ORCID Profile
0000-0002-8044-444X
Current Organisation
University of Wollongong
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Public health nutrition | Ecological Impacts of Climate Change | Law | Public Nutrition Intervention | Law not elsewhere classified | Food sciences | Food sustainability
Nutrition | Climate Change Adaptation Measures | Law Reform |
Publisher: Wiley
Date: 21-10-2021
DOI: 10.1111/JHN.12818
Abstract: When aiming to develop dietary messaging to achieve reductions in added sugar intakes, it is necessary to identify key food contributors. Food contributors are not expected to remain static over time. Therefore, the present study aimed to compare the total added sugars (AS) intake and related food sources for adult respondents of two Australian national consumption surveys. Repeated 24-h recall data from the 1995 National Nutrition Survey (1995NNS, n = 10 851) and the 2011-12 National Nutrition and Physical Activity Survey (2012NNPAS, n = 9341) was used to estimate AS consumption. Food group sources of AS were examined per consumer and per capita and the food group predictors of energy provided by AS were determined. A significant difference in total AS intake was identified by age and gender between the surveys (all P < 0.001). Increased variability in food group contributions per consumer was also identified. Nine of the top 20 food groups from the 1995NNS differed (P 40% AS coming from only three food groups. Age-stratified analyses showed that the 'sugar, honeys and syrups' and the 'sweetened beverages' food groups were the top contributors between the surveys up to the age group of 70 years. 'Sugar, honey and syrups', 'chocolate and chocolate-based confectionery,' and 'other confectionery' (all, P < 0.001) were significant predictors of AS intake (1995NNS, r At a population level, food group contributions to AS intakes for Australian adults have not changed substantially over time, yet notable shifts in AS can be seen when targeting only the consumers of these food sources. 'Cake type desserts' appear to be increasingly consumed though 'sweetened beverages' remain a major contributor to AS intakes warranting targeted public health strategies.
Publisher: Elsevier BV
Date: 2017
DOI: 10.1016/J.NUT.2016.07.011
Abstract: The aim of this study was to examine the relationship between sodium and potassium intakes and blood pressure (BP) in a clinical s le. Secondary analysis of baseline data from 328 participants (mean age: 43.6 ± 8 y, mean body mass index [BMI]: 32.4 ± 4.2 kg/m Urinary sodium was positively correlated (Spearman's rho) with SBP (r = 0.176 P = 0.001) and DBP (r = 0.150 P = 0.003). The ratio of sodium to potassium was positively correlated with SBP (r = 0.1 P = 0.035). Urinary sodium (F [4,323] = 20.381 P < 0.0005 adjusted R In the present study, a high dietary sodium intake and high sodium-to-potassium ratio predicted high SBP. This suggests a need to focus dietary advice on reduction of sources of sodium and increasing sources of potassium in weight loss interventions to improve BP control.
Publisher: Elsevier BV
Date: 02-2014
Publisher: Cambridge University Press (CUP)
Date: 14-10-2020
DOI: 10.1017/S1368980020004024
Abstract: Diet and nutrition in childhood has been associated with the risk of chronic disease later in life. The aim of this review was to identify key characteristics of successful experiential nutrition interventions aimed to change nutrition-related cognitive and behavioural outcomes in primary schoolchildren. A systematic literature review was undertaken using search terms (‘food security’, ‘school’, ‘nutrition’ and ‘program’) applied to five scientific databases (CINAHL, Scopus, Web of Science, Medline and Academic Search complete), with outcomes defined as nutrition-related knowledge, attitudes and/or dietary behaviours. Primary school-aged children exposed to interventions conducted, at least partially, on school grounds. A total of 3800 articles were identified from the initial search and manual searching, of which sixty-seven articles were eligible for inclusion. Forty-two articles met the criteria of being successful, defined as achieving significant differences in outcomes of interest, accompanied by a demonstrated reach. Interventions included school gardens ( n 9), food provision ( n 5), taste testing ( n 8), cooking classes ( n 10) and multicomponent programmes ( n 10). Nutrition education (when combined with taste testing), cooking-related activities and gardening interventions increased children’s willingness to taste unfamiliar foods including new fruits and vegetables, improved their cooking and food preparation skills and increased nutritional knowledge. This review provides evidence that nutrition education programmes in primary schoolchildren that are experiential in nature are most likely to be successful if they include multiple strategies, have parental involvement and focus specifically on vegetable intake.
Publisher: Cambridge University Press (CUP)
Date: 03-08-2012
DOI: 10.1017/S0007114511003850
Abstract: Several regulatory bodies have approved a health claim on the cholesterol-lowering effects of oat β-glucan at levels of 3·0 g/d. The present study aimed to test whether 1·5 g/d β-glucan provided as ready-to-eat oat flakes was as effective in lowering cholesterol as 3·0 g/d from oats porridge. A 6-week randomised controlled trial was conducted in eighty-seven mildly hypercholesterolaemic ( ≥ 5 mmol/l and 7·5 mmol/l) men and women assigned to one of three diet arms (25 % energy (E%) protein 45 E% carbohydrate 30 E% fat, at energy requirements for weight maintenance): (1) minimal β-glucan (control) (2) low-dose oat β-glucan (1·5 g β-glucan oats low – OL) or (3) higher dose oat β-glucan (3·0 g β-glucan oats high – OH). Changes in total cholesterol and LDL-cholesterol (LDL-C) from baseline were assessed using a linear mixed model and repeated-measures ANOVA, adjusted for weight change. Total cholesterol reduced significantly in all groups ( − 7·8 ( sd 13·8) %, − 7·2 ( sd 12·4) % and − 5·5 ( sd 9·3) % in the OH, OL and control groups), as did LDL-C ( − 8·4 ( sd 18·5) %, − 8·5 ( sd 18·5) % and − 5·5 ( sd 12·4) % in the OH, OL and control groups), but between-group differences were not significant. In responders only ( n 60), β-glucan groups had higher reductions in LDL-C ( − 18·3 ( sd 11·1) % and − 18·1 ( sd 9·2) % in the OH and OL groups) compared with controls ( − 11·7 ( sd 7·9) % P = 0·044). Intakes of oat β-glucan were as effective at doses of 1·5 g/d compared with 3 g/d when provided in different food formats that delivered similar amounts of soluble β-glucan.
Publisher: Wiley
Date: 10-09-2014
Publisher: Informa UK Limited
Date: 02-04-2016
DOI: 10.1080/21551197.2016.1168760
Abstract: Unyielding, disproportionate growth in the 65 years and older age group has precipitated serious concern about the propensity of health and aged-care services to cope in the very near future. Preservation of health and independence for as long as possible into later life will be necessary to attenuate demand for such services. Maintenance of nutritional status is acknowledged as fundamental for achievement of this aim. Determinants of food choice within this age group need to be identified and better understood to facilitate the development of pertinent strategies for encouraging nutritional intakes supportive of optimal health. A systematic review of the literature consistent with PRISMA guidelines was performed to identify articles investigating influences on food choice among older people. Articles were limited to those published between 1996 and 2014 and to studies conducted within countries where the dominant cultural, political and economic situations were comparable to those in Australia. Twenty-four articles were identified and subjected to qualitative analysis. Several themes were revealed and grouped into three broad domains: (i) changes associated with ageing (ii) psychosocial aspects and (iii) personal resources. Food choice among older people is determined by a complex interaction between multiple factors. Findings suggest the need for further investigations involving larger, more demographically erse s les of participants, with the inclusion of a direct observational component in the study design.
Publisher: BMJ
Date: 14-02-1998
Abstract: Traditional Chinese herbal medicine (TCHM) plays an essential role in the international pharmaceutical industry due to its rich resources and unique curative properties. The flowers, stems, and leaves of Fritillaria contain a wide range of phytochemical compounds, including flavonoids, essential oils, saponins, and alkaloids, which may be useful for medicinal purposes.
Publisher: BMJ
Date: 11-2016
Publisher: Elsevier BV
Date: 09-2017
Publisher: Wiley
Date: 10-08-2018
Abstract: To develop and assess the validity and reproducibility of a food frequency questionnaire (FFQ) to measure total flavonoid intake, and in idual flavonoid subclasses, in older adults. Retrospective analysis of flavonoid intake in older adults informed the development of a FFQ to measure flavonoid intake and determine the flavonoid subclasses consumed (anthocyanins, flavan-3-ols, flavones, flavonols and flavanones). Older adults (n = 42, mean age 75.3 ± 8.6 years) attended two interviews 1 month apart where anthropometrics (height and weight), blood pressure (BP), demographic data and a 93-item self-administered FFQ were collected. A 4-day food record (FR) was randomly administered between the two interview dates, and each food item was assigned a flavonoid and flavonoid subclass content using the United States Department of Agriculture flavonoid database. The criterion validity and reproducibility of the FFQ was assessed against a 4-day FR using the Wilcoxon signed-rank sum test, Spearman's correlation coefficient (r), Bland-Altman Plots and Cohen's kappa. Total flavonoid intake was determined (median intake FFQ = 919.3 mg/day, FR = 781.4 mg/day). Tests of validity indicated that the FFQ consistently overestimated total flavonoid intake compared with the 4-day FR. There was a significant difference in estimates between the FFQ and the 4-day FR for total flavonoid intake (Wilcoxon signed-rank sum P < 0.001 Bland-Altman plots indicated large bias and wide limits of agreement), but they were well correlated (Spearman's r 0.93, P < 0.001 Cohen's kappa κ = 0.619, P 0.05 Spearman's r 0.91, P < 0.001 Bland-Altman plots visually showed small, non-significant bias and wide limits of agreement and Cohen's kappa κ = 0.619, P < 0.001), with a small mean percentage difference (6.7%). For in idual flavonoid subclasses, the tests of reproducibility between FFQ1 and FFQ2 showed similarly high reproducibility. The developed FFQ appears suitable for satisfactorily ranking in iduals according to total flavonoid intake. The FFQ shows limitations for estimating absolute total flavonoid intake and intake of flavonoid subclasses in comparison to a 4-day FR in terms of overestimating intake. Refinement and further validation of this tool may be required.
Publisher: Wiley
Date: 08-09-2022
DOI: 10.1111/JHN.12943
Abstract: The present study aimed to evaluate the effectiveness of nutrition interventions on frailty and factors related to frailty, including malnutrition, sarcopenia and functional ability, among community dwelling older adults. A secondary aim was to synthesise current clinical guidelines for the identification and management of frailty, and then identify whether they aligned with the findings of the literature review. A systematic literature review was undertaken using four electronic databases to identify randomised controlled clinical trials that assessed the effect of nutrition interventions on frailty and outcomes related to frailty in community-dwelling older adults (PROSPERO #CRD42017069094). The quality of the included studies was appraised. A rapid review was conducted using the Google Scholar database to identify existing clinical recommendations relating to the second aim. The search strategy identified 13 studies. Multifactorial interventions with nutritional education and protein-energy supplementation improved frailty stratus and physical performance in 75% and 58% of studies, respectively. Weight and nutritional status improved in 80% of studies that used oral nutritional support. The recommended process for clinical management of frailty involves screening, followed by full assessment using validated instruments and the development of a comprehensive management plan with a multidisciplinary team. Multifactorial interventions were found to be more effective than nutrition intervention alone for improving frailty and physical performance. Protein-energy supplementation tended to be effective only in malnourished older adults. The results were inconclusive for the use of micronutrient supplementation for frailty and outcomes related to frailty. Existing clinical guidelines are aligned with the evidence recommending comprehensive interventions to improve frailty.
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/J.NUT.2004.09.007
Abstract: We investigated whether habitual intakes of sodium (Na), potassium, magnesium, and calcium differ across South African ethnic groups, assessed the proportion of Na intake, which is discretionary, and identified which food sources were the major contributors to Na intake. This was a cross-sectional study of 325 black, white, and mixed ancestry hypertensive and normotensive subjects. Three repeated 24-h urine s les were collected for assessment of urinary Na, and three corresponding 24-h dietary recalls were administered by trained fieldworkers. Blood pressure and weight were measured at each visit. Secondary analyses were performed on existing dietary databases obtained from four regional surveys undertaken in South African adults. Mean urinary Na excretion values equated to daily salt (NaCl) intakes of 7.8, 8.5, and 9.5 g in black, mixed ancestry, and white subjects, respectively (P < 0.05). Between 33% and 46% of total Na intake was discretionary, and, of the non-discretionary sources, bread was the single greatest contributor to Na intake in all groups. Ethnic differences in calcium intake were evident, with black subjects having particularly low intakes. Urban versus rural differences existed with respect to sources of dietary Na, with greater than 70% of total non-discretionary Na being provided by bread and cereals in rural black South Africans compared with 49% to 54% in urban dwellers. White South Africans have higher habitual intakes of Na, but also higher calcium intakes, than their black and mixed ancestry counterparts. All ethnic groups had Na intakes in excess of 6 g/d of salt, whereas potassium intakes in all groups were below the recommended level of 90 mM/d. Dietary differences may contribute to ethnically related differences in blood pressure.
Publisher: Informa UK Limited
Date: 02-10-2015
DOI: 10.1080/21551197.2015.1088917
Abstract: Flavonoids, consumed in plant-based foods, have been linked to risk reduction of cancers, cardiovascular, and neurodegenerative diseases. The paucity of information on dietary sources and quantities of flavonoid intake in older adults limits interpretation of epidemiological studies that link flavonoid intake with health outcomes in this population. It was our aim to describe total flavonoid intake, including flavonoid subclasses, in older Australians and to identify rich and commonly consumed sources of flavonoids in this age group. Twelve days of weighed food record dietary data from a subs le of the Blue Mountains Eye Study baseline cohort study of older Australians (n = 79) was analyzed using the US Department of Agriculture flavonoid database. Mean intake of flavonoids was estimated to be 683 mg/day (SD = 507) of which flavan-3-ols contributed 92%, followed by flavonols (4%), flavanones (3%), and flavones (<1%). Black tea was the major flavonoid source, providing 89% of total flavonoid intake. No differences in intake between genders were identified. Dietary intake of flavonoids and flavonoid subclasses in older Australians is similar to the one other estimation of intake in Australian older adults and confirms the types of foods that contribute to flavonoid intake among this s le of older Australians.
Publisher: Informa UK Limited
Date: 13-11-2019
DOI: 10.1080/21551197.2019.1689882
Abstract: This retrospective observational study evaluated the association between nutritional status, functional ability and discharge outcomes. Data from 1430 older rehabilitation patients (43% male, median age 79 years, interquartile range: 74-84) were analyzed. One fifth (20.6%,
Publisher: Wiley
Date: 06-2012
Publisher: MDPI AG
Date: 02-04-2015
DOI: 10.3390/NU7042415
Publisher: Wiley
Date: 29-11-2010
Publisher: MDPI AG
Date: 28-08-2017
DOI: 10.3390/NU9090939
Publisher: Springer Science and Business Media LLC
Date: 19-04-2014
DOI: 10.1007/S10995-014-1485-0
Abstract: A healthy diet during pregnancy is essential for normal growth and development of the foetus. Pregnant women may obtain nutrition information from a number of sources but evidence regarding the adequacy and extent of this information is sparse. A systematic literature review was conducted to identify sources of nutrition information accessed by pregnant women, their perceived needs for nutrition education, the perceptions of healthcare providers about nutrition education in pregnancy, and to assess the effectiveness of public health programs that aim to improve nutritional practices. The Scopus data base was searched during January, 2013 and in February 2014 to access both qualitative and quantitative studies published between 2002 and 2014 which focused on healthy pregnant women and their healthcare providers in developed countries. Articles were excluded if they focused on the needs of women with medical conditions, including obesity, gestational diabetes or malnutrition. Of 506 articles identified by the search terms, 25 articles were deemed to be eligible for inclusion. Generally, women were not receiving adequate nutrition education during pregnancy. Although healthcare practitioners perceived nutrition education to be important, barriers to providing education to clients included lack of time, lack of resources and lack of relevant training. Further well designed studies are needed to identify the most effective nutrition education strategies to improve nutrition knowledge and dietary behaviours for women during antenatal care.
Publisher: Springer Science and Business Media LLC
Date: 08-2013
Abstract: Chronic disease risk on a population level can be quantified through health surveys, either continuous or periodic. To date, information gathered from primary care interactions, using sentinel sites, has not been investigated as a potentially valuable surveillance system in Australia. A pilot study was conducted in a single General Practice in a regional area of New South Wales, Australia to assess the feasibility of accessing data obtained through a computerised chronic disease management program that has been designed for desktop application (Pen Computer Systems (PCS) Clinical Audit Tool: ™ PCS CAT). Collated patient data included information on chronic disease management and prevention, prevalence of overweight and obesity, mental health indicators, medication profiling and home medicine reviews, as well as uptake of preventive health services (immunisation and cervical cancer screening). Higher than national average estimates were found for the age-adjusted prevalence of chronic diseases such as hypertension (14.3% for s le vs 10.4%, nationally), anxiety disorders (4.4% vs 3.8%) and obesity/overweight (67.1 vs 63.4%). Preventive health assessment items were undersubscribed, ranging from 6–20% in eligible patients. This pilot study has demonstrated that the scope of data collected by patient visits to their General Practitioners, facilitated through the Medicare-funded primary health care system in Australia, offers a feasible opportunity for monitoring of chronic disease prevalence and its associated risk factors. The inclusion of a larger number of sentinel sites that are generalizable to the population being served would provide an accurate and region-specific system for the purposes of population health planning at the primary care level in order to improve the overall health of the community.
Publisher: Springer Science and Business Media LLC
Date: 19-07-2021
DOI: 10.1038/S41430-021-00980-9
Abstract: Vitamin D deficiency remains a global public health issue, particularly in minority ethnic groups. This review investigates the vitamin D status (as measured by 25(OH)D and dietary intake) of the African-Caribbean population globally. A systematic review was conducted by searching key databases (PUBMED, Web of Science, Scopus) from inception until October 2019. Search terms included ‘Vitamin D status’ and ‘African-Caribbean’. A random effects and fixed effects meta-analysis was performed by combining means and standard error of the mean. The search yielded 19 papers that included n = 5670 African-Caribbean participants from six countries. A meta-analysis found this population to have sufficient ( nmol/L) 25(OH)D levels at 67.8 nmol/L, 95% CI (57.9, 7.6) but poor dietary intake of vitamin D at only 3.0 µg/day, 95% CI (1.67,4.31). For those living at low latitudes ‘insufficient’ (as defined by study authors) 25(OH)D levels were found only in participants with type 2 diabetes and in those undergoing haemodialysis. Suboptimal dietary vitamin D intake (according to the UK recommended nutrient intake of 10 µg/day) was reported in all studies at high latitudes. Studies at lower latitudes, with lower recommended dietary intakes (Caribbean recommended dietary intake: 2.5 µg/day) found ‘sufficient’ intake in two out of three studies. 25(OH)D sufficiency was found in African-Caribbean populations at lower latitudes. However, at higher latitudes, 25(OH)D deficiency and low dietary vitamin D intake was prevalent.
Publisher: Springer Science and Business Media LLC
Date: 24-03-2016
DOI: 10.1038/JHH.2016.10
Abstract: The dietary approaches to stop hypertension (DASH) diet provides strong evidence for an optimal dietary pattern for blood pressure (BP) control however, investigation at the level of key foods in a dietary pattern is sparse. This study aimed to assess the relationship between dietary patterns driven by key foods with BP in a s le of obese Australian adults. Secondary analysis was conducted on baseline data of 118 participants (45.1±8.4 years, mean BP=124.1±15.8/72.6±9.2 mm Hg) recruited in a weight reduction randomized controlled trial (ACTRN12608000425392). Dietary assessment was by a validated diet history interview. The average of three office BP measurements was taken. Factor analysis extracted dietary patterns and their relation to systolic BP (SBP) and diastolic BP (DBP) was analysed using multiple linear regression. Eight dietary patterns were identified based on leading foods: meat and alcohol seafood fats fruits and nuts legumes confectionery sweet foods and yeast extracts and seasonings. A lower SBP was associated with alignment with the fruit and nuts pattern (β=-4.1 (95% confidence interval -7.5 to -0.7) mm Hg) and with seafood for DBP (β=-2.4 (-4.6 to -0.3) mm Hg). SBP and DBP were higher with yeast extract and seasonings (β=4.3 (1.4-7.3) 2.5 (0.9-4.0) mm Hg, respectively). In obese adults attending for weight loss, dietary patterns that included larger amounts of fruits and nuts and/or seafood were associated with lower BP at baseline, whereas patterns that were characterised by yeast extract and seasonings were associated with higher BP.
Publisher: MDPI AG
Date: 06-08-2013
DOI: 10.3390/NU5083118
Publisher: Wiley
Date: 04-2001
DOI: 10.1046/J.1365-277X.2001.00280.X
Abstract: The purpose of this study was to investigate whether differences exist in eating attitudes and body shape concerns amongst adolescent schoolgirls representing South Africa's ethnically and culturally erse population currently undergoing epidemiological transition. A questionnaire survey, including the Eating Attitudes Test, Body Shape Questionnaire and a Body Silhouette Chart, was administered to 228 South African schoolgirls (60 black, 83 mixed race and 85 white) aged 15-18 years from five secondary schools in the greater Cape Town area. Black girls had significantly higher mean BMI values (24.1 (3.3)) than either white (21.9 (3.0)) or mixed race girls (22.1 (3.7)) (P < 0.05). Controlling for differences in BMI, white subjects scored significantly higher on the Body Shape Questionnaire than did mixed race or black subjects, whereas no ethnic differences were found for Eating Attitude Test scores. A comparable percentage (mean = 18.8%) of black, mixed race and white girls had scores indicative of eating disorder pathology on the Eating Attitudes Test, while a higher percentage of white, compared to mixed race and black, girls had abnormal scores on the Body Shape Questionnaire (33%, 26% and 20%, respectively P < 0.05). The ideal body size desired by white girls was significantly smaller than that of the mixed race or black s les. Dissatisfaction with present body size was significantly higher in white, compared to black or mixed race girls (P < 0.001). These findings suggest that the prevalence of abnormal eating attitudes is equally common in South African schoolgirls from different ethnic backgrounds. White girls exhibit greater body image concerns and body image dissatisfaction than mixed race or black in iduals. These findings reinforce the notion that eating disorders are culture-reactive rather than culture-bound phenomena and provide insight into the extent of eating-related problems and body image issues in developing societies.
Publisher: Wiley
Date: 02-2016
Publisher: Wiley
Date: 29-01-2013
Publisher: Springer Science and Business Media LLC
Date: 04-2015
DOI: 10.1038/EJCN.2015.45
Abstract: Dietary weight loss interventions have heterogeneous outcomes in long-term studies, with many participants regaining part or all of the lost weight. Growth mixture modelling is a novel analytic approach that can be used to identify different trajectories of weight change during a trial rather than focussing on the total amount of weight lost. Data were pooled from two 12-month dietary weight loss studies where no significant difference was detected between the treatment and control arms, thus allowing analysis independent of treatment. The data set included 231 subjects (74.5% female), with a mean weight loss of 6.40 kg (4.96). Growth mixture models were used to identify participants with similar trajectories of change in body mass index (BMI). Three subgroups were identified. A rapid and continuing BMI loss over the study period (rapid, n=53), a rapid initial weight loss in the first 3 months with a slowing rate over the remaining 9 months (maintainers, n=146) and those with an initial loss trajectory, which slowed and began to increase at 9 months (reci ists, n=53). Age (s.d.) and BMI (s.d.) were significantly different between the three groups (rapid 53 years (7), 28.99 kg/m(2) (3.30) maintainers 47 years (9), 30.90 kg/m(2) (2.95) reci ists 44 years (7), 34.84 kg/m(2) (1.92), both P<0.001). Older subjects with lower BMIs were more likely to have a rapid and continuing weight loss in a 1-year dietary-based weight loss intervention. Different interventional approaches may be necessary for different ages and baseline BMIs and stratification prior to randomisation may be necessary to prevent confounding in weight loss trials.
Publisher: Elsevier BV
Date: 2016
Publisher: Informa UK Limited
Date: 23-02-2016
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.1016/J.CCT.2015.10.008
Abstract: Integrating professional expertise in diet, exercise and behavioural support may provide more effective preventive health services but this needs testing. We describe the design and baseline results of a trial in the Illawarra region of New South Wales, Australia. The HealthTrack study is a 12 month randomised controlled trial testing effects of a novel interdisciplinary lifestyle intervention versus usual care. The study recruited overweight and obese adults 25-54 years resident in the Illawarra. Primary outcomes were weight, and secondary outcomes were disease risk factors (lipids, glucose, blood pressure), and behaviour (diet, activity, and psychological factors). Protocols, recruitment and baseline characteristics are reported. Between May 2014 and April 2015, 377 participants were recruited and randomised. The median age (IQR) of the mostly female s le (74%) was 45 (37-51) years. The s le comprised obese (BMI 32 (29-35) kg/m(2)) well educated (79% post school qualifications) non-smokers (96%). A high proportion reported suffering from anxiety (26.8%) and depression (33.7%). Metabolic syndrome was identified in 34.9% of the s le. The HealthTrack study s le was recruited to test the effectiveness of an interdisciplinary approach to preventive healthcare in self-identified overweight adults in the Illawarra region. The profile of participants gives some indication of those likely to use services similar to the trial design.
Publisher: Wiley
Date: 20-10-2015
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.NUT.2009.08.016
Abstract: To assess the iodine status and knowledge and practices related to iodine nutrition of Australian women during pregnancy. A cross-sectional study was conducted at a public antenatal clinic in the Illawarra region of New South Wales. One hundred thirty-nine pregnant women across all trimesters provided a spot urine s le (n = 110) and completed a short questionnaire (n = 139) in English. Iodine status was based on World Health Organization/International Committee for the Control of Iodine Deficiency Disorders urine iodine concentration (UIC) categories. Median UIC was 87.5 μg/L (interquartile range 62) only 14.5% of participants had an adequate UIC value ≥150 μg/L. Fifteen percent of women had very low UIC values (<50 μg/L), whereas 45.5% had values in the 50- to 99-μg/L range. Knowledge of the adverse health effects of an inadequate iodine intake was poor. Approximately half the participants were able to indicate good dietary sources of iodine, such as fish (58%) and iodized salt (51%). However, a high level of confusion regarding other foods was evident. Only a small number of participants (11%) reported that they had intentionally changed their diet to increase iodine intake during pregnancy, but 59% indicated supplement use, of which 35% contained iodine. Those who were taking supplements that contained iodine had significantly higher UIC levels (139.1 μg/L) than those who were not (90.8 μg/L, P < 0.05). Public health strategies, including nutritional education and supplementation, are urgently required to improve the iodine status of pregnant women. Currently, no readily accessible information on iodine is available to women attending antenatal clinics in Australia.
Publisher: Wiley
Date: 20-11-2019
Abstract: Nutrition during pregnancy is fundamental to both the health of the mother and her baby. Sources of nutrition-related information are available via many sources but their accuracy is unknown. The present study aimed to (a) identify where women source their nutrition information during pregnancy and (2) assess the accuracy of nutrition information for pregnancy that is available on the internet. A survey instrument that identified the main sources of nutrition information was administered to 68 pregnant women recruited online. Data from this survey were compared to previous similar surveys conducted with pregnant mothers across years 2008, 2011 and 2014. A content analysis of websites was simultaneously conducted to assess the accuracy of available information. The main source of nutrition information for a variety of topics was verbal communication from health professionals (% responses affirmative for that source ranged from 6.6% to 69% across survey years). There was an increasing trend in internet sourced information for most nutrition topics, but this source remained low for iodine across all years (range: 7.3%-15.9%). The internet was the main source of information for listeria/food safety (15.3%-32.4%) and healthy eating (25%-42%). Of the n = 165 websites identified by the content analysis, 82.4% (n = 136) were rated as accurate, with government (96.9%) and business/company (100%) sites having the highest accuracy. Verbal communication from health professionals remains the most important source of nutrition information for pregnancy. The high credibility of websites indicates this to be an additional resource. Further study into health literacy levels among women visiting these sites is needed to assess impact on dietary behaviour.
Publisher: Cambridge University Press (CUP)
Date: 29-11-2018
DOI: 10.1017/S0007114518003239
Abstract: Changes in added sugar intake have been associated with corresponding changes in body weight. Potential mechanisms, particularly the impact of added sugar intake on appetite, warrant exploration. A systematic literature review of randomised controlled trials investigated the association between added sugar consumption and appetite in overweight and obese adults. A systematic search of Medline, Cochrane CENTRAL, Web of Science and CINAHL included studies that examined the relationship between added sugar intake and appetite markers, in comparison with a group with lower added sugar intake. A total of twenty-one articles describing nineteen studies were included in the review. The effect of added sugar on appetite was explored separately by reported comparisons of added sugar type and their effect to three study outcomes: energy consumption ( n 20 comparisons) satiety ( n 18) and appetite hormones, leptin ( n 4) or ghrelin ( n 7). Increased added sugar consumption did not impact subsequent energy intake ( n 9), nor did it influence satiety ( n 12) or ghrelin levels ( n 4). Differences in the total daily energy intake were comparable with the differences in energy values of tested products ( n 3). Added sugar intake was reported to increase leptin levels ( n 3). This review did not find a consistent relationship between added sugar intake and appetite measures, which may be partially explained by variations in study methodologies. There is a need for randomised controlled trials examining a range of added sugar sources and doses on appetite in overweight and obese adults to better understand implications for weight gain.
Publisher: Springer Science and Business Media LLC
Date: 24-03-2016
Publisher: Springer Science and Business Media LLC
Date: 05-05-2011
DOI: 10.1038/JHH.2011.33
Abstract: Dopamine via G-protein-coupled receptor kinase 4 (GRK-4) regulates sodium (Na) balance in the proximal tubule of the kidney. Single-nucleotide polymorphisms of GRK-4 have been linked to impaired natriuresis and salt-sensitive hypertension. The purpose of this report was to determine the effect of GRK-4 gene polymorphisms on the blood pressure (BP) responses to dietary intervention. Black subjects aged 50-75 years with mild-to-moderate hypertension were randomised to an 8-week dietary intervention (n=40) or standard diet (n=40). BP was measured at baseline and at 8 weeks using 24-h ambulatory BP. All subjects underwent DNA analysis for the R65L and A142V polymorphisms. Data were analysed using generalised linear models. For the whole group, between-diet differences in mean 24-h ambulatory systolic BP was -4.53 mm Hg (95% confidence interval -9.05 to -0.01, P=0.05). In the intervention arm, the combined CC and CT group of the A142V showed a significant reduction in both systolic and diastolic ambulatory BP (-10 mm Hg, P=0.023 and -6.5 mm Hg, P=0.01, respectively), whereas the TT group demonstrated no reduction. Similarly, the combined GG and GT groups of the R65L showed a significant reduction in ambulatory BP (-10.6 mm Hg for systolic, P=0.004 and 5.8 mm Hg for diastolic, P=0.006). There was no response in the TT group. GRK-4 polymorphisms predict BP response to dietary modification in Black subjects with mild-to-moderate hypertension. These data may provide at least one among a range of clinical tools to target selected hypertensives to dietary intervention.
Publisher: MDPI AG
Date: 27-02-2023
DOI: 10.3390/NU15051194
Abstract: Despite the positive relationship between anthocyanin-rich foods and cognitive health, a dietary deficit exists in older adults. Effective interventions require an understanding of people’s dietary behaviors situated in social and cultural contexts. Therefore, the aim of this study was to explore older adults’ perceptions about increasing their consumption of anthocyanin-rich foods for cognitive health. Following an educational session and the provision of a recipe and information book, an online survey and focus groups with Australian adults aged 65 years or older (n = 20) explored the barriers and enablers towards eating more anthocyanin-rich foods and potential strategies to achieve dietary change. An iterative, qualitative analysis identified the themes and classified the barriers, enablers and strategies onto the Social-Ecological model levels of influence (in idual, interpersonal, community, society). Enabling factors included a desire to eat healthily, taste preference and familiarity of anthocyanin-rich foods (in idual), social support (community), and the availability of some anthocyanin-rich foods (society). The barriers included budget, dietary preferences and motivation (in idual), household influences (interpersonal), limited availability and access to some anthocyanin-rich foods (community) and the cost and the seasonal variability (society). The strategies included increasing in idual-level knowledge, skills, and confidence in utilizing anthocyanin-rich foods, educational initiatives about the potential cognitive benefits, and advocating to increase access to anthocyanin-rich foods in the food supply. This study provides for the first time, insight into the various levels of influence impacting older adults’ ability to consume an anthocyanin-rich diet for cognitive health. Future interventions should be tailored to reflect the barriers and enablers and to provide targeted education about anthocyanin-rich foods.
Publisher: Elsevier BV
Date: 06-2010
DOI: 10.1016/J.NUMECD.2009.04.007
Abstract: Decreasing energy intake relative to energy expenditure is the indisputable tenet of weight loss. In addition to caloric restriction modification of the type of dietary fat may provide further benefits. The aim of the present study was to examine the effect of energy restriction alone and with dietary fat modification on weight loss and adiposity, as well as on risk factors for obesity related disease. One-hundred and fifty overweight men and women were randomized into a 3month controlled trial with four low fat (30% energy) dietary arms: (1) isocaloric (LF) (2) isocaloric with 10% polyunsaturated fatty acids (LF-PUFA) (3) low calorie (LF-LC) (-2MJ) (4) low calorie with 10% PUFA (LF-PUFA-LC). Primary outcomes were changes in body weight and body fat and secondary outcomes were changes in fasting levels of leptin, insulin, glucose, lipids and erythrocyte fatty acids. Changes in dietary intake were assessed using 3day food records. One-hundred and twenty-two participants entered the study and 95 completed the study. All groups lost weight and body fat (P<0.0001 time effect for both), but the LC groups lost more weight (P=0.026 for diet effect). All groups reduced total cholesterol levels (P<0.0001 time effect and P=0.017 intervention effect), but the LC and PUFA groups were better at reducing triacylglycerol levels (P=0.056 diet effect). HDL increased with LF-LC and LF-PUFA but not with LF-PUFA-LC (0.042 diet effect). The LF and LF-LC groups reported greater dietary fat reductions than the two PUFA groups (P=0.043). Energy restriction has the most potent effect on weight loss and lipids, but fat modification is also beneficial when energy restriction is more modest.
Publisher: Springer Science and Business Media LLC
Date: 05-06-2020
DOI: 10.1186/S12882-020-01805-W
Abstract: There is mounting evidence that in iduals with kidney disease and kidney stones have an abnormal gut microbiota composition. No studies to date have summarised the evidence to categorise how the gut microbiota profile of these in iduals may differ from controls. Synthesis of this evidence is essential to inform future clinical trials. This systematic review aims to characterise differences of the gut microbial community in adults with kidney disease and kidney stones, as well as to describe the functional capacity of the gut microbiota and reporting of diet as a confounder in these studies. Included studies were those that investigated the gut microbial community in adults with kidney disease or kidney stones and compared this to the profile of controls. Six scientific databases (CINHAL, Medline, PubMed, Scopus, Web of Science and Cochrane Library), as well as selected grey literature sources, were searched. Quality assessment was undertaken independently by three authors. The system of evidence level criteria was employed to quantitatively evaluate the alteration of microbiota by strictly considering the number, methodological quality and consistency of the findings. Additional findings relating to altered functions of the gut microbiota, dietary intakes and dietary methodologies used were qualitatively summarised. Twenty-five articles met the eligibility criteria and included data from a total of 892 adults with kidney disease or kidney stones and 1400 controls. Compared to controls, adults with kidney disease had increased abundances of several microbes including Enterobacteriaceae, Streptococcaceae, Streptococcus and decreased abundances of Prevotellaceae, Prevotella, Prevotella 9 and Roseburia among other taxa. Adults with kidney stones also had an altered microbial composition with variations to Bacteroides, Lachnospiraceae NK4A136 group, Ruminiclostridium 5 group , Dorea, Enterobacter, Christensenellaceae and its genus Christensenellaceae R7 group . Differences in the functional potential of the microbial community between controls and adults with kidney disease or kidney stones were also identified. Only three of the 25 articles presented dietary data, and of these studies, only two used a valid dietary assessment method. The gut microbiota profile of adults with kidney disease and kidney stones differs from controls. Future study designs should include adequate reporting of important confounders such as dietary intake to assist with interpretation of findings.
Publisher: Lyson Center for Civic Agriculture and Food Systems
Date: 14-11-2022
DOI: 10.5304/JAFSCD.2022.121.007
Abstract: Australian local governments undertake a range of activities that can contribute to a healthy, sustainable, and equitable food system. However, their engagement in food system governance is highly uneven, and only a handful have developed dedicated food system policies. This article reports on case studies of food system policy development and implementation in six local governments in the states of New South Wales and Victoria. The main motivators for policy and program development were to improve environmental sustainability, reduce food waste, improve diet-related health and food security, and support local, sustainable agriculture. Key steps included consulting with the community, identifying local food-related issues, and developing policy solutions. Local government activities targeted many dimensions of the food system, and policy implementation processes included hiring dedicated food system employees, creating partnerships with organizations outside local government, advocacy to higher levels of government for policy and legislative change, and program evaluation. The research also identified key enablers of and barriers to policy development and implementation, including factors internal to local government (e.g., presence/absence of local champions, high-level leadership, and a supportive internal culture) as well as important state- and federal-level constraints, including absence of comprehensive policy frameworks for food and nutrition, of dedicated funding for local government food system work, and of leadership for food system governance from higher levels of government. The authors conclude with recommendations for strengthening the role of Australian local governments in creating a healthy, sustainable, and equitable food system, applicable to both local governments and to Australian state and federal governments. These recommendations may also be useful to local governments in other national jurisdictions.
Publisher: Wiley
Date: 19-06-2022
DOI: 10.1002/HPJA.626
Abstract: Urgent action is required by all levels of government to create a food system capable of nourishing a rapidly growing population while remaining within planetary boundaries. This study investigated policies and programs implemented by Australian local governments (LGs) that aim to contribute to a healthy, sustainable and equitable food system. An online survey was completed by LGs (n = 64) in New South Wales and Victoria, Australia. Questions focused on LGs' food system‐related policies and programs, barriers to and enablers of engaging in food system work and organisational responsibilities for food system work. Preventing food waste, organising food‐related social/cultural events and providing potable water were the most commonly reported activities. Few LGs reported policies/activities on market gardening or sustainable agricultural practices, or strengthening food system resilience. LGs implemented a wide range of initiatives, such as hosting food forums, using research to identify and address food access issues and providing healthy food and drink options within LG‐owned/managed facilities. Enablers of food system work included internal LG support, human resources, external funding and partnerships. Barriers included lack of community interest, short‐term and/or project‐based funding, internal governance issues and restrictive state government planning frameworks. Australian LGs undertake a wide range of actions addressing erse food system issues however, internal and external barriers constrain their involvement in creating a healthy, sustainable and equitable food system. Legislative reform, combined with increased financial and human resource capacity, would support LGs to expand, strengthen and sustain their food system work.
Publisher: Wiley
Date: 26-06-2022
DOI: 10.1002/HPJA.625
Abstract: To assess the impact of a multi‐lingual education video on the healthy eating knowledge of in iduals in refugee and newly arrived migrant community groups. A mixed methods, pre‐ and post‐test study design was used. Participants completed a verbal questionnaire with pictorial answer sheets prior to and immediately after viewing one chapter of a healthy eating video. Qualitative data was obtained through semi‐structured, focus group discussions following the video viewing. Eighty‐six participants were recruited via convenience s ling through refugee community organisations in the Illawarra Shoalhaven, South Western Sydney and Northern Sydney Local Health Districts. Study participants self‐selected to attend Arabic (n = 17), Dari (n = 12), Karen (n = 32) or Tibetan (n = 25) sessions. In 85 participants with pre‐post results, there was a significant improvement in healthy eating knowledge after viewing the video (mean score 61% [SD 23.2] vs 75% [SD 24.2] [ P .05]). Increased mean scores were observed in all language groups except the Karen‐speaking group. Focus group responses indicated the video improved food literacy, particularly in the areas of food safety, fruit and vegetable consumption, label reading, writing a shopping list and decreasing intake of sugary drinks. The video improved healthy eating knowledge of in iduals in refugee and newly‐arrived migrant community groups. There is potential for these nutrition education resources to inform and educate newly arrived refugees and migrants to Australia about healthy eating practices, however, future research is required to determine their effect on actual behaviour change.
Publisher: MDPI AG
Date: 12-06-2019
Abstract: Rapid urbanization in low- and middle-income countries (LMICs) is transforming dietary patterns from reliance on traditional staples to increased consumption of energy-dense foods high in saturated fats, trans fats, sugars, and salt. A systematic literature review was conducted to determine major food sources of salt in LMICs that could be targeted in strategies to lower population salt intake. Articles were sourced using Medline, Web of Science, Scopus, and grey literature. Inclusion criteria were: reported dietary intake of Na/salt using dietary assessment methods and food composition tables and/or laboratory analysis of salt content of specific foods in populations in countries defined as low or middle income (LMIC) according to World Bank criteria. Of the 3207 records retrieved, 15 studies conducted in 12 LMICs from erse geographical regions met the eligibility criteria. The major sources of dietary salt were breads, meat and meat products, bakery products, instant noodles, salted preserved foods, milk and dairy products, and condiments. Identification of foods that contribute to salt intake in LMICs allows for development of multi-faceted approaches to salt reduction that include consumer education, accompanied by product reformulation.
Publisher: SAGE Publications
Date: 02-2005
Abstract: The aim of this study was to document the breastfeeding practices, beliefs, and attitudes of periurban South African lactating mothers with infants younger than 6 months. None of the mothers (n = 115, mean age 26 ± 6.3 years) reported exclusively breastfeeding their infants, with complementary breastfeeding being the most practiced (78%) feeding mode. Complementary foods were fed to 32% of infants by their first month of life. Perceived inadequate production of breast milk was the most common (90%) reason cited for adding foods and liquids to breastfeeds. Mothers valued use of traditional herbal preparations (muthi), with more then half (56%) of the infants having received their first dose of muthi before 1 month of age. Our study provides important data on breastfeeding practices of women living within resource-poor settings. Development of successful infant-feeding interventions aimed at promoting overall infant health can benefit from knowledge of these breastfeeding patterns.
Publisher: Wiley
Date: 27-10-2003
DOI: 10.1046/J.1464-410X.2003.04472.X
Abstract: To investigate the potential influence of cranberry juice on urinary biochemical and physicochemical risk factors associated with the formation of calcium oxalate kidney stones, as this product might affect the chemical composition of urine. Urinary variables were assessed in a randomized cross-over trial in 20 South African men (students) with no previous history of kidney stones. The first group of 10 subjects drank 500 mL of cranberry juice diluted with 1500 mL tap water for 2 weeks, while the second group drank 2000 mL of tap water for the same period. This was followed by a 2-week 'washout' period before the two groups crossed over. During the experimental phase subjects kept a 3-day food diary to assess their dietary and fluid intakes 24-h urine s les were collected at baseline and on day 14 of the trial periods, and analysed using modern laboratory techniques. Urine analysis data were used to calculate the relative urinary supersaturations of calcium oxalate, uric acid and calcium phosphate. Data were assessed statistically by analysis of variance. The ingestion of cranberry juice significantly and uniquely altered three key urinary risk factors. Oxalate and phosphate excretion decreased while citrate excretion increased. In addition, there was a decrease in the relative supersaturation of calcium oxalate, which tended to be significantly lower than that induced by water alone. Cranberry juice has antilithogenic properties and, as such, deserves consideration as a conservative therapeutic protocol in managing calcium oxalate urolithiasis.
Publisher: Wiley
Date: 25-04-2021
DOI: 10.1111/JOCN.15711
Abstract: The aim of this paper is to explore the perceptions, attitudes and beliefs of middle‐aged Australians around their health, lifestyle risks and chronic disease. Health promotion and risk reduction are important to stem the rising prevalence of chronic disease. While there has been much emphasis on supporting these strategies in older Australians, there has been less attention on those in middle age. However, as this group age, their health will inevitably be impacted by lifestyle risk. A qualitative descriptive study using semi‐structured interviews. Reporting was guided by the COREQ checklist. Thirty‐four participants aged 40–65 years were recruited across South Eastern New South Wales, Australia, using convenience s ling. Semi‐structured interviews were conducted by four registered nurses with qualitative research experience. Verbatim transcripts were analysed using thematic analysis. Sixteen women and 18 men participated in the interviews. Four themes emerged, namely: adopting healthy lifestyles denial an impetus for change and sustaining change. Perceptions about what constituted good health varied, with male participants being more ambivalent about their health. Impetus for change was mostly influenced by family history, awareness of health risks and identification of risks by health professionals. Participants found sustaining change challenging, particularly with regard to smoking cessation and dietary modifications. Understanding the perceptions of health of middle‐aged people is important and enables health professionals to engage in early behavioural change conversations that consider perceived barriers to lifestyle modification. Findings from this study emphasise the importance of discussions about lifestyle risk to reduce the future burden of chronic disease. These findings illustrate the importance of understanding perceptions of health to guide primary health care nurses to develop person‐centred health promotion and chronic disease prevention strategies in this age group.
Publisher: Wiley
Date: 24-10-2018
Abstract: One in seven Australian schoolchildren do not consume breakfast. School-based breakfast programs assist at-risk children to meet their nutritional requirements and provide cognitive and behavioural benefits, but may result in significant food costs and waste. The present study aimed to explore acceptability and perceived benefits of a novel free primary school-based breakfast program utilising donated food. Process evaluation included quantification of amount of food donated, number of meals provided and nutritional analysis of some of the meal items. Impact evaluation was based on thematic analysis of focus groups held with students, parents and teachers to explore their perspectives about the program. Breakfast diaries and hunger rating visual analogue scales were used to evaluate students' breakfast habits at home over five consecutive days. The program saved 14.4 t of food from landfill through conversion into 44 000 meals. One-fifth of children interviewed arrived at school without having breakfast at least once per week while one-third of students reported being hungry on arrival at school. Benefits of participation in the program included increased willingness to attend school, improved alertness and behaviour, as well as creation of an equitable, supportive environment beneficial for low income or food insecure families. This novel breakfast program based on donated food was widely accepted by students, teachers and parents, providing benefits beyond the mere provision of food. It provides a model for school-based interventions to combine breakfast programs with sustainable food production approaches.
Publisher: South African Medical Association NPC
Date: 21-12-2016
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.NUT.2013.01.017
Abstract: Missing data due to study dropout is common in weight loss trials and several statistical methods exist to account for it. The aim of this study was to identify methods in the literature and to compare the effects of methods of analysis using simulated data sets. Literature was obtained for a 1-y period to identify analytical methods used in reporting weight loss trials. A comparison of methods with large or small between-group weight loss, and missing data that was, or was not, missing randomly was conducted in simulated data sets based on previous research. Twenty-seven studies, some with multiple analyses, were retrieved. Complete case analysis (n = 17), last observation carried forward (n = 6), baseline carried forward (n = 4), maximum likelihood (n = 6), and multiple imputation (n = 2) were the common methods of accounting for missing data. When comparing methods on simulated data, all demonstrated a significant effect when the between-group weight loss was large (P < 0.001, interaction term) regardless of whether the data was missing completely at random. When the weight loss interaction was small, the method used for analysis gave considerably different results with mixed models (P = 0.180) and multiple imputations (P = 0.125) closest to the full data model (P = 0.033). The simulation analysis showed that when data were not missing at random, treatment effects were small, and the amount of missing data was substantial, the analysis method had an effect on the significance of the outcome. Careful attention must be paid when analyzing or appraising studies with missing data and small effects to ensure appropriate conclusions are drawn.
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/J.NUT.2004.09.012
Abstract: We investigated whether food variety and ersity are associated with physical and cognitive functioning in older adults in Botswana and designed a simple set of screening questions that predict food variety in this population. Data were collected (1998) as a national household survey of 1085 subjects 60 y and older. A food variety score, based on a food frequency checklist, was calculated by summing the frequency of weekly intakes of 16 food items (0 to 66). A dietary ersity score was calculated as the number of food groups consumed weekly (0 to 5). A representative subs le (n = 393) was randomly selected for the clinical component of the survey, and measurements on dependency and cognitive function were conducted. Low food variety was found: 35.2%, 59.3%, and 22.4% of subjects consumed no dairy products, fruits, and vegetables, respectively. A higher food variety score was associated with urban residence, ownership of cattle, higher education, and more frequent meals, and these indicators were used to construct a nutritional risk indicator. Higher food variety score was associated with better self-reported health and better cognitive function. Similarly, a higher score on the nutritional risk indicator screening tool was associated with desirable health outcomes. A limited number of foods is consumed, leading to an overall pattern of poor food variety. Higher food variety was associated with improved physical and cognitive functions. A screening tool that predicts food variety in this population has been developed and is recommended to be incorporated at a primary care level to identify older adults most at risk of a poor quality diet.
Publisher: Wiley
Date: 13-11-2019
Abstract: To summarise the views and suggestions of service providers and health professionals on issues related to the development of National Meal Guidelines. A national online survey of meal service providers and health professionals in Australia was conducted. Potential participants were identified from previously conducted workshop consultations. Snowball s ling was used whereby participants were encouraged to share the survey link with relevant colleagues. De-identified data were collated and closed responses calculated based on the proportion of participants answering each question. Open-ended responses were systematically examined to identify common themes within the data. The 289 participants were mostly female (83%) and service providers (47%). Most participants described their services to be home-delivery (57%), sourcing meals from external providers (47%), were providing menu choice (59%), and were able to cater for special diets (95%). Participants felt that National Meal Guidelines would be beneficial in improving meal service provision and promoting consistency between organisations but were concerned that they may be impractical and costly. They also identified priority areas for inclusion in the guidelines including nutrition recommendations for customers, dietary modifications for special needs, menu variety/structure and considerations about meal types. Nourishing mid-meal snacks, food fortification and screening and monitoring of malnutrition are future considerations for service activities. Future research should examine the uptake and satisfaction of service providers and health professionals with the National Meal Guidelines.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.NUT.2014.03.020
Abstract: In countries with traditionally low fish consumption such as Australia, foods enriched with ω-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFA) may play a role in meeting ω-3 LCPUFA intakes for optimal health. The aim of this study was to assess the effect of replacing bread, egg, milk, and yogurt with ω-3 LCPUFA enrichment of these foods on total ω-3 LCPUFA intake in Australian children's diets. Dietary modeling was undertaken using survey data from a nationally representative s le of 4487 children (2249 boys, 2238 girls) ages 2 to 16 y in whom the Multiple Source Method was used to estimate usual ω-3 LPUFA intakes distributions from two 24-h dietary recalls, corrected for within-person variation 15 models were constructed. The adjusted mean ± SD and median and interquartile range (IQR) of usual dietary intakes of ω-3 LCPUFA gradually increased from 2.5 ± 0.8 to 7.1 ± 4.9 mg/d and 2.3 (1.9-2.9) to 5.4 (3.6-9.2), respectively, after the modeling (P = 0.001 for each model). Median (IQR) intake of total ω-3 LCPUFAs in non-fish eaters and fish eaters was 1.4 (0.8-2.3) and 2.3 (1.0-6.1) mg/d, respectively, which increased threefold to 4.3 (2.6-7.8) and 7.5 (3.9-13) mg/d, respectively, after replacement of all four ω-3 enriched foods. Replacement of four core foods with ω-3 enriched alternatives resulted in improved simulated ω-3 LCPUFA intakes in Australian children but not to optimal levels of intake. Increased fish consumption is still the most effective strategy for increasing ω-3 LCPUFA intake.
Publisher: Wiley
Date: 26-04-2022
DOI: 10.1111/JHN.13009
Abstract: Malnutrition affects between 20% and 50% of hospital inpatients on admission, with further declines expected during hospitalisation. This review summarises the existing literature on hospital‐acquired malnutrition that examines the magnitude of nutritional deterioration amongst adult inpatients and identifies preventable barriers to optimising nutrition support during episodes of care. A systematic review was conducted to answer the question: Among adult hospital inpatients, the presence of which modifiable factors contribute to hospital‐acquired malnutrition? A database search was conducted between the 24 April and 30 June 2020 using CINAHL, MEDLINE, Scopus and PubMed databases according to a protocol registered with PROSPERO (CD42020182728). In addition, issues of the 10 top clinical nutrition journals published during the period of from 1 April 2015 to 30 March 2020 were hand‐searched. Fifteen articles were eligible for inclusion from a total of 5944 retrieved abstracts. A narrative synthesis of evidence was completed because of the high level of heterogeneity in methodologies. Nutritional deterioration is common among previously well‐nourished and nutritionally compromised patients, with studies reporting that 10%–65% of patients experienced nutritional decline. Frequently reported barriers were mealtime interruptions, meal dissatisfaction, procedure‐related fasting, effects of illness or treatment, chewing difficulties, poor appetite and malnutrition as a low clinical priority. The findings of this review support the need for routine nutritional risk screening throughout each hospital admission with hospital‐acquired malnutrition affecting up to 65% of inpatients. Clear establishment of the roles and responsibilities of each member within multidisciplinary healthcare teams in the provision of nutrition care and cost–benefit analyses are recommended to demonstrate the effectiveness of changes to models of care.
Publisher: Cambridge University Press (CUP)
Date: 09-05-2023
DOI: 10.1017/S0007114523001101
Abstract: Despite evidence for favourable health outcomes associated with plant-based diets, a database containing the plant and animal content of all foods eaten is required to undertake a reliable assessment of plant-based diets within a population. This study aimed to expand an existing Australian food database to include the plant and animal content of all whole foods, beverages, multi-ingredient products and mixed dishes. Twenty-three plant- and animal-based food group classifications were first defined. The food servings per 100 g of each product were then systematically calculated using either a recipe-based approach, a food label-based approach, estimates based on similar products or online recipes. Overall, 4687 (83·5 %) foods and beverages were identified as plant or plant-containing products, and 3701 (65·9 %) were animal or animal-containing products. Results highlighted the versatility of plant and animal ingredients as they were found in various foods across many food categories, including savoury and sweet foods, as well as discretionary and core foods. For ex le, over 97 % of animal fat-containing foods were found in major food groups outside the AUSNUT 2011–2013 ‘fats and oils’ group. Surprisingly, fruits, nuts and seeds were present in a greater percentage of discretionary products than in core foods and beverages. This article describes a systematic approach that is suitable for the development of other novel food databases. This database allows more accurate quantitative estimates of plant and animal intakes, which is significant for future epidemiological and clinical research aiming to investigate plant-based diets and their related health outcomes.
Publisher: Wiley
Date: 08-05-2008
Publisher: Springer Science and Business Media LLC
Date: 30-10-2009
DOI: 10.1007/S12603-009-0214-7
Abstract: To validate a revision of the Mini Nutritional Assessment short-form (MNA(R)-SF) against the full MNA, a standard tool for nutritional evaluation. A literature search identified studies that used the MNA for nutritional screening in geriatric patients. The contacted authors submitted original datasets that were merged into a single database. Various combinations of the questions on the current MNA-SF were tested using this database through combination analysis and ROC based derivation of classification thresholds. Twenty-seven datasets (n=6257 participants) were initially processed from which twelve were used in the current analysis on a s le of 2032 study participants (mean age 82.3y) with complete information on all MNA items. The original MNA-SF was a combination of six questions from the full MNA. A revised MNA-SF included calf circumference (CC) substituted for BMI performed equally well. A revised three-category scoring classification for this revised MNA-SF, using BMI and/or CC, had good sensitivity compared to the full MNA. The newly revised MNA-SF is a valid nutritional screening tool applicable to geriatric health care professionals with the option of using CC when BMI cannot be calculated. This revised MNA-SF increases the applicability of this rapid screening tool in clinical practice through the inclusion of a "malnourished" category.
Publisher: Wiley
Date: 09-2010
DOI: 10.1111/J.1532-5415.2010.03016.X
Abstract: To provide pooled data on the prevalence of malnutrition in elderly people as evaluated using the Mini Nutritional Assessment (MNA). Retrospective pooled analysis of previously published datasets. Hospital, rehabilitation, nursing home, community. Four thousand five hundred seven people (75.2% female) with a mean age of 82.3. The prevalence of malnutrition in the combined database and in the four settings was examined. Twenty-four data sets with information on full MNA classification from researchers from 12 countries were submitted. In the combined database, the prevalence of malnutrition was 22.8%, with considerable differences between the settings (rehabilitation, 50.5% hospital, 38.7% nursing home, 13.8% community, 5.8%). In the combined database, the "at risk" group had a prevalence of 46.2%. Consequently, approximately two-thirds of study participants were at nutritional risk or malnourished. The MNA has gained worldwide acceptance and shows a high prevalence of malnutrition in different settings, except for the community. Because of its specific geriatric focus, the MNA should be recommended as the basis for nutritional evaluation in older people.
Publisher: Cambridge University Press (CUP)
Date: 02-2009
Publisher: MDPI AG
Date: 12-11-2017
DOI: 10.3390/NU9111238
Publisher: Springer Science and Business Media LLC
Date: 19-10-2017
DOI: 10.1007/S00394-015-1083-Y
Abstract: Dietary flavonoids, including anthocyanins, may positively influence cognition and may be beneficial for the prevention and treatment of dementia. We aimed to assess whether daily consumption of anthocyanin-rich cherry juice changed cognitive function in older adults with dementia. Blood pressure and anti-inflammatory effects were examined as secondary outcomes. A 12-week randomised controlled trial assessed cognitive outcomes in older adults (+70 year) with mild-to-moderate dementia (n = 49) after consumption of 200 ml/day of either a cherry juice or a control juice with negligible anthocyanin content. Blood pressure and inflammatory markers (CRP and IL-6) were measured at 6 and 12 weeks. ANCOVA controlling for baseline and RMANOVA assessed change in cognition and blood pressure. Improvements in verbal fluency (p = 0.014), short-term memory (p = 0.014) and long-term memory (p ≤ 0.001) were found in the cherry juice group. A significant reduction in systolic (p = 0.038) blood pressure and a trend for diastolic (p = 0.160) blood pressure reduction was evident in the intervention group. Markers of inflammation (CRP and IL-6) were not altered. Inclusion of an anthocyanin-rich beverage may be a practical and feasible way to improve total anthocyanin consumption in older adults with mild-to-moderate dementia, with potential to improve specific cognitive outcomes.
Publisher: Wiley
Date: 03-2010
Publisher: Springer Science and Business Media LLC
Date: 29-06-2005
Abstract: To investigate the association between added sugar and macronutrient and micronutrient intakes, and to assess whether added sugar intake is related to biochemical indices of nutritional status, Mini-Nutritional Assessment (MNA) score, body mass index (BMI) and performance on physical function tests. A cross-sectional, analytical study. Convenient s le of 285 institutionalised and community-dwelling black South African men and women aged 60+ y. An interviewer-administered 24-h dietary recall and MNA were performed. Serum albumin, vitamin B12, ferritin, cholesterol, haemoglobin, red blood cell (RBC) folate and plasma vitamin C were measured. Handgrip strength, BMI, 'sit-to-stand' and 'get-up-and-go' tests were measured. Outcome variables were analysed according to tertiles of added sugar, in grams and as a percentage of total energy (% E). In each tertile of sugar intake, mean MNA score fell in the 'at-risk' classification. In women, energy, protein, % E protein, fibre, thiamin, riboflavin, niacin, vitamin B6, folate, pantothenic acid, biotin, vitamin C, calcium, iron, magnesium, phosphorus, zinc, copper and selenium intake were significantly lowest in subjects in the highest % E sugar tertile. In men, no differences were found for micronutrient intake according to tertiles of total added sugar or % E added sugar. Physical function declined with increasing sugar intake, and suboptimal RBC folate and plasma ascorbic acid status was associated with increasing sugar intake (in women). No relationship was found between added sugar intake and the very high prevalence (65%) of obesity in women. A nutrient-diluting effect of added sugars intake was demonstrated in elderly black South African women. Further studies in this population are required in order to develop food-based dietary guidelines, which include messages on added sugar intake.
Publisher: Wiley
Date: 08-07-2019
DOI: 10.1111/JHN.12582
Abstract: Evidence has shown that anthocyanins, a subclass of polyphenol, are metabolised in the gut, modulate bacterial species and exert bioactive effects through this interaction. A systematic literature review was undertaken to determine the level of current evidence for the association between anthocyanin intake and changes in gut microbiota populations. The studies included were also assessed for the different techniques used in microbiota determination. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, scientific databases, including Scopus, PubMed, ScienceDirect, Web of Science and MEDLINE, were searched up to June 2017. Details on population/s le, study design, intervention/control, dosage and method of microbiota determination were extracted. Six studies (three in vitro, two animal and one human trials) were included in the review, which showed that anthocyanins induced a significant proliferative effect on Bifidobacterium spp., known for their wide use in probiotics and for the treatment of irritable bowel syndrome. There was also an observed inhibition of Clostridium histolyticum, which was shown to be pathogenic in humans. The depth of analysis is an important consideration for the choice of microbiota determination technique with respect to a comprehensive, high-resolution microbiota analysis or analysis of the main microbiota taxa. Very limited research has been carried out in the area of anthocyanins and gut microbiota beneficial effects have generally been observed, and further clinical trials in humans are needed to confirm changes to gut microbes in relation to dietary anthocyanin intake and potential health benefits.
Publisher: Public Library of Science (PLoS)
Date: 27-03-2017
Publisher: Springer Science and Business Media LLC
Date: 29-01-2023
DOI: 10.1038/S41371-021-00653-X
Abstract: South Africa was among the first countries to adopt mandatory regulation in 2016 to lower the salt content in processed foods, aiming to reduce population salt intake to <5 g/day. To assess the effectiveness of this regulation in 20-30 year-old adults, we determined the change in salt intake over a mean follow-up time of 4.56-years spanning the implementation of the regulation. This observational study included baseline (2013-2016 N = 668 24.9 ± 3 years 47.8% black 40.7% men) and follow-up data (2018-ongoing N = 311 25.4 ± 3.05 years 51.1% black 43.4% men) for participants of the African-PREDICT study. Salt intake was estimated from 24-h urinary sodium excretion. Median salt intake at baseline (N = 668) was 7.88 g/day (IQR: 5.67). In those followed (N = 311), salt intake reduced from baseline [median (IQR): 7.91 g/day (5.83)] to follow-up [7.26 g/day (5.30)] [unadjusted median: -0.82 g/day]. After adjusting for baseline salt intake to address regression to the mean, the mean salt reduction was -1.2 g/day. The greatest reductions were in men [mean difference: -1.47 g/day], black adults [mean difference: -2.04 g/day], and participants from low [mean difference: -1.89 g/day] or middle [mean difference: -1.84 g/day] socio-economic status groups, adjusting for baseline salt intake. Our preliminary findings suggest that South Africa's salt regulation has been effective in lowering salt intake in young adults by ~1.2 g salt/day. Our study supports the effectiveness of upstream interventions to lower population salt intake, particularly for vulnerable groups who may typically consume more processed foods. It needs to be determined if the legislation has the anticipated population health gains.
Publisher: MDPI AG
Date: 04-01-2022
DOI: 10.3390/NU14010216
Abstract: The purpose of this study was to explore the perspective of renal dietitians regarding plant-based diets for chronic kidney disease (CKD) management and evaluate the acceptability of a hypothetical plant-based dietary prescription aiming for the consumption of 30 unique plant foods per week. This study used an exploratory mixed methods design. Forty-six renal dietitians participated in either an online survey (n = 35) or an in-depth interview (n = 11). Dietitians perceived that plant-based diets could address multiple clinical concerns relevant to CKD. Forty percent of survey respondents reported the hypothetical dietary prescription was realistic for people with CKD, 34.3% were unsure, and 25.7% perceived it as unrealistic. Strengths of the hypothetical prescription included shifting the focus to whole foods and using practical resources like recipes. Limited staffing, time, and follow-up opportunities with patients, as well as differing nutrition philosophies were the most commonly reported challenges to implementation while a supportive multidisciplinary team was identified as an important enabler. To increase patient acceptance of plant-based dietary approaches, education about plant food benefits was recommended, as was implementing small, incremental dietary changes. Successful implementation of plant-based diets is perceived to require frequent patient contact and ongoing education and support by a dietitian. Buy-in from the multidisciplinary team was also considered imperative.
Publisher: Springer Science and Business Media LLC
Date: 07-2020
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.NUTRES.2013.08.003
Abstract: Pork represents a core food that provides key nutrients to the diet. Dietary guidelines recommend limiting processed meat intake because of adverse health outcomes. The aims of this study were to describe pork consumption, assess the contribution of pork to nutrient intakes, and compare anthropometric characteristics between pork consumers and nonconsumers in a survey of Australian children. We hypothesized that pork consumption will contribute to intakes of key nutrients and that the weight status of children who consume pork will be similar to nonconsumers. This study involved a secondary analysis of the 2007 Australian National Children's Nutrition and Physical Activity Survey. Pork and pork-containing dishes were identified and classified as fresh or processed pork. The contributions of pork to nutrient intakes were calculated. Weight, waist circumference, and body mass index were compared between pork consumers and nonconsumers. Data from 4487 children were available for use. Of this s le, 2245 reported consuming pork, 14% (n = 310) of whom consumed fresh pork, whereas 93% (n = 2084) consumed processed pork. All types of pork contributed to intakes of protein, niacin, and zinc. In addition, fresh pork contributed to intakes of thiamine, long-chain omega-3, phosphorous, and potassium. Total and processed pork contributed 12.2% and 13.0% of sodium, respectively. There were no significant differences between weight, waist circumference, and body mass index in consumers and nonconsumers of total, fresh, or processed pork. In a survey of Australian children, processed pork was the most frequently consumed form of pork, suggesting a deviation from dietary guidelines.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/PY17088
Abstract: Nurses are well-positioned to provide basic nutrition education and reinforce nutrition messages to patients in hospital and primary care settings. Despite this, nurses may not receive adequate training to provide this service, and there is limited opportunity for nurses to engage in nutrition-focused continuing education (CE). The aim of this review was to determine whether nurse nutrition education results in improved knowledge and practices and explore which models of CE for nutrition may be most acceptable and effective in practice. Web of Science and Scopus were searched for case-series studies published between 2000 and 2016 that investigated changes in nutrition knowledge of nurses and midwives. Only studies that could transcend to nurses providing patient nutrition education were included. Twelve articles met the eligibility criteria. Articles are explored in terms of mode of delivery, duration of intervention and educational strategies employed. Nutrition CE programs that are delivered face-to-face or by self-directed learning manuals, which utilise active learning strategies, are positively associated with improvements in nutrition knowledge. Web-based CE and self-directed learning may be favourable modes of delivery as they may assist in addressing resource and time contraints.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.JAND.2016.07.019
Abstract: Dietary pattern analysis provides important evidence revealing diet-disease relationships. It may be especially useful in areas less well researched, such as diet and hypertension in clinical populations. The aim of this study was to identify the association between dietary patterns and blood pressure (BP) in a s le of overweight adults volunteering for a clinical trial for weight loss. This cross-sectional analysis used baseline data from the HealthTrack study, a 12-month randomized controlled trial. Dietary intake was evaluated with 4-day food records. Participants were 328 adults recruited from the Illawarra region of New South Wales, Australia, between May 2014 and April 2015. Resting BP and 24-hour urine sodium and potassium were measured. Dietary patterns were derived by principal component analysis from 21 food groups. Multiple regression analysis was performed to assess the association between the extracted dietary patterns and BP. The participants' mean age was 43.6±8.0 years, mean body mass index was 32.4±4.2, and mean systolic BP/diastolic BP was 124.9±14.5/73.3±9.9 mm Hg. Six major dietary patterns were identified: "nuts, seeds, fruit, and fish," "milk and meat," "breads, cereals, and snacks," "cereal-based products, fats, and oils," "alcohol, eggs, and legumes," and "savoury sauces, condiments, and meat." The "nuts, seeds, fruit, and fish" dietary pattern was significantly and inversely associated with systolic BP (F [7,320]=15.248 P<0.0005 adjusted R A dietary pattern rich in nuts, seeds, fruit, and fish was inversely associated with blood pressure in this clinical s le. The findings suggest that current dietary guidelines are relevant to an overweight clinical population and support the value of dietary pattern analysis when exploring the diet-disease relationship.
Publisher: Elsevier BV
Date: 02-2019
Publisher: Wiley
Date: 02-07-2020
DOI: 10.1111/JHN.12690
Abstract: There is a global increase in populations aged over 65 years. Physiological changes that occur during ageing may increase the nutritional risk for older adults. To avoid malnutrition and address some of the barriers to obtain an adequate food supply, home-delivered meals services provide meals in the home or in congregate settings for older adults who require nutritional support. This systematic literature review explored whether nutritional intake is improved in community-living older adults when receiving meal services compared to when meal services are not received. Four electronic databases were searched up to 31 January 2019. In total, 13 original studies were included in this analysis with the components: intervention of home-delivered meal or congregate meal services to older adults comparison with groups not receiving meal services or days not receiving the meal service and nutritional intake as an outcome measured by food history, dietary recall and/or food frequency questionnaire. The results supported a beneficial effect of home-delivered meals on dietary intake of energy, protein and/or certain micronutrients in older adults. The increased total energy intake is a positive influence on malnutrition risk in frail older adults and the increased protein intake supports good health, promotes recovery from illness and assists in maintaining functionality in older adults. Additionally, there was a particular increase in calcium intake, which is relevant in ageing, especially for bone health.
Publisher: Wiley
Date: 08-09-2014
DOI: 10.1111/AJO.12239
Abstract: To assess nutrition-related knowledge and practices, including supplement use, of both pregnant women and healthcare providers that participate in antenatal shared care (ANSC). Pregnant women enrolled in ANSC (n = 142) completed a knowledge and practices survey and a validated iodine-specific Food Frequency Questionnaire. General practitioners (GP) and nurses (N = 61) participating in the ANSC program completed a short survey which assessed their knowledge about nutrition for pregnancy, focussing on iodine. Both groups had poor knowledge about the importance and roles of iodine during pregnancy. Most women (82%) reported taking a supplement during their current pregnancy, and 70% were taking a supplement containing iodine. Only 26% of GPs discussed iodine supplementation with pregnant patients. The median (IQR) iodine intake of pregnant women was 189 (129-260) μg/day which meets the estimated average requirement (160 μg/day). Half (52%) of women's dietary iodine was provided by dairy foods, and only 7% came from fish and seafood. Most healthcare providers (74%) expressed interest in receiving ongoing professional education about iodine in pregnancy. Ongoing nutrition education for ANSC health practitioners is required to ensure that women receive sufficient dietary advice for optimal pregnancy outcomes. Further research is required to address reasons behind dietary choices of Australian pregnant women.
Publisher: Springer Science and Business Media LLC
Date: 13-03-2020
Publisher: MDPI AG
Date: 07-06-2018
DOI: 10.3390/NU10060736
Publisher: Wiley
Date: 12-1997
Publisher: MDPI AG
Date: 12-11-2021
Abstract: Globally, there is increasing interest in monitoring actions to create healthy, equitable and environmentally sustainable food environments. Currently, there is a lack of detailed tools for monitoring and benchmarking university food environments. This study aimed to develop the University Food Environment Assessment (Uni-Food) tool and process to benchmark the healthiness, equity, and environmental sustainability of food environments in tertiary education settings, and pilot test its implementation in three Australian universities in 2021. The Uni-Food tool development was informed by a review of the literature and input from an expert advisory panel. It comprises three components: (1) university systems and governance, (2) c us facilities and environments, and (3) food retail outlets. The process for implementing the tool is designed for universities to self-assess the extent to which they have implemented recommended practice in 68 indicators, across 16 domains, weighted based on their relative importance. The pilot implementation of the tool identified moderate ersity in food environments across universities and highlighted several opportunities for improvements at each institution. The assessment process was found to be reliable, with assessors rating the tool as easy to use, requiring minimal resources. Broad application of the tool has the potential to increase accountability and guide best practice in tertiary education and other complex institutional settings.
Publisher: Springer Science and Business Media LLC
Date: 10-05-2019
DOI: 10.1038/S41371-019-0210-2
Abstract: Repeated 24-hour urine collection is considered to be the gold standard for assessing salt intake. This is often impractical in large-population studies, especially in low–middle-income countries. Equations to estimate 24-hour urinary salt excretion from a spot urine s le have been developed, but have not been widely validated in African populations. This study aimed to systematically assess the validity of four existing equations to predict 24-hour urinary sodium excretion (24UNa) from spot urine s les in a nationally representative s le of South Africans. Spot and 24-hour urine s les were collected in a subs le ( n = 438) of participants from the World Health Organisation Study on global AGEing and adult health (SAGE) Wave 2 in South Africa in 2015. Measured 24UNa values were compared with predicted 24UNa values from the Kawasaki, Tanaka, INTERSALT and Mage equations using Bland–Altman plots. In this subs le (mean age 52.8 ± 16.4 years body mass index 30.2 ± 8.2 kg/m 2 76% female 73% black African 42% hypertensive), all four equations produced a significantly different population estimate compared with the measured median value of 6.7 g salt/day (IQR 4.4–10.5). Although INTERSALT underestimated salt intake (−3.77 g/d −1.64 to −7.09), the other equations overestimated by 1.28 g/d (−3.52 1.97), 6.24 g/d (2.22 9.45), and 17.18 g/d (8.42 31.96) for Tanaka, Kawasaki, and Mage, respectively. Bland–Altman curves indicated unacceptably wide levels of agreement. Use of these equations to estimate population level salt intake from spot urine s les in South Africans is not recommended.
Publisher: Elsevier BV
Date: 08-2020
DOI: 10.1093/CDN/NZAA084
Publisher: Elsevier BV
Date: 09-2016
DOI: 10.1016/J.NUT.2016.02.004
Abstract: A nutrient dilution effect of diets high in added sugar has been reported in some older populations, but the evidence is inconsistent. The aim of this study was to investigate the association between added sugar intakes (according to recommended guidelines) and nutrient intake, food consumption, and body mass index (BMI). A cross-sectional analysis of data collected between 2007 and 2009 from participants of the Blue Mountains Eye study 4 was performed (n = 879). Dietary intake was assessed using a semiquantitative food frequency questionnaire. Added sugar content of foods was determined by applying a systematic step-wise method. BMI was calculated from measured weight and height. Food and nutrient intakes and BMI were assessed according to categories of percentage energy from added sugar (EAS% 10%) using analysis of covariance for multivariate analysis. Micronutrient intake including retinol equivalents, vitamins B6, B12, C, E, and D, and minerals including calcium, iron, and magnesium showed a significant inverse association with EAS% intakes (Ptrend < 0.05). In people with the lowest intake of added sugars (<5% energy) intake of alcohol, fruits, and vegetables were higher and intake of sugar sweetened beverages was lower compared to other participants (all Ptrend < 0.001). BMI was similar between the three EAS% categories. Energy intake from added sugar greater than the recommended level of 10% is associated with lower micronutrient intakes, indicating micronutrient dilution. Conversely, added sugar intakes <5% of energy intake are associated with higher micronutrient intakes. This information may inform dietary messages targeted at optimizing diet quality in older adults.
Publisher: Cambridge University Press (CUP)
Date: 05-2007
DOI: 10.1017/S0007114507172822
Abstract: The aim of this study was to measure the effects of 12 weeks of conjugated linoleic acid (CLA) supplementation on body composition, RER, RMR, blood lipid profiles, insulin sensitivity and appetite in exercising, normal-weight persons. In this double-blind, randomised, controlled trial, sixty-two non-obese subjects (twenty-five men, thirty-seven women) received either 3·9 g/d CLA or 3·9 g high-oleic acid sunflower oil for 12 weeks. Prior to and after 12 weeks of supplementation, oral glucose tolerance, blood lipid concentrations, body composition (dual-energy X-ray absorptiometry and computerised tomography scans), RMR, resting and exercising RER and appetite were measured. There were no significant effects of CLA on body composition or distribution, RMR, RER or appetite. During the oral glucose tolerance tests, mean plasma insulin concentrations (0, 30, 120 min) were significantly lower ( P = 0·04) in women who supplemented with CLA (24·3 ( sd 9·7) to 20·4 ( sd 8·5) μU/ml) compared to high-oleic acid sunflower oil control (23·7 ( sd 9·8) to 26·0 ( sd 8·8) μU/ml). Serum NEFA levels in response to oral glucose were attenuated in both men and women in the CLA ( P = 0·001) compared to control group. However, serum total cholesterol and LDL-cholesterol concentrations decreased in both groups and HDL-cholesterol concentrations decreased in women over 12 weeks ( P = 0·001, P = 0·02, P = 0·02, respectively). In conclusion, mixed-isomer CLA supplementation had a favourable effect on serum insulin and NEFA response to oral glucose in non-obese, regularly exercising women, but there were no CLA-specific effects on body composition, energy expenditure or appetite.
Publisher: MDPI AG
Date: 16-06-2017
DOI: 10.3390/NU9060612
Publisher: Wiley
Date: 08-03-2021
DOI: 10.1111/AJAG.12903
Abstract: To assess whether nutritional screening and intervention improve the nutritional status of older adults living in the community. The Kiama MOW service performed nutrition screening, after being trained by the research team and maintained the dataset. De‐identified data was provided to the research team for analysis. Meals on Wheels staff also kept detailed notes during the nutrition screening process and in discussions with clients. These notes were provided to the research team along with the de‐identified quantitative data, a summary of the measures taken following screening, including interventions that were recommended to clients by MOW staff. Staff were not formally interviewed about their experiences in conducting nutrition screening but their open‐ended text comments were retrospectively summarised, as well as anecdotal comments made to the research team who were involved in training and supporting the MOW team during the intervention period. Forty‐one in iduals (25 women, mean age = 79.8 ± 8.9 years) were referred (21 well‐nourished, 16 at risk of malnutrition and 4 malnourished). After reassessment (n = 19), nutritional status had significantly improved ( P = .008 for all referrals and P .001 for those at risk of malnutrition or malnourished). The main interventions provided were as follows: nutrition education (100%), home‐delivered meals (78%) and social outings including meals (17%). The My Aged Care portal may be a feasible source of referral of this population to perform routine nutrition screening for appropriate intervention.
Publisher: Springer Science and Business Media LLC
Date: 12-01-2018
Publisher: Wiley
Date: 05-07-2017
DOI: 10.1002/AJHB.23033
Publisher: Wiley
Date: 08-2020
DOI: 10.1111/JCH.13937
Publisher: Cambridge University Press (CUP)
Date: 16-04-2018
DOI: 10.1017/S136898001800068X
Abstract: To meet some of the UN’s seventeen Sustainable Development Goals by 2030, there is a need for more effective policy to reduce food insecurity in low-income and lower-middle-income countries (LMIC). Measuring progress towards these goals requires reliable indicators of food security in these countries. Routinely conducted household consumption and expenditure surveys (HCES) provide potentially valuable and nationally representative data sets for this purpose. The present study aimed to assess methods used to determine national food security status using proxy measures from HCES data in LMIC globally. A scoping literature review was conducted using electronic databases. Of the 929 abstracts identified, a total of twenty articles were reviewed against strict inclusion and exclusion criteria and included for further analysis. Fourteen LMIC globally were represented in the twenty articles. The simplest metric used to indicate food insecurity compared household food expenditure against a level of expenditure considered to be below the poverty line. Data on acquisition of food was commonly converted to available energy for the household using local food composition tables and expressed as a proportion of household total energy requirements. Dietary ersity was also assessed in some studies as well as experience of food insecurity. The review demonstrated that routinely collected HCES data sets provide a useful resource for the measurement of household food security in often resource-limited LMIC. Standardisation of methods used to assess food security is needed to allow for more useful comparisons between countries, as well as to assess temporal trends.
Publisher: Wiley
Date: 12-2002
DOI: 10.1046/J.1440-6047.11.SUPP3.6.X
Abstract: The potential impact of dietary manipulation on the maintenance of physical and cognitive function between middle and old age has profound consequences for optimization of health, independence and well-being for the latter years. This review article considers four key areas: the role of diet and longevity potential dietary measures to prevent sarcopenia diet and cognitive function and dietary interventions with regard to primary or secondary prevention of age-related chronic disorders. Caloric restriction has been shown to slow ageing and maintain health status in both primates and rats. The evidence has limited applicability to humans, since it is unlikely that 30% reduced diets could be maintained long-term. The causes of sarcopenia, which manifests as loss of strength, disability and reduced quality of life, are multifactorial. However, resistance with ageing to regulatory amino acids known to modulate translation and initiation, particularly leucine, raise possibilities with regard to dietary intervention. The pattern of protein intake appears to be important in whole-body protein retention in older adults. A body of evidence is emerging that associates various dietary factors with a reduction in cognitive decline with age, or a delay in the progression of Alzheimer's disease, particularly with regard to intake of vitamin E and C-containing foods, as well as fish intake. Epidemiological evidence demonstrates a role for dietary intervention in the primary prevention of chronic diseases, even in old age. However, the potentially harmful effects of micronutrient supplementation in the secondary prevention of coronary heart disease raise concern regarding appropriate dietary messages for the elderly. The role of the antioxidants, lycopene, lutein and zeaxanthin, in the prevention of cataracts and age-related macular degeneration support the almost universal dietary guideline 'eat more fruit and vegetables'. In future dietary guidelines for the elderly need to be evidence-based and take into account protective food patterns, rather than target specific foods.
Publisher: Cambridge University Press (CUP)
Date: 08-2005
DOI: 10.1079/PHN2005783
Abstract: To develop a nutrition screening tool for use in older South Africans. A cross-sectional validation study in 283 free-living and institutionalised black South Africans (60+ years). Trained fieldworkers administered a 24-hour recall and the Mini Nutritional Assessment (MNA) screening tool, and performed anthropometric measurements and physical function tests. Cognitive function was assessed using a validated version of the Six-Item Cognitive Impairment Test. Biochemical indicators assessed included serum albumin, haemoglobin, ferritin, vitamin B 12 , red-blood-cell folate, cholesterol and vitamin C. The MNA was used as the gold standard against which a novel screening tool was developed using a six-step systematic approach, namely: correspondence analysis identification of key questions determination of internal consistency correlational analyses with objective measures determination of reference cut-off values for categories of nutritional risk and determination of sensitivity and specificity. The new screening tool includes nine separate concepts, comprising a total of 14 questions, as well as measurement of mid-upper arm circumference. The new tool score was positively associated with level of independence in either basic activities of daily living ( r = 0.472) or the more complex instrumental activities of daily living ( r = 0.233). A three-category scoring system of nutritional risk was developed and shown to significantly characterise subjects according to physical function tests, level of independence and cognitive function. The new tool has good sensitivity (87.5%) and specificity (95.0%) compared with the MNA scoring system. It has a very high negative predictive value (99.5%), which means that the tool is unlikely to falsely classify subjects as well nourished/at risk when they are in fact malnourished. A novel screening tool has been shown to have content-, construct- and criterion-related validity, and the in idual items have been shown to have good internal consistency. Further validation of the tool in a new population of elderly Africans is warranted.
Publisher: Cambridge University Press (CUP)
Date: 06-2005
DOI: 10.1079/PHN2004696
Abstract: To determine the level of knowledge regarding iodine nutrition and its relationship with socio-economic status in the South African population. A cross-sectional population survey collecting questionnaire information on knowledge of iodine nutrition and sociodemographic variables in a multistage, stratified, cluster study s le, representative of the adult South African population. Home visits and personal interviews in the language of the respondent. Data were collected from one adult in each of the selected 2164 households, and the participation rate was 98%. Only 15.4% of respondents correctly identified iodised salt as the primary dietary source of iodine, 16.2% knew the thyroid gland needs iodine for its functioning, and a mere 3.9% considered brain damage, and 0.8% considered cretinism, as the most important health consequence of iodine deficiency. Compared with respondents from high socio-economic households, respondents from low socio-economic households were considerably less informed about aspects of iodine nutrition covered in this study. The knowledge level of iodine nutrition is low among South Africans, particularly among the low socio-economic groups. These data suggest that the international emphasis on brain damage resulting from iodine deficiency has not been conveyed successfully to the consumer level in this country.
Publisher: Springer Science and Business Media LLC
Date: 02-09-2015
Publisher: Springer Science and Business Media LLC
Date: 04-2013
DOI: 10.1007/S12603-013-0035-6
Abstract: Community-based services, such as Meals on Wheels (MOW), allow older adults to remain in their homes for as long as possible. Many MOW recipients experience decreased appetite that limits intake at mealtimes. This pilot study aimed to determine the feasibility of providing high protein high energy snacks to improve nutrient intakes of MOW clients in a regional centre of New South Wales, Australia. A convenience s le of 12 MOW clients. Participants received snacks five times a week, in addition to their usual MOW order, for four weeks. Nutritional status was assessed using the Mini Nutritional Assessment tool. Pre-post changes in dietary intake were assessed using a diet history and food frequency questionnaire. Qualitative interviews conducted in clients' homes were digitally recorded, transcribed verbatim, and themes identified. Post-intervention, there was a trend for an increased energy (mean = +415kJ (SD=1477) /day) and protein (+7.2 (±14.06) g/day) intake. MNA scores significantly increased (P= 0.036) and proportion of respondents categorised as 'malnourished' or 'at risk of malnutrition' decreased from 17% to 8%, and 67% to 25%, respectively (P <0.05). Mean body weight increased from 67.1 (±14.3) to 67.8 (±14.8) (P= 0.008), while Body Mass Index (BMI) increased by a mean of 0.78 (±1.16) kg/m2 (P = 0.039). Only half of participants indicated interest in continuing with the program. Reasons included the role of snacks serving as a reminder to eat, as well as their perceived nutritional value. Identified barriers included perceived lack of need for additional food, ability to self-provide such items, and a perceived adequate health status. Provision of an additional daily mid-meal snack may be a useful addition to existing MOW services, for improved energy and protein intakes. However, not all MOW clients at risk of malnutrition perceived the snacks to be beneficial to them.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 19-01-2015
Publisher: Springer Science and Business Media LLC
Date: 20-03-2018
DOI: 10.1038/S41430-018-0123-0
Abstract: In addition to weight-loss, healthy dietary patterns and lower sodium intakes can help reduce blood pressure (BP), but in idualised dietary advice may be necessary to achieve these effects. This study aimed to examine the impact of in idualised dietary advice on BP in the intensive phase of a weight-loss trial. Secondary analysis of baseline and 3-month data from the HealthTrack randomised controlled trial (n = 211). Participants were randomly assigned to one of three dietary advice groups: general advice (control), in idualised advice (intervention group, I), or intervention group supplemented with 30 g walnuts/day (IW). Resting BP and 24-h urine sodium and potassium were measured. Dietary intake was evaluated through diet history interviews. Unadjusted SBP reduced significantly in all groups (IW and I groups P < 0.001 control group P = 0.002) and DBP in IW and I groups (P < 0.001). Compared to controls, the reductions in BP were 3-4 mmHg greater in the I and IW groups, but this only reached significance for DBP in the I group (-3.3 mmHg P = 0.041). After controlling for age, sex, medication, weight-loss, physical activity and smoking, only the IW group showed a significant association between SBP reduction and increased urinary potassium (β = -0.101, P = 0.044), decreased sodium:potassium ratio (β = 2.446, P = 0.037) and increased consumption of seed and nut products and dishes (β = -0.108, P = 0.034). Dietary patterns with distinctive foods and lower sodium:potassium ratios may enhance the effects of weight-loss on BP. The patterns were best achieved with in idualised dietary advice and food supplements.
Publisher: Wiley
Date: 08-04-2014
DOI: 10.1111/AJO.12210
Abstract: Antenatal care has been routine practice throughout the world since early in the 20th century, and in most developed countries, antenatal care consists of a scheduled program of in idual consultations with a healthcare practitioner, using a doctor or midwife. Women seek antenatal care that provides a physical review of the health and development of their unborn baby, the reassurance and ability to be listened to and the opportunity for their partner to be involved in their care. To identify the types of antenatal care services that are available to Australian women and investigate the views and opinions of Australian women related to these services. A systematic literature review using Scopus and Medline databases was used to find appropriate journal articles in January 2013. Articles were restricted to those in the Australian setting from the past 10 years with a focus on different models of antenatal care and the views and experiences of women during their antenatal care. Eighteen relevant peer-reviewed journal articles were included. Emerging forms of antenatal care that are showing increasing levels of satisfaction from Australian women include continuity of carer, the midwifery-led care and group- or community-led care. These approaches are proving to be safe and successful. Newer models of antenatal care in Australia may offer benefits over standard practice.
Publisher: Cambridge University Press (CUP)
Date: 12-2008
DOI: 10.1017/S136898000800342X
Abstract: To assess the impact of a food-based intervention on blood pressure (BP) in free-living South African men and women aged 50–75 years, with drug-treated mild-to-moderate hypertension. A double-blind controlled trial was undertaken in eighty drug-treated mild-to-moderate hypertensive subjects randomised to an intervention ( n 40) or control ( n 40) arm. The intervention was 8-week provision of six food items with a modified cation content (salt replacement (SOLO™), bread, margarine, stock cubes, soup mix and a flavour enhancer) and 500 ml of maas (fermented milk)/d. The control diet provided the same quantities of the targeted foods but of standard commercial composition and 500 ml/d of artificially sweetened cooldrink. The intervention effect estimated as the contrast of the within-diet group changes in BP from baseline to post-intervention was a significant reduction of 6·2 mmHg (95 % CI 0·9, 11·4) for systolic BP. The largest intervention effect in 24 h BP was for wake systolic BP with a reduction of 5·1 mmHg (95 % CI 0·4, 9·9). For wake diastolic BP the reduction was 2·7 mmHg (95 % CI −0·2, 5·6). Modification of the cation content of a limited number of commonly consumed foods lowers BP by a clinically significant magnitude in treated South African hypertensive patients of low socio-economic status. The magnitude of BP reduction provides motivation for a public health strategy that could be adopted through lobbying of the food industry by consumer and health agencies.
Publisher: Springer Science and Business Media LLC
Date: 16-02-2023
DOI: 10.1038/S41430-023-01274-Y
Abstract: Cardio-metabolic risk factors, including hypertension, are increasingly appearing in childhood. The aims of this study were to examine the associations between dietary trajectories across childhood and subsequent blood pressure (BP) at age 10/11, and to further determine whether these associations were explained by BMI or fat mass. Data from 4360 participants from the Longitudinal Study of Australian Children were analysed. Dietary scores were computed based on similarity