass index [BMI], 25.6 [4.5] kg/m(2) ) and 172 regular donors (mean age, 29.4 [5.5] years BMI, 24.7 [3.8] kg/m(2) ) participated. Fifty percent of regular donors and 24% of new donors had depleted iron stores (serum ferritin <15 μg/L difference p = 0.036). Dietary iron intake was higher in regular donors (mean [SE], 12.6 [0.7] mg/day) compared to new donors (9.9 [0.4] mg/day p = 0.006). Eighty-five percent of regular donors and 79% of new donors met the estimated average requirement for iron. Despite the fact that most of these donors had an adequate dietary iron intake, more than half of the blood donors had depleted iron stores. Increasing dietary iron intake through supplements and/or dietary means is expected to be necessary to maintain adequate iron status in this group.

Selenium Content of Australian Foods: A Review of Literature Values

Publisher: Elsevier BV

Date: 04-2002

DOI: 10.1006/JFCA.2002.1047

Home food availability mediates associations between mothers’ nutrition knowledge and child diet

Publisher: Elsevier BV

Date: 12-2013

DOI: 10.1016/J.APPET.2013.07.006

Abstract: Evidence suggests that mothers' nutrition knowledge and home food availability (HFA) are directly and independently associated with children's food intakes. In this study we test the hypothesis that HFA mediates the association between maternal nutrition knowledge and child diet. In this cross-sectional study of Australian women living in socioeconomically disadvantaged neighbourhoods in Melbourne, Australia, mothers with dependent children (aged 5-12 years) provided data on their child's diet, HFA, nutrition knowledge and a range of sociodemographic characteristics. To test our hypothesis we assessed associations between nutrition knowledge and HFA, and between HFA and child food intake (adjusting for nutrition knowledge and child age). In all instances significant associations were found. HFA was found to mediate relationships between mother's nutrition knowledge and children's intake of fruit, vegetables, salty foods and soft drink. Our analyses showed that HFA was a mediator of the associations between maternal nutrition knowledge and child's diet in this population. This supports a focus on nutrition education that expands mothers' understanding of what foods to buy, prepare and serve. Further exploration of these associations will provide a stronger evidence base upon which to inform 'best bets' for parent-focussed nutrition promotion seeking to promote children's healthy eating.

Five Authors Reply

Publisher: Oxford University Press (OUP)

Date: 06-08-2014

DOI: 10.1093/AJE/KWU201

Three-year change in diet quality and associated changes in BMI among schoolchildren living in socio-economically disadvantaged neighbourhoods

Publisher: Cambridge University Press (CUP)

Date: 28-04-2014

DOI: 10.1017/S0007114514000749

Abstract: Findings from research that has assessed the influence of dietary factors on child obesity have been equivocal. In the present study, we aimed to test the hypothesis that a positive change in diet quality is associated with favourable changes in BMI z -scores (zBMI) in schoolchildren from low socio-economic backgrounds and to examine whether this effect is modified by BMI category at baseline. The present study utilised data from a subs le ( n 216) of the Resilience for Eating and Activity Despite Inequality study, a longitudinal cohort study with data collected in 2007–8 (T1) and 2010–11 (T2) in socio-economically disadvantaged women and children (5–12 years at T1). Dietary data were collected using a FFQ and diet quality index (DQI) scores derived at both time points. The objective measures of weight, height and physical activity (accelerometers) were included. The other variables were reported in the questionnaires. We examined the association between change in DQI and change in zBMI, using linear regression analyses adjusted for physical activity, screen sedentary behaviour and maternal education level both in the whole s le and in the s le stratified by overweight status at baseline. After accounting for potential covariates, change in diet quality was found to be inversely associated with change in zBMI only in children who were overweight at baseline ( P = 0·035), thus supporting the hypothesis that improvement in diet quality is associated with a concurrent improvement in zBMI among already overweight children, but not among those with a normal BMI status. The identification of modifiable behaviours such as diet quality that affect zBMI longitudinally is valuable to inform future weight gain prevention interventions in vulnerable groups.

Nutritional status of children with cystic fibrosis measured by total body potassium as a marker of body cell mass: Lack of sensitivity of anthropometric measures

Publisher: Elsevier BV

Date: 02-2000

DOI: 10.1016/S0022-3476(00)70100-4

Abstract: To investigate measures aimed at defining the nutritional status of cystic fibrosis (CF) populations, this study compared standard anthropometric measurements and total body potassium (TBK) as indicators of malnutrition. Height, weight, and TBK measurements of 226 children with CF from Royal Children's Hospital, Brisbane, Australia, were analyzed. Z scores for height for age, weight for age, and weight for height were analyzed by means of the National Centre for Health Statistics reference. TBK was measured by means of whole body counting and compared with predicted TBK for age. Two criteria were evaluated with respect to malnutrition: (1) a z score < -2.0 and (2) a TBK for age <80% of predicted. Males and females with CF had lower mean height-for-age and weight-for-age z scores than the National Centre for Health Statistics reference (P <.01), but mean weight-for-height z score was not significantly different. There were no significant gender differences. According to anthropometry, only 7.5% of this population were underweight and 7.6% were stunted. However, with TBK as an indicator of nutritional status, 29.9% of males and 22.0% of females were malnourished. There are large differences in the percentage of patients with CF identified as malnourished depending on whether anthropometry or body composition data are used as the nutritional indicator. At an in idual level, weight-based indicators are not sensitive indicators of suboptimal nutritional status in CF, significantly underestimating the extent of malnutrition. Current recommendations in which anthropometry is used as the indicator of malnutrition in CF should be revised.

Advancing nutrition promotion research and practice

Publisher: Wiley

Date: 12-2015

DOI: 10.1111/1747-0080.12248

The Role of a Food Literacy Intervention in Promoting Food Security and Food Literacy-OzHarvest's NEST Program

Publisher: MDPI AG

Date: 23-07-2020

DOI: 10.3390/NU12082197

Abstract: Food literacy interventions are widely implemented to improve the food security and health of low-socioeconomic adults. The purpose of this study was to conduct an inquiry into the value of OzHarvest’s six-week NEST (Nutrition Education and Skills Training) program in promoting food security and food literacy, and to identify the barriers and enablers that participants experienced in sustaining food security, and in utilising their food literacy skills beyond the program. A descriptive evaluation study with pre-post surveys (n = 21) and post-program interviews (n = 17) was conducted, with a convenience s le of NEST program participants living in Sydney, Newcastle, and Melbourne, Australia. Participants demonstrated improvements in food security status (p = 0.030), cooking confidence (p = 0.001), food preparation behaviours (p = 0.006), nutrition knowledge (p = 0.033), vegetable consumption (p = 0.043), and a reduction in intake of sugar-sweetened beverages (p = 0.017), and salty snack foods (p = 0.011). The interviews revealed that participants learned to stretch their food budgets and make meaningful changes to their food utilisation (a key dimension of food security). Interviews also identified enablers (e.g., social support) and barriers (e.g., health conditions) to achieving food security. Acknowledging the need for a multi-faceted approach that also addresses upstream determinants, interventions like NEST may play a role in promoting food security and food literacy.

An index measuring adherence to complementary feeding guidelines has convergent validity as a measure of infant diet quality

Publisher: Elsevier BV

Date: 05-2012

DOI: 10.3945/JN.111.154971

Abstract: The complementary feeding period is an important stage of child development. The study aim was to develop an index reflecting the degree of adherence to complementary feeding guidelines, evaluate its convergent validity, and explore associations with socio-demographic factors and dietary pattern scores in childhood. Data were analyzed from the Avon Longitudinal Study of Parents and Children (n = 6065) using parent-completed dietary questionnaires at 6 mo of age, socio-demographic information, and dietary patterns derived by principal component analysis at age 3 y. The Complementary Feeding Utility Index (CFUI) consists of 14 components: breastfeeding duration, feeding to appetite, timing of introduction to solids, exposure to iron-rich cereals, fruit and vegetable intake, exposure to high-fat/-salt/-sugar foods including sugary drinks, food texture, and meal/snack frequency. Regression analyses were undertaken to investigate associations between index scores, socio-demographic factors, food and nutrient intakes, and dietary pattern scores at age 3 y. Milk and food intake at 6 mo and nutrient intake at 8 mo of age varied across quintiles of index score in largely the expected directions. Associations were found among index score, maternal age, education, social class, maternal smoking history, and prepregnancy BMI. After adjustment for socio-demographic factors, the index score was associated with "processed" [β = -0.234 (95% CI = -0.260, -0.209)] and "healthy" [β = 0.185 (95% CI = 0.155, 0.215)] dietary pattern scores at age 3 y. The CFUI is able to discriminate across food intake, nutrient intake, and socio-demographic factors and is associated with later dietary patterns.

Adequacy of iron intakes and socio-demographic factors associated with iron intakes of Australian pre-schoolers

Publisher: Springer Science and Business Media LLC

Date: 02-2019

DOI: 10.1007/S00394-019-01897-7

Abstract: To estimate the prevalence of inadequate iron intakes and identify socio-demographic factors associated with iron intakes of Australian children aged 2-5 years. Data from the 2011-2012 National Nutrition and Physical Activity Survey component of the Australian Health Survey were analysed (n = 783, 2-5 years old). Dietary intake was assessed via two non-consecutive 24-h recalls. Prevalence of inadequate iron intake was estimated using the full probability approach after estimating the distribution of usual intakes with PC-SIDE. Associations between potential socio-demographic factors and energy-adjusted iron intakes were assessed via linear regression accounting for the complex survey design. Mean (SD) iron intakes for pre-schoolers were 7.9 (1.9) mg/day and the prevalence of inadequate iron intake was 10.1% (95% CI 7.9%, 12.1%). Male sex (mean difference between boys and girls: - 0.22 (95% CI - 0.03, - 0.41) mg/day p = 0.022) and age (each additional year was associated with 0.11 (95% CI - 0.22, - 0.00) mg/day lower iron intake p = 0.048) were negatively associated with pre-schooler iron intakes. This study provides current data relating to the iron nutrition of Australian pre-schoolers. Poor iron intakes continue to be a problem for 10% of Australian children beyond the second year of life, with iron intakes being lower for boys compared to girls and declining with age. Future research should examine strategies to improve iron intakes of young children, with a focus on promoting iron-rich food sources.

A provisional database for the silicon content of foods in the United Kingdom

Publisher: Cambridge University Press (CUP)

Date: 11-2005

DOI: 10.1079/BJN20051542

Abstract: Si may play an important role in bone formation and connective tissue metabolism. Although biological interest in this element has recently increased, limited literature exists on the Si content of foods. To further our knowledge and understanding of the relationship between dietary Si and human health, a reliable food composition database, relevant for the UK population, is required. A total of 207 foods and beverages, commonly consumed in the UK, were analysed for Si content. Composite s les were analysed using inductively coupled plasma–optical emission spectrometry following microwave-assisted digestion with nitric acid and H 2 O 2 . The highest concentrations of Si were found in cereals and cereal products, especially less refined cereals and oat-based products. Fruit and vegetables were highly variable sources of Si with substantial amounts present in Kenyan beans, French beans, runner beans, spinach, dried fruit, bananas and red lentils, but undetectable amounts in tomatoes, oranges and onions. Of the beverages, beer, a macerated whole-grain cereal product, contained the greatest level of Si, whilst drinking water was a variable source with some mineral waters relatively high in Si. The present study provides a provisional database for the Si content of UK foods, which will allow the estimation of dietary intakes of Si in the UK population and investigation into the role of dietary Si in human health.

A systematic scoping review of the habitual dietary costs in low socioeconomic groups compared to high socioeconomic groups in Australia

Publisher: Springer Science and Business Media LLC

Date: 12-2020

DOI: 10.1186/S12937-020-00654-5

Abstract: Low socioeconomic groups (SEGs) in Australia are less likely to consume diets consistent with the Australian Dietary Guidelines (ADGs) and suffer poorer health than the broader population. The unaffordability, or perceived high cost, of healthy diets may be a factor. Detailed data on the cost of habitually consumed diets is required in order to inform strategies to alleviate socioeconomic impacts on dietary intake. This systematic scoping review aims to identify the cost of the habitual dietary intake of low SEGs in Australia, in terms of the whole diet and its composite foods, in comparison to the cost in higher SEGs. A systematic search of peer-reviewed literature since 2000 and key government and non-government organisation (NGO) websites was undertaken. Data were extracted, synthesised and analysed in relation to study populations, dietary cost assessment measures, socioeconomic measures, and dietary cost and affordability. The review identified four studies meeting inclusion criteria. Results confirmed that overall, low SEGs spend a lower amount, yet a higher proportion of household income, on food and drinks than higher SEGs. Quantitative comparison of the dietary costs between included studies was not possible due to difference in populations and study metrics. Costs of the habitual diet in these studies were not reported for ADG food groups, so did not allow for assessment of the healthfulness of the dietary intake or comparison with costs of recommended diets at food group level. Existing research does not provide sufficiently granular data of the costs of habitual diets of low SEGs in comparison to higher SEGs or data in a form that can inform strategies and interventions to improve dietary intake and diet-related health of low SEGs in Australia. Future empirical health research requires more granular measures of habitual spending on ADG food groups across SEGs.

Predictors of high-energy foods and beverages: a longitudinal study among socio-economically disadvantaged adolescents

Publisher: Cambridge University Press (CUP)

Date: 05-11-2012

DOI: 10.1017/S136898001200482X

Variation in outcomes of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT) Program according to maternal education and age

Publisher: Elsevier BV

Date: 2014

DOI: 10.1016/J.YPMED.2013.10.021

Abstract: To assess the effectiveness of the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program according to maternal education and age. A cluster-randomised controlled trial involving 542 mother/infant pairs from 62 existing first-time parent groups was conducted in 2008 in Melbourne, Australia. The intervention involved 6 × 2-hour dietitian-delivered sessions, DVD and written resources from infant age 4-15 months. Outcomes included infant diet (3 × 24 h diet recalls), physical activity (accelerometry), television viewing and body mass index. We tested for moderation by maternal education (with/without a University degree) and age (< 32 and ≥ 32 years). The trial was registered with the ISRCTN Register (identifier 81847050). Interaction effects with the treatment arm were observed for maternal education and age. The intervention effects on vegetable (positive effect) and sweet snack consumption (negative effect) were greater in children with higher educated mothers while intervention effects on water consumption (positive effect) were greater in infants with lower educated mothers. The intervention was also more effective in increasing both vegetable and water consumption in infants with mothers aged < 32 years. Child obesity prevention interventions may be differentially effective according to maternal education and age. Evidence of differential effects is important for informing more sensitively targeted/tailored approaches.

Sources and Correlates of Sodium Consumption in the First 2 Years of Life

Publisher: Elsevier BV

Date: 10-2014

DOI: 10.1016/J.JAND.2014.04.028

Abstract: High sodium intake during infancy and early childhood can change salt preference and blood pressure trajectories across life, representing a modifiable cardiovascular risk factor. Describing young children's sodium intake is important for informing effective targets for sodium reduction. This study aimed to describe food sources and demographic and behavioral correlates of sodium intake in 295 young Australian children using three unscheduled 24-hour recalls (when children were 9 and then 18 months of age) with mothers participating within an existing randomized controlled trial, the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program. Differences in in idual-level and family-level demographic and behavioral variables were assessed across tertiles of sodium density (mg/1,000 kcal). Descriptive statistics were used to describe food-group contributions to total energy and sodium intakes at both ages. Mean sodium intake was 486 mg (standard deviation=232 mg) at 9 months and had more than doubled to 1,069 mg (standard deviation=331 mg) at 18 months of age. Fifty-four percent of children at 18 months exceeded the Recommended Daily Upper Level for sodium intake, with bread, cheese, breakfast cereal, soup, and mixed dishes all important sources of sodium at both ages. Yeast extracts, processed meats, and bread products became important additional sources at 18 months. A greater proportion of children in the highest sodium-density tertile had ceased breastfeeding and had commenced solids at an earlier age. The key food sources of sodium for children younger than 2 years are those that contribute to the whole population's high salt burden and highlight the essential role governments and food industry must play to reduce salt in commonly consumed foods.

Does food planning mediate the association between living arrangements and fruit and vegetable consumption among women aged 40 years and older?

Publisher: Elsevier BV

Date: 06-2010

DOI: 10.1016/J.APPET.2010.02.009

Abstract: The objective of this paper was to investigate whether food planning strategies mediate the association between living arrangements and fruit and vegetable consumption amongst women aged 40 years and over. A community s le of 473 women aged 40 years and over from metropolitan Melbourne, Australia, provided survey data on their living arrangements, education, fruit and vegetable consumption and the amount of food planning they undertake. Fruit and vegetable consumption was significantly higher amongst women who lived with others compared to those living alone. Food planning was found to mediate the association between living arrangements and fruit consumption by 8% and vegetable consumption by 13%. This study provides evidence of a mediating effect of food planning on the relationship between living arrangements and fruit and vegetable consumption. With the ageing of the population increasing the potential for a rise in the number of single-occupant households, identifying ways of helping in iduals to plan their food purchasing and preparation may increase fruit and vegetable intake.

Comparability of dietary patterns assessed by multiple dietary assessment methods: results from the 1946 British Birth Cohort

Publisher: Springer Science and Business Media LLC

Date: 03-11-2004

DOI: 10.1038/SJ.EJCN.1602079

Abstract: The aim of this study is to evaluate the consistency of dietary patterns assessed through the use of a dietary recall and a 5-day food diary. Participants (n = 2265) of a longitudinal study of health and development completed 48-h dietary recall at interview, followed by a 5-day food diary and with the 24 h immediately preceding the interview analysed separately as a 24-h recall. Mean intakes of foods and nutrients were calculated and dietary patterns were assessed using exploratory factor analysis, using the method of principal components. Paired t-tests and correlation coefficients were used to compare the three dietary assessment methods. Five distinct dietary patterns were identified using the food diary and the 48-h recall but were less consistent on the 24-h recall. Correlations between factor scores on the 48-h recall and the food diary (r = 0.13-0.67) were higher than those between the 24-h recall and food diary (r = -0.01-0.59). The recall methods were effective at ranking subjects according to food and nutrient intakes, with the 48-h recall and food diary showing higher correlations in both males and females. This study indicates that a 48-h recall effectively characterises dietary patterns in British adults when compared to a food diary and ranks participants appropriately with respect to most nutrients and foods and is superior to a single 24-h recall. These results have implications for longitudinal studies where maximising response rates to repeat dietary assessment tools is essential.

Associations between Partnering and Parenting Transitions and Dietary Habits in Young Adults

Publisher: Elsevier BV

Date: 08-2017

DOI: 10.1016/J.JAND.2016.12.008

Abstract: Partnering and parenting are important life-stage transitions that often occur during young adulthood. Little is known about how these transitions affect two dietary behaviors linked to increased cardiometabolic disease risk: skipping breakfast and takeaway-food consumption. Our aim was to examine whether partnering and parenting transitions during a 5-year period were associated with change in diet quality, skipping breakfast, and takeaway-food consumption. We conducted a cohort study. Questionnaires were completed at baseline (2004 to 2006) and follow-up (2009 to 2011). Marital status and number of children were self-reported. Australian participants (n=1,402 [39% men]) aged 26 to 36 years were included. Diet quality was assessed using a Dietary Guideline Index. Breakfast skipping (not eating before 9 am the previous day) and frequent takeaway-food consumption (≥2 times/week) were reported. Linear regression (mean differences in Dietary Guideline Index) and log binomial regression (relative risks for skipping breakfast and frequent takeaway-food consumption) were adjusted for age, education, follow-up duration, day of the week (skipping breakfast only), the other transition, and baseline behavior. During the 5-year follow-up, 101 men and 93 women became married/living as married, and 149 men and 155 women had their first child. Diet quality improved among all groups and was similar at follow-up between those who experienced the transitions and those who did not. Compared to having no children, having a first child was associated with a lower risk of skipping breakfast for men (relative risk 0.65 95% CI 0.42 to 1.01) and women (relative risk 0.47 95% CI 0.31 to 0.72). Men who became partnered also had a lower risk of skipping breakfast than those who remained single (relative risk 0.64 95% CI 0.42 to 0.98). The transitions were not significantly associated with takeaway-food consumption. Life-stage transitions were not associated with better diet quality. Participants who became partnered or parents were more likely to eat breakfast at follow-up than those who remained single or had no children.

Dietary Patterns in New Zealand Women: Evaluating Differences in Body Composition and Metabolic Biomarkers

Publisher: MDPI AG

Date: 18-07-2012

DOI: 10.3390/NU11071643

Abstract: The combinations of food consumed together (dietary patterns) may have a greater influence on health than nutrients or food groups consumed independently. This study investigated the relationship between dietary patterns, body composition and metabolic biomarkers of premenopausal New Zealand women from three ethnic groups. In total, 408 New Zealand European, Māori and Pacific women aged 16–45 years participated in the Women’s EXPLORE (EXamining Predictors Linking Obesity Related Elements) study. Participants completed a 220-item food frequency questionnaire. Several body composition parameters and metabolic biomarkers were measured. Dietary patterns were extracted by principal component analysis and dietary pattern scores were categorised into tertiles to assess links with other measured parameters. Women with higher scores for the ‘refined and processed’ pattern were younger, had higher body mass index, total body fat, plasma leptin and plasma insulin (p 0.001), and lower plasma ghrelin levels (p 0.05) than women with lower scores. In addition, more Māori (51%) and Pacific (68%) women followed the ‘refined and processed’ pattern, while more New Zealand European women (40%) followed the ‘sweet and savoury snacking’ pattern. These data show that dietary pattern analysis is a useful tool to assess links between diet and metabolic health. It further reveals interesting ethnic group-specific differences in dietary pattern use.

An Energy-Dense, Nutrient-Poor Dietary Pattern Is Inversely Associated with Bone Health in Women

Publisher: Elsevier BV

Date: 08-2011

DOI: 10.3945/JN.111.138271

Abstract: Measures of dietary patterns have been increasingly used to capture the complex nature of dietary intake. Few studies have investigated the impact of specific dietary patterns on bone health. Areal bone mineral density (BMD) at the lumbar spine and total hip and total body bone mineral content (BMC) were measured using DXA in Australian women aged 18-65 y (n = 527). Dietary patterns were assessed using a 4-d food diary and factor analysis. Scores were calculated based on the amount of each food consumed in the pattern and the weightings determined by factor analysis. Analysis was conducted using generalized estimating equation methods. Factor analysis revealed 5 dietary patterns. Pattern 1 (high consumption of refined cereals, soft drinks, fried potatoes, sausages and processed meat, vegetable oils, beer, and takeaway foods and low consumption of other vegetables, vegetable dishes, tea, coffee, fruit, wholegrain breads, and breakfast cereals) were significantly inversely associated with total body BMC (g) [β = -15.4 (95% CI -27.4, -3.3), adjusted for age, height, physical activity, smoking, education, energy, and calcium intake]. Pattern 4 (high consumption of legumes, seafood, seeds, nuts, wine, rice and rice dishes, other vegetables, and vegetable dishes and low consumption of bacon and ham) were directly associated with BMD at both sites and total body BMC in adjusted models [BMC (g): β = 15.2 (95% CI 2.84, 27.6), fully adjusted model]. The remaining dietary patterns were not consistently associated with BMD or BMC. This study identified specific dietary patterns associated with BMD and total body BMC among women and provides evidence that will contribute to potential food-based strategies for improving bone health.

Foods and nutrients provide important insights into optimal eating patterns

Publisher: Wiley

Date: 24-05-2006

DOI: 10.1111/J.1747-0080.2006.00066.X

Fruit and Vegetable Consumption and the Risk of Proximal Colon, Distal Colon, and Rectal Cancers in a Case-Control Study in Western Australia

Publisher: Elsevier BV

Date: 10-2011

DOI: 10.1016/J.JADA.2011.07.008

Abstract: Fruits and vegetables (F/V) have been examined extensively in nutrition research in relation to colorectal cancer (CRC). However, their protective effect is subject to debate, possibly because of different effects on different subsites of the large bowel. To determine whether any association between F/V consumption and risk of CRC differed by subsite of the bowel (proximal colon, distal colon, and rectum). The Western Australian Bowel Health Study is a population-based, case-control study conducted between June 2005 and August 2007. Complete food frequency questionnaire data were analysed from 834 CRC cases and 939 controls. Logistic regression analysis was used to estimate the effects of quartiles of F/V intake on risk of CRC at different subsites. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for CRC overall and for the three separate subsites. Risk of proximal colon cancer and rectal cancer was not associated with intakes of total F/V, total vegetable, or total fruit. Brassica vegetable intake was inversely related with proximal colon cancer (Q4 vs Q1 OR 0.62 95% CI 0.41 to 0.93). For distal colon cancer, significant negative trends were seen for total F/V, and total vegetable intake. Distal colon cancer risk was significantly decreased for intake of dark yellow vegetables (Q4 vs Q1 OR 0.61 95% CI 0.41 to 0.92) and apples (Q4 vs Q1 OR 0.51 95% CI 0.34 to 0.77). An increased risk for CRC was found to be associated with intake of fruit juice (Q4 vs Q1 OR 1.74 95% CI 1.24 to 2.45). Our results suggest that different F/V may confer different risks for cancer of the proximal colon, distal colon, or rectum. Future studies might consider taking into account the location of the tumor when examining the relation between F/V consumption and risk of CRC.

Validation of a FFQ to estimate the intake of PUFA using plasma phospholipid fatty acids and weighed foods records

Publisher: Cambridge University Press (CUP)

Date: 03-2007

DOI: 10.1017/S0007114507381385

Abstract: Due to the growing knowledge about the role of specific fatty acids in health and disease, dietary intake measurements of in idual fatty acids or classes of fatty acids are becoming increasingly important. The objective of this study was to evaluate the ability of the Nambour FFQ to estimate intakes of specific fatty acids, particularly PUFA. The study population was a sub-s le of adult participants in a randomised controlled trial of β-carotene and sunscreen in the prevention of skin cancer ( n 43). Dietary intake was assessed by a self-administered FFQ and a weighed food record (WFR). Non-fasting blood s les were collected and analysed for plasma phospholipid fatty acids. Median intakes on the FFQ were generally higher than the WFR except for the n -3 PUFA groups, where the FFQ estimated higher intakes. Correlations between the FFQ and WFR were moderate ( r 0·32–0·59) except for trans fatty acids ( r 0·03). Correlations between each of the dietary assessment methods and the plasma phospholipids were poor for all fatty acids other than the PUFA. Using the methods of triads approach, the FFQ validity coefficients for total n -3 fatty acids, total long chain n -3 fatty acids, EPA, arachidonic acid, docosapentaenoic acid and DHA were 0·50, 0·63, 0·45 and 0·62 and 0·62, respectively. For most fatty acids, the FFQ adequately estimates group mean fatty acid intakes and can adequately rank in iduals however, the ability of this FFQ to estimate trans fatty acids was poor.

Mediators of improved child diet quality following a health promotion intervention: The Melbourne InFANT Program

Publisher: Springer Science and Business Media LLC

Date: 04-11-2014

DOI: 10.1186/S12966-014-0137-5

Economic evaluation of price discounts and skill-building strategies on purchase and consumption of healthy food and beverages: The SHELf randomized controlled trial

Publisher: Elsevier BV

Date: 06-2016

DOI: 10.1016/J.SOCSCIMED.2016.04.015

Abstract: Pricing strategies are a promising approach for promoting healthier dietary choices. However, robust evidence of the cost-effectiveness of pricing manipulations on dietary behaviour is limited. We aimed to assess the cost-effectiveness of a 20% price reduction on fruits and vegetables and a combined skills-based behaviour change and price reduction intervention. Cost-effectiveness analysis from a societal perspective was undertaken for the randomized controlled trial Supermarket Healthy Eating for Life (SHELf). Female shoppers in Melbourne, Australia were randomized to: (1) skill-building (n = 160) (2) price reductions (n = 161) (3) combined skill-building and price reduction (n = 161) or (4) control group (n = 161). The intervention was implemented for three months followed by a six month follow-up. Costs were measured in 2012 Australian dollars. Fruit and vegetable purchasing and consumption were measured in grams/week. At three months, compared to control participants, price reduction participants increased vegetable purchases by 233 g/week (95% CI 4 to 462, p = 0.046) and fruit purchases by 364 g/week (95% CI 95 to 633, p = 0.008). Participants in the combined group purchased 280 g/week more fruits (95% CI 27 to 533, p = 0.03) than participants in the control group. Increases were not maintained six-month post intervention. No effect was noticed in the skill-building group. Compared to the control group, the price reduction intervention cost an additional A$2.3 per increased serving of vegetables purchased per week or an additional A$3 per increased serving of fruit purchased per week. The combined intervention cost an additional A$12 per increased serving of fruit purchased per week compared to the control group. A 20% discount on fruits and vegetables was effective in promoting overall fruit and vegetable purchases during the period the discount was active and may be cost-effective. The price discount program gave better value for money than the combined price reduction and skill-building intervention. The SHELf trial is registered with Current Controlled Trials Registration ISRCTN39432901.

Association between diet quality, dietary patterns and cardiometabolic health in Australian adults: a cross-sectional study

Publisher: Springer Science and Business Media LLC

Date: 12-02-2018

DOI: 10.1186/S12937-018-0326-1

Development and evaluation of a food frequency questionnaire to assess nutrient intakes of adult women in New Zealand

Publisher: Wiley

Date: 14-09-2018

DOI: 10.1111/1747-0080.12472

Social and Physical Environmental Correlates of Adults' Weekend Sitting Time and Moderating Effects of Retirement Status and Physical Health

Publisher: MDPI AG

Date: 19-09-2014

DOI: 10.3390/IJERPH110909790

Development of Principles for Health-Related Information on Social Media: Delphi Study

Publisher: JMIR Publications Inc.

Date: 08-09-2022

DOI: 10.2196/37337

Abstract: Health-related misinformation can be propagated via social media and is a threat to public health. Several quality assessment tools and principles to evaluate health-related information in the public domain exist however, these were not designed specifically for social media. This study aims to develop Principles for Health-related Information on Social Media (PRHISM), which can be used to evaluate the quality of health-related social media content. A modified Delphi approach was used to obtain expert consensus on the principles and functions of PRHISM. Health and social media experts were recruited via Twitter, email, and snowballing. A total of 3 surveys were administered between February 2021 and May 2021. The first survey was informed by a literature review and included open-ended questions and items from existing quality assessment tools. Subsequent surveys were informed by the results of the proceeding survey. Consensus was deemed if ≥80% agreement was reached, and items with consensus were considered relevant to include in PRHISM. After the third survey, principles were finalized, and an instruction manual and scoring tool for PRHISM were developed and circulated to expert participants for final feedback. A total of 34 experts consented to participate, of whom 18 (53%) responded to all 3 Delphi surveys. In total, 13 principles were considered relevant and were included in PRHISM. When the instructions and PRHISM scoring tool were circulated, no objections to the wording of the final principles were received. A total of 13 quality principles were included in the PRHISM tool, along with a scoring system and implementation tool. The principles promote accessibility, transparency, provision of authoritative and evidence-based information and support for consumers’ relationships with health care providers. PRHISM can be used to evaluate the quality of health-related information provided on social media. These principles may also be useful to content creators for developing high-quality health-related social media content and assist consumers in discerning high- and low-quality information.

Eating occasion situational factors and sugar-sweetened beverage consumption in young adults

Publisher: Springer Science and Business Media LLC

Date: 03-06-2020

DOI: 10.1186/S12966-020-00975-Y

Abstract: Young adulthood represents an influential transitional period marked by poor dietary habits and excess weight gain. Sugar-sweetened beverages (SSB) are a major source of excess caloric intake among young adults, yet little is known about the correlates of SSB consumption. This study examines the in idual and situational correlates of SSB consumption, using real-time assessment of Australian young adults’ eating occasions. Dietary, sociodemographic and health behaviour data were collected during the Measuring EAting in Everyday Life (MEALS) study ( n = 675 adults, 18–30 y). Participants reported all foods and beverages consumed over 3–4 non-consecutive days using a real-time Smartphone food diary application (“FoodNow”). For every eating occasion, food and beverage intake was recorded along with situational characteristics (eating location, purchase location, presence of others and activities while eating). A beverage occasion was defined as any eating occasion where a beverage was consumed and a SSB occasion was defined as any eating occasion where a SSB was consumed. Multilevel logistic regression was used to examine in idual and situational characteristics with SSB intake at beverage occasions (i.e. factors associated with choosing a SSB over other non-alcoholic beverages) and to examine factors associated with consuming a SSB at any occasion where food and/or beverages were consumed. Thirty-five percent of participants consumed SSBs during the recording period ( n = 237). Of the 2185 beverage eating occasions reported by SSB consumers, 481 (20%) contained a SSB. SSB were rarely consumed on their own (i.e. other foods were present). Having a lower than tertiary education (odds ratio [95% confidence interval]: 1.53 [1.16, 2.01] p 0.01) eating in a café/restaurant, compared to at home (3.02 [1.58, 5.78] p 0.001), and purchasing beverages from a convenience outlet, compared to a supermarket/grocery store (4.58 [2.85, 7.38] p 0.001) were associated with SSB intake at beverage eating occasions. Similar associations were also found when all food and/or beverage eating occasions were examined. In this study, SSB were often consumed with other foods and intake was associated with in idual and situational factors. Further studies are needed to confirm these findings and explore how SSB are consumed in relation to their accompanying foods.

Does the availability of snack foods in supermarkets vary internationally?

Publisher: Springer Science and Business Media LLC

Date: 2013

DOI: 10.1186/1479-5868-10-56

Tracking of dietary intakes in early childhood: the Melbourne InFANT Program

Publisher: Springer Science and Business Media LLC

Date: 16-01-2013

DOI: 10.1038/EJCN.2012.218

Major dietary patterns of young and middle aged women: results from a prospective Australian cohort study

Publisher: Springer Science and Business Media LLC

Date: 04-08-2010

DOI: 10.1038/EJCN.2010.121

Abstract: The aim of this study was to assess the major dietary patterns of two age cohorts of women, to determine to the extent to which the dietary patterns differ between the cohorts and to assess whether they vary according to sociodemographic and behavioural characteristics and patterns of nutrient intake. Dietary intake was assessed using an 80-item food frequency questionnaire for women aged 50-55 years (n=10 150 'middle age') in 2001 and aged 25-30 years (n=7371 'young') in 2003, from the Australian Longitudinal Study on Women's Health. Factor analysis using principal component extraction was used to identify dietary patterns, and a pattern score was calculated from the consumption of the food items identified with each dietary pattern. Associations between the dietary pattern scores and sociodemographic and behavioural characteristics and nutrient intakes were investigated using regression analysis. Six dietary patterns were identified and were labelled: cooked vegetables fruit Mediterranean-style processed meat, meat and takeaway reduced fat dairy and high-fat and sugar foods. Regression analysis revealed that healthier dietary patterns were significantly associated with other favourable health-related behaviours, higher socioeconomic status and living in urban areas (P-values <0.05). In spite of differences in the level of consumption of in idual food items, the similarity in dietary patterns across two generations of women suggests that policies and interventions to improve diet should focus on social and economic factors and general health-related behaviour rather than different age groups.

Dietary patterns by reduced rank regression are associated with obesity and hypertension in Australian adults

Publisher: Cambridge University Press (CUP)

Date: 25-01-2017

DOI: 10.1017/S0007114516004505

Abstract: Evidence linking dietary patterns (DP) and obesity and hypertension prevalence is inconsistent. We aimed to identify DP derived from energy density, fibre and sugar intakes, as well as Na, K, fibre, SFA and PUFA, and investigate associations with obesity and hypertension. Adults ( n 4908) were included from the cross-sectional Australian Health Survey 2011–2013. Two 24-h dietary recalls estimated food and nutrient intakes. Reduced rank regression derived DP with dietary energy density (DED), fibre density and total sugar intake as response variables for obesity and Na:K, SFA:PUFA and fibre density as variables for hypertension. Poisson regression investigated relationships between DP and prevalence ratios (PR) of overweight/obesity (BMI≥25 kg/m 2 ) and hypertension (blood pressure≥140/90 mmHg). Obesity-DP1 was positively correlated with fibre density and sugars and inversely with DED. Obesity-DP2 was positively correlated with sugars and inversely with fibre density. In iduals in the highest tertile of Obesity-DP1 and Obesity-DP2, compared with the lowest, had lower (PR 0·88 95 % CI 0·81, 0·95) and higher (PR 1·09 95 % CI 1·01, 1·18) prevalence of obesity, respectively. Na:K and SFA:PUFA were positively correlated with Hypertension-DP1 and inversely correlated with Hypertension-DP2, respectively. There was a trend towards higher hypertension prevalence in the highest tertile of Hypertension-DP1 compared with the lowest (PR 1·18 95 % CI 0·99, 1·41). Hypertension-DP2 was not associated with hypertension. Obesity prevalence was inversely associated with low-DED, high-fibre and high-sugar (natural sugars) diets and positively associated with low-fibre and high-sugar (added sugars) diets. Hypertension prevalence was higher on low-fibre and high-Na and SFA diets.

National Osteoarthritis Strategy brief report Living well with osteoarthritis

Publisher: The Royal Australian College of General Practitioners

Date: 07-2020

DOI: 10.31128/AJGP-08-19-5051-02

The clustering of diet, physical activity and sedentary behavior in children and adolescents: a review

Publisher: Springer Science and Business Media LLC

Date: 2014

DOI: 10.1186/1479-5868-11-4

Women and food FAQs

Publisher: Elsevier BV

Date: 11-2004

DOI: 10.1383/WOHM.1.1.49.55410

Predictors of Dietary Energy Density among Preschool Aged Children

Publisher: MDPI AG

Date: 06-02-2018

DOI: 10.3390/NU10020178

No effect ofn-3 long-chain polyunsaturated fatty acid (EPA and DHA) supplementation on depressed mood and cognitive function: a randomised controlled trial

Publisher: Cambridge University Press (CUP)

Date: 02-2008

DOI: 10.1017/S0007114507801097

Abstract: Low dietary intakes of the n -3 long-chain PUFA (LCPUFA) EPA and DHA are thought to be associated with increased risk for a variety of adverse outcomes, including some psychiatric disorders. Evidence from observational and intervention studies for a role of n -3 LCPUFA in depression is mixed, with some support for a benefit of EPA and/or DHA in major depressive illness. The present study was a double-blind randomised controlled trial that evaluated the effects of EPA+DHA supplementation (1·5 g/d) on mood and cognitive function in mild to moderately depressed in iduals. Of 218 participants who entered the trial, 190 completed the planned 12 weeks intervention. Compliance, confirmed by plasma fatty acid concentrations, was good, but there was no evidence of a difference between supplemented and placebo groups in the primary outcome – namely, the depression subscale of the Depression Anxiety and Stress Scales at 12 weeks. Mean depression score was 8·4 for the EPA+DHA group and 9·6 for the placebo group, with an adjusted difference of − 1·0 (95 % CI − 2·8, 0·8 P = 0·27). Other measures of mood, mental health and cognitive function, including Beck Depression Inventory score and attentional bias toward threat words, were similarly little affected by the intervention. In conclusion, substantially increasing EPA+DHA intake for 3 months was found not to have beneficial or harmful effects on mood in mild to moderate depression. Adding the present result to a meta-analysis of previous relevant randomised controlled trial results confirmed an overall negligible benefit of n -3 LCPUFA supplementation for depressed mood.

How and why does discretionary food consumption change when we promote fruit and vegetables? Results from the ShopSmart randomised controlled trial

Publisher: Cambridge University Press (CUP)

Date: 10-2019

DOI: 10.1017/S1368980019002830

Abstract: The present study aimed to identify whether discretionary food consumption declined in an intervention focused primarily on promoting fruit and vegetable consumption. We also aimed to identify potential mediators explaining intervention effects on discretionary food consumption. Secondary analysis of data from the ShopSmart study, a randomised controlled trial involving a 6-month intervention promoting fruit and vegetable consumption. Linear regression models examined intervention effects on discretionary food consumption at intervention completion (T2). A half-longitudinal mediator analyses was performed to examine the potential mediating effect of personal and environmental factors on the association between the intervention effects and discretionary food consumption. Indirect (mediated) effects were tested by the product of coefficients method with bootstrapped se using Andrew Hayes’ PROCESS macro for SPSS. Women were recruited via the Coles FlyBuys loyalty card database in socio-economically disadvantaged suburbs of Melbourne, Australia. Analyses included 225 women (116 intervention and 109 control). Compared with controls, intervention participants consumed fewer discretionary foods at T2, after adjusting for key confounders ( B = −0·194, 95 % CI −0·378, −0·010 servings/d P = 0·039). While some mediators were associated with the outcome (taste, outcome expectancies, self-efficacy, time constraints), there was no evidence that they mediated intervention effects. The study demonstrated that a behavioural intervention promoting fruit and vegetable consumption among socio-economically disadvantaged participants was effective in reducing discretionary food intake. Although specific mediators were not identified, researchers should continue searching for mechanisms by which interventions have an effect to guide future programme design.

The effect of an early childhood obesity intervention on father's obesity risk behaviors: the Melbourne InFANT Program

Publisher: Springer Science and Business Media LLC

Date: 2014

DOI: 10.1186/1479-5868-11-18

The contribution of diet, physical activity and sedentary behaviour to body mass index in women with and without polycystic ovary syndrome

Publisher: Oxford University Press (OUP)

Date: 15-06-2013

DOI: 10.1093/HUMREP/DET256

Abstract: What is the contribution of diet, physical activity and sedentary behaviour to body mass index (BMI) in women with and without polycystic ovary syndrome (PCOS)? PCOS status, higher energy intake and glycaemic index and lower physical activity were independently associated with BMI. Obesity worsens the clinical features of PCOS and women with PCOS have an elevated prevalence of overweight and obesity. It is not known whether there is a contribution of lifestyle factors such as dietary intake, physical activity or sedentary behaviour to the elevated prevalence of obesity in PCOS. This study is a population-based observational study with data currently collected at 13 year follow-up. The study commenced in 1996. For this analysis, data are analysed at one time point corresponding to the Survey 5 of the cohort in 2009. At this time 8200 participants remained (58% retention of baseline participants) of which 7466 replied to the questionnaire 409 self-reported a diagnosis of PCOS and 7057 no diagnosis of PCOS. Australian women born in 1973-1978 from the Australian Longitudinal Study on Women's Health. Mean BMI was higher in women with PCOS compared with non-PCOS (29.3 ± 7.5 versus 25.6 ± 5.8 kg/m(2), P < 0.001). Women with PCOS reported a better dietary intake (elevated diet quality and micronutrient intake and lower saturated fat and glycaemic index intake) but increased energy intake, increased sitting time and no differences in total physical activity compared with non-PCOS. PCOS status, higher energy intake and glycaemic index and lower physical activity, as well as age, smoking, alcohol intake, occupation, education and country of birth, were independently associated with BMI. The weaknesses of this study include the self-reported diagnosis of PCOS, and the women not reporting PCOS not having their control status clinically verified which is likely to underrepresent the PCOS population. We are also unable to determine if lifestyle behaviours contributed to the PCOS diagnosis or were altered in response to diagnosis. The strengths of this study include the community-based nature of the s le which minimizes selection bias to include women with a variety of clinical presentations. These results are therefore generalizable to a broader population than the majority of research in PCOS examining this research question which are performed in clinic-based populations. This study is in agreement with the literature that PCOS is independently associated with elevated BMI. We provide new insights that diet quality is subtly improved but that sedentary behaviour is elevated in PCOS and that PCOS status, higher energy intake and glycaemic index and lower physical activity are independently associated with BMI. L.J.M. was supported by a South Australian Cardiovascular Research Development Program (SACVRDP) Fellowship (AC11S374) a program collaboratively funded by the National Heart Foundation of Australia, the South Australian Department of Health and the South Australian Health and Medical Research Institute, S.A.M. was funded by an Australian Research Council Future Fellowship (FT100100581), S.Z. was funded by a Heart Foundation Career Development Fellowship (ID CR10S5330) and H.J.T. was funded by an NHMRC fellowship (ID 545888). None of the authors has any conflict of interest to declare. Not applicable.

Home environment predictors of vegetable and fruit intakes among Australian children aged 18 months

Publisher: Elsevier BV

Date: 08-2019

DOI: 10.1016/J.APPET.2019.04.009

Abstract: Suboptimal vegetable and fruit consumption by young children is common. Identifying predictors of vegetable and fruit intakes is important for informing strategies to promote sufficient intakes of these foods from early life. The aim of the present study was to examine predictors of toddlers' vegetable and fruit intakes at age 18 months. This study involved secondary analysis of data from 361 child-mother dyads participating in the Melbourne Infant Feeding, Activity and Nutrition Trial in 2008-2010 at child ages four, nine and 18 months. Children's vegetable and fruit intakes were assessed at age 18 months using multiple 24-h dietary recalls. Data on potential predictor measures were collected via parent-completed questionnaires when children were four or nine months of age. Bivariate and multivariable linear regression models were used to test associations between children's average daily vegetable or fruit intake and potential predictors controlling for treatment arm and clustering by parent group. Multivariable models also controlled for covariates and potential confounders. Home availability of vegetables at age nine months was found to predict children's vegetable intake at age 18 months and remained significant (β = 20.19, 95% CI:7.23, 33.15, p = 0.003) in the multivariable model. Children's average daily fruit intake at age 18 months was predicted by maternal education at child age four months and the availability of fruits in their home at child age nine months. Maternal education remained significant (β = 30.83, 95% CI:12.17, 49.48, p = 0.002) in the multivariable model. Strategies to promote adequate vegetable and fruit intakes among young children should address known barriers to the availability of vegetables and fruits in the home from early in life. Additionally, messages encouraging fruit consumption may need to be tailored to mothers with lower levels of education.

Understanding determinants of nutrition, physical activity and quality of life among older adults: the Wellbeing, Eating and Exercise for a Long Life (WELL) study

Publisher: Springer Science and Business Media LLC

Date: 2012

DOI: 10.1186/1477-7525-10-109

A systematic review of temporal body weight and dietary intake patterns in adults: implications on future public health nutrition interventions to promote healthy weight

Publisher: Springer Science and Business Media LLC

Date: 31-01-2022

DOI: 10.1007/S00394-021-02791-X

Abstract: The global prevalence of overweight remains high effective strategies that consider patterns of body weight changes to identify periods when adults are susceptible to weight gain are warranted. This systematic review aimed to investigate body weight patterns, and how they were associated with dietary intake and/or dietary behaviours (Prospero CRD42020161977). Systematic literature search was conducted in the Medline, Embase, and CINAHL databases until November 2020. Observational studies in adults (18 years and over) that reported at least two measurements of weight and dietary intake in a year were included. Risk of bias was conducted using the Evidence Analysis Library by the Academy of Nutrition and Dietetics tool. This review included 16 unique studies after title, abstract, and full-text screening, and findings were narratively synthesised. Of the six studies conducted in the farming populations, five were conducted in countries with two seasons (dry vs. rainy seasons) and all studies observed higher body weight during the dry season (up to 3.1 kg difference between seasons). The remaining study was conducted in a sub-tropical country and did not observe temporal weight patterns. Higher dietary intake was also reported during the dry season in the tropical countries. In non-farming populations (n = 10), temporal patterns were also seen, where higher body weight and adiposity was observed during colder seasons (autumn and winter). However, the opposite was found in a study conducted in Iran, where higher weight was seen in summer. Concurrent with higher body weight, higher energy, fat, carbohydrate and soda consumption, and lower fiber and vegetable intake were observed. Temporal weight and dietary patterns exist, and they were country- and context-specific these patterns were also related to factors such as activity levels, seasons and occupation. Future interventions should consider temporal patterns in the design and delivery of timely and tailored dietary interventions to promote optimal body weight. PROSPERO Registration: CRD42020161977.

Validity of short food questionnaire items to measure intake in children and adolescents: a systematic review

Publisher: Wiley

Date: 26-08-0077

DOI: 10.1111/JHN.12399

Abstract: Short food questions are appealing to measure dietary intakes. A review of studies published between 2004 and 2016 was undertaken and these were included in the present study if they reported on a question or short item questionnaire (≤50 items, data presented as ≤30 food groups) measuring food intake or food-related habits, in children (aged 6 months to 18 years), and reported question validity or reliability. Thirty studies met the inclusion criteria. Most questions assessed foods or food groups (n = 29), with the most commonly assessed being fruit (n = 22) or vegetable intake (n = 23), dairy foods and discretionary foods (n = 20 studies each). Four studies assessed food habits, with the most common being breakfast and meal frequency (n = 4 studies). Twenty studies assessed reliability, and 25 studies determined accuracy and were most commonly compared against food records. Evaluation of question performance relied on statistical tests such as correlation. The present study has identified valid and reliable questions for the range of key food groups of interest to public health nutrition. Questions were more likely to be reliable than accurate, and relatively few questions were both reliable and accurate. Gaps in repeatable and valid short food questions have been identified that will provide direction for future tool development.

What do Australian adults eat for breakfast? A latent variable mixture modelling approach for understanding combinations of foods at eating occasions

Publisher: Springer Science and Business Media LLC

Date: 25-03-2021

DOI: 10.1186/S12966-021-01115-W

Abstract: The patterning of food intake at eating occasions is a poorly understood, albeit important, step towards achieving a healthy dietary pattern. However, to capture the many permutations of food combinations at eating occasions, novel analytic approaches are required. We applied a latent variable mixture modelling (LVMM) approach to understand how foods are consumed in relation to each other at breakfast. Dietary intake at breakfast ( n = 8145 occasions) was assessed via 24-h recall during the 2011–12 Australian National Nutrition and Physical Activity Survey ( n = 3545 men and n = 4127 women, ⩾19 y). LVMM was used to determine breakfast food profiles based on 35 food group variables, reflecting compliance with Australian Dietary Guidelines. F and adjusted-chi2 tests assessed differences in timing of consumption and participant characteristics between the breakfast profiles. Regression models, adjusted for covariates, were used to examine associations between breakfast food profiles and objective adiposity measures (BMI and waist circumference). Five distinct profiles were found. Three were similar for men and women. These were labelled: “Wholegrain cereals and milks” (men: 16%, women: 17%), “Protein-foods” (men and women: 11%) and “Mixed cereals and milks” (men: 33%, women: 37%). Two “Breads and spreads” profiles were also found that were differentiated by their accompanying beverages (men) or type of grain (women). Profiles were found to vary by timing of consumption, participant characteristics and adiposity indicators. For ex le, the “Protein-foods” profile occurred more frequently on weekends and after 9 am. Men with a “Bread and spreads (plus tea/coffee)” profile were older ( P 0.001) and had lower income and education levels ( P 0.05), when compared to the other profiles. Women with a “Protein-foods” profile were younger (P 0.001) and less likely to be married ( P 0.01). Both men and women with a “Wholegrain cereals and milks” profile had the most favourable adiposity estimates ( P 0.05). We identified five breakfast food profiles in adults that varied by timing of consumption, participant characteristics and adiposity indicators. LVMM was a useful approach for capturing the complexity of food combinations at breakfast. Future research could collect contextual information about eating occasions to understand the complex factors that influence food choices.

Family food involvement and frequency of family dinner meals among Australian children aged 10–12years. Cross-sectional and longitudinal associations with dietary patterns

Publisher: Elsevier BV

Date: 04-2014

DOI: 10.1016/J.APPET.2013.12.021

Abstract: Involvement in meal preparation and eating meals with the family are associated with better dietary patterns in adolescents, however little research has included older children or longitudinal study designs. This 3-year longitudinal study examines cross-sectional and longitudinal associations between family food involvement, family dinner meal frequency and dietary patterns during late childhood. Questionnaires were completed by parents of 188 children from Greater Melbourne, Australia at baseline in 2002 (mean age=11.25years) and at follow-up in 2006 (mean age=14.16years). Principal components analysis (PCA) was used to identify dietary patterns. Factor analysis (FA) was used to determine the principal factors from six indicators of family food involvement. Multiple linear regression models were used to predict the dietary patterns of children and adolescents at baseline and at follow-up, 3years later, from baseline indicators of family food involvement and frequency of family dinner meals. PCA revealed two dietary patterns, labeled a healthful pattern and an energy-dense pattern. FA revealed one factor for family food involvement. Cross-sectionally among boys, family food involvement score (β=0.55, 95% CI: 0.02, 1.07) and eating family dinner meals daily (β=1.11, 95% CI: 0.27, 1.96) during late childhood were positively associated with the healthful pattern. Eating family dinner meals daily was inversely associated with the energy-dense pattern, cross-sectionally among boys (β=-0.56, 95% CI: -1.06, -0.06). No significant cross-sectional associations were found among girls and no significant longitudinal associations were found for either gender. Involvement in family food and eating dinner with the family during late childhood may have a positive influence on dietary patterns of boys. No evidence was found to suggest the effects on dietary patterns persist into adolescence.

Are dietary inequalities among Australian adults changing? a nationally representative analysis of dietary change according to socioeconomic position between 1995 and 2011-13

Publisher: Springer Science and Business Media LLC

Date: 02-04-2018

DOI: 10.1186/S12966-018-0666-4

Associations of diet quality with health-related quality of life in older Australian men and women

Publisher: Elsevier BV

Date: 04-2015

DOI: 10.1016/J.EXGER.2015.01.047

Abstract: This study investigated associations between diet quality measures and quality of life two years later. Adults 55-65 years participating in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 1150 men and n = 1307 women) completed a postal survey including a 111-item food frequency questionnaire in 2010. Diet quality in 2010 was assessed via the dietary guideline index (DGI), recommended food score (RFS) and Mediterranean diet score (MDS). The RAND 36-item survey assessed health-related quality of life in 2012. Associations were assessed using logistic regression adjusted for covariates. In men, DGI and RFS were associated with better reported energy (OR = 1.79, CI: 1.25, 2.55 and OR = 1.56, CI: 1.11, 2.19 respectively), and DGI was additionally associated with better general health (OR = 1.54, 95% CI: 1.08, 2.20), and overall mental component summary scale (OR = 1.51, CI: 1.07, 2.15) in the fully adjusted model. In women, associations between two indices of diet quality (DGI, RFS) physical function (OR = 1.66, CI: 1.19, 2.31 and OR = 1.70, CI: 1.21, 2.37 respectively) and general health (OR = 1.83, CI: 1.32, 2.54 and OR = 1.54, CI: 1.11, 2.14 respectively) were observed. DGI was also associated with overall physical component summary score (OR = 1.56, CI: 1.12, 2.17). Additional associations between emotional wellbeing and DGI (OR = 1.40, CI: 1.01, 1.93) and RFS (OR = 1.44, CI: 1.04, 1.99), and MDS and energy (OR = 1.53, CI: 1.11, 2.10) were observed in the fully adjusted model, in women only. Older adults with better quality diets report better health-related quality of life, with additional associations with emotional wellbeing observed in women.

Education and lifestyle predict change in dietary patterns and diet quality of adults 55 years and over

Publisher: Springer Science and Business Media LLC

Date: 07-11-2019

DOI: 10.1186/S12937-019-0495-6

Abstract: Diet is a key risk factor for chronic disease, and an increasing concern among older adults. We aim to examine the changes in dietary patterns using principal component analysis and a diet quality index among older adults and examine the predictors of dietary change over a 4 year period. Data was obtained via a postal survey in a prospective cohort, the Wellbeing Eating and Exercise for a Long Life (WELL) study. Australian adults aged 55 years and over ( n = 1005 men and n = 1106 women) completed a food frequency at three time points and provided self-reported personal characteristics. Principal component analysis was used to assess dietary patterns and diet quality was assessed using the 2013 Revised Dietary Guideline Index. The relationships between predictors and change in dietary patterns were assessed by multiple linear regression. Two dietary patterns were consistently identified in men and women at three time points over 4 years. One was characterised by vegetables, fruit and white meat, and the other was characterised by red and processed meat and processed foods. Reduced consumption of key food groups within the principal component analysis-determined dietary patterns was observed. An increase in diet quality over 4 years was observed in men only. Reported higher education levels and favourable lifestyle characteristics, including not smoking and physical activity, at baseline predicted an increase in healthier dietary patterns over 4 years. There was stability in the main dietary patterns identified over time, however participants reported an overall decrease in the frequency of consumption of key food groups. Compliance with the Australian Dietary Guidelines remained poor and therefore targeting this population in nutritional initiatives is important. Design of nutrition promotion for older adults need to consider those with lower socioeconomic status, as having a lower level of education was a predictor of poorer dietary patterns. It is important to consider how nutrition behaviours can be targeted alongside other lifestyle behaviours, such as smoking and inadequate physical activity to improve health.

Associations between sedentary behaviours and dietary intakes among adolescents

Publisher: Cambridge University Press (CUP)

Date: 10-01-2018

DOI: 10.1017/S136898001700372X

Abstract: The purpose of the current study was to examine associations of in idual and aggregated screen-based behaviours, and total sitting time, with healthy and unhealthy dietary intakes among adolescents. Cross-sectional study of adolescents. Participants self-reported durations of television viewing, computer use, playing electronic games (e-games), total sitting time, daily servings of fruits and vegetables, and frequency of consumption of sugar-sweetened beverages (SSB), diet beverages, fast foods and discretionary snacks. Logistic regression models were conducted to identify associations of screen-based behaviours, total screen time and total sitting time with dietary intakes. Victoria, Australia. Adolescents ( n 939) in School Year 11 (mean age 16·8 years). The results showed that watching television (≥2 h/d) was positively associated with consuming SSB and diet beverages each week and consuming discretionary snacks at least once daily, whereas computer use (≥2 h/d) was inversely associated with daily fruit and vegetable intake and positively associated with weekly fast-food consumption. Playing e-games (any) was inversely associated with daily vegetable intake and positively associated with weekly SSB consumption. Total screen (≥2 h/d) and sitting (h/d) times were inversely associated with daily fruit and vegetable consumption, with total screen time also positively associated with daily discretionary snack consumption and weekly consumption of SSB and fast foods. In idual and aggregated screen-based behaviours, as well as total sitting time, are associated with a number of indicators of healthy and unhealthy dietary intake. Future research should explore whether reducing recreational screen time improves adolescents’ diets.

Longitudinal predictors of frequent vegetable and fruit consumption among socio-economically disadvantaged Australian adolescents

Publisher: Elsevier BV

Date: 07-2014

DOI: 10.1016/J.APPET.2014.03.023

Abstract: Adequate vegetable and fruit consumption is necessary for preventing nutrition-related diseases. Socio-economically disadvantaged adolescents tend to consume relatively few vegetables and fruits. However, despite nutritional challenges associated with socio-economic disadvantage, a minority of adolescents manage to eat vegetables and fruit in quantities that are more in line with dietary recommendations. This investigation aimed to identify predictors of more frequent intakes of fruits and vegetables among adolescents over a 2-year follow-up period. Data were drawn from 521 socio-economically disadvantaged (maternal education ≤Year 10 of secondary school) Australian adolescents aged 12-15 years. Participants were recruited from 37 secondary schools and were asked to complete online surveys in 2004/2005 (baseline) and 2006/2007 (follow-up). Surveys comprised a 38-item FFQ and questions based on Social Ecological models examining intrapersonal, social and environmental influences on diet. At baseline and follow-up, respectively, 29% and 24% of adolescents frequently consumed vegetables (≥2 times/day) 33% and 36% frequently consumed fruit (≥1 time/day). In multivariable logistic regressions, baseline consumption strongly predicted consumption at follow-up. Frequently being served vegetables at dinner predicted frequent vegetable consumption. Female sex, rarely purchasing food or drink from school vending machines, and usually being expected to eat all foods served predicted frequent fruit consumption. Findings suggest nutrition promotion initiatives aimed at improving eating behaviours among this at-risk population and should focus on younger adolescents, particularly boys improving adolescent eating behaviours at school and encouraging families to increase home availability of healthy foods and to implement meal time rules.

Dietary Intake, Cost, and Affordability by Socioeconomic Group in Australia

Publisher: MDPI AG

Date: 17-12-2021

DOI: 10.3390/IJERPH182413315

Abstract: Few Australians consume diets consistent with the Australian Dietary Guidelines. A major problem is high intake of discretionary food and drinks (those not needed for health and high in saturated fat, added sugar, salt and/or alcohol). Low socioeconomic groups (SEGs) suffer particularly poor diet-related health. Surprisingly, detailed quantitative dietary data across SEGs was lacking. Analysis of the most recent national nutrition survey data produced habitual intakes of a reference household (two adults and two children) in SEG quintiles of household income. Cost and affordability of habitual and recommended diets for the reference household were determined using methods based on the Healthy Diets Australian Standardised Affordability and Pricing protocol. Low SEGs reported significantly lower intakes of healthy food and drinks yet similarly high intakes of discretionary choices to high SEGs (435 serves/fortnight). Total habitual diets of low SEGs cost significantly less than those of high SEGs (AU$751/fortnight to AU$853/fortnight). Results confirmed low SEGs cannot afford a healthy diet. Lower intakes of healthy choices in low SEGs may help explain their higher rates of diet-related disease compared to higher SEGs. The findings can inform potential policy actions to improve affordability of healthy foods and help drive healthier diets for all Australians.

Socioeconomic variation in diet and activity-related behaviours of Australian children and adolescents aged 2-16 years

Publisher: Wiley

Date: 19-06-2012

DOI: 10.1111/J.2047-6310.2012.00060.X

Abstract: Evidence for age-related variation in the relationship between obesity-related behaviours and socioeconomic position may assist in the targeting of dietary and physical activity interventions among children. To investigate the relationship between different indicators of socioeconomic position and obesity-related behaviours across childhood and adolescence. Data were from 4487 children aged 2 to 16 years participating in the cross-sectional 2007 Australian National Children's Nutrition and Physical Activity Survey. Socioeconomic position was defined by the highest education of the primary or secondary carer and parental income. Activity was assessed using recall methods with physical activity also assessed using pedometers. Intake of energy-dense drinks and snack foods, fruits and vegetables was assessed using 2 × 24-h dietary recalls. A socioeconomic gradient was evident for each dietary measure (although in age-specific analyses, not for energy-dense snacks in older children), as well as television viewing, but not physical activity. Whether each behaviour was most strongly related to parental income or education of the primary or secondary carer was age and sex dependent. The socioeconomic gradient was strongest for television viewing time and consumption of fruit and energy-dense drinks. A strong socioeconomic gradient in eating behaviours and television viewing time was observed. Relationships for particular behaviours differed by age, sex and how socioeconomic position was defined. Socioeconomic indicators define different population groups and represent different components of socioeconomic position. These findings may provide insights into who should be targeted in preventive health efforts at different life stages.

Dietary patterns and associations with biomarkers of inflammation in adults: a systematic review of observational studies

Publisher: Springer Science and Business Media LLC

Date: 12-03-2021

DOI: 10.1186/S12937-021-00674-9

Abstract: Evidence indicates that low-grade inflammation is involved in manychronic diseases of ageing. Modifiable lifestyle factors including dietcan affect low-grade inflammation. Dietary patterns allow assessment of the complex interactions of food nutrients and health and may be associated with inflammatory status. This systematic review aimed to summarises current evidence from observational studies for associations between dietary patterns and inflammatory biomarkers in the general adult population. This review followed the PRISMA guidelines. We conducted a systematic search in Embase, CINAHL Complete, Global Health and MEDLINE complete databases. Search terms included terms for diet (“dietary patterns”, “diet scores”) and inflammation (“inflammation“, “c-reactive protein“, “interleukin“). The search produced 7161 records. Duplicates were removed leaving 3164 for screening. There were 69 studies included (60 cross-sectional, 9 longitudinal). Papers included studies that were: 1) observational studies 2) conducted in community-dwelling adults over 18 years of age 3) assessed dietary patterns 4) measured specified biomarkers of inflammation and 5) published in English. Dietary patterns were assessed using diet scores ( n = 45), data-driven approaches ( n = 22), both a data-driven approach and diet score ( n = 2). The most frequently assessed biomarkers were CRP ( n = 64) and/or IL-6 ( n = 22). Cross-sectionally the majority of analyses reported an association between higher diet scores (mostly Mediterranean and anti-inflammatory diet scores) and lower inflammatory markers with 82 significant associations from 133 analyses. Only 22 of 145 cross-sectional analyses using data-driven approaches reported an association between a dietary patterns and lower inflammatory markers the majority reported no association. Evidence of an association between dietary patterns and inflammatory markers longitudinally is limited, with the majority reporting no association. Adherence to healthy, Mediterranean and anti-inflammatory dietary scores, appear to be associated with lower inflammatory status cross-sectionally. Future research could focus on longitudinal studies using a potential outcomes approach in the data analysis. PROSPERO Registration Number CRD42019114501 .

Diet quality is associated with obesity and hypertension in Australian adults: a cross sectional study

Publisher: Springer Science and Business Media LLC

Date: 10-2016

DOI: 10.1186/S12889-016-3714-5

Dietary patterns and successful ageing: a systematic review

Publisher: Springer Science and Business Media LLC

Date: 22-12-2015

DOI: 10.1007/S00394-015-1123-7

A Health Behavior Score is Associated with Hypertension and Obesity Among Australian Adults

Publisher: Wiley

Date: 16-07-2017

DOI: 10.1002/OBY.21911

Abstract: To investigate associations between a health behavior score and prevalence of hypertension and overweight/obesity. Adults (n = 4,609 19-85 years) were included from the cross-sectional Australian National Nutrition and Physical Activity Survey. A health behavior score was derived based on in iduals meeting recommendations for diet quality, smoking, physical activity, sedentary time, and sleep. Poisson regression estimated the prevalence ratio (PR) of hypertension and overweight/obesity by health behavior score. In iduals meeting three (PR: 0.67, 95% CI: 0.54-0.86 P = 0.001), four (PR: 0.76, 95% CI: 0.59-0.96 P = 0.024), or five (PR: 0.63, 95% CI: 0.43-0.94 P = 0.024) health behavior recommendations had a lower hypertension PR compared with those meeting zero or one recommendation. The PR of overweight/obesity was lower in in iduals meeting three (PR: 0.98, 95% CI: 0.95-1.02 P = 0.019), four (PR: 0.95, 95% CI: 0.91-0.99 P = 0.019), or five (PR: 0.94, 95% CI: 0.90-0.99 P = 0.022) recommendations compared with those meeting zero or one. Hypertension and overweight/obesity prevalence were lower in in iduals who had above-average diet quality, never smoked, were physically active, spent less time sedentary, and got adequate sleep. These findings support a holistic approach to public health recommendations.

THE CONTRIBUTION OF DIET, PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOUR TO BODY MASS INDEX IN WOMEN WITH AND WITHOUT POLYCYSTIC OVARY SYNDROME

Publisher: Elsevier BV

Date: 09-2013

DOI: 10.1016/J.FERTNSTERT.2013.07.823

Associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders: an analysis of data from the 2008/09 New Zealand Adult Nutrition Survey

Publisher: Springer Science and Business Media LLC

Date: 04-04-2017

DOI: 10.1007/S00394-017-1421-3

Abstract: To investigate associations between dietary patterns, socio-demographic factors and anthropometric measurements in adult New Zealanders. Dietary patterns were identified using factor analysis in adults 15 years plus (n = 4657) using 24-h diet recall data from the 2008/09 New Zealand Adult Nutrition Survey. Multivariate regression was used to investigate associations between dietary patterns and age, gender and ethnicity. After controlling for demographic factors, associations between dietary patterns and food insecurity, deprivation, education, and smoking were investigated. Associations between dietary patterns and body mass index and waist circumference were examined adjusting for demographic factors, smoking and energy intake. Two dietary patterns were identified. 'Healthy' was characterised by breakfast cereal, low fat milk, soy and rice milk, soup and stock, yoghurt, bananas, apples, other fruit and tea, and low intakes of pies and pastries, potato chips, white bread, takeaway foods, soft drinks, beer and wine. 'Traditional' was characterised by beef, starchy vegetables, green vegetables, carrots, tomatoes, savoury sauces, regular milk, cream, sugar, tea and coffee, and was low in takeaway foods. The 'healthy' pattern was positively associated with age, female gender, New Zealand European or other ethnicity, and a secondary school qualification, and inversely associated with smoking, food insecurity, area deprivation, BMI and waist circumference. The 'traditional' pattern was positively associated with age, male gender, smoking, food insecurity and inversely associated with a secondary school qualification. A 'Healthy' dietary pattern was associated with higher socio-economic status and reduced adiposity, while the 'traditional' pattern was associated with lower socio-economic status.

Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality

Publisher: Cambridge University Press (CUP)

Date: 19-03-2015

DOI: 10.1017/S0954422414000262

Abstract: Traditionally, nutrition research has focused on in idual nutrients, and more recently dietary patterns. However, there has been relatively little focus on dietary intake at the level of a ‘meal’. The purpose of the present paper was to review the literature on adults' meal patterns, including how meal patterns have previously been defined and their associations with nutrient intakes and diet quality. For this narrative literature review, a comprehensive search of electronic databases was undertaken to identify studies in adults aged ≥ 19 years that have investigated meal patterns and their association with nutrient intakes and/or diet quality. To date, different approaches have been used to define meals with little investigation of how these definitions influence the characterisation of meal patterns. This review identified thirty-four and fourteen studies that have examined associations between adults' meals patterns, nutrient intakes and diet quality, respectively. Most studies defined meals using a participant-identified approach, but varied in the additional criteria used to determine in idual meals, snacks and/or eating occasions. Studies also varied in the types of meal patterns, nutrients and diet quality indicators examined. The most consistent finding was an inverse association between skipping breakfast and diet quality. No consistent association was found for other meal patterns, and little research has examined how meal timing is associated with diet quality. In conclusion, an understanding of the influence of different meal definitions on the characterisation of meal patterns will facilitate the interpretation of the existing literature, and may provide guidance on the most appropriate definitions to use.

Dietary Supplement Use among Australian Adults: Findings from the 2011–2012 National Nutrition and Physical Activity Survey

Publisher: MDPI AG

Date: 14-11-2017

DOI: 10.3390/NU9111248

Involvement of Young Australian Adults in Meal Preparation: Cross-Sectional Associations with Sociodemographic Factors and Diet Quality

Publisher: Elsevier BV

Date: 09-2010

DOI: 10.1016/J.JADA.2010.06.011

Abstract: Involvement in meal preparation has the potential to affect diet quality, but has not been thoroughly investigated. The study aims were to describe the involvement of young adult men and women in meal preparation and to investigate whether extent of involvement was associated with diet quality. During 2004 to 2006, a national s le of 2,814 Australian adults aged 26 to 36 years completed a self-administered questionnaire on demographics, diet, and lifestyle factors. Participants were asked to report who was usually responsible for preparing the main meal on working days. Responses were categorized as "myself," "shared," or "someone else." Diet quality was assessed by calculating the mean number of daily servings for each food group. Analysis of variance was used to test for differences in means of dietary intake data. More women (65%) than men (29%) had sole responsibility for meal preparation. Shared meal preparation was reported by 23% of women and 27% of men. Factors associated with greater involvement in meal preparation included marital status, education, occupation, and physical activity. After adjusting for sociodemographic and lifestyle factors, men who prepared the main meal themselves had a higher intake of lean meat and alternatives. Women who shared the meal preparation had higher intakes of vegetables and dairy however, these differences in diet quality were only small. These results suggest that strategies seeking to motivate greater involvement in meal preparation might not be sufficient to markedly improve diet quality in young Australian adults.

Diet quality indices, genetic risk and risk of cardiovascular disease and mortality: a longitudinal analysis of 77 004 UK Biobank participants

Publisher: BMJ

Date: 04-2021

DOI: 10.1136/BMJOPEN-2020-045362

Abstract: To examine associations of three diet quality indices and a polygenic risk score with incidence of all-cause mortality, cardiovascular disease (CVD) mortality, myocardial infarction (MI) and stroke. Prospective cohort study. UK Biobank, UK. 77 004 men and women (40–70 years) recruited between 2006 and 2010. A polygenic risk score was created from 300 single nucleotide polymorphisms associated with CVD. Cox proportional HRs were used to estimate independent effects of diet quality and genetic risk on all-cause mortality, CVD mortality, MI and stroke risk. Dietary intake (Oxford WebQ) was used to calculate Recommended Food Score (RFS), Healthy Diet Indicator (HDI) and Mediterranean Diet Score (MDS). New all-cause (n=2409) and CVD (n=364) deaths and MI (n=1141) and stroke (n=748) events were identified during mean follow-ups of 7.9 and 7.8 years, respectively. The adjusted HR associated with one-point higher RFS for all-cause mortality was 0.96 (95% CI: 0.94 to 0.98), CVD mortality was 0.94 (95% CI: 0.90 to 0.98), MI was 0.97 (95% CI: 0.95 to 1.00) and stroke was 0.94 (95% CI: 0.91 to 0.98). The adjusted HR for all-cause mortality associated with one-point higher HDI and MDS was 0.97 (95% CI: 0.93 to 0.99) and 0.95 (95% CI: 0.91 to 0.98), respectively. The adjusted HR associated with one-point higher MDS for stroke was 0.93 (95% CI: 0.87 to 1.00). There was little evidence of associations between HDI and risk of CVD mortality, MI or stroke. There was evidence of an interaction between diet quality and genetic risk score for MI. Higher diet quality predicted lower risk of all-cause mortality, independent of genetic risk. Higher RFS was also associated with lower risk of CVD mortality and MI. These findings demonstrate the benefit of following a healthy diet, regardless of genetic risk.

Cross-Continental Comparison of National Food Consumption Survey Methods—A Narrative Review

Publisher: MDPI AG

Date: 13-05-2015

DOI: 10.3390/NU7053587

Socioeconomic Inequities in Diet Quality and Nutrient Intakes among Australian Adults: Findings from a Nationally Representative Cross-Sectional Study

Publisher: MDPI AG

Date: 04-10-2017

DOI: 10.3390/NU9101092

Dietary Patterns, Insulin Resistance, and Incidence of Type 2 Diabetes in the Whitehall II Study

Publisher: American Diabetes Association

Date: 07-2008

DOI: 10.2337/DC07-1946

Abstract: OBJECTIVE—The aim of this study was to identify a dietary pattern associated with insulin resistance and investigate whether this pattern was prospectively associated with type 2 diabetes. RESEARCH DESIGN AND METHODS—Analysis was based on 7,339 participants of the Whitehall II study. Dietary intake was measured using a 127-item food frequency questionnaire. We used the reduced rank regression method to determine dietary patterns using the homeostasis model assessment of insulin resistance as the intermediate or response variable. The association between the dietary pattern identified and incidence of type 2 diabetes was investigated using Cox proportional hazard regression models. RESULTS—We identified a dietary pattern characterized by high consumption of low-calorie/diet soft drinks, onions, sugar-sweetened beverages, burgers and sausages, crisps and other snacks, and white bread and low consumption of medium-/high-fiber breakfast cereals, jam, French dressing/vinaigrette, and wholemeal bread. Higher dietary pattern scores were associated with increased risk of type 2 diabetes (hazard ratio for top quartile 2.95 [95% CI 2.19–3.97] adjusted for age, sex, and energy misreporting). This relationship was attenuated after adjustment for ethnicity, employment grade, health behaviors (smoking, alcohol use, and physical activity) but remained significant after further adjustment for blood pressure and BMI (1.51 [1.10–2.09]). CONCLUSIONS—A dietary pattern associated with insulin resistance predicts type 2 diabetes risk after adjustment for a range of confounders. This study adds to the evidence that dietary patterns are an important risk factor for type 2 diabetes.

Exploring the Dietary Patterns of Young New Zealand Women and Associations with BMI and Body Fat

Publisher: MDPI AG

Date: 26-07-2016

DOI: 10.3390/NU8080450

Individual, social–environmental and physical–environmental correlates of diet quality in young adults aged 18–30 years

Publisher: Elsevier BV

Date: 07-2021

DOI: 10.1016/J.APPET.2021.105175

Selected Dietary Micronutrients and the Risk of Right- and Left-Sided Colorectal Cancers: A Case-Control Study in Western Australia

Publisher: Elsevier BV

Date: 03-2011

DOI: 10.1016/J.ANNEPIDEM.2010.10.005

Abstract: Contradictory results about the role of dietary factors in the causation of colorectal cancer (CRC) may partly be due to failure to discriminate between left- and right-sided CRC. We undertook a population-based case-control study comparing 577 cases of left-sided CRC and 277 cases of right-sided CRC (n = 277) with 958 age- and sex-matched controls. Dietary exposure was measured using a food frequency questionnaire. Odds ratios (OR) were calculated across quintiles of dietary intakes of micronutrients, adjusting for potential confounders. Compared to those in the lowest quartiles of intake, we found a protective role of phosphorus on CRC particularly for right-sided cancers (Q5 OR = 0.66, 95% confidence interval [CI]: 0.52-1.02) and protective associations for iron and zinc were observed with left-sided cancers (Q5 OR = 0.78, 95% CI: 0.56-1.09 and Q5 OR = 0.65, 95% CI: 0.46-0.92, respectively). An increased risk of left-sided cancer, was observed for vitamin E (Q5 OR = 1.37, 95% CI: 0.97-1.96). An increased risk of CRC was observed for vitamin E and decreased risks were seen for phosphorus, iron, and zinc. Differences in the risk of developing CRC according to subsite were observed for phosphorus and vitamin E.

Is the relationship between sedentary behaviour and cardiometabolic health in adolescents independent of dietary intake? A systematic review

Publisher: Wiley

Date: 22-06-2015

DOI: 10.1111/OBR.12302

Daily eating frequency and cardiometabolic risk factors in young Australian adults: cross-sectional analyses

Publisher: Cambridge University Press (CUP)

Date: 16-12-2011

DOI: 10.1017/S0007114511006398

Abstract: Eating frequency may be important in the development of overweight and obesity and other cardiometabolic risk factors however, the evidence is inconsistent. The aim of the present study was to examine the associations between the number of eating occasions and cardiometabolic risk factors in a national population-based s le of young adults. A cohort of 1273 men and 1502 women, aged 26–36 years, completed a meal pattern chart to record when they had eaten during the previous day (in hourly intervals). The total number of eating occasions was calculated. Diet quality was assessed, waist circumference was measured and a fasting blood s le was taken. Dietary intake was compared with the Australian Guide to Healthy Eating. The associations between the number of eating occasions and cardiometabolic risk factors were calculated using linear regression. Analyses were adjusted for age, education and physical activity. Most men ate three to five times per d and most women ate four to six times. The proportion of participants meeting dietary recommendations increased with the number of eating occasions. For men, an additional eating occasion was associated with reductions in mean values for waist circumference ( − 0·75 cm), fasting glucose ( − 0·02 mmol/l), fasting insulin ( − 0·34 mU/l 2·04 pmol/l), TAG ( − 0·03 mmol/l), total cholesterol ( − 0·08 mmol/l) and LDL-cholesterol ( − 0·06 mmol/l). Adjustment for waist circumference attenuated the results. Significant trends were not observed for women. In conclusion, a higher number of eating occasions were associated with reduced cardiometabolic risk factors in men. Many associations were mediated by waist circumference.

The association between socio-economic position and diet quality in Australian adults

Publisher: Cambridge University Press (CUP)

Date: 20-05-2015

DOI: 10.1017/S1368980015001470

Abstract: We aimed to investigate the association between multiple measures of socio-economic position (SEP) and diet quality, using a diet quality index representing current national dietary guidelines, in the Australian adult population. Cross-sectional study. Linear regression analyses were used to estimate the association between indicators of SEP (educational attainment, level of income and area-level disadvantage) and diet quality (measured using the Dietary Guideline Index (DGI)) in the total s le and stratified by sex and age (≤55 years and years). A large randomly selected s le of the Australian adult population. Australian adults ( n 9296 aged ≥25 years) from the Australian Diabetes, Obesity and Lifestyle Study. A higher level of educational attainment and income and a lower level of area-level disadvantage were significantly associated with a higher DGI score, across the gradient of SEP. The association between indicators of SEP and DGI score was consistently stronger among those aged ≤55 years compared with their older counterparts. The most disadvantaged group had a DGI score between 2 and 5 units lower (depending on the marker of SEP) compared with the group with the least disadvantage. A higher level of SEP was consistently associated with a higher level of diet quality for all indicators of SEP examined. In order to reduce socio-economic inequalities in diet quality, healthy eating initiatives need to act across the gradient of socio-economic disadvantage with a proportionate focus on those with greater socio-economic disadvantage.

Diet quality in young adults and its association with food-related behaviours

Publisher: Cambridge University Press (CUP)

Date: 18-07-2013

DOI: 10.1017/S1368980013001924

Abstract: To determine the diet quality of a group of young adults and explore its associations with two food-related behaviours (involvement in meal preparation and consumption of commercially prepared meals). Cross-sectional study of young adults. S le characteristics, food-related behaviours and dietary intake were assessed using a self-administered questionnaire including an FFQ. Diet quality was measured using the fifteen-item Dietary Guideline Index (DGI) designed to assess adherence to Australian dietary guidelines. One-way ANOVA, t tests and multiple linear regression analyses were used to explore the relationships between DGI scores, s le characteristics and food-related behaviours. University students enrolled in an undergraduate nutrition class, Melbourne, Australia. Students ( n 309) aged 18–36 years. The DGI score was normally distributed, with a mean score of 93·4 ( sd 17·1) points (range 51·9–127·4 points), out of a possible score of 150 points. In multivariate analyses adjusted for age, sex, nationality, BMI and maternal education, cooking meals for oneself was positively associated with DGI score ( β = 0·15 95 % CI 1·15, 10·03 P = 0·01) frequency of takeaway and frequency of convenience meal consumption were inversely associated with DGI score ( β = −0·21 95 % CI −9·96, −2·32 P = 0·002 and β = −0·16 95 % CI −7·40, −0·97 P 0·01, respectively). Cooking meals for oneself was linked to higher diet quality among young adults, while consumption of commercially prepared meals was associated with poorer diet quality. Maintaining education programmes that promote cooking skills within young adults has the potential to improve DGI scores.

Novel Online or Mobile Methods to Assess Eating Patterns

Publisher: Springer Science and Business Media LLC

Date: 11-07-2017

DOI: 10.1007/S13668-017-0211-0

Cross-sectional and prospective mediating effects of dietary intake on the relationship between sedentary behaviour and body mass index in adolescents

Publisher: Springer Science and Business Media LLC

Date: 29-09-2017

DOI: 10.1186/S12889-017-4771-0

Temporal eating patterns: Associations with nutrient intakes, diet quality, and measures of adiposity

Publisher: Elsevier BV

Date: 04-2017

DOI: 10.3945/AJCN.117.156588

Economic evaluation protocol for a multicentre randomised controlled trial to compare Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) versus usual care cardiac rehabilitation among people with coronary heart disease

Publisher: BMJ

Date: 08-2020

DOI: 10.1136/BMJOPEN-2020-038178

Abstract: It is important to ascertain the cost-effectiveness of alternative services to traditional cardiac rehabilitation while the economic credentials of the Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) programme among people with coronary heart disease (CHD) are unknown. This economic protocol outlines the methods for undertaking a trial-based economic evaluation of SCRAM in the real-world setting in Australia. The within-trial economic evaluation will be undertaken alongside a randomised controlled trial (RCT) designed to determine the effectiveness of SCRAM in comparison with the usual care cardiac rehabilitation (UC) alone in people with CHD. Pathway analysis will be performed to identify all the costs related to the delivery of SCRAM and UC. Both a healthcare system and a limited societal perspective will be adopted to gauge all costs associated with health resource utilisation and productivity loss. Healthcare resource use over the 6-month participation period will be extracted from administrative databases (ie, Pharmaceutical Benefits Scheme and Medical Benefits Schedule). Productivity loss will be measured by absenteeism from work (valued by human capital approach). The primary outcomes for the economic evaluation are maximal oxygen uptake (VO 2 max, mL/kg/min, primary RCT outcome) and quality-adjusted life years estimated from health-related quality of life as assessed by the Assessment of Quality of Life-8D instrument. The incremental cost-effectiveness ratio will be calculated using the differences in costs and benefits (ie, primary and secondary outcomes) between the two randomised groups from both perspectives with no discounting. All costs will be valued in Australian dollars for year 2020. The study protocol has been approved under Australia’s National Mutual Acceptance agreement by the Melbourne Health Human Research Ethics Committee (HREC/18/MH/119). It is anticipated that SCRAM is a cost-effective cardiac telerehabilitation programme for people with CHD from both a healthcare and a limited societal perspective in Australia. The evaluation will provide evidence to underpin national scale-up of the programme to a wider population. The results of the economic analysis will be submitted for publication in a peer-reviewed journal. Australian New Zealand Clinical Trials Registry (ACTRN12618001458224).

Dietary Patterns of Adolescents and Risk of Obesity and Hypertension1, ,3

Publisher: Elsevier BV

Date: 02-2008

DOI: 10.1093/JN/138.2.364

Abstract: Increasingly, measures of dietary patterns have been used to capture the complex nature of dietary intake and investigate its association with health. Certain dietary patterns may be important in the prevention of chronic disease however, there are few investigations in adolescents. The aim of this study was to describe the dietary patterns of adolescents and their associations with sociodemographic factors, nutrient intakes, and behavioral and health outcomes. Analysis was conducted using data collected in the 1995 Australian National Nutrition Survey of participants aged 12-18 y who completed a 108-item FFQ (n = 764). Dietary patterns were identified using factor analysis and associations with sociodemographic factors and behavioral and health outcomes investigated. Factor analysis revealed 3 dietary patterns labeled a fruit, salad, cereals, and fish pattern a high fat and sugar pattern and a vegetables pattern, which explained 11.9, 5.9, and 3.9% of the variation in food intakes, respectively. The high fat and sugar pattern was positively associated with being male (P or = 16 y. This study suggests that specific dietary patterns are already evident in adolescence and a dietary pattern rich in fruit, salad, cereals, and fish pattern may be associated with diastolic blood pressure in older adolescents.

Understanding food and nutrition‐related behaviours: Putting together the pieces of the puzzle

Publisher: Wiley

Date: 06-2012

DOI: 10.1111/J.1747-0080.2012.01595.X

Mediators of the relationship between sedentary behavior and depressive symptoms amongst disadvantaged women

Publisher: Elsevier BV

Date: 03-2014

DOI: 10.1016/J.MHPA.2013.09.005

Evidence Use in the Development of the Australian Dietary Guidelines: A Qualitative Study

Publisher: MDPI AG

Date: 23-10-2021

DOI: 10.3390/NU13113748

Abstract: Dietary guidelines are important nutrition policy reference standards that should be informed by the best available evidence. The types of evidence that are reviewed and the evidence review methods that are used have implications for evidence translation. The aim of this study was to explore perceived advantages, disadvantages, and practicalities associated with the synthesis and translation of evidence from nutrient-based, food-based, and dietary patterns research in dietary guideline development. A qualitative descriptive study was conducted. Twenty-two semi-structured interviews were conducted with people involved in the development of the 2013 Australian Dietary Guidelines (ADGs). Transcripts were analysed thematically. To inform future ADGs, there was support for reviewing evidence on a range of dietary exposures (including dietary patterns, foods and food groups, nutrients and food components, and eating occasions) and health outcomes, as well as evidence on environmental sustainability and equity. At the evidence synthesis stage, practicalities associated with planning the evidence review and conducting original systematic reviews were discussed. At the evidence translation stage, practicalities associated with integrating the evidence and consulting stakeholders were described. To ensure that the best available evidence is translated into future ADGs, evidence review methods should be selected based on the exposures and outcomes of interest.

Iron intakes of Australian infants and toddlers: findings from the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program

Publisher: Cambridge University Press (CUP)

Date: 17-11-2016

DOI: 10.1017/S0007114515004286

Abstract: Fe deficiency remains the most common nutritional deficiency worldwide and young children are at particular risk. Preventative food-based strategies require knowledge of current intakes, sources of Fe, and factors associated with low Fe intakes yet few data are available for Australian children under 2 years. This study’s objectives were to determine intakes and food sources of Fe for Australian infants and toddlers and identify non-dietary factors associated with Fe intake. Dietary, anthropometric and socio-demographic data from the Melbourne Infant Feeding, Activity and Nutrition Trial Program were analysed for 485 infants (mean age: 9·1 ( sd 1·2) months) and 423 toddlers (mean age: 19·6 ( sd 2·6) months) and their mothers. Dietary intakes were assessed via 24-h recalls over 3 non-consecutive days. Prevalence of inadequate Fe intake was estimated using the full probability approach. Associations between potential non-dietary predictors (sex, breast-feeding status, age when introduced to solid foods, maternal age, maternal education, maternal employment status and mother’s country of birth) and Fe intakes were assessed using linear regression. Mean Fe intakes were 9·1 ( sd 4·3) mg/d for infants and 6·6 ( sd 2·4) mg/d for toddlers. Our results showed that 32·6 % of infants and 18·6 % of toddlers had inadequate Fe intake. Main food sources of Fe were Fe-fortified infant formula and cereals for infants and toddlers, respectively. Female sex and current breast-feeding were negatively associated with infant Fe intakes. Introduction to solid foods at or later than 6 months was negatively associated with Fe intake in toddlers. These data may facilitate food-based interventions to improve Australian children’s Fe intake levels.

Evaluation of brief dietary questions to estimate vegetable and fruit consumption – using serum carotenoids and red-cell folate

Publisher: Cambridge University Press (CUP)

Date: 05-2005

DOI: 10.1079/PHN2004688

Abstract: To evaluate responses to self-administered brief questions regarding consumption of vegetables and fruit by comparison with blood levels of serum carotenoids and red-cell folate. A cross-sectional study in which participants reported their usual intake of fruit and vegetables in servings per day, and serum levels of five carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin and lycopene) and red-cell folate were measured. Serum carotenoid levels were determined by high-performance liquid chromatography, and red-cell folate by an automated immunoassay system. Between October and December 2000, a s le of 1598 adults aged 25 years and over, from six randomly selected urban centres in Queensland, Australia, were examined as part of a national study conducted to determine the prevalence of diabetes and associated cardiovascular risk factors. Statistically significant ( P .01) associations with vegetable and fruit intake (categorised into groups: ≤1 serving, 2–3 servings and ≥4 servings per day) were observed for α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin and red-cell folate. The mean level of these carotenoids and of red-cell folate increased with increasing frequency of reported servings of vegetables and fruit, both before and after adjusting for potential confounding factors. A significant association with lycopene was observed only for vegetable intake before adjusting for confounders. These data indicate that brief questions may be a simple and valuable tool for monitoring vegetable and fruit intake in this population.

Skipping breakfast among Australian children and adolescents; findings from the 2011–12 National Nutrition and Physical Activity Survey

Publisher: Elsevier BV

Date: 12-2017

DOI: 10.1111/1753-6405.12715

Abstract: Skipping breakfast has been linked with poor diet quality, higher BMI and adverse cardiometabolic outcomes. This study aimed to determine the prevalence and correlates of skipping breakfast among Australian children and adolescents. A total of 1,592 2-17-year-olds completed two 24-hour recalls, collected via face-to-face and telephone interview, in the 2011-12 National Nutrition and Physical Activity Survey. Breakfast was an eating occasion of ≥210kJ named as 'breakfast' by the participant. Child, household and adult correlates of skipping breakfast were reported. Odds ratios were calculated using ordinal regression. Linear regression was used to examine differences in dietary intake. Survey weights were applied to give nationally representative estimates. Most (86.8% of boys, 81.4% of girls) ate breakfast on both days, 11.8% of boys and 14.8% girls skipped on one day and 1.4% boys and 3.8% girls skipped on both days. Characteristics associated with skipping breakfast were being female, being older, being underweight or overweight/obese, poorer diet, lower physical activity, inadequate sleep, lower household income, greater socioeconomic disadvantage, and being from a single-parent home. Skipping breakfast was common among Australian adolescents but few consistently skipped. Implications for public health: Interventions to increase breakfast should target adolescents, particularly girls, and low SEP households.

The quality of dietary intake methodology and reporting in child and adolescent obesity intervention trials: A systematic review

Publisher: Wiley

Date: 15-08-2012

DOI: 10.1111/J.1467-789X.2012.01022.X

Diet quality and cognitive function in mid-aged and older men and women

Publisher: Springer Science and Business Media LLC

Date: 12-2019

DOI: 10.1186/S12877-019-1326-5

Abstract: To date much research into nutrition and cognitive function has been at the nutrient or food level, with inconsistent results. There is increasing interest in the dietary pattern approach to assess whole diet quality and its association with cognitive function. This study investigated if diet quality is associated with cognitive function in men and women aged 55 years and over. Adults aged 55–65 years in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia ( n = 617) completed a postal survey including a 111-item food frequency questionnaire in 2010 and 2014. Diet quality was assessed via the revised dietary guideline index (DGI-2013) and also by its in idual components which assessed key food groups and dietary behaviours from the Australian Dietary Guidelines. The Telephone Interview of Cognitive Status (TICS-m) measured cognitive function in 2014. Associations between past (2010) and recent (2014) diet quality and its components, and cognitive function were assessed by linear regression adjusted for covariates. After adjustment for age, sex, education, urban/rural status and physical activity there were no associations between diet quality in 2010 and cognitive function in 2014. However participants who reported higher dietary variety (B = 0.28, 95% CI 0.03, 0.52) and women who reported “sometimes” adding salt to food after cooking (B = 0.98, 95% CI 0.25, 1.71) in 2010 displayed better cognitive function in 2014. In 2014, usual consumption of higher fibre bread choices in the total s le (B = 1.32, 95% CI 0.42, 2.23), and higher diet quality (B = 0.03, 95% CI 0.00, 0.07) and greater fluid consumption (B = 0.14, 95% CI 0.01, 0.27) in men were all associated with better cognitive function. In addition, men who reported “usually” adding salt to their food during cooking displayed poorer cognitive function (B = -1.37, 95% CI -2.39, − 0.35). There were no other associations between dietary intake and cognitive function observed in the adjusted models. An association between dietary variety and some limited dietary behaviours and cognitive function was observed, with variation by gender. Future research should consider trajectories of dietary change over longer time periods as determinants of health and function in older age.

Australasian nutrition research for prevention and management of child obesity: Innovation and progress in the last decade

Publisher: Wiley

Date: 31-03-2014

DOI: 10.1111/J.2047-6310.2014.225.X

Abstract: The Food and Nutrition stream of Australasian Child and Adolescent Obesity Research Network (ACAORN) aims to improve the quality of dietary methodologies and the reporting of dietary intake within Australasian child obesity research (www.acaorn.org.au/streams/nutrition/). With 2012 marking ACAORN's 10th anniversary, this commentary profiles a selection of child obesity nutrition research published over the last decade by Food and Nutrition Stream members. In addition, stream activities have included the development of an online selection guide to assist researchers in their selection of appropriate dietary intake methodologies (www.acaorn.org.au/streams/nutrition/dietary-intake/index.php). The quantity and quality of research to guide effective child obesity prevention and treatment has increased substantially over the last decade. ACAORN provides a successful case study of how research networks can provide a collegial atmosphere to foster and coordinate research efforts in an otherwise competitive environment.

Predicting healthy lifestyle patterns among retirement age older adults in the WELL study: A latent class analysis of sex differences

Publisher: Elsevier BV

Date: 2014

DOI: 10.1016/J.MATURITAS.2013.09.010

Abstract: The aim of this study was to identify subgroups of retirement age older adults with respect to their lifestyle patterns of eating, drinking, smoking, physical activity and TV viewing behaviors, and to examine the association between these patterns and socio-demographic covariates. The s le consisted of 3133 older adults aged 55-65 years from the Wellbeing, Eating and Exercise for a Long Life (WELL) study, 2010. This study used latent class analysis (stratified by sex), with a set of lifestyle indicators and including socio-demographic covariates. Statistical analyses were performed by generalized linear latent and mixed models in Stata. Two classes of lifestyle patterns were identified: Healthy (53% men and 72% women) and less healthy lifestyles. Physical activity, TV-viewing time, and fruit intake were good indicators distinguishing the "Healthier" class, whereas consumption of vegetables, alcohol (men) and fast food (women) could not clearly discriminate older adults in the two classes. Class membership was associated with education, body mass index, and self-rated health. This study contributes to the literature on lifestyle behaviors among older adults, and provides evidence that there are meaningful sex differences in lifestyle behaviors between subgroups of older adults. From a policy perspective, understanding indicators or "markers" of healthy and less healthy lifestyle patterns is important for identifying target groups for interventions.

ShopSmart 4 Health: results of a randomized controlled trial of a behavioral intervention promoting fruit and vegetable consumption among socioeconomically disadvantaged women

Publisher: Elsevier BV

Date: 08-2016

DOI: 10.3945/AJCN.116.133173

Abstract: Behavioral interventions show potential for promoting increased fruit and vegetable consumption in the general population. However, little is known about their effectiveness or cost-effectiveness among socioeconomically disadvantaged groups, who are less likely to consume adequate fruit and vegetables. This study investigated the effects and costs of a behavior change intervention for increasing fruit and vegetable purchasing and consumption among socioeconomically disadvantaged women. ShopSmart 4 Health was a randomized controlled trial involving a 3-mo retrospective baseline data collection phase [time (T) 0], a 6-mo intervention (T1-T2), and a 6-mo no-intervention follow-up (T3). Socioeconomically disadvantaged women who were primary household shoppers in Melbourne, Australia, were randomly assigned to either a behavior change intervention arm (n = 124) or a control arm (n = 124). Supermarket transaction (sales) data and surveys measured the main outcomes: fruit and vegetable purchases and self-reported fruit and vegetable consumption. An analysis of supermarket transaction data showed no significant intervention effects on vegetable or fruit purchasing at T2 or T3. Participants in the behavior change intervention arm reported consumption of significantly more vegetables during the intervention (T2) than did controls, with smaller intervention effects sustained at 6 mo postintervention (T3). Relative to controls, vegetable consumption increased by ∼0.5 serving · participant(-1) · d(-1) from baseline to T2 and remained 0.28 servings/d higher than baseline at T3 among those who received the intervention. There was no intervention effect on reported fruit consumption. The behavior change intervention cost A$3.10 (in Australian dollars) · increased serving of vegetables(-1) · d(-1)CONCLUSIONS: This behavioral intervention increased vegetable consumption among socioeconomically disadvantaged women. However, the lack of observed effects on fruit consumption and on both fruit and vegetable purchasing at intervention stores suggests that further investigation of effective nutrition promotion approaches for this key target group is required. The ShopSmart 4 Health trial was registered at www.isrctn.com as ISRCTN48771770.

Is healthy behavior contagious: associations of social norms with physical activity and healthy eating

Publisher: Springer Science and Business Media LLC

Date: 2010

DOI: 10.1186/1479-5868-7-86

Growth failure in cystic fibrosis

Publisher: Wiley

Date: 02-1999

DOI: 10.1046/J.1440-1754.1999.00329.X

Abstract: The aim of this study was to describe and compare the nutritional status of children aged 0-18 years attending the cystic fibrosis (CF) clinic at the Royal Children's Hospital, Brisbane, Australia, as outpatients in 1986 and 1996. The heights, weights and pulmonary function of children attending the CF clinic as outpatients in 1986 (n = 97) and 1996 (n = 227) were retrospectively analysed using a computerized database maintained by the CF clinic. The heights and weights were analysed in terms of z scores for height for age (HAZ), weight for age (WAZ) and weight for height (WHZ). Pulmonary function data is not available for all children. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and forced mid expiratory flows (FEF) were expressed as a percentage of predicted and are presented here. The 1986 s le consisted of 41 males (age range 0.18-14.59 years, mean age 6.52 (4.33)) and 56 females (age range 0.15-14.97 years, mean age 7.75 (3.70)). The 1996 s le consisted of 111 males (age range 0.09-17.97 years, mean age 8.80 (5.49)) and 114 females (age range 0.12-17.98 years, mean age 8.49 (5.26)). In 1986, males were shorter than females (P = 0.0096) and females had a lower mean FVC than males (P = 0.0438). In 1996, males were shorter, lighter and more wasted than females (P = 0.0357, P = 0.0034 and P = 0.0273, respectively) and females had a lower mean FEV1 and mean FVC than males (P = 0.0176 and P = 0.0079, respectively). Males in 1996 were lighter and more wasted than males in 1986 (P = 0.0023 and P = 0.0139, respectively) and had a lower mean FEV1, mean FVC and mean FEF (P < 0.0001, P = 0.0012 and P = 0.0069, respectively). Females in 1996 were shorter and lighter than females in 1986 (P = 0.0273 and P = 0.0405, respectively) and had a lower mean FEV1, mean FVC and mean FEF (P < 0.0001, P < 0.0001 and P or = 75% or FEV1 < 75%), there were no significant differences in z scores between the 1986 group and 1996 group. Similarly, when the 1986 group were matched for gender and FEV1 with the 1996 group, there were no significant differences in z scores for males or females. It is suggested that the apparent worsening of nutritional status among the 1996 group of CF patients is in fact due to an effect of increased survival of patients with more severe clinical symptoms. The findings from this study highlight the continuing, and in fact, worsening problem of growth failure in children with CF.

Prospective associations between diet quality and body mass index in disadvantaged women: the Resilience for Eating and Activity Despite Inequality (READI) study

Publisher: Oxford University Press (OUP)

Date: 07-04-2017

DOI: 10.1093/IJE/DYX040

Examining the correlates of meal skipping in Australian young adults

Publisher: Springer Science and Business Media LLC

Date: 03-04-2019

DOI: 10.1186/S12937-019-0451-5

Intake of B vitamins in childhood and adult life in relation to psychological distress among women in a British birth cohort

Publisher: Cambridge University Press (CUP)

Date: 02-2009

DOI: 10.1017/S1368980008002413

Abstract: Lower levels of B vitamins (particularly folate, vitamin B 12 and vitamin B 6 ) may be associated with psychological distress. Little is known about the impact of childhood nutrition on psychological distress in adult life. We investigated whether prospectively measured childhood and adult dietary intakes of thiamin, riboflavin, niacin, folate, vitamin B 6 and vitamin B 12 were related to the psychological distress of women in mid-age, taking into account socio-economic, behavioural and lifestyle factors. Prospective data were collected from a cohort of 636 British women followed up since their birth in 1946. Participants completed a 28-item, scaled version of the General Health Questionnaire (GHQ-28) to measure psychological distress at age 53 years. Dietary intakes in childhood (at age four) were determined by 24h recall and in adulthood (at age 36, 43 and 53 years) by a 5d food record. Low dietary vitamin B 12 intake at age 53 was associated with higher psychological distress at that age. Women in the lowest third of vitamin B 12 intake in adulthood had a higher GHQ-28 score compared with those in the highest third (percentage change, adjusted regression coefficient, 21 (95% CI 3, 39)). There were no other significant associations between dietary B vitamin intake in childhood or adulthood and psychological distress in the cohort. Overall, there is evidence that intake of vitamin B 12 at age 53 is related to adult psychological distress but there is no evidence for the effects of other adult B vitamin intakes or childhood intakes on psychological distress.

Protein Intake During Infancy and Subsequent Body Mass Index in Early Childhood: Results from the Melbourne InFANT Program

Publisher: Elsevier BV

Date: 09-2021

DOI: 10.1016/J.JAND.2021.02.022

The impact of financial incentives on participants’ food purchasing patterns in a supermarket-based randomized controlled trial

Publisher: Springer Science and Business Media LLC

Date: 25-08-2017

DOI: 10.1186/S12966-017-0573-0

Associations between dietary patterns and blood pressure in a sample of Australian adults

Publisher: Springer Science and Business Media LLC

Date: 14-01-2020

DOI: 10.1186/S12937-019-0519-2

Abstract: Investigating effects of whole diets on blood pressure (BP) can contribute to development of diet-based recommendations for health. Our aim was to assess the relationship between dietary patterns and BP in a s le of free-living Australian adults. Usual dietary patterns of participants recruited to dietary intervention studies were assessed using factor analysis (two 24-h recalls). The mean of seven days of daily, seated BP measurements were used. Complete data from 251 participants (112 males mean age 55.1(9.1) (SD) years body mass index (BMI) 29.5(3.9) kg/m 2 ) was included. Three dietary patterns were identified. Only Dietary Pattern 2 was positively associated with home systolic BP (β = 1.88, 95% CI 0.16, 3.60) after adjusting for age, sex, BMI, anti-hypertensive medication, smoking, education, physical activity and energy intake. This dietary pattern was characterised by high consumption of low-fibre bread, pasta, noodles and rice, meat dishes, poultry dishes and egg dishes, mixed cereal dishes, salted nuts and low consumption of milk and yoghurt (low-fat), vegetable juice, vegetables and high-fibre bread. Dietary Pattern 2 was also positively associated with intakes of energy ( P = 0.002) and sodium ( P = 0.005) and inversely associated with potassium intake ( P = 0.002). After adjustment for energy, only the inverse association with potassium remained ( P 0.001). In this s le of Australian adults, Dietary Pattern 2 was associated with higher BP and thus chronic disease risk, supporting the evidence that diets high in energy and sodium, and low in potassium from vegetables and dairy, are detrimental to cardiovascular health.

The availability of snack food displays that may trigger impulse purchases in Melbourne supermarkets

Publisher: Springer Science and Business Media LLC

Date: 15-03-2012

DOI: 10.1186/1471-2458-12-194

Is the perception of time pressure a barrier to healthy eating and physical activity among women?

Publisher: Cambridge University Press (CUP)

Date: 07-2009

DOI: 10.1017/S1368980008003066

Abstract: To describe the proportion of women reporting time is a barrier to healthy eating and physical activity, the characteristics of these women and the perceived causes of time pressure, and to examine associations between perceptions of time as a barrier and consumption of fruit, vegetables and fast food, and physical activity. A cross-sectional survey of food intake, physical activity and perceived causes of time pressure. A randomly selected community s le. A s le of 1580 women self-reported their food intake and their perceptions of the causes of time pressure in relation to healthy eating. An additional 1521 women self-reported their leisure-time physical activity and their perceptions of the causes of time pressure in relation to physical activity. Time pressure was reported as a barrier to healthy eating by 41 % of the women and as a barrier to physical activity by 73 %. Those who reported time pressure as a barrier to healthy eating were significantly less likely to meet fruit, vegetable and physical activity recommendations, and more likely to eat fast food more frequently. Women reporting time pressure as a barrier to healthy eating and physical activity are less likely to meet recommendations than are women who do not see time pressure as a barrier. Further research is required to understand the perception of time pressure issues among women and devise strategies to improve women’s food and physical activity behaviours.

The Diet Quality of Food-Insecure Australian Adults—A Nationally Representative Cross-Sectional Analysis

Publisher: MDPI AG

Date: 05-10-2022

DOI: 10.3390/NU14194133

Abstract: Poor diet quality exacerbates risks for acute and chronic conditions. People experiencing food insecurity have an increased likelihood of lower diet quality however, this has not been investigated in the Australian context. The aim of this cross-sectional study was to examine whether the diet quality of Australian adults differed according to their household food security status. Data were analysed from a nationally representative s le (≥19 years n = 9115) collected as part of the National Nutrition and Physical Activity Survey 2011-12. Household food security status and socio-demographic and health characteristics were assessed using data from an 18-module health interview. A 24 h dietary recall was used to estimate food and nutrient intakes and to calculate the Dietary Guidelines Index (DGI). DGI is a food-based score (0 to 130) that assesses adherence to the 2013 Australian Dietary Guidelines. Survey-weighted linear regression models, adjusted for age and sex, were used to examine diet quality (total DGI and component scores), and total energy and nutrient intake by food security status. Adults from food-insecure households had a mean total DGI score 3.5 points lower (95% CI −5.57, −1.46) than food-secure adults (p = 0.001). Adults from households experiencing food insecurity, when compared to those who were food-secure, had several lower DGI component scores including for dietary variety (1.6 vs. 2.3, p = 0.009), fruit (3.8 vs. 5.0, p = 0.001) and vegetables (3.7 vs. 4.4, p = 0.010). Adults from food-insecure households consumed on average more carbohydrates (45.6 vs. 43.3, p = 0.004) and total sugar (21.8 vs. 19.0, p = 0.003) as a percentage of daily energy and less protein (18.5 vs. 17.2, p = 0.004), mono-unsaturated fats (11.2 vs. 11.8, p = 0.026) as a percentage of daily energy, and fibre (20.1 vs. 23.0, p = 0.003), than food-secure adults. Sub-optimal diet may be one of the contributing factors to, or outcomes of, poorer health in food-insecure populations. Food security interventions are required to better address nutrition in food-insecure households and should be tailored to the health and socio-demographic characteristics of this population.

Longitudinal Associations Between Fish Consumption and Depression in Young Adults

Publisher: Oxford University Press (OUP)

Date: 15-04-2014

DOI: 10.1093/AJE/KWU050

Abstract: Few studies have examined longitudinal associations between fish consumption and depression none have defined depression using a diagnostic tool. We investigated whether fish consumption was associated with fewer new depression episodes in a national study of Australian adults. In 2004-2006, 1,386 adults aged 26-36 years (38% males) completed a 127-item (9 fish items) food frequency questionnaire. Fish intake was examined continuously (times/week) and dichotomously (reference group: <2 times/week). During 2009-2011, the lifetime version of the Composite International Diagnostic Interview was administered by telephone. New episodes of major depression/dysthymic disorder (since baseline) were defined using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. During follow-up, 160 (18.8%) women and 70 (13.1%) men experienced depression. For women, each additional weekly serving of fish consumed at baseline decreased the risk of having a new depressive episode by 6% (adjusted relative risk = 0.94, 95% confidence interval: 0.87, 1.01). Women who ate fish ≥2 times/week at baseline had a 25% lower risk of depression during follow-up than those who ate fish <2 times/week (adjusted relative risk = 0.75, 95% confidence interval: 0.57, 0.99). Reverse causation was also suggested but appeared to be restricted to persons with recent depression. Fish consumption was not associated with depression in men. These findings provide further evidence that fish consumption may be beneficial for women's mental health.

A parent focused child obesity prevention intervention improves some mother obesity risk behaviors: the Melbourne infant program

Publisher: Springer Science and Business Media LLC

Date: 2012

DOI: 10.1186/1479-5868-9-100

Parents' dietary patterns are significantly correlated: findings from the Melbourne Infant Feeding Activity and Nutrition Trial Program

Publisher: Cambridge University Press (CUP)

Date: 11-2012

DOI: 10.1017/S0007114511005757

Abstract: The objectives of the present study were to identify dietary patterns independently in first-time mothers and fathers, and to examine whether these patterns were correlated within families. Dietary intakes were collected at baseline in the Melbourne Infant Feeding Activity and Nutrition Trial Program using a validated FFQ in 454 pairs of first-time mothers and fathers. Education level was reported in associated questionnaires. Principal components analyses included frequencies of fifty-five food groups and were performed independently in mothers and fathers. Spearman's correlation coefficients were used to assess associations between dietary pattern scores. A total of four dietary patterns were identified in mothers and fathers. Of these, three dietary patterns had similar characteristics between these two populations, namely ‘Fruits and vegetables’, ‘High-energy snack and processed foods’, ‘High-fat foods’ in mothers and ‘Fruits’, ‘High-energy snack and processed foods’, ‘High-fat foods’ in fathers. The following two additional patterns were identified: ‘Cereals and sweet foods’ in mothers and ‘Potatoes and vegetables’ in fathers. Patterns incorporating healthier food items were found to be positively associated with parent education. An inverse association with education was found for the ‘High-fat foods’ and ‘High-energy snack and processed foods’ dietary patterns. Qualitatively similar patterns between corresponding mothers and fathers were the most strongly correlated (ρ = 0·34–0·45, P 0·001). There were some differences in dietary patterns between mothers and fathers, suggesting that it is worth deriving patterns separately when considering couples, and more generally between men and women. Exploring how these various patterns correlate within households provides important insights to guide the development and implementation of family-based interventions.

Scores on the dietary guideline index for children and adolescents are associated with nutrient intake and socio-economic position but not adiposity

Publisher: Elsevier BV

Date: 07-2011

DOI: 10.3945/JN.110.136879

Abstract: Diet quality indices reflect overall dietary patterns better than single nutrients or food groups. The study aims were to develop a measure of adherence with dietary guidelines applicable to child and adolescent populations in Australia and determine the association between index scores and food and nutrient intake, socio-demographic characteristics, and measures of adiposity. Data were analyzed from 4- to 16-y-old participants of the 2007 Australian Children's Nutrition and Physical Activity Survey (n = 3416). The Dietary Guideline Index for Children and Adolescents (DGI-CA) comprises 11 components: 5 core food groups, wholegrain bread, reduced-fat dairy foods, extra foods (nutrient poor and high in fat, salt, and added sugar), healthy fats/oils, water, and diet variety (possible score of 100). The index criteria were age specific. The mean DGI-CA score was low (53.6 ± 0.4), similar between boys and girls, and differed by age the youngest children scored higher than the oldest children (P < 0.0001). Higher DGI-CA scores were associated with lower energy intake, energy density, total and saturated fat, and sugar intake higher protein, carbohydrate, fiber, calcium, iron, vitamin C, vitamin A, folate, phosphorous, magnesium, zinc, and iodine intakes and a higher polyunsaturated:saturated fat ratio (P < 0.0001). DGI-CA scores were associated with socio-economic characteristics and measures of family circumstance. Weak positive associations were observed between DGI-CA score and BMI or waist circumference Z-scores in the 4- to 10-y and 12- to 16-y age groups only. This index is the first validated index in Australia and one of the few international indices to describe the diet quality of children and adolescents.

Diet Quality Is Associated with All-Cause Mortality in Adults Aged 65 Years and Older3

Publisher: Elsevier BV

Date: 02-2012

DOI: 10.3945/JN.111.148692

A new Australian food selection guide: Future challenges and opportunities

Publisher: Wiley

Date: 22-05-2007

DOI: 10.1111/J.1747-0080.2007.00149.X

Educational inequalities in TV viewing among older adults: a mediation analysis of ecological factors

Publisher: Springer Science and Business Media LLC

Date: 2013

DOI: 10.1186/1479-5868-10-138

The Predictors of Diet Quality among Australian Children Aged 3.5 Years

Publisher: Elsevier BV

Date: 07-2016

DOI: 10.1016/J.JAND.2015.12.014

Abstract: It is critical to promote healthy eating early in life. The aim of this study was to examine diet quality and its predictors among Australian preschool-aged children. Diet was assessed at age 3.5 years using multiple 24-hour recalls. Diet quality was assessed using an adapted version of the Revised Children's Diet Quality Index (RC-DQI). Potential predictors of diet quality were from questionnaires at age 3, 9, and 18 months and informed by the ecologic model of childhood overweight. Potential predictors included child's sex, age of introduction to solid foods, breastfeeding status, food acceptance, maternal nutrition knowledge, modeling of healthy eating, self-efficacy, education, and home food availability. Data from 244 children participating in the Melbourne Infant Feeding, Activity, and Nutrition Trial in 2008-2010 and follow-up data collection in 2011-2013 were examined. Diet quality at age 3.5 years. Bivariate logistic regression was performed to assess the relationship between diet quality and each predictor. A multivariable logistic regression model accounting for influences of covariates, treatment arm, and clustering by group tested associations between diet quality and significant predictors from bivariate analyses. RC-DQI scores had a mean±standard deviation score of 62.8±8.3 points out of a maximum of 85 points. Breastfeeding status (odds ratio [OR] 2.34, 95% CI 1.33 to 4.10) and maternal modeling of healthy eating (OR 1.75, 95% CI 1.01 to 3.03) were positively associated with RC-DQI scores. Both breastfeeding status (OR 3.09, 95% CI 1.63 to 5.85) and modeling (OR 2.01, 95% CI 1.04 to 3.88) remained positively associated with diet quality after adjustment for child age, body mass index z score, energy intake, treatment arm, and clustering. Breastfeeding status and modeling of healthy eating were independently associated with children's diet quality. Early intervention could assist mothers to practice these behaviors to provide support for improving child diet quality.

Lifestyle behaviours associated with 5-year weight gain in a prospective cohort of Australian adults aged 26-36 years at baseline

Publisher: Springer Science and Business Media LLC

Date: 10-01-2017

DOI: 10.1186/S12889-016-3931-Y

Missing data in FFQs: making assumptions about item non-response

Publisher: Cambridge University Press (CUP)

Date: 07-12-2017

DOI: 10.1017/S1368980016002986

Abstract: FFQs are a popular method of capturing dietary information in epidemiological studies and may be used to derive dietary exposures such as nutrient intake or overall dietary patterns and diet quality. As FFQs can involve large numbers of questions, participants may fail to respond to all questions, leaving researchers to decide how to deal with missing data when deriving intake measures. The aim of the present commentary is to discuss the current practice for dealing with item non-response in FFQs and to propose a research agenda for reporting and handling missing data in FFQs. Single imputation techniques, such as zero imputation (assuming no consumption of the item) or mean imputation, are commonly used to deal with item non-response in FFQs. However, single imputation methods make strong assumptions about the missing data mechanism and do not reflect the uncertainty created by the missing data. This can lead to incorrect inference about associations between diet and health outcomes. Although the use of multiple imputation methods in epidemiology has increased, these have seldom been used in the field of nutritional epidemiology to address missing data in FFQs. We discuss methods for dealing with item non-response in FFQs, highlighting the assumptions made under each approach. Researchers analysing FFQs should ensure that missing data are handled appropriately and clearly report how missing data were treated in analyses. Simulation studies are required to enable systematic evaluation of the utility of various methods for handling item non-response in FFQs under different assumptions about the missing data mechanism.

Energy-dense dietary patterns high in free sugars and saturated fat and associations with obesity in young adults

Publisher: Springer Science and Business Media LLC

Date: 06-12-2021

DOI: 10.1007/S00394-021-02758-Y

Abstract: To derive dietary patterns based on dietary energy density (DED), free sugars, SFA, and fiber and investigate association with odds of overweight/obesity in young adults. Cross-sectional data from 625 young Australian adults (18–30 years) were used. Dietary patterns were derived using reduced rank regression based on dietary data from a smartphone food diary using DED, free sugars, SFA, and fiber density as response variables. Multivariable logistic regression was used to investigate associations between dietary patterns and odds of self-reported overweight/obesity (BMI ≥ 25 kg/m 2 ). Two dietary patterns were identified (DP1 and DP2). DP-1 was positively correlated with DED, free sugars, and SFA, and inversely correlated with fiber density. It was characterized by higher sugar-sweetened beverages intake and lower vegetable intake, and associated with higher odds of overweight/obesity (OR: 1.22 95% CI 1.05, 1.42). DP-2 was positively correlated with fiber density and free sugars, and inversely correlated with DED and SFA. It was characterized by higher sugar-sweetened beverages intake and lower non-lean red meat intake, and was not significantly associated with overweight/obesity. An energy-dense dietary pattern high in free sugars and SFA and low in fiber was associated with higher odds of obesity in young adults. These findings support dietary interventions that target reductions in energy-dense foods and sugar-sweetened beverages.

Food patterns associated with blood lipids are predictive of coronary heart disease: the Whitehall II study

Publisher: Cambridge University Press (CUP)

Date: 30-03-2009

DOI: 10.1017/S0007114509243030

Dietary patterns are associated with depressive symptoms in older Australian women but not men

Publisher: Cambridge University Press (CUP)

Date: 25-09-2019

DOI: 10.1017/S0007114519002435

Abstract: Studies have examined the association between depressive symptoms and dietary patterns however, only few studies focused on older adults. The present study examines the association between current and past dietary patterns and depression in a community-dwelling adult population aged 55 years and over. Adults ( n 4082) were recruited into the Wellbeing, Eating and Exercise for a Long Life study in Victoria, Australia. In 2010 and 2014, data were collected using self-administered questionnaires including a 111-item FFQ, the RAND thirty-six-item Short Form Health Survey of health-related quality of life and the International Physical Activity Questionnaire. Depressive symptoms were assessed using the Geriatric Depression Scale in 2014. Current (2014) and past (2010) dietary patterns were determined using principal component analysis. Association between dietary patterns and depressive symptoms was assessed using a mixed model analysis with adjustment for covariates. Two similar dietary patterns were identified in men and women ( n 2142). In women, a healthy dietary pattern (characterised by frequent intake of vegetables, fruits and fish) was associated with lower levels of depressive symptoms (current diet: β = −0·260, 95 % CI −0·451, −0·070 past diet: β = −0·201, 95 % CI −0·390, −0·013). A current unhealthy dietary pattern in women (characterised by frequent intake of red and processed meat, potatoes, hot chips, cakes, deserts and ice cream) was associated with higher levels of depressive symptoms ( β = 1·367, 95 % CI 0·679, 2·056). No associations were identified in men. Further research is needed to confirm these findings and to understand the differences that may occur by sex.

Weight management practices associated with PCOS and their relationships with diet and physical activity

Publisher: Oxford University Press (OUP)

Date: 08-01-2017

DOI: 10.1093/HUMREP/DEW348

Abstract: Do weight management practices differ in women with and without PCOS? Women in the general population with self-reported PCOS are more likely to be using healthy weight management practices and alternative non-lifestyle measures for weight management than women without PCOS. Lifestyle management is the first-line treatment in PCOS. However, the specific weight management practices used by women with PCOS and their effect on diet and physical activity are unclear. The study was a population-based observational cross-sectional study involving women in the 1973-1978 cohort (n = 7767 total n = 556 with PCOS, n = 7211 without PCOS). Women with and without self-reported PCOS were included. Self-reported outcome measures included healthy lifestyle-related or alternative non-lifestyle-related (e.g. laxatives or smoking) weight management practices, dietary intake and physical activity. Women with PCOS were more likely to be following both healthy [reducing meal or snack size (odds ratio (OR) 1.50, 95% CI 1.14, 1.96, P = 0.004) and reducing fat or sugar intake (OR 1.32, 95% CI 1.03, 1.69, P = 0.027) or following a low glycaemic index diet (OR 2.88, 95% CI 2.30, 3.59, P < 0.001)] and alternative [smoking (OR 1.60, 95% CI 1.02, 2.52, P = 0.043) or use of laxative, diet pills, fasting or diuretics (OR 1.45, 95% CI 1.07, 1.97, P = 0.017)] weight management practices than women without PCOS. In PCOS, the use of a range of healthy weight management practices was associated with increases in physical activity (P < 0.001), diet quality (P < 0.001), percentage protein intake (P < 0.001) and decreases in glycaemic index (P < 0.001), and percentages of fat (P = 0.001), saturated fat (P < 0.001) or fibre (P = 0.003). Use of alternative weight management practices was associated with decreases in diet quality. Limitations include the use of self-reported data for PCOS, height, weight, diet, physical activity and weight management behaviours. In PCOS, we should focus on improving healthy weight practices across both diet quality and quantity, and on assessing alternative weight practices and their potential adverse effect on dietary intake. L.M. is supported by a South Australian Cardiovascular Research Development Program Fellowship (ID AC11S374) a program collaboratively funded by the National Heart Foundation, the South Australian Department of Health and the South Australian Health and Medical Research Institute. H.T. is supported by the NHMRC. S.A.M. is supported by an NHMRC Career Development Fellowship Level 2, ID1104636 and was previously supported by an ARC Future Fellowship (2011-2015, FT100100581). The authors declare no conflict of interest. Not applicable.

Lunch frequency among adolescents: associations with sociodemographic factors and school characteristics

Publisher: Cambridge University Press (CUP)

Date: 20-05-2015

DOI: 10.1017/S1368980015001457

Abstract: To investigate: (i) how lunch frequency of adolescents varies between schools and between classes within schools (ii) the associations between frequency of lunch and in idual sociodemographic factors and school characteristics and (iii) if any observed associations between lunch frequency and school characteristics vary by gender and age groups. Cross-sectional study in which students and school headmasters completed self-administered questionnaires. Associations were estimated by multilevel multivariate logistic regression. The Danish arm of the Health Behaviour in School-Aged Children study 2010. Students ( n 4922) aged 11, 13 and 15 years attending a random s le of seventy-three schools. The school-level and class-level variations in low lunch frequency were small (intraclass correlation coefficient ·1 %). At the in idual level, low lunch frequency was most common among students who were boys, 13- and 15-year-olds, from medium and low family social class, descendants of immigrants, living in a single-parent family and in a reconstructed family. School-level analyses suggested that having access to a canteen at school was associated with low lunch frequency (OR=1·47 95% CI 1·14, 1·89). Likewise not having an adult present during lunch breaks was associated with low lunch frequency (OR=1·44 95% CI 1·18, 1·75). Cross-level interactions suggested that these associations differed by age group. Lunch frequency among Danish students appears to be largely influenced by sociodemographic factors. Additionally, the presence of an adult during lunch breaks promotes frequent lunch consumption while availability of a canteen may discourage frequent lunch consumption. These findings vary between older and younger students.

Relationship of the Perceived Social and Physical Environment with Mental Health-Related Quality of Life in Middle-Aged and Older Adults: Mediating Effects of Physical Activity

Publisher: Public Library of Science (PLoS)

Date: 23-03-2015

DOI: 10.1371/JOURNAL.PONE.0120475

Health, Behavioral, Cognitive, and Social Correlates of Breakfast Skipping among Women Living in Socioeconomically Disadvantaged Neighborhoods

Publisher: Elsevier BV

Date: 11-2013

DOI: 10.3945/JN.113.181396

Abstract: Breakfast skipping is a potentially modifiable behavior that has negative effects on health and is socioeconomically patterned. This study aimed to examine the intrapersonal (health, behavioral, and cognitive) and social factors associated with breakfast skipping. Nonpregnant women (n = 4123) aged 18-45 y from socioeconomically disadvantaged neighborhoods throughout Victoria, Australia, completed a postal questionnaire. Sociodemographic characteristics, diet, physical activity, sedentary behaviors, and cognitive and social factors were assessed by self-report. Breakfast skipping was defined in 2 ways: 1) "rarely/never" eating breakfast (n = 498) and 2) eating breakfast ≤2 d/wk (includes those who rarely/never ate breakfast n = 865). Poisson regression was used to calculate prevalence ratios and linear trends, adjusting for covariates. The P values for linear trends are reported below. Compared with breakfast consumers, women who reported rarely/never eating breakfast tended to have poorer self-rated health (P-trend < 0.001), be current smokers (P-trend < 0.001), pay less attention to health (P-trend < 0.001), not prioritize their own healthy eating when busy looking after their family (P-trend < 0.001), have less nutrition knowledge (P-trend < 0.001), and a lower proportion were trying to control their weight (P-trend < 0.020). When breakfast skipping was defined as eating breakfast ≤2 d/wk, additional associations were found for having lower leisure-time physical activity (P-trend = 0.012) and less self-efficacy for eating a healthy diet (P-trend < 0.043). In conclusion, a range of intrapersonal and social factors were significantly associated with breakfast skipping among women living in socioeconomically disadvantaged areas. Acknowledging the cross-sectional design and need for causal confirmation, programs that aim to promote breakfast consumption in this population group should consider targeting family-related barriers to healthy eating and nutrition knowledge.

Supporting Engagement, Adherence, and Behavior Change in Online Dietary Interventions

Publisher: Elsevier BV

Date: 06-2019

DOI: 10.1016/J.JNEB.2019.03.006

Abstract: Poor diet is a leading cause of death and disease globally. This epidemic requires effective and accessible interventions to stop the increasing number of diet-related deaths and the health and economic impacts of diet-related disease. Online interventions provide flexibility and accessibility. With the ubiquitous use of smartphones, they can be intertwined with daily activities such as shopping and eating. The aim of this review is to determine what features and behavior change techniques employed in online dietary interventions for adult populations promoting dietary behavior change. The researchers conducted a systematic search of Cumulative Index of Nursing and Allied Health, Cochrane Library, Global Health, MEDLINE, PsychINFO, and psychological and behavioral sciences electronic bibliography databases, and specialist electronic health (e-health) journals from database inception to January, 2018. Studies were included if they were randomized controlled trials of online dietary interventions with active comparator conditions in adult populations, and with reported dietary change measures. A quality score was applied to each study calculated by a developed scoring system. The review analyzed intervention dietary change measures, attrition (nonuse and dropout), engagement (metrics and intensity of use), adherence (defined as compliance to the treatment protocol), behavior change techniques employed to achieve dietary change, and techniques employed in successful (those who achieved significant results in the targeted dietary behavior) vs unsuccessful interventions as reported by the studies. A total of 21 studies composed of a total of 7,455 adults and reporting on 19 different e-health interventions were included from 1,237 records. These studies targeted dietary change as measured by reduced energy intake (5) or changes in specific dietary components (15) and overall diet quality (4). Dietary change was a behavior target in general healthy populations (12) and for managing diseases such as obesity and cardiovascular disease (7), or for improving quality of life for those with chronic conditions (1). Improvements in dietary behavior were seen in 14 of the 19 interventions reported. The results suggest that online interventions can be successful in achieving dietary behavior change across a range of defined populations. However, disparate reporting of engagement and limited reporting of nonuse attrition rates limited the analysis of which behavior change techniques were most effective in achieving this change. The results of this review support the potential of online and smartphone dietary interventions as a method to achieve change in diet in defined populations. However, further work needs to be done in examining how users engage with interventions, and thus which behavior change techniques are most effective.

Associations between diet quality and obesity in a nationally representative sample of Iranian households: A cross-sectional study

Publisher: Wiley

Date: 06-08-2022

DOI: 10.1002/OSP4.536

Abstract: Research examining associations between diet quality and obesity in Iranian adults is limited by small and non‐representative s les. This study examined associations between two diet quality indices and obesity risk in a nationally representative s le of Iranian adults and interactions by sex and area of residence. Data on 18,307 adults (mean age 37 [SD 15.2] years) were used from the Iranian National Survey 2001–2003. Two diet quality indices (Healthy Eating Index 2015, HEI‐2015, and Diet Quality Index International, DQI‐I) were calculated from household 24‐h dietary recalls. Multi‐level regression analyses were used to examine the association between household diet quality and in idual‐level obesity risk, with interaction terms for sex and area of residence. Higher household HEI‐2015 and DQI‐I were associated with higher risk of obesity (HEI‐2015: relative risk ratio: 1.04, 95% CI: 1.03, 1.05 DQI‐I: relative risk ratio: 1.02, 95% CI: 1.01, 1.02), with stronger effect sizes in adults living in rural areas. Higher diet quality (HEI‐2015 and DQI‐I) was associated with higher obesity risk, which was stronger in adults living in rural areas. Due to the complexity of examining these associations in a Middle Eastern country undergoing a nutrition transition, longitudinal research is needed to confirm these findings.

Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study

Publisher: Elsevier BV

Date: 12-2010

DOI: 10.3945/AJCN.2010.30101

Abstract: The long-term effects of skipping breakfast on cardiometabolic health are not well understood. The objective was to examine longitudinal associations of breakfast skipping in childhood and adulthood with cardiometabolic risk factors in adulthood. In 1985, a national s le of 9-15-y-old Australian children reported whether they usually ate breakfast before school. During follow-up in 2004-2006, 2184 participants (26-36 y of age) completed a meal-frequency chart for the previous day. Skipping breakfast was defined as not eating between 0600 and 0900. Participants were classified into 4 groups: skipped breakfast in neither childhood nor adulthood (n = 1359), skipped breakfast only in childhood (n = 224), skipped breakfast only in adulthood (n = 515), and skipped breakfast in both childhood and adulthood (n = 86). Diet quality was assessed, waist circumference was measured, and blood s les were taken after a 12-h fast (n = 1730). Differences in mean waist circumference and blood glucose, insulin, and lipid concentrations were calculated by linear regression. After adjustment for age, sex, and sociodemographic and lifestyle factors, participants who skipped breakfast in both childhood and adulthood had a larger waist circumference (mean difference: 4.63 cm 95% CI: 1.72, 7.53 cm) and higher fasting insulin (mean difference: 2.02 mU/L 95% CI: 0.75, 3.29 mU/L), total cholesterol (mean difference: 0.40 mmol/L 95% CI: 0.13, 0.68 mmol/L), and LDL cholesterol (mean difference: 0.40 mmol/L 95% CI: 0.16, 0.64 mmol/L) concentrations than did those who ate breakfast at both time points. Additional adjustments for diet quality and waist circumference attenuated the associations with cardiometabolic variables, but the differences remained significant. Skipping breakfast over a long period may have detrimental effects on cardiometabolic health. Promoting the benefits of eating breakfast could be a simple and important public health message.

Dietary patterns of Australian pre-schoolers and associations with haem and non-haem iron intakes

Publisher: Springer Science and Business Media LLC

Date: 23-01-2021

DOI: 10.1007/S00394-020-02477-W

Evaluating a novel dietary diversity questionnaire to assess dietary diversity and adequacy of New Zealand women

Publisher: Elsevier BV

Date: 11-2021

DOI: 10.1016/J.NUT.2021.111468

Abstract: We sought to develop and evaluate the relative validity of a dietary ersity questionnaire (DDQ) that reflects food-group ersity, food variety, and micronutrient adequacy among New Zealand women. A cross-sectional study included New Zealand women (Auckland based ages 16-45 y, n = 101), completing a 7-d DDQ and 4-d weighed food record (reference method). The relative validity of the DDQ was evaluated by correlating nutritious and discretionary dietary ersity scores (DDSs number of food groups) and food-variety scores (number of foods), calculated from both methods. The dietary mean adequacy ratio (MAR micronutrient intakes relative to estimated average requirements) was calculated from the weighed food record and correlated to dietary ersity and food-variety scores from the DDQ to assess construct validity. Cross-tabulation was used to explore dietary ersity measures versus adequacy ratios. Significance was set at P < 0.05. The median (interquartile range) DDSs (maximum 25) from the DDQ-23 (21-23)-and the weighed food record-18 (17-19)-were significantly correlated (r The DDQ is a quick, low-burden tool for describing nutritious and discretionary dietary ersity reflecting micronutrient adequacy in high-income settings. It requires further validation across different time frames, population groups, and settings.

The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program follow-up

Publisher: Elsevier BV

Date: 2013

DOI: 10.1016/J.CCT.2012.10.008

Abstract: The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program, is a community-based, cluster-randomised controlled trial of an obesity prevention intervention delivered to first-time parents of infants from age 4-20 months. Conducted from 2008 to 2010, the program had high uptake and retention and showed positive impacts on some dietary outcomes and television viewing. Funding was secured for a follow-up study of participants two and 3.5 years post intervention (at child ages ~3.5 and 5 years). The follow-up study aims to assess intervention effects, mediators and moderators of effects, and program cost-effectiveness over the longer term. The 492 families still enrolled in the Melbourne InFANT Program at intervention conclusion will be recontacted and renewed consent sought to participate in this follow-up study. No further intervention will occur. Home visit data collections will occur approximately two and 3.5 years post intervention. Main outcomes to be assessed include child body mass index, waist circumference, diet (3 × 24-hour recalls food frequency questionnaire), physical activity (8 days ActiGraph accelerometer data parent reported active play) and sedentary time (8days ActiGraph accelerometer and ActivPAL inclinometer data parent reported screen time). Follow-up of participants of the Melbourne InFANT Program at two and 3.5 years post intervention will allow assessment of longer term intervention effects, investigation of potential mediators and moderators of such effects, and economic evaluation of the longer term outcomes. This information will be valuable to researchers and policy makers in progressing the field of early childhood obesity prevention.

Characterizing children's eating patterns: does the choice of eating occasion definition matter?

Publisher: Springer Science and Business Media LLC

Date: 19-12-2021

DOI: 10.1186/S12966-021-01231-7

Abstract: Recommendations to define eating occasions (EO) currently exist for research in adults, but not for children or adolescents. We examined how varying EO definitions affect the characterization of eating patterns in children and adolescents. Cross-sectional dietary data collected using a 24-h recall data during the 2011–12 Australian National Nutrition and Physical Activity Survey (1364 boys and 1337 girls aged 2–18 years) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (EO separated by 15- or 60-min and/or an additional energy criterion of 21 or 210 kJ). Frequency of and total energy intake from meals, snacks, and all EO were estimated. F tests stratified by gender and age-group, were used to assess differences between definitions. Agreement between definitions of meal and snack frequencies was assessed using intraclass correlation coefficients (ICC). Linear regression was used to estimate the proportion of variance in total energy intake (kJ) and BMI z-score predicted by each definition. Mean frequencies of meals and snacks differed between the participant-identified and time-of-day definitions, in boys and girls and for all age groups ( P 0.01). Across the six neutral definitions, there were differences between mean frequencies of EO with the largest mean difference observed for children aged 2–3 y (boys: 2.3, girls: 2.5 P 0.003). Between the participant-identified and time-of-day definitions, there was good agreement for frequencies of snacks (ICC for both genders: 0.93) but not meals (boys: 0.36 girls: 0.38). The 15-min time interval plus 210 kJ definition of an EO consistently predicted the most variance in total energy intake (R 2 range = 8.1–34.8). Definitions that delineated meals and snacks better predicted variance in BMI z-score, when compared to the neutral definitions. How eating patterns are characterized vary depending on the EO definitions employed, particularly in young children. Variance in total energy intake was best predicted by a variation of the neutral definition whereas definitions that delineated meals and snacks performed better in relation to predicting BMI variance. Further international research that compares EO definitions in children will help inform a standard approach.

Does Personalized Nutrition Advice Improve Dietary Intake in Healthy Adults? A Systematic Review of Randomized Controlled Trials

Publisher: Elsevier BV

Date: 05-2021

DOI: 10.1093/ADVANCES/NMAA144

Approaches to Defining Healthy Diets: A Background Paper for the International Expert Consultation on Sustainable Healthy Diets

Publisher: SAGE Publications

Date: 12-2020

DOI: 10.1177/0379572120973111

Abstract: Healthy diets promote optimal growth and development and prevent malnutrition in all its forms, including undernutrition, obesity, and diet-related noncommunicable diseases (NCDs). This background paper for the International Expert Consultation on Sustainable Healthy Diets characterizes healthy diets and their implications for food system sustainability. Three complementary approaches to defining healthy diets are compared: World Health Organization (WHO) guidelines or recommendations developed between 1996 and 2019 2017 Global Burden of Disease (GBD) risk factor study estimates of diet-related risk–outcome associations and analyses associating indices of whole dietary patterns with health outcomes in population studies and clinical trials. World Health Organization dietary recommendations are global reference points for preventing undernutrition and reducing NCD risks they emphasize increasing intakes of fruits, vegetables (excepting starchy root vegetables), legumes, nuts, and whole grains limiting energy intake from free sugars and total fats consuming unsaturated rather than saturated or trans fats and limiting salt intake. Global Burden of Disease findings align well with WHO recommendations but include some additional risk factors such as high consumption of processed meat this approach quantifies contributions of diet-related risks to the NCD burden. Evidence on whole dietary patterns supports WHO and GBD findings and raises concerns about potential adverse health effects of foods with high levels of industrial processing. Implied shifts toward plant foods and away from animal foods (excepting fish and seafood), and for changes in food production systems have direct relevance to the sustainability agenda.

1055The applicability of the Healthy Eating Index to measure Iranian diet quality

Publisher: Oxford University Press (OUP)

Date: 09-2021

DOI: 10.1093/IJE/DYAB168.185

Abstract: Iranian diet quality has been evaluated using indices that are not based on Iranian dietary guidelines. This study examined the applicability of the Healthy Eating Index (HEI) by examining associations with sociodemographics, nutrient intakes and nutrient adequacy. Household sociodemographics and dietary intakes (three 24-h dietary recalls) were collected in the cross-sectional National Comprehensive Study on Household Food Consumption Patterns and Nutritional Status 2001-2003. Household diet quality was calculated using the HEI. Regression analyses examined associations between diet quality and sociodemographics, nutrient intakes and nutrient adequacy. A total of 6584 households were included in this study. Age (β-coeff 2.11 95% CI: 1.64, 2.44), education (β-coeff 4.58 4.05, 5.11) and living in urban areas (β-coeff 2.87 2.56, 3.19) (as reported by the household head) were positively associated with diet quality. Higher diet quality was associated with higher intake of protein (% energy) (β-coeff 0.08 0.07, 0.08), calcium (mg/day) (β-coeff 12.10 11.23, 12.98), iron (mg/day) (β-coeff 0.04 0.02, 0.05), vitamin C (mg/day) (β-coeff 3.61 3.45, 3.77) and fibre (g/day) (β-coeff 0.12 0.11, 0.14), lower intake of sodium (mg/day) (β-coeff -83.45 -93.02, -73.88) and adequate intake of calcium (mg/day) (OR 1.10 95% CI: 1.09, 1.12) and vitamin C (mg/day) (1.19 1.18, 1.20). Higher HEI was associated with a range of sociodemographics and better nutrient intakes and nutrient adequacy. HEI was applicable for assessing the diet quality of Iranian households.

Longitudinal trajectories of diet quality and subsequent mortality among Chinese adults: results from the China health and nutrition survey 1997-2015

Publisher: Springer Science and Business Media LLC

Date: 07-04-2021

DOI: 10.1186/S12966-021-01118-7

Abstract: China has witnessed a significant nutritional transition. However, there is a gap in the literature investigating the association between change of diet and mortality among Chinese. Thus, we aimed to explore the longitudinal trajectories of diet quality over 10 years (from 1997 to 2006) and the subsequent risk of death till 2015 among Chinese adults. Data from the China Health and Nutrition Survey were analyzed in 6398 adults. Dietary intake was assessed using three consecutive 24-h recalls. Diet quality was assessed by the Chinese Healthy Eating Index (CHEI), which includes 17 components and is based on the Dietary Guidelines for Chinese. Latent Class Growth Analysis was conducted to derive trajectories of diet quality over 10 years. Cox proportional hazard regression was used to calculate hazard ratios for total mortality. Four distinct CHEI trajectories were identified: 1) worsening 2) low-moderate-low 3) improving 4) high-moderate-high. Group 3 had the lowest mortality rate (5.6%) in the subsequent 9 years, while the groups with worsening or low diet quality had a higher mortality rate (Group 1: 7.5% Group 2: 10.8%). In the fully adjusted model, compared to group 2, mortality rates were lower for group 3 (RR = 0.73 95% CI: 0.55, 0.97) and group 4 (RR = 0.76 95% CI: 0.59, 0.98). No associations with mortality were found for the group 1, when compared to group 2. Long-term improved diet quality and adherence to the Dietary Guidelines for Chinese may decrease the risk of death in Chinese adults.

Smartphone Cardiac Rehabilitation, Assisted Self-Management Versus Usual Care: Protocol for a Multicenter Randomized Controlled Trial to Compare Effects and Costs Among People With Coronary Heart Disease

Publisher: JMIR Publications Inc.

Date: 27-01-2020

DOI: 10.2196/15022

Abstract: Alternative evidence-based cardiac rehabilitation (CR) delivery models that overcome significant barriers to access and delivery are needed to address persistent low utilization. Models utilizing contemporary digital technologies could significantly improve reach and fidelity as complementary alternatives to traditional center-based programs. The aim of this study is to compare the effects and costs of the innovative Smartphone Cardiac Rehabilitation, Assisted self-Management (SCRAM) intervention with usual care CR. In this investigator-, assessor-, and statistician-blinded parallel 2-arm randomized controlled trial, 220 adults (18+ years) with coronary heart disease are being recruited from 3 hospitals in metropolitan and regional Victoria, Australia. Participants are randomized (1:1) to receive advice to engage with usual care CR or the SCRAM intervention. SCRAM is a 24-week dual-phase intervention that includes 12 weeks of real-time remote exercise supervision and coaching from exercise physiologists, which is followed by 12 weeks of data-driven nonreal-time remote coaching via telephone. Both intervention phases include evidence- and theory-based multifactorial behavior change support delivered via smartphone push notifications. Outcomes assessed at baseline, 12 weeks, and 24 weeks include maximal aerobic exercise capacity (primary outcome at 24 weeks), modifiable cardiovascular risk factors, exercise adherence, secondary prevention self-management behaviors, health-related quality of life, and adverse events. Economic and process evaluations will determine cost-effectiveness and participant perceptions of the treatment arms, respectively. The trial was funded in November 2017 and received ethical approval in June 2018. Recruitment began in November 2018. As of September 2019, 54 participants have been randomized into the trial. The innovative multiphase SCRAM intervention delivers real-time remote exercise supervision and evidence-based self-management behavioral support to participants, regardless of their geographic proximity to traditional center-based CR facilities. Our trial will provide unique and valuable information about effects of SCRAM on outcomes associated with cardiac and all-cause mortality, as well as acceptability and cost-effectiveness. These findings will be important to inform health care providers about the potential for innovative program delivery models, such as SCRAM, to be implemented at scale, as a complement to existing CR programs. The inclusion of a cohort comprising metropolitan-, regional-, and rural-dwelling participants will help to understand the role of this delivery model across health care contexts with erse needs. Australian New Zealand Clinical Trials Registry (ACTRN): 12618001458224 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374508. DERR1-10.2196/15022

The extended Infant Feeding, Activity and Nutrition Trial (InFANT Extend) Program: a cluster-randomized controlled trial of an early intervention to prevent childhood obesity

Publisher: Springer Science and Business Media LLC

Date: 18-02-2016

DOI: 10.1186/S12889-016-2836-0

Predictors and risks of body fat profiles in young New Zealand European, Māori and Pacific women: study protocol for the women’s EXPLORE study

Publisher: Springer Science and Business Media LLC

Date: 14-03-2015

DOI: 10.1186/S40064-015-0916-8

Meal Frequency but Not Snack Frequency Is Associated with Micronutrient Intakes and Overall Diet Quality in Australian Men and Women

Publisher: Elsevier BV

Date: 10-2016

DOI: 10.3945/JN.116.234070

Abstract: Skipping breakfast is associated with poorer diet quality among adults, but evidence of associations for other eating patterns [e.g., eating occasion (EO), meal, or snack frequency] is equivocal. An understanding of how eating patterns are associated with diet quality is needed to inform population-level dietary recommendations. We aimed in this cross-sectional study to determine the relation between frequency of meals, snacks, and all EOs with nutrient intakes and diet quality in a representative s le of Australian adults. Dietary data for 5242 adults aged ≥19 y collected via two 24-h recalls during the 2011-2012 National Nutrition and Physical Activity Survey were analyzed. EO, meal, and snack frequency was calculated. Adherence to recommendations for healthy eating was assessed with the use of the 2013 Dietary Guidelines Index (DGI) and its subcomponents. Linear regression, adjusted for covariates and energy misreporting, was used to examine associations between eating patterns, energy-adjusted nutrient intakes, and the DGI-2013. The frequency of meals, but not of snacks, was positively associated with micronutrient intakes, overall diet quality [men: β = 5.6 (95% CI: 3.9, 7.3) women: β = 4.1 (95% CI: 2.2, 5.9) P < 0.001], and DGI-2013 component scores for cereals, lean meat and alternatives, and alcohol intake (P < 0.05). A higher frequency of all EOs, meals, and snacks was positively associated with DGI-2013 scores for food variety, fruits, and dairy foods (P < 0.05). Conversely, a higher snack frequency was associated with a lower compliance with guidelines for discretionary foods and added sugars among men (P < 0.05). These findings suggest that meal frequency is an important determinant of nutrient intakes and diet quality in Australian adults. Inconsistent associations for snack frequency suggest that the quality of snack choices is variable. More research examining the dietary profiles of eating patterns and their relations with diet quality is needed to inform the development of meal-based guidelines and messages that encourage healthy eating.

Clustering of diet, physical activity and sedentary behaviour among Australian children: cross-sectional and longitudinal associations with overweight and obesity

Publisher: Springer Science and Business Media LLC

Date: 24-04-2015

DOI: 10.1038/IJO.2015.66

Abstract: Evidence suggests diet, physical activity (PA) and sedentary behaviour cluster together in children, but research supporting an association with overweight/obesity is equivocal. Furthermore, the stability of clusters over time is unknown. The aim of this study was to examine the clustering of diet, PA and sedentary behaviour in Australian children and cross-sectional and longitudinal associations with overweight/obesity. Stability of obesity-related clusters over 3 years was also examined. Data were drawn from the baseline (T1: 2002/2003) and follow-up waves (T2: 2005/2006) of the Health Eating and Play Study. Parents of Australian children aged 5-6 (n=87) and 10-12 years (n=123) completed questionnaires. Children wore accelerometers and height and weight were measured. Obesity-related clusters were determined using K-medians cluster analysis. Multivariate regression models assessed cross-sectional and longitudinal associations between cluster membership, and body mass index (BMI) Z-score and weight status. Kappa statistics assessed cluster stability over time. Three clusters, labelled 'most healthy', 'energy-dense (ED) consumers who watch TV' and 'high sedentary behaviour/low moderate-to-vigorous PA' were identified at baseline and at follow-up. No cross-sectional associations were found between cluster membership, and BMI Z-score or weight status at baseline. Longitudinally, children in the 'ED consumers who watch TV' cluster had a higher odds of being overweight/obese at follow-up (odds ratio=2.8 95% confidence interval: 1.1, 6.9 P<0.05). Tracking of cluster membership was fair to moderate in younger (K=0.24 P=0.0001) and older children (K=0.46 P<0.0001). This study identified an unhealthy cluster of TV viewing with ED food/drink consumption, which predicted overweight/obesity in a small longitudinal s le of Australian children. Cluster stability was fair to moderate over 3 years and is a novel finding. Prospective research in larger s les is needed to examine how obesity-related clusters track over time and influence the development of overweight and obesity.

ShopSmart 4 Health – Protocol of a skills-based randomised controlled trial promoting fruit and vegetable consumption among socioeconomically disadvantaged women

Publisher: Springer Science and Business Media LLC

Date: 14-05-2013

DOI: 10.1186/1471-2458-13-466

Comparative analysis of microRNA expression in mouse and human brown adipose tissue

Publisher: Springer Science and Business Media LLC

Date: 19-10-2015

DOI: 10.1186/S12864-015-2045-8

Nineteen-Year Associations between Three Diet Quality Indices and All-Cause and Cardiovascular Disease Mortality: The Australian Diabetes, Obesity, and Lifestyle Study

Publisher: Elsevier BV

Date: 03-2022

DOI: 10.1093/JN/NXAB386

Abstract: Examining a variety of diet quality methodologies will inform best practice use of diet quality indices for assessing all-cause and cardiovascular disease (CVD) mortality. To examine the association between 3 diet quality indices (Australian Dietary Guideline Index, DGI Dietary Inflammatory Index, DII Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay, MIND) and risk of all-cause mortality, CVD mortality, and nonfatal CVD events ≤19 y later. Data on 10,009 adults (mean age 51.8 y 52% female) from the Australian Diabetes, Obesity, and Lifestyle study were used. An FFQ was used to calculate DGI, DII, and MIND at baseline. Cox proportional hazard models were used to estimate HRs and 95% CI of all-cause mortality, CVD mortality, and nonfatal CVD events (stroke myocardial infarction) according to 1 SD increase in diet quality, adjusted for age, sex, education, smoking, physical activity, energy intake, history of stroke or heart attack, and diabetes and hypertension status. Deaths due to all-cause (n = 1955) and CVD (n = 520), and nonfatal CVD events (n = 264) were identified during mean follow-ups of 17.7, 17.4, and 9.6 y, respectively. For all-cause mortality, HRs associated with higher DGI, DII, and MIND were 0.94 (95% CI: 0.89, 0.99), 1.08 (95% CI: 1.02, 1.15), and 0.93 (95% CI: 0.89, 0.98), respectively. For CVD mortality, HRs associated with higher DGI, DII, and MIND were 0.93 (95% CI: 0.85, 0.99), 1.10 (95% CI: 1.00, 1.24), and 0.90 (95% CI: 0.82, 0.98), respectively. There was limited evidence of associations between diet quality and nonfatal CVD events. A better quality diet predicted lower risk of all-cause and CVD mortality in Australian adults, whereas a more inflammatory diet predicted higher mortality risk. These findings highlight the applicability of following Australian dietary guidelines, a Mediterranean-style diet, and a low-inflammatory diet for the reduction of all-cause and CVD mortality risk.

Association between maternal education and diet of children at 9 months is partially explained by mothers' diet

Publisher: Wiley

Date: 08-04-2015

DOI: 10.1111/MCN.12031

No effect of n-3 long-chain polyunsaturated fatty acid (EPA and DHA) supplementation on depressed mood and cognitive function: a randomised controlled trial – reply by Rogers et al.

Publisher: Cambridge University Press (CUP)

Date: 12-2008

DOI: 10.1017/S0007114508975656

Abstract: We recently reported a null outcome from a study of n -3 long-chain PUFA supplementation in depressed mood ( 1 ) .

Long-term outcomes (2 and 3.5 years post-intervention) of the INFANT early childhood intervention to improve health behaviors and reduce obesity: cluster randomised controlled trial follow-up

Publisher: Springer Science and Business Media LLC

Date: 25-07-2020

DOI: 10.1186/S12966-020-00994-9

Abstract: The few health behavior interventions commencing in infancy have shown promising effects. Greater insight into their longer-term benefits is required. This study aimed to assess post-intervention effects of the Melbourne INFANT Program to child age 5y on diet, movement and adiposity. Two and 3.5y post-intervention follow-up (2011–13 analyses completed 2019) of participants retained in the Melbourne INFANT Program at its conclusion (child age ~ 19 m 2008–10) was conducted. The Melbourne INFANT Program is a 15-month, six session program delivered within first-time parent groups in Melbourne, Australia, between child age 4-19 m. It involves strategies to help parents promote healthy diet, physical activity and reduced sedentary behavior in their infants. No intervention was delivered during the follow-up period reported in this paper. At all time points height, weight and waist circumference were measured by researchers, children wore Actigraph and activPAL accelerometers for 8-days, mothers reported children’s television viewing and use of health services. Children’s dietary intake was reported by mothers in three unscheduled telephone-administered 24-h recalls. Of those retained at program conclusion (child age 18 m, n = 480 89%), 361 families (75% retention) participated in the first follow-up (2y post-intervention age 3.6y) and 337 (70% retention) in the second follow-up (3.5y post-intervention age 5y). At 3.6y children in the intervention group had higher fruit (adjusted mean difference [MD] = 25.34 g CI 95 :1.68,48.99), vegetable (MD = 19.41 CI 95 :3.15,35.67) and water intake (MD = 113.33 CI 95 :40.42,186.25), than controls. At 5y they consumed less non-core drinks (MD = -27.60 CI 95 :-54.58,-0.62). Sweet snack intake was lower for intervention children at both 3.6y (MD = -5.70 CI 95 :-9.75,-1.65) and 5y (MD = -6.84 CI 95 :-12.47,-1.21). Intervention group children viewed approximately 10 min/day less television than controls at both follow-ups, although the confidence intervals spanned zero (MD = -9.63 CI 95 :-30.79,11.53 MD = -11.34 CI 95 :-25.02,2.34, respectively). There was no evidence for effect on zBMI, waist circumference z-score or physical activity. The impact of this low-dose intervention delivered during infancy was still evident up to school commencement age for several targeted health behaviors but not adiposity. Some of these effects were only observed after the conclusion of the intervention, demonstrating the importance of long-term follow-up of interventions delivered during early childhood. ISRCTN Register ISRCTN81847050 , registered 7th November 2007.

Involvement of Young Australian Adults in Meal Preparation: Cross-Sectional Associations with Abdominal Obesity and Body Mass Index

Publisher: Elsevier BV

Date: 08-2011

DOI: 10.1016/J.JADA.2011.05.011

Abstract: Previous research has shown that involvement in meal preparation is positively associated with better diet quality. However, it is unclear whether there is an association between involvement in meal preparation and being overweight or obese. This study investigated whether the level of involvement in meal preparation was associated with objectively measured weight status in young adults. During 2004-2006, a national s le of 1,996 Australian adults aged 26 to 36 years completed a self-administered questionnaire including questions on sociodemographic characteristics, diet, and physical activity. Participants were asked to report who usually prepared the main meal on working days and responses were categorized as "myself," "shared," or "someone else." Waist circumference, weight, and height were measured by trained staff. Moderate abdominal obesity was defined as waist circumference ≥94 cm for men and ≥80 cm for women. Overweight was defined as body mass index (calculated as kg/m(2)) ≥25. Prevalence ratios were calculated using log binomial regression. After adjusting for age, education, and leisure time physical activity, men who shared the meal preparation had a slightly lower prevalence of moderate abdominal obesity (prevalence ratio=0.92 95% confidence interval [CI]: 0.86 to 0.99) than those whose meals were usually prepared by someone else. There was no association with having sole responsibility (prevalence ratio=0.99 95% CI: 0.92 to 1.06). There were no associations between level of involvement in meal preparation and being overweight (shared responsibility prevalence ratio=0.99 95% CI: 0.92 to 1.07 sole responsibility prevalence ratio=0.98 95% CI: 0.91 to 1.05). For women, level of involvement was not associated with moderate abdominal obesity (shared responsibility prevalence ratio=0.93 95% CI: 0.84 to 1.03 sole responsibility prevalence ratio=0.94 95% CI: 0.86 to 1.03) or being overweight (shared responsibility prevalence ratio=0.93 95% CI: 0.84 to 1.02 sole responsibility prevalence ratio=0.93 95% CI: 0.85 to 1.02). In this s le of young adults, level of involvement in meal preparation was not strongly related to weight status.

Early Childhood Vegetable, Fruit, and Discretionary Food Intakes Do Not Meet Dietary Guidelines, but Do Show Socioeconomic Differences and Tracking over Time

Publisher: Elsevier BV

Date: 09-2018

DOI: 10.1016/J.JAND.2017.12.009

Abstract: Dietary intakes of young children are likely to be important determinants of their short- and long-term health, yet there are few longitudinal dietary studies of this age group, and no previous assessments of diets before age 2 years compared with national dietary guidelines. This study aimed to compare vegetable, fruit, and discretionary food intakes of children aged 9 months to 5 years to dietary guidelines, and to assess differences in intakes by socioeconomic status and tracking of intakes across early childhood. This study analyzed longitudinal data from the Melbourne Infant Feeding Activity and Nutrition Trial Program early childhood lifestyle intervention trial, and is the first study to compare diets of children younger than age 2 years to national dietary guidelines. Participants were 467 children in Melbourne, Australia, aged 4 months at baseline (study conducted 2008-2015). Multiple 24-hour recalls with parents were conducted at child ages 9 months, 1.5 years, 3.5 years, and 5 years. Intakes of vegetables, fruits, and discretionary foods were compared with Australian Dietary Guidelines. Differences by socioeconomic status and tracking of intakes of each food group were assessed by multivariable linear regression. Few children (<10%) met guidelines for discretionary food intakes at any age. Most children (≥90%) met vegetable and fruit guidelines at 9 months, but thereafter rates of adequate intakes reduced substantially. Children of higher socioeconomic status consumed diets closer to guidelines for most food groups at most ages. Tracking of intakes was apparent across ages, with the strongest and most consistent tracking for discretionary foods. This study shows that diets of Australian children participating in this lifestyle intervention trial were suboptimal from early life. The evidence of differences by socioeconomic status and tracking from age 9 months, particularly for discretionary foods, highlights the importance of research and action to support appropriate introduction of complementary foods during the first year of life, and of focusing these efforts on disadvantaged groups.

Clustering of Obesity-Related Risk Behaviors in Children and Their Mothers

Publisher: Elsevier BV

Date: 02-2011

DOI: 10.1016/J.ANNEPIDEM.2010.11.001

Abstract: To examine the clustering and patterns of obesity-related behaviors in children and their mothers and the concordance between mother and child pairs. Primary school-aged children and their mothers in Victoria, Australia, participated (data from 549 mothers, 352 children, and 304 mother/child pairs). Examination of behavior patterns included 1) assessment of the overlap in national physical activity, screen-time, and fruit and vegetable consumption guidelines being met and 2) cluster analysis of positive (consumption of fruits and vegetables) and negative (consumption of energy dense food/drink) dietary behaviors, sedentary behavior/screen-time, and physical activity. Only partial overlap was observed between groups meeting national recommendations for sedentary behavior and consumption of fruit and vegetables and energy-dense food. Less than 40% of mothers and children were meeting sedentary behavior guidelines. In both mothers and children five clusters were identified. With the exception of a single cluster in children with high levels of physical activity, clusters of healthy and unhealthy behavior were concordant in mothers and their children (p < .0001), particularly those defined by sedentary behaviors and consumption of energy-dense food/drink. Complex patterns of obesity-related behaviors exist in children and their mothers. The concordance of clusters between children and their mothers suggests that modeling of sedentary behavior and creation of a child's eating environment by parents may be particularly important influences on children's behavior.

Dietary patterns, assessed from a weighed food record, and survival among elderly participants from the United Kingdom

Publisher: Springer Science and Business Media LLC

Date: 02-06-2010

DOI: 10.1038/EJCN.2010.93

Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults: cross-sectional data from the WELL study

Publisher: Springer Science and Business Media LLC

Date: 25-07-2012

DOI: 10.1186/1471-2458-12-551

Abstract: Lifestyle behaviours, such as healthy diet, physical activity and sedentary behaviour, are key elements of healthy ageing and important modifiable risk factors in the prevention of chronic diseases. Little is known about the relationship between these behaviours in older adults. The purpose of this study was to explore the relationship between fruit and vegetable (F& V) intake, leisure-time physical activity (LTPA) and sitting time (ST), and their association with self-rated health in older adults. This cross-sectional study comprised 3,644 older adults (48% men) aged 55–65 years, who participated in the Wellbeing, Eating and Exercise for a Long Life (“WELL”) study. Respondents completed a postal survey about their health and their eating and physical activity behaviours in 2010 (38% response rate). Spearman’s coefficient (rho) was used to evaluate the relationship between F& V intake, LTPA and ST. Their in idual and shared associations with self-rated health were examined using ordinal logistic regression models, stratified by sex and adjusted for confounders (BMI, smoking, long-term illness and socio-demographic characteristics). The correlations between F& V intake, LTPA and ST were low. F& V intake and LTPA were positively associated with self-rated health. Each additional serving of F& V or MET-hour of LTPA were associated with approximately 10% higher likelihood of reporting health as good or better among women and men. The association between ST and self-rated health was not significant in the multivariate analysis. A significant interaction was found (ST*F& V intake). The effect of F& V intake on self-rated health increased with increasing ST in women, whereas the effect decreased with increasing ST in men. This study contributes to the scarce literature related to lifestyle behaviours and their association with health indicators among older adults. The findings suggest that a modest increase in F& V intake, or LTPA could have a marked effect on the health of older adults. Further research is needed to fully understand the correlates and determinants of lifestyle behaviours, particularly sitting time, in this age group.

Development of a food composition database for the estimation of dietary intakes of glucosinolates, the biologically active constituents of cruciferous vegetables

Publisher: Cambridge University Press (CUP)

Date: 09-2003

DOI: 10.1079/BJN2003917

Abstract: Evidence indicates that cruciferous vegetables are protective against a range of cancers with glucosinolates and their breakdown products considered the biologically active constituents. To date, epidemiological studies have not investigated the intakes of these constituents due to a lack of food composition databases. The aim of the present study was to develop a database for the glucosinolate content of cruciferous vegetables that can be used to quantify dietary exposure for use in epidemiological studies of diet–disease relationships. Published food composition data sources for the glucosinolate content of cruciferous vegetables were identified and assessed for data quality using established criteria. Adequate data for the total glucosinolate content were available from eighteen published studies providing 140 estimates for forty-two items. The highest glucosinolate values were for cress (389 mg/100 g) while the lowest values were for Pe-tsai chinese cabbage (20 mg/100 g). There is considerable variation in the values reported for the same vegetable by different studies, with a median difference between the minimum and maximum values of 5·8-fold. Limited analysis of cooked cruciferous vegetables has been conducted however, the available data show that average losses during cooking are approximately 36 %. This is the first attempt to collate the available literature on the glucosinolate content of cruciferous vegetables. These data will allow quantification of intakes of the glucosinolates, which can be used in epidemiological studies to investigate the role of cruciferous vegetables in cancer aetiology and prevention.

Antioxidants and basal cell carcinoma of the skin: A nested case–control study

Publisher: Springer Science and Business Media LLC

Date: 06-2005

DOI: 10.1007/S10552-004-8022-1

Abstract: To investigate the relationship between basal cell carcinoma (BCC) and antioxidant nutrients, specifically carotenoids, vitamin E and selenium. The Nambour Skin Cancer Study is an ongoing, community-based study of randomly selected adult residents of a township in sub-tropical Queensland, Australia. Using a nested case-control design, incident cases of BCC (n=90) were compared with age and sex matched controls (n=90). Dietary exposure was measured using food frequency questionnaire estimates of intake as well as serum biomarkers. Other determinants of skin cancer including sun exposure were also considered. Dietary intakes were adjusted for energy intake, and serum carotenoids and vitamin E were adjusted for serum cholesterol. Odds ratios were calculated across quartiles of dietary intake and serum biomarkers and linear trends were assessed using logistic regression, adjusting for age, sex and supplement use. In this prospective study no significant associations were found between BCC and carotenoids, vitamin E or selenium, as measured by serum biomarkers or dietary intake, although there was a suggestion of a positive association with lutein intake.

A Health Promotion Intervention Can Affect Diet Quality in Early Childhood

Publisher: Elsevier BV

Date: 10-2013

DOI: 10.3945/JN.113.177931

Abstract: Initiatives to promote children's nutrition and prevent childhood obesity are vital. Dietary patterns are a useful way to characterize whole diets, though no previous early childhood health promotion trial to our knowledge has assessed intervention impact using this approach. This research aimed to assess the effect of a healthy eating and physical activity intervention on young children's dietary patterns. The Melbourne Infant Feeding Activity and Nutrition Trial Program was a health promotion, cluster-randomized controlled trial involving 542 families. Child diets were assessed by multiple 24-h recalls postintervention at ~18 mo of age. An Obesity Protective Dietary Index (OPDI) was created and dietary patterns were also assessed by principal components analysis (PCA). These outcomes were used to compare intervention and control participants to test the effectiveness of the intervention. Children in the intervention arm scored higher (15.6 ± 5.9) than those in the control arm (14.5 ± 6.7) for the OPDI (scores out of 30, P = 0.01). Three dietary patterns were identified by PCA however, the scores did not substantially differ between the intervention and control arms. In conclusion, this paper presents novel results in both the evaluation of an early childhood health promotion intervention and the assessment of child dietary patterns. The results highlight the capacity for such an initiative to improve child diets and the need for further research in this area.

Nutritional care of older patients: experiences of general practitioners and practice nurses

Publisher: CSIRO Publishing

Date: 2017

DOI: 10.1071/PY16021

Abstract: Older people living in the community face unique nutritional issues that put them at risk of undernutrition, which is associated with increased morbidity and mortality. Primary healthcare staff such as general practitioners (GPs) and practice nurses (PNs) are well placed to identify nutritional problems early and intervene. The aim of this study was to understand the experiences and current practices in a s le of GPs and PNs with regards to nutritional care of elderly patients. An online survey of GPs and PNs working in regional Victoria was conducted. Among the 45 respondents, 89% reported encountering consultations with a nutritional component for older patients within the previous 3 months, and 94% of those took some action, most commonly referrals, dietary advice or prescribing supplements. Although the majority (63%) felt confident in providing appropriate nutritional recommendations for patients, 68% reported a desire for further professional development in the area. Given the frequency of nutritional issues presenting, further work is required to determine how well equipped primary healthcare staff are to provide nutritional advice to older patients.

Energy expenditure and the body cell mass in cystic fibrosis

Publisher: Elsevier BV

Date: 2001

DOI: 10.1016/S0899-9007(00)00470-6

Abstract: Poor nutritional status in patients with cystic fibrosis (CF) is associated with severe lung disease, and possible causative factors include inadequate intake, malabsorption, and increased energy requirements. Body cell mass (which can be quantified by measurement of total body potassium) provides an ideal standard for measurements of energy expenditure. The aim of this study was to compare resting energy expenditure (REE) in patients with CF with both predicted values and age-matched healthy children and to determine whether REE was related to either nutritional status or pulmonary function. REE was measured by indirect calorimetry and body cell mass by scanning with total body potassium in 30 patients with CF (12 male, mean age = 13.07 +/- 0.55 y) and 18 healthy children (six male, mean age = 12.56 +/- 1.25 y). Nutritional status was expressed as a percentage of predicted total body potassium. Lung function was measured in the CF group by spirometry and expressed as the percentage of predicted forced expiratory volume in 1 s. Mean REE was significantly increased in the patients with CF compared with healthy children (119.3 +/- 3.1% predicted versus 103.6 +/- 5% predicted, P < 0.001) and, using multiple regression techniques, REE for total body potassium was significantly increased in patients with CF (P = 0.0001). There was no relation between REE and nutritional status or pulmonary disease status in the CF group. In conclusion, REE is increased in children and adolescents with CF but is not directly related to nutritional status or pulmonary disease.

Is greater variety of chocolates and confectionery in supermarkets associated with more consumption?

Publisher: Elsevier BV

Date: 06-2011

DOI: 10.1111/J.1753-6405.2011.00706.X

Early Life Protein Intake: Food Sources, Correlates, and Tracking across the First 5 Years of Life

Publisher: Elsevier BV

Date: 08-2017

DOI: 10.1016/J.JAND.2017.03.016

Abstract: High consumption of protein has been associated with accelerated growth and adiposity in early childhood. To describe intake, food sources, correlates, and tracking of protein in young children. Secondary analysis of Melbourne Infant Feeding Activity and Nutrition Trial (InFANT). Dietary data were collected using three 24-hour dietary recalls at ages 9 and 18 months as well as 3.5 and 5 years. First-time mothers and their child (n=542) participated in an 18-month intervention to prevent childhood obesity and the cohort was followed-up with no intervention when children were aged 3.5 and 5 years. Protein intake, food sources, correlates, and tracking of protein. Child and maternal correlates of protein intake were identified using linear regression and tracking of protein intake was examined using Pearson correlations of residualized protein scores between time points. Mean protein (grams per day) intake was 29.7±11.0, 46.3±11.5, 54.2±13.8, and 60.0±14.8 at 9 and 18 months and 3.5 and 5 years, respectively. Protein intakes at all ages were two to three times greater than age-appropriate Australian recommendations. The primary source of protein at 9 months was breast/formula milk. At later ages, the principal sources were milk/milk products, breads/cereals, and meat/meat products. Earlier breastfeeding cessation, earlier introduction of solids, high dairy milk consumption (≥500 mL), and high maternal education were significant predictors of high protein intake at various times (P<0.05). Slight tracking was found for protein intakes at 9 months, 18 months, and 5 years (r=0.16 to 0.21 P<0.01). This study provides unique insights into food sources and correlates of young children's high protein intakes, and confirms that early protein intakes track slightly up to age 5 years. These finding have potential to inform nutrition interventions and strategies to address high protein intakes and protein-related obesity risk.

Depressed mood and n-3 polyunsaturated fatty acid intake from fish: non-linear or confounded association?

Publisher: Springer Science and Business Media LLC

Date: 11-12-2006

DOI: 10.1007/S00127-006-0142-3

Abstract: There is increasing evidence of an association between low dietary intake of essential n-3 long chain polyunsaturated fatty acids (n-3 EFAs) and depressed mood. This study aimed to evaluate this association in a large population-based s le of UK in iduals. N-3 EFA intake (intake from fish alone, and from all sources (fish and supplements)), depressed mood (assessed using the short-form Depression, Anxiety and Stress Scales) and demographic variables (sex, age, Index of Multiple Deprivation (IMD) based on postal code, and date of questionnaire completion) were obtained simultaneously by self-report questionnaire (N = 2982). Using polynomial regression, a non-linear relationship between depressed mood and n-3 EFA intake from fish was found, with the incremental decrease in depressed mood diminishing as n-3 EFA intake increased. However, this relationship was attenuated by adjustment for age and IMD. No relationship between depression and n-3 EFA intake from all sources was found. These findings suggest that higher levels of n-3 EFA intake from fish are associated with lower levels of depressed mood, but the association disappears after adjustment for age and social deprivation, and after inclusion of n-3 EFA intake from supplements. This study does have a number of limitations, but the findings available suggest that the apparent associations between depressed mood and n-3 EFA intake from fish may simply reflect a wider association between depressed mood and lifestyle.

Dietary Patterns Throughout Adult Life Are Associated with Body Mass Index, Waist Circumference, Blood Pressure, and Red Cell Folate ,2

Publisher: Elsevier BV

Date: 2007

DOI: 10.1093/JN/137.1.99

Abstract: Dietary patterns are important in the prevention of chronic disease however, there are few studies that include repeat measures of dietary patterns. The objective of this study was to assess the relations between dietary patterns during adult life (at ages 36, 43, and 53 y) and risk factors for chronic disease at age 53 y. Participants of a longitudinal study of health completed a 5-d food diary at 3 occasions during adult life (n = 1265). Factor analysis was used to identify dietary patterns and a pattern score was calculated from the consumption of the food items in each dietary pattern. Means and 95% CI for dietary pattern scores were calculated for each risk factor category using random effects models adjusted for socio-demographic and health-related behaviors. In women, the fruit, vegetables, and dairy pattern was inversely associated with BMI (P < 0.004), waist circumference (P = 0.0007), blood pressure (P = 0.02), and was positively associated with red cell folate (P < 0.03). The ethnic foods and alcohol pattern was also inversely associated with blood pressure (P = 0.008), whereas the meat, potatoes and sweet foods pattern was positively associated with glycated hemoglobin (P = 0.01). In men, a mixed pattern was inversely associated with waist circumference (P = 0.02) and blood pressure (P = 0.01), whereas there were no significant associations with the ethnic foods and alcohol pattern. Specific dietary patterns throughout adult life were associated with chronic disease risk factors.

Dietary patterns, foods and nutrients: a descriptive analysis of the systematic reviews conducted to inform the Australian Dietary Guidelines

Publisher: Cambridge University Press (CUP)

Date: 11-08-2020

DOI: 10.1017/S0954422420000190

Abstract: Dietary guidelines should be underpinned by the best available evidence on relationships between diet and health, including evidence from nutrient-based, food-based and dietary patterns research. The primary aim of the present study was to analyse the systematic reviews conducted to inform the 2013 Australian Dietary Guidelines according to dietary exposure. The secondary aim was to analyse the reviews by health outcome, and design of included studies. To identify the systematic reviews, the dietary guidelines report was used as a starting point and relevant references were retrieved. The evidence report contained the data used in this analysis. Descriptive statistics were used to analyse reviews according to exposure, outcome, and design of included studies. A total of 143 systematic reviews were included in this analysis. Foods were the most common exposure (86·7 % of reviews), followed by nutrients (10·5 %) and dietary patterns (2·8 %). Chronic disease morbidity and/or mortality was the most common outcome (80·4 %), followed by chronic disease risk factors (19·6 %). Most reviews included evidence from cohort or nested case–control studies (92·3 %), many included evidence from case–control studies (61·5 %) and some included evidence from randomised controlled trials (28·7 %). These results reflect the research questions that were asked, the systematic review methods that were used, and the evidence that was available. In developing future iterations of the Australian Dietary Guidelines, there is an opportunity to review the latest evidence from dietary patterns research.

Eating patterns of Australian adults: associations with blood pressure and hypertension prevalence

Publisher: Springer Science and Business Media LLC

Date: 06-06-2019

DOI: 10.1007/S00394-018-1741-Y

A comparison of the dietary patterns derived by principal component analysis and cluster analysis in older Australians

Publisher: Springer Science and Business Media LLC

Date: 29-02-2016

DOI: 10.1186/S12966-016-0353-2

Takeaway food consumption and cardio-metabolic risk factors in young adults

Publisher: Springer Science and Business Media LLC

Date: 07-12-2011

DOI: 10.1038/EJCN.2011.202

Abstract: Takeaway food consumption is positively associated with adiposity. Little is known about the associations with other cardio-metabolic risk factors. This study aimed to determine whether takeaway food consumption is associated with fasting glucose, insulin, lipids, homeostasis model assessment (HOMA) and blood pressure. A national s le of 1896, 26-36 year olds completed a questionnaire on socio-demographics, takeaway food consumption, physical activity and sedentary behaviour. Waist circumference and blood pressure were measured, and a fasting blood s le was taken. For this analysis, takeaway food consumption was dichotomised to once a week or less and twice a week or more. Linear regression was used to calculate differences in the adjusted mean values for fasting lipids, glucose, insulin, HOMA and blood pressure. Models were adjusted for age, employment status, leisure time physical activity and TV viewing. Compared with women who ate takeaway once a week or less, women who ate takeaway twice a week or more had significantly higher adjusted mean fasting glucose (4.82 vs 4.88 mmol/l, respectively P=0.045), higher HOMA scores (1.27 vs 1.40, respectively, P=0.034) and tended to have a higher mean fasting insulin (5.95 vs 6.45 mU/l, respectively, P=0.054). Similar associations were observed for men for fasting insulin and HOMA score, but the differences were not statistically significant. For both women and men adjustment for waist circumference attenuated the associations. Consuming takeaway food at least twice a week was associated with cardio-metabolic risk factors in women but less so in men. The effect of takeaway food consumption was attenuated when adjusted for obesity.

Dietary Quality Is Associated with Diabetes and Cardio-Metabolic Risk Factors

Publisher: Elsevier BV

Date: 04-2009

DOI: 10.3945/JN.108.096784

Abstract: In this study, our aim was to investigate the associations between diet quality and newly diagnosed diabetes, prediabetes, and cardio-metabolic risk factors. The analysis was based on 7441 participants of the Australian Diabetes, Obesity and Lifestyle study, a cross-sectional study of adults aged > or =25 y involving a 75-g oral glucose tolerance test. Diet quality was assessed via a dietary guideline index and FFQ data. Associations between diet quality and diabetes, prediabetes (impaired fasting glycemia, impaired glucose tolerance), and cardiovascular risk factors were investigated using linear and logistic regression adjusted for age, education, smoking, physical activity, sedentary behavior, and BMI. Higher diet quality was significantly associated with lower systolic and diastolic blood pressure among men, lower fasting plasma glucose among men and women, and lower systolic blood pressure, fasting plasma insulin, and 2-h plasma glucose and greater insulin sensitivity among women. Diet quality was inversely associated with abdominal obesity [odds ratio (OR) for top quartile: 0.68, 0.48-0.96], hypertension (OR: 0.50, 0.31-0.81), and type 2 diabetes (OR: 0.38, 0.18-0.80) among men. Lack of compliance with established dietary guidelines was associated with type 2 diabetes and cardio-metabolic risk factors. Further work is required to determine whether this dietary index has predictive validity for health in longitudinal studies.

Influence of price discounts and skill-building strategies on purchase and consumption of healthy food and beverages: outcomes of the Supermarket Healthy Eating for Life randomized controlled trial

Publisher: Elsevier BV

Date: 05-2015

DOI: 10.3945/AJCN.114.096735

Abstract: Fiscal strategies are increasingly considered upstream nutrition promotion measures. However, few trials have investigated the effectiveness or cost effectiveness of pricing manipulations on diet in real-world settings. We assessed the effects on fruit, vegetable, and beverage purchasing and consumption of a 20% price-reduction intervention, a tailored skills-based behavior-change intervention, and a combined intervention compared with a control condition. The Supermarket Healthy Eating for Life trial was a randomized controlled trial conducted over 3 mo [baseline (time 1) to postintervention (time 2) with a 6-mo follow-up (time 3)]. Female primary household shoppers in Melbourne, Australia, were randomly assigned to a 1) skill-building (n = 160), 2) price-reduction (n = 161), 3) combined skill-building and price-reduction (n = 160), or 4) control (n = 161) group. Supermarket transaction data and surveys were used to measure the following study outcomes: fruit, vegetable, and beverage purchases and self-reported fruit and vegetable consumption at each time point. At 3 mo (time 2), price reduction-alone participants purchased more total vegetables and frozen vegetables than did controls. Price reduction-alone and price reduction-plus-skill-building participants purchased more fruit than did controls. Relative to controls, in the price-reduction group, total vegetable consumption increased by 233 g/wk (3.1 servings or 15% more than at baseline), and fruit purchases increased by 364 g/wk (2.4 servings 35% more than at baseline). Increases were not maintained 6 mo postintervention (time 3). Price reduction-alone participants showed a tendency for a slight increase in fruit consumption at time 2 (P = 0.09) that was maintained at time 3 (P = 0.014). No intervention improved purchases of bottled water or low-calorie beverages. A 20% price reduction in fruit and vegetables resulted in increased purchasing per household of 35% for fruit and 15% for vegetables over the price-reduction period. These findings show that price modifications can directly increase produce purchases. The Supermarket Healthy Eating for Life trial was registered at Current Controlled Trials Registration as ISRCTN39432901.

Lifestyle Patterns Begin in Early Childhood, Persist and Are Socioeconomically Patterned, Confirming the Importance of Early Life Interventions

Publisher: MDPI AG

Date: 09-03-2020

DOI: 10.3390/NU12030724

Abstract: Traditional approaches to understanding the behavioural determinants of adiposity have considered diet, physical activity and sedentary behaviour in isolation. Although integrative approaches have identified a variety of lifestyle patterns in children at preschool-age or older, along with some variability by socio-economic positions, this has rarely been examined in younger cohorts. We aimed to identify lifestyle patterns at 1.5, 3.5 and 5 years, including dietary intake, outdoor time and television viewing time, to assess associations with maternal education (as a proxy for socio-economic position), and to investigate their persistence between toddlerhood and preschool age. Participants were 417 and 293 children aged 1.5 y from the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) and InFANT Extend Programs, respectively. Data were collected using questionnaires at child ages 1.5, 3.5 and 5 y (InFANT) and 1.5 and 3.5 y (InFANT Extend). Principal component analysis was undertaken at each time point on the separate and pooled datasets. Associations between the lifestyle patterns scores and maternal education were assessed with multivariable regression analysis. Two lifestyle patterns (“Discretionary consumption and TV” and “Fruit, vegetables and outdoor”) were identified as early as 1.5 y. They remained consistent across ages and were evident in both datasets. These patterns were inversely and positively associated with maternal education, respectively. Such early clustering of obesity related energy balance behaviours and tracking during early childhood suggests there may be shared antecedents common to the in idual behaviours that could be targeted for intervention. Our findings provide support for interventions targeting multiple behaviours and tailored to the level of family socio-economic disadvantage.

Nutrition promotion approaches preferred by Australian adolescents attending schools in disadvantaged neighbourhoods: a qualitative study

Publisher: Springer Science and Business Media LLC

Date: 19-05-2015

DOI: 10.1186/S12887-015-0379-7

Effects of breaking up sitting on adolescents' postprandial glucose after consuming meals varying in energy: a cross-over randomised trial

Publisher: Elsevier BV

Date: 03-2018

DOI: 10.1016/J.JSAMS.2017.06.002

Abstract: To explore the impact of uninterrupted sitting versus sitting with resistance-type activity breaks on adolescents' postprandial glucose responses while consuming a diet varying in energy. Cross-over randomised trial. Thirteen healthy participants (16.4±1.3years) completed a four-treatment cross-over trial: (1) uninterrupted sitting+high-energy diet (2) sitting with breaks+high-energy diet (3) uninterrupted sitting+standard-energy diet and (4) sitting with breaks+standard-energy diet. For all four conditions, two identical meals were consumed at 0h and 3h. A continuous glucose monitoring system (CGM) recorded interstitial glucose concentrations every five minutes. Linear mixed models examined differences in glucose positive incremental area under the curve (iAUC) and total AUC between the sitting and diet conditions for the first meal, second meal and entire trial period. Compared to the uninterrupted sitting conditions, the breaks condition elicited a 36.0mmol/L/h (95%CI 6.6-65.5) and 35.9mmol/L/h (95%CI 6.6-65.5) lower iAUC response after the first and second meal, respectively, but not for the entire trial period or for total AUC. Compared to the standard-energy diet, the high-energy diet elicited a 55.0mmol/L/h (95%CI 25.8-84.2) and 75.7mmol/L/h (95%CI 8.6-142.7) higher iAUC response after the first meal and entire trial, respectively. Similar response to the high-energy diet were observed for total AUC. According to iAUC, interrupting sitting had a significant effect on lowering postprandial glucose for both dietary conditions, however, it was not significant when examining total AUC. Larger studies are needed to confirm these findings. ACTRN12615001145594.

Correlates of meal skipping in young adults: a systematic review

Publisher: Springer Science and Business Media LLC

Date: 12-2016

DOI: 10.1186/S12966-016-0451-1

Socio-economic differences in predictors of frequent dairy food consumption among Australian adolescents: a longitudinal study

Publisher: Cambridge University Press (CUP)

Date: 23-02-2015

DOI: 10.1017/S1368980015000324

Abstract: Sufficient dairy food consumption during adolescence is necessary for preventing disease. While socio-economically disadvantaged adolescents tend to consume few dairy foods, some eat quantities more in line with dietary recommendations despite socio-economic challenges. Socio-economic variations in factors supportive of adolescents’ frequent dairy consumption remain unexplored. The present study aimed to identify cross-sectional and longitudinal associations between intrapersonal, social and environmental factors and adolescents’ frequent dairy consumption at baseline and two years later across socio-economic strata, and to examine whether socio-economic position moderated observed effects. Online surveys completed at baseline (2004–2005) and follow-up (2006–2007) included a thirty-eight-item FFQ and questions based on social ecological models examining intrapersonal, social and environmental dietary influences. Thirty-seven secondary schools in Victoria, Australia. Australian adolescents ( n 1201) aged 12–15 years, drawn from a sub-s le of 3264 adolescents (response rate=33 %). While frequent breakfast consumption was cross-sectionally associated with frequent dairy consumption among all adolescents, additional associated factors differed by socio-economic position. Baseline dairy consumption longitudinally predicted consumption at follow-up. No further factors predicted frequent consumption among disadvantaged adolescents, while four additional factors were predictive among advantaged adolescents. Socio-economic position moderated two predictors infrequently eating dinner alone and never purchasing from school vending machines predicted frequent consumption among advantaged adolescents. Nutrition promotion initiatives aimed at improving adolescents’ dairy consumption should employ multifactorial approaches informed by social ecological models and address socio-economic differences in influences on eating behaviours e.g. selected intrapersonal factors among all adolescents and social factors (e.g. mealtime rules) among advantaged adolescents.

Great app-eal' but not there yet: A review of iPhone nutrition applications relevant to child weight management

Publisher: Wiley

Date: 16-04-2015

DOI: 10.1111/1747-0080.12184

Supplement Use Is Associated with Health Status and Health-Related Behaviors in the 1946 British Birth Cohort

Publisher: Elsevier BV

Date: 07-2005

DOI: 10.1093/JN/135.7.1782

Abstract: Use of dietary supplements may be one of a number of health-related behaviors that cluster together. The current study investigated the underlying diet, health-related characteristics, and behaviors of users and nonusers of dietary supplements in a longitudinal study of health. Participants (n = 1776) completed a 5-d food diary including information on dietary supplement use (vitamins, minerals, and nutraceuticals) at age 53 y. Sociodemographic information and data on smoking, alcohol, and physical activity were obtained along with anthropometric measurements, blood pressure, and a blood s le (nonfasting subjects). A significantly greater percentage of women reported supplement use compared with men (45.1 vs. 25.2%). Supplement use was associated with lower BMI, lower waist circumference, higher plasma folate and plasma vitamin B-12 concentrations, nonsmoking, participation in physical activity, and nonmanual social class in women and with plasma folate concentrations and participation in physical activity in men. Nonsupplement users tended to be nonconsumers of breakfast cereals, fruit, fruit juice, yogurt, oily fish, and olive oil and had lower dietary intakes of potassium, magnesium, phosphorus, iron, and vitamin C even after adjustment for sociodemographic and behavioral factors. Overall, supplement users tended to differ from nonsupplement users on a range of health-related behaviors and health status indicators, although there were fewer significant associations in men. Similarly, dietary supplements users tended to have underlying diets that, were healthier and those taking supplements may be the least likely to need them. These results support the notion of a clustering of healthy behaviors and cardiovascular risk factors, particularly for women.

Diet quality and telomere length in older Australian men and women

Publisher: Springer Science and Business Media LLC

Date: 26-10-2016

DOI: 10.1007/S00394-016-1326-6

Exploring barriers to meeting recommendations for fruit and vegetable intake among adults in regional areas: A mixed-methods analysis of variations across socio-demographics

Publisher: Elsevier BV

Date: 10-2020

DOI: 10.1016/J.APPET.2020.104750

Temporal eating patterns: a latent class analysis approach

Publisher: Springer Science and Business Media LLC

Date: 07-01-2017

DOI: 10.1186/S12966-016-0459-6

Does Diet Mediate Associations of Volume and Bouts of Sedentary Time with Cardiometabolic Health Indicators in Adolescents?

Publisher: Wiley

Date: 25-01-2017

DOI: 10.1002/OBY.21750

Cost and Affordability of Healthy, Equitable and Sustainable Diets in Low Socioeconomic Groups in Australia

Publisher: MDPI AG

Date: 23-08-2021

DOI: 10.3390/NU13082900

Abstract: Few Australians consume a healthy, equitable and more sustainable diet consistent with the Australian Dietary Guidelines (ADGs). Low socioeconomic groups (SEGs) suffer particularly poor diet-related health problems. However, granular information on dietary intakes and affordability of recommended diets was lacking for low SEGs. The Healthy Diets Australian Standardised Affordability and Pricing protocol was modified for low SEGs to align with relevant dietary intakes reported in the National Nutrition Survey 2011–2012(which included less healthy and more discretionary options than the broader population), household structures, food purchasing habits, and incomes. Cost and affordability of habitual and recommended diets of low SEGs were calculated using prices of ‘standard brands’ and ‘cheapest options’. With ‘standard brands’, recommended diets cost less than habitual diets, but were unaffordable for low SEGs. With ‘cheapest options’, both diets were more affordable, but recommended diets cost more than habitual diets for some low SEGs, potentially contributing to perceptions that healthy food is unaffordable. The study confirms the need for an equity lens to better target dietary guidelines for low SEGs. It also highlights urgent policy action is needed to help improve affordability of recommended diets.

Associations between the perceived environment and physical activity among adults aged 55-65 years: Does urban-rural area of residence matter?

Publisher: Human Kinetics

Date: 2015

DOI: 10.1123/JAPA.2012-0271

Abstract: This study aimed to determine whether associations between the perceived environment and physical activity are moderated by urban-rural status among midolder aged adults. Environmental (safety, aesthetics, physical activity environment) and physical activity (total, leisure, transport) data from 3,888 adults (55 to 65 years) from urban and rural areas of Victoria, Australia, were analyzed. Multinomial logistic regression examined interactions between urban-rural status and environments in associations with physical activity. Significant ( P .05) interactions were evident and indicated positive associations only among older rural adults for both safety and aesthetics with total and transport physical activity (e.g., rural adults reporting higher safety were 91% to 118% more likely to have higher activity than rural adults reporting low safety). In contrast, the physical activity environment was positively associated with leisure activity among only urban adults. Findings suggest that some tailoring of physical activity promotion strategies targeting the environment may be required for urban and rural midolder aged adults.

Characterizing eating patterns: a comparison of eating occasion definitions

Publisher: Elsevier BV

Date: 11-2015

DOI: 10.3945/AJCN.115.114660

Abstract: To date, many approaches have been used to define eating occasions (EOs). A standard definition for EOs is required to facilitate further research. In this study, we examined the influence of differing definitions of EOs on the characterization of eating patterns. Cross-sectional dietary data from two 24-h recalls collected during the 2011-12 Australian National Nutrition and Physical Activity Survey (n = 5242 adults, aged ≥19 y) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (in idual EOs separated by different time intervals and/or an additional energy criterion of 210 kJ). Frequency of and total energy intake from meals, snacks, and all EOs were estimated, as appropriate. Differences were tested by using F tests, stratified by sex and age group. Agreement between different definitions of meal and snack frequencies was assessed by using intraclass correlation coefficients (ICCs). For each definition, linear regression was used to estimate the proportion of variance in total energy intake (kJ) and amount of food intake (g) predicted by frequency of EOs and meals and snacks. Among both sexes and across all age groups, mean frequencies of meals differed between the participant-identified and time-of-day definitions (mean difference range = 0.1-0.3 P < 0.001). There were statistically significant differences between mean frequencies of EOs across the 6 neutral definitions (P < 0.001). There was good agreement for snacks (men: ICC = 0.89 women: ICC = 0.87) but not meal frequencies (men: ICC = 0.38 women: ICC = 0.36) between the participant-identified and time-of-day definitions. The neutral definition (15-min time interval plus energy criterion) best predicted variance in total energy intake (R(2) range = 19.3-27.8). Different approaches to the definition of EOs affect how eating patterns are characterized, with the neutral definition best predicting variance in total energy intake. Further research that examines how different EO definitions affect associations with health outcomes is needed to develop consensus on a standard EO definition.

Variation in supermarket exposure to energy-dense snack foods by socio-economic position

Publisher: Cambridge University Press (CUP)

Date: 22-05-2012

DOI: 10.1017/S1368980012002649

Abstract: The present study aimed to examine the availability of energy-dense, nutrient-poor snack foods (and fruits and vegetables) in supermarkets located in socio-economically advantaged and disadvantaged neighbourhoods. Cross-sectional supermarket audit. Melbourne, Australia. Measures included product shelf space and number of varieties for soft drinks, crisps, chocolate, confectionery and fruits and vegetables, as well as store size. Thirty-five supermarkets (response 83 %) from neighbourhoods in the lowest and highest quintile of socio-economic disadvantage. Shelf space allocated to soft drinks (23·6 m v . 17·7 m, P = 0·006), crisps (16·5 m v . 13·0 m, P = 0·016), chocolate (12·2 m v . 10·1 m, P = 0·022) and confectionery (6·7 m v . 5·1 m, P = 0·003) was greater in stores from socio-economically disadvantaged neighbourhoods. After adjustment for store size (stores in disadvantaged areas being larger), shelf space for confectionery (6·3 m v . 5·6 m, P = 0·024) and combined shelf space for all energy-dense foods and drinks (55·0 m v . 48·9 m, P = 0·017) remained greater in stores from socio-economically disadvantaged neighbourhoods. The ratio of shelf space allocated to fruits and vegetables to that for energy-dense snack foods also varied by socio-economic disadvantage after adjustment for store size (most disadvantaged v . least disadvantaged: 1·7 v . 2·1, P = 0·025). Varieties of fruits and vegetables and chocolate bars were more numerous in less disadvantaged areas ( P 0·05). Exposure to energy-dense snack foods and soft drinks in supermarkets was greater in socio-economically disadvantaged neighbourhoods. This may impact purchasing, consumption and cultural norms related to eating behaviours and may therefore work against elimination of the known socio-economic gradient in obesity levels. Reform of supermarket stocking practices may represent an effective means of obesity prevention.

Quality and accuracy of online nutrition-related information: a systematic review of content analysis studies

Publisher: Cambridge University Press (CUP)

Date: 04-05-2023

DOI: 10.1017/S1368980023000873

Abstract: This systematic review aimed to summarise the level of quality and accuracy of nutrition-related information on websites and social media and determine if quality and accuracy varied between websites and social media or publishers of information. This systematic review was registered with PROSPERO (CRD42021224277). CINAHL, MEDLINE, Embase, Global Health and Academic Search Complete were systematically searched on 15 January 2021 to identify content analysis studies, published in English after 1989, that evaluated the quality and/or accuracy of nutrition-related information published on websites or social media. A coding framework was used to classify studies’ findings about information quality and/or accuracy as poor, good, moderate or varied. The Academy of Nutrition and Dietetics Quality Criteria Checklist was used to assess the risk of bias. N/A. N/A. From 10 482 articles retrieved, sixty-four were included. Most studies evaluated information from websites ( n 53, 82·8 %). Similar numbers of studies assessed quality ( n 41, 64·1 %) and accuracy ( n 47, 73·4 %). Almost half of the studies reported that quality ( n 20, 48·8 %) or accuracy ( n 23, 48·9 %) was low. Quality and accuracy of information were similar on social media and websites, however, varied between information publishers. High risk of bias in s le selection and quality or accuracy evaluations was a common limitation. Online nutrition-related information is often inaccurate and of low quality. Consumers seeking information online are at risk of being misinformed. More action is needed to improve the public’s eHealth and media literacy and the reliability of online nutrition-related information.

Associations between dietary patterns at 6 and 15 months of age and sociodemographic factors

Publisher: Springer Science and Business Media LLC

Date: 11-01-2012

DOI: 10.1038/EJCN.2011.219

Abstract: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) have previously shown that dietary patterns are observable by 3 years. However, it is not clear when dietary patterns emerge. We aimed to describe dietary patterns in early life and their associations with maternal and infant sociodemographic characteristics. Principal component analysis was applied to diet questionnaires of ALSPAC participants at 6 months (n = 7052) and 15 months (n = 5610) to extract dietary patterns. The sociodemographic factors associated with dietary patterns were investigated using regression analyses. Four dietary patterns were extracted at both 6 and 15 months. A traditional-style pattern characterized by home-prepared meats, vegetables and desserts, a second pattern characterized by ready-prepared baby foods and a third pattern characterized by discretionary foods such as biscuits, sweets and crisps were identified at both ages. At 6 months, the fourth pattern was characterized predominantly by breastfeeding and at 15 months, by contemporary-style foods including herbs, legumes, nuts, raw fruit and vegetables. Higher maternal age and education, number of siblings and lower body mass index (BMI) was associated with higher scores on the breastfeeding or meat, vegetables and desserts patterns, whereas higher discretionary food pattern scores were associated with younger maternal age, lower education, higher BMI and more siblings. Associations between sociodemographic factors and the ready-prepared baby food pattern scores were inconsistent across ages. Dietary patterns emerge from infancy and are associated with sociodemographic characteristics.

Mediating effects of dietary intake on associations of TV viewing, body mass index and metabolic syndrome in adolescents

Publisher: Wiley

Date: 29-07-2016

DOI: 10.1002/OSP4.60

Adherence to the Australian dietary guidelines and development of depressive symptoms at 5 years follow-up amongst women in the READI cohort study

Publisher: Springer Science and Business Media LLC

Date: 10-04-2020

DOI: 10.1186/S12937-020-00540-0

Abstract: Depression is the single largest contributor to global disability. There is growing evidence that a healthy diet is associated with reduced depression risk. However, beyond the Mediterranean diet, few longitudinal studies have explored the relationship between adherence to national dietary guidelines and depression. Hence, this study investigates the relationship between adherence to Australian Dietary Guidelines and depressive symptoms. Data was drawn from the READI longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-s le of 837 women. A generalized linear model was used to explore whether baseline diet (assessed using the Dietary Guideline Index (DGI-2013 score range 0 to 85)) was associated with risk of developing depressive symptoms (measured by the Centre for Epidemiologic Studies Depression (CES-D)) at 5 years follow-up, whilst adjusting for potential confounders. A fixed-effects model was used to assess associations between concurrent changes in diet quality and depressive symptoms from baseline to 5 years follow-up. An association between baseline diet quality and risk of developing depressive symptoms at follow-up was observed, where a 10 unit increase in DGI-2013 score was associated with an estimated 12% lower risk of developing heightened depressive symptoms (RR = 0.875, 95%CI 0.784 to 0.978, p = 0.018). The fixed-effects model indicated that an increase in DGI score over 5 years follow-up was associated with a lower (improved) CES-D score (B = -0.044, 95% CI − 0.08 to − 0.01, p = 0.024). Our results provide evidence that better adherence to the Australian Dietary Guidelines may result in improved depressive symptoms. The growing high-quality evidence regarding the diet-depression relationship provides us with a rationale for developing strategies for supporting dietary behaviour change programs to lower depression rates.

Independent and joint associations of TV viewing time and snack food consumption with the metabolic syndrome and its components; a cross-sectional study in Australian adults

Publisher: Springer Science and Business Media LLC

Date: 2013

DOI: 10.1186/1479-5868-10-96

Evaluation of a smartphone food diary application using objectively measured energy expenditure

Publisher: Springer Science and Business Media LLC

Date: 14-03-2017

DOI: 10.1186/S12966-017-0488-9

Using reduced rank regression methods to identify dietary patterns associated with obesity: a cross-country study among European and Australian adolescents

Publisher: Cambridge University Press (CUP)

Date: 28-01-2017

DOI: 10.1017/S0007114516004669

Abstract: This study aims to examine repeatability of reduced rank regression (RRR) methods in calculating dietary patterns (DP) and cross-sectional associations with overweight (OW)/obesity across European and Australian s les of adolescents. Data from two cross-sectional surveys in Europe (2006/2007 Healthy Lifestyle in Europe by Nutrition in Adolescence study, including 1954 adolescents, 12–17 years) and Australia (2007 National Children’s Nutrition and Physical Activity Survey, including 1498 adolescents, 12–16 years) were used. Dietary intake was measured using two non-consecutive, 24-h recalls. RRR was used to identify DP using dietary energy density, fibre density and percentage of energy intake from fat as the intermediate variables. Associations between DP scores and body mass/fat were examined using multivariable linear and logistic regression as appropriate, stratified by sex. The first DP extracted (labelled ‘energy dense, high fat, low fibre’) explained 47 and 31 % of the response variation in Australian and European adolescents, respectively. It was similar for European and Australian adolescents and characterised by higher consumption of biscuits/cakes, chocolate/confectionery, crisps/savoury snacks, sugar-sweetened beverages, and lower consumption of yogurt, high-fibre bread, vegetables and fresh fruit. DP scores were inversely associated with BMI z -scores in Australian adolescent boys and borderline inverse in European adolescent boys (so as with %BF). Similarly, a lower likelihood for OW in boys was observed with higher DP scores in both surveys. No such relationships were observed in adolescent girls. In conclusion, the DP identified in this cross-country study was comparable for European and Australian adolescents, demonstrating robustness of the RRR method in calculating DP among populations. However, longitudinal designs are more relevant when studying diet–obesity associations, to prevent reverse causality.

Validation of a food-frequency questionnaire assessment of carotenoid and vitamin E intake using weighed food records and plasma biomarkers: The method of triads model

Publisher: Springer Science and Business Media LLC

Date: 13-10-2004

DOI: 10.1038/SJ.EJCN.1602060

Abstract: Reliability or validity studies are important for the evaluation of measurement error in dietary assessment methods. An approach to validation known as the method of triads uses triangulation techniques to calculate the validity coefficient of a food-frequency questionnaire (FFQ). To assess the validity of an FFQ estimates of carotenoid and vitamin E intake against serum biomarker measurements and weighed food records (WFRs), by applying the method of triads. The study population was a sub-s le of adult participants in a randomised controlled trial of beta-carotene and sunscreen in the prevention of skin cancer. Dietary intake was assessed by a self-administered FFQ and a WFR. Nonfasting blood s les were collected and plasma analysed for five carotenoids (alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, lycopene) and vitamin E. Correlation coefficients were calculated between each of the dietary methods and the validity coefficient was calculated using the method of triads. The 95% confidence intervals for the validity coefficients were estimated using bootstrap s ling. The validity coefficients of the FFQ were highest for alpha-carotene (0.85) and lycopene (0.62), followed by beta-carotene (0.55) and total carotenoids (0.55), while the lowest validity coefficient was for lutein (0.19). The method of triads could not be used for beta-cryptoxanthin and vitamin E, as one of the three underlying correlations was negative. Results were similar to other studies of validity using biomarkers and the method of triads. For many dietary factors, the upper limit of the validity coefficients was less than 0.5 and therefore only strong relationships between dietary exposure and disease will be detected.

Nutrition screening of older people in a community general practice, using the MNA-SF

Publisher: Springer Science and Business Media LLC

Date: 18-03-2013

DOI: 10.1007/S12603-013-0020-0

Abstract: The study aimed to determine the prevalence of malnutrition risk in a population of older people (aged 75 years and over) attending a community general practice and identify characteristics of those classified as malnourished or at risk of malnutrition. Cross-sectional study of nutritional risk screen conducted over a six month period. Patients attending a general practice clinic in Victoria, Australia, who attended for the "75 plus" health assessment check. The Mini Nutritional Assessment Short Form (MNA®-SF) was included as part of the health assessment. Information was collected on living situation, co-morbidities, independence with meal preparation and eating, number of medications. Height and weight was measured and MNA®-SF score recorded. Two hundred and twenty five patients attending a general practice for a health assessment with a mean age of 81.3(4.3)(SD) years, 52% female and 34% living alone. Only one patient was categorised by the MNA®-SF as malnourished, with an additional 16% classified as at risk of malnutrition. The mean Body Mass Index (BMI) of the at-risk group was significantly lower than the well-nourished group (23.6 ± 0.8 (SEM) vs 27.4 ± 0.3 p=0.0001). However, 34% of the at-risk group had a BMI of 25 or more with only 13% in the underweight category. In this population of older adults attending their general practitioner for an annual health assessment, one in six were identified as being at nutritional risk which is an additional risk factor for a severe health issue. Importantly, one third of the at-risk group had a BMI in the overweight or obese category, highlighting that older people can be at nutritional risk although they may be overweight or obese.

The association of mavenism and pleasure with food involvement in older adults

Publisher: Springer Science and Business Media LLC

Date: 2014

DOI: 10.1186/1479-5868-11-60

A process evaluation of the Supermarket Healthy Eating for Life (SHELf) randomized controlled trial

Publisher: Springer Science and Business Media LLC

Date: 24-02-2016

DOI: 10.1186/S12966-016-0352-3

Clustering of children’s obesity-related behaviours: associations with sociodemographic indicators

Publisher: Springer Science and Business Media LLC

Date: 15-01-2014

DOI: 10.1038/EJCN.2013.295

Abstract: Research suggests obesity-related behaviours cluster together in children and adolescents, but how these cluster patterns differ by sociodemographic indicators remains unclear. Furthermore, few studies examining clustering of behaviours have included younger children or an objective measure of physical activity (PA) and sedentary behaviour. Therefore, the aim of this study was to examine clustering patterns of diet, PA and sedentary behaviour in 5- to 6- and 10- to 12-year-old children, and their cross-sectional associations with sociodemographic indicators. In this cross-sectional study, data from the baseline wave (2002/2003) of the Health Eating and Play study (HEAPS) were used. Questionnaires were completed by parents of Australian children aged 5-6 (n=362) and 10-12 years (n=610). Children wore accelerometers for up to 7 days. K-medians cluster analysis identified groups of children with similar diet, PA and sedentary behaviours. Chi-square tests assessed cluster differences by gender, maternal education and marital status. For each age group, three reliable and meaningful clusters were identified and labelled 'most healthy', 'energy-dense (ED) consumers who watch TV' and 'high sedentary behaviour/low moderate-to-vigorous PA (MVPA)'. Clusters varied by sociodemographic indicators. For ex le, a higher proportion of older girls comprised the 'high sedentary behaviour/low MVPA' cluster (χ(2)=22.4, P<0.001). Among both age groups, the 'ED consumers who watch TV' cluster comprised more children with lower educated mothers (younger children: χ(2)=34.9, P<0.001 older children: χ(2)=27.3, P<0.001). Identification of cluster patterns of obesity-related risk factors in children, and across sociodemographic groups may assist the targeting of public health initiatives, to those most in need.

A Revised Australian Dietary Guideline Index and Its Association with Key Sociodemographic Factors, Health Behaviors and Body Mass Index in Peri-Retirement Aged Adults

Publisher: MDPI AG

Date: 11-03-2016

DOI: 10.3390/NU8030160

Understanding Meal Choices in Young Adults and Interactions with Demographics, Diet Quality, and Health Behaviors: A Discrete Choice Experiment

Publisher: Elsevier BV

Date: 08-2021

DOI: 10.1093/JN/NXAB106

Abstract: Our understanding of meal choices is limited by methodologies that do not account for the complexity of food choice behaviors. Discrete choice experiments (DCEs) rank choices in a decision-making context. This study aimed to rank the relative importance of influences on meal choices in young adults and examine interactions by subgroups. Adults (18-30 y) living in Australia were recruited via social media to complete an Internet-based DCE and survey. Participants were presented with 12 choice sets about a typical weekday meal, consisting of 5 attributes (taste, preparation time, nutrition content, cost, and quality). Diet quality (Dietary Guideline Index) was calculated from brief dietary questions. Conditional logit models ranked meal attributes, including interactions by sex, education, area-level disadvantage, diet quality, and weight status. In total, 577 adults (46% female, mean ± SD age 23.8 ± 3.8 y) completed the DCE and survey. Nutrition content was the most important influence on meal choice (B: 1.48 95% CI: 1.31, 1.64), followed by cost (B: -0.75 95% CI: -0.87, -0.63), quality (B: 0.58 95% CI: 0.49, 0.67), taste (B: 0.55 95% CI: 0.45, 0.65), and preparation time (B: -0.42 95% CI: -0.52, -0.31). Females, those with higher diet quality, and those with a BMI (in kg/m2) <25 had higher preferences for better nutrition content. Females had higher preferences for better taste and lower preferences for higher-cost meals. Participants with higher education had higher preferences for better nutrition content. Participants living in higher area-level disadvantage areas had higher preferences for longer preparation time. Nutrition content was the most important influence on young adults' meal choices. Preferences differed by sex, socioeconomic position, diet quality, and weight status. Findings show the suitability of DCEs for understanding food choice behaviors in young adults and support the need for meal-based interventions to be tailored according to demographic and health characteristics.

The role of energy intake and energy misreporting in the associations between eating patterns and adiposity

Publisher: Springer Science and Business Media LLC

Date: 31-05-2018

DOI: 10.1038/EJCN.2017.90

Abstract: Research examining associations between eating occasion (EO) frequency and adiposity is inconclusive studies examining the impact of energy misreporting are rare. This study examined associations between eating patterns and adiposity, with adjustment for energy misreporting, in a nationally representative s le of Australian adults. Dietary intake was assessed via two 24-h recalls collected during the 2011-12 National Nutrition and Physical Activity Survey (n=4050 adults, aged ⩾19 years). Frequencies of all EOs, meals and snacks were calculated. Height, weight and waist circumference (WC) were measured. Energy misreporting was assessed as the ratio of energy intake to predicted energy expenditure (EI:EE). Energy misreporters were identified by EI:EE ratios, 1.32. Multivariate regression models assessed associations between eating patterns and body mass index (BMI), WC, overweight/obesity (BMI ⩾25 kg m After adjustment for covariates and EI:EE, frequency of all EOs, meals (women only) and snacks was positively associated with WC and BMI (all P<0.01). Snack, but not meal frequency, was also associated with overweight/obesity (men: OR=1.22, 95% CI 1.07-1.39 women: OR=1.26, 95% CI 1.10-1.43) and central overweight/obesity (men: OR=1.17, 95% CI 1.04-1.32 women: OR=1.21, 95% CI 1.06-1.37). Multivariate analysis that excluded energy misreporters and adjusted for EI yielded either null or inverse associations (P<0.05). These findings suggest that the associations between eating patterns and adiposity are complicated by the role of EI and energy misreporting. Longitudinal research that considers the impact of EI and energy misreporting is needed to better understand the relationship between eating patterns and obesity.

Ranking of meal preferences and interactions with demographic characteristics: a discrete choice experiment in young adults

Publisher: Springer Science and Business Media LLC

Date: 12-2020

DOI: 10.1186/S12966-020-01059-7

Abstract: The diet of young adults is poor, yet little is known about the relative importance of influences on healthy eating in a decision-making context. The aim of this exploratory study was to understand the relative ranking of influences on meal choices in young adults and to investigate interactions between meal preferences and demographic and health characteristics. Adults aged 18–30 years ( n = 92, mean age: 23.9 (SD 3.4) years) completed an online discrete choice experiment. Participants were presented with 12 choice sets reflecting a typical weekday meal and were asked to choose between four meal options. Each meal consisted of a combination of five meal attributes (preparation time, cost, taste, familiarity and nutrition content) that each had three attribute levels. Data were analysed using conditional logit models. Subgroup analyses were performed by sex, education, income, weight status and meeting fruit and vegetable recommendations. Comparing the highest and lowest attribute levels, meal preferences were higher for better taste (B = 0.38 95% CI: 0.12, 0.63), familiarity (B = 0.37 95% CI: 0.21, 0.54) and nutrition content (B = 1.11 95% CI: 0.81, 1.41) and lower for increased preparation times (B = −0.33 95% CI: − 0.53, − 0.12) and cost (B = −0.50 95% CI: − 0.75, − 0.24). Nutrition content was the most important influence on meal choice. Cost was the second most important, followed by taste, familiarity and preparation time. Compared to males, females had a higher preference for better nutrition content, taste and familiarity and a lower preference for increased cost. Higher educated participants had a higher preference for better nutrition content, familiarity and taste compared to lower educated participants. Young adults who met recommendations for fruit and vegetable intake had a higher preference for better nutrition content compared to participants who did not meet recommendations. Nutrition content was the most important influence on young adults’ meal choices, followed by cost, taste, familiarity and preparation time. Preferences varied by demographics and health characteristics, suggesting that the focus of dietary interventions may benefit from being tailored to specific young adult groups.

Supermarket Healthy Eating for Life (SHELf): protocol of a randomised controlled trial promoting healthy food and beverage consumption through price reduction and skill-building strategies

Publisher: Springer Science and Business Media LLC

Date: 22-09-2011

DOI: 10.1186/1471-2458-11-715

Quantifying the overall impact of an early childhood multi‐behavioural lifestyle intervention

Publisher: Wiley

Date: 17-10-2021

DOI: 10.1111/IJPO.12861

Abstract: The overall impact of interventions targeting multiple behaviours remains largely unexplored. This study adopted an integrative lifestyle pattern analysis approach to assess the overall effectiveness of an early childhood intervention on change across multiple behaviours. The Melbourne INFANT program was a 15‐month cluster‐randomized controlled trial involving 4‐month‐old infants and their parents at baseline in 2008 ( n = 542). The intervention included six education sessions helping parents to promote a healthy diet, physical activity and limit sedentary behaviour in their infants. Participants were followed‐up twice post‐intervention, at ages 3.6 (2011) and 5 years (2013), to assess sustained effects of the intervention. Previous principal component analyses identified two lifestyle patterns from dietary intake, outdoor time and television viewing time. Random effect linear regression models were conducted to assess the impact of the intervention on lifestyle patterns. The intervention group had a lower ‘Discretionary consumption and TV’ lifestyle pattern score than the control group at all time points with adjusted mean difference: −0.29, 95% CI −0.49, −0.09, p = 0.004 post‐intervention at age 1.5 years −0.29, 95% CI −0.54, −0.04, p = 0.02 at the first follow‐up (age 3.6 years) and −0.21, 95% CI −0.43, 0.01, p = 0.06 at the second follow‐up (age 5.0 years). No evidence of between‐group differences was found for the ‘Fruit, vegetables and outdoor’ lifestyle pattern score. This early childhood intervention designed to promote change in more than one obesity‐related behaviour was effective in improving correlated unhealthy lifestyle behaviours. Lifestyle pattern analysis is a useful and interpretable approach for evaluating multi‐behavioural interventions.

Takeaway food consumption and its associations with diet quality and abdominal obesity: a cross-sectional study of young adults

Publisher: Springer Science and Business Media LLC

Date: 2009

DOI: 10.1186/1479-5868-6-29

Correlates of dietary resilience among socioeconomically disadvantaged adolescents

Publisher: Springer Science and Business Media LLC

Date: 22-06-2011

DOI: 10.1038/EJCN.2011.107

Abstract: Despite increased risk for unhealthy diets, some socioeconomically disadvantaged adolescents manage to consume a healthy diet, thereby showing 'dietary resilience'. This investigation aimed to describe the vegetable and fruit intakes of socioeconomically disadvantaged adolescents, and explore the intrapersonal, social and environmental factors associated with more favourable dietary intakes among socioeconomically disadvantaged adolescents. The present investigation draws on data from 1014 socioeconomically disadvantaged adolescents (55% girls), a sub-s le of 3264 adolescents aged 12-15 years recruited from 37 secondary schools in Victoria, Australia. The adolescents completed an online survey in 2004-2005 comprising an FFQ and questions pertaining to intrapersonal, social and environmental factors informed by the Social Cognitive Theory (SCT). Frequent vegetable and fruit intake was defined as 2 times per day and 1 time per day, respectively. Approximately one-third of socioeconomically disadvantaged adolescents frequently consumed vegetables and fruit (boys, 29% and 27% respectively girls, 29% and 36% respectively). Greater perceived importance of health, and frequently being served vegetables with dinner, were associated with frequent intakes. Friends' support for healthy eating was associated with boys' frequent vegetable intake. Less stringent adherence to family meal-time rules was associated with frequent intakes however, the opposite was observed when girls were expected to eat all foods served. Nutrition promotion messages targeting socioeconomically disadvantaged adolescents could focus on fostering appreciation for health and providing families with strategies to increase meal-time vegetable availability. Friends could be encouraged to support healthy eating among boys. Family meal-time rules warrant further investigation.

An Index of Diet and Eating Patterns Is a Valid Measure of Diet Quality in an Australian Population1,

Publisher: Elsevier BV

Date: 2008

DOI: 10.1093/JN/138.1.86

Abstract: Diet indices represent an integrated approach to assessing eating patterns and behaviors. The aim of this study was to develop a comprehensive food-based dietary index to reflect adherence to healthy eating recommendations, evaluate the construct validity of the index using nutrient intakes, and evaluate this index in relation to sociodemographic factors, health behaviors, risk factors, and self-assessed health status. Data were analyzed from adult participants of the Australian National Nutrition Survey who completed a 108-item FFQ and a food habits questionnaire (n = 8220). The dietary guideline index (DGI) consisted of 15 items reflecting the dietary guidelines, including dietary indicators of vegetables and legumes, fruit, total cereals, meat and alternatives, total dairy, beverages, sodium, saturated fat, alcoholic beverages, and added sugars. Diet quality was incorporated using indicators relating to whole-grain cereals, lean meat, reduced/low fat dairy, and dietary variety. We investigated associations between the DGI score, sociodemographic factors, health behaviors, chronic disease risk factors, and nutrient intakes. We found associations between the DGI scores and sex, age, income, area-level socioeconomic disadvantage, smoking, physical activity, waist:hip ratio, systolic blood pressure (males only), and self-assessed health status (females only) (all P < 0.05). Higher DGI scores were associated with lower intakes of energy, total fat, and saturated fat and higher intakes of fiber, beta-carotene, vitamin C, folate, calcium, and iron (P < 0.05). This food-based dietary index is able to discriminate across a variety of sociodemographic factors, health behaviors, and self-assessed health and reflects intakes of key nutrients.

Smartphone Cardiac Rehabilitation, Assisted Self-Management Versus Usual Care: Protocol for a Multicenter Randomized Controlled Trial to Compare Effects and Costs Among People With Coronary Heart Disease (Preprint)

Publisher: JMIR Publications Inc.

Date: 13-06-2019

DOI: 10.2196/PREPRINTS.15022

Abstract: lternative evidence-based cardiac rehabilitation (CR) delivery models that overcome significant barriers to access and delivery are needed to address persistent low utilization. Models utilizing contemporary digital technologies could significantly improve reach and fidelity as complementary alternatives to traditional center-based programs. he aim of this study is to compare the effects and costs of the innovative i Smartphone Cardiac Rehabilitation, Assisted self-Management /i (SCRAM) intervention with usual care CR. n this investigator-, assessor-, and statistician-blinded parallel 2-arm randomized controlled trial, 220 adults (18+ years) with coronary heart disease are being recruited from 3 hospitals in metropolitan and regional Victoria, Australia. Participants are randomized (1:1) to receive advice to engage with usual care CR or the SCRAM intervention. SCRAM is a 24-week dual-phase intervention that includes 12 weeks of real-time remote exercise supervision and coaching from exercise physiologists, which is followed by 12 weeks of data-driven nonreal-time remote coaching via telephone. Both intervention phases include evidence- and theory-based multifactorial behavior change support delivered via smartphone push notifications. Outcomes assessed at baseline, 12 weeks, and 24 weeks include maximal aerobic exercise capacity (primary outcome at 24 weeks), modifiable cardiovascular risk factors, exercise adherence, secondary prevention self-management behaviors, health-related quality of life, and adverse events. Economic and process evaluations will determine cost-effectiveness and participant perceptions of the treatment arms, respectively. he trial was funded in November 2017 and received ethical approval in June 2018. Recruitment began in November 2018. As of September 2019, 54 participants have been randomized into the trial. he innovative multiphase SCRAM intervention delivers real-time remote exercise supervision and evidence-based self-management behavioral support to participants, regardless of their geographic proximity to traditional center-based CR facilities. Our trial will provide unique and valuable information about effects of SCRAM on outcomes associated with cardiac and all-cause mortality, as well as acceptability and cost-effectiveness. These findings will be important to inform health care providers about the potential for innovative program delivery models, such as SCRAM, to be implemented at scale, as a complement to existing CR programs. The inclusion of a cohort comprising metropolitan-, regional-, and rural-dwelling participants will help to understand the role of this delivery model across health care contexts with erse needs. ustralian New Zealand Clinical Trials Registry (ACTRN): 12618001458224 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374508. ERR1-10.2196/15022

The characterisation of overweight and obese women who are under reporting energy intake during pregnancy

Publisher: Springer Science and Business Media LLC

Date: 06-2018

DOI: 10.1186/S12884-018-1826-X

A dietary guideline adherence score is positively associated with dietary biomarkers but not lipid profile in healthy children

Publisher: Elsevier BV

Date: 2015

DOI: 10.3945/JN.114.197970

Abstract: Whether dietary indexes are associated with biomarkers of children's dietary intake is unclear. The study aim was to examine the relations between diet quality and selected plasma biomarkers of dietary intake and serum lipid profile. The study s le consisted of 130 children aged 4-13 y (mean ± SD: 8.6 ± 2.9 y) derived by using baseline data from an intervention study. The Dietary Guideline Index for Children and Adolescents (DGI-CA) comprises the following 11 components with age-specific criteria: 5 core food groups, whole-grain bread, reduced-fat dairy foods, discretionary foods (nutrient poor high in saturated fat, salt, and added sugar), healthy fats/oils, water, and diet variety (possible score of 100). A higher score reflects greater compliance with dietary guidelines. Venous blood was collected for measurements of serum lipids, fatty acid composition, plasma carotenoids, lutein, lycopene, and α-tocopherol. Linear regression was used to examine the relation between DGI-CA score (independent variable) and concentrations of biomarkers by using the log-transformed variable (outcome), controlling for confounders. DGI-CA score was positively associated (P 0.05). Diet quality, conceptualized as adherence to national dietary guidelines, is cross-sectionally associated with plasma biomarkers of dietary exposure but not serum lipid profile. This trial was registered with the Australia New Zealand Clinical Trial Registry (www.anztr.org.au) as ACTRN12609000453280.

Development and evaluation of a food frequency questionnaire for use among young children

Publisher: Public Library of Science (PLoS)

Date: 25-03-2020

DOI: 10.1371/JOURNAL.PONE.0230669

A Dietary Inflammatory Index and associations with C-reactive protein in a general adult population

Publisher: Springer Science and Business Media LLC

Date: 15-05-2021

DOI: 10.1007/S00394-021-02573-5

Author's Response

Publisher: Elsevier BV

Date: 05-2012

DOI: 10.1016/J.JAND.2012.03.005

A comparison of diet quality indices in a nationally representative cross-sectional study of Iranian households

Publisher: Springer Science and Business Media LLC

Date: 12-2020

DOI: 10.1186/S12937-020-00646-5

Abstract: Iranian diet quality has been evaluated using indices that have not been created based on Iranian dietary guidelines. This study aimed to examine the applicability of two diet quality indices by examining their associations with nutrient adequacy, nutrient intakes and sociodemographics. Dietary data were collected using three 24-h dietary recalls from Iranian households. Nutrient adequacy was assessed using World Health Organization/Food and Agriculture Organization 2002 (WHO/FAO) cut points. Household diet quality was calculated using the Healthy Eating Index (HEI) and Diet Quality Index-International (DQI-I). Sociodemographics of the household members were assessed. Regression analyses were used to examine associations between diet quality and nutrient adequacy, and between sociodemographics and diet quality. A total of 6935 households were included in the analysis. Higher household diet quality was associated with adequate intake of calcium (HEI: OR 1.11, 95% CI: 1.10, 1.13 DQI-I: OR 1.14, 95% CI: 1.13, 1.16), vitamin C (HEI: OR 1.19, 95% CI: 1.17, 1.20 DQI-I: OR 1.12, 95% CI: 1.11, 1.12) and protein (HEI: OR 1.01, 95% CI: 1.00, 1.02 DQI-I: OR 1.09, 95% CI: 1.08, 1.09) . Higher household diet quality was associated with household heads who were older ( 56 years old) (HEI: β 2.06, 95% CI: 1.63, 2.50 DQI-I β 2.90, 95% CI: 2.34, 3.45), higher educated (college/university completed) (HEI: β 4.54, 95% CI: 4.02, 5.06 DQI-I: β 2.11, 95% CI: 1.45, 2.77) and living in urban areas (HEI: β 2.85, 95% CI: 2.54, 3.16 DQI-I: β 0.72, 95% CI: 0.32, 1.12). Based on associations with nutrient adequacy and sociodemographics, the applicability of two diet quality indices for assessing the diet quality of Iranian households was demonstrated. Results also indicated DQI-I may be more applicable than HEI for evaluating Iranian nutrient adequacy. Findings have implications for the design and assessment of diet quality in Iranian populations. Future research should examine the link between these diet quality indices and health outcomes.

Vegetarian diets and health

Publisher: BMJ

Date: 04-09-2019

DOI: 10.1136/BMJ.L5272

University Of Queensland

Location: Australia

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Queensland University Of Technology

Location: Australia

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ARC Future Fellowships - Grant ID: FT100100581

Start Date: 07-2011

End Date: 12-2015

Amount: $688,679.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP0990129

Start Date: 01-2010

End Date: 12-2013

Amount: $70,000.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP130100713

Start Date: 2013

End Date: 12-2016

Amount: $278,717.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP1095595

Start Date: 2010

End Date: 12-2013

Amount: $210,000.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP190101323

Start Date: 2019

End Date: 12-2023

Amount: $342,899.00

Funder: Australian Research Council

Discovery Projects - Grant ID: DP170100544

Start Date: 05-2017

End Date: 12-2020

Amount: $486,000.00

Funder: Australian Research Council

Linkage Infrastructure, Equipment And Facilities - Grant ID: LE140100099

Start Date: 07-2014

End Date: 12-2015

Amount: $154,000.00

Funder: Australian Research Council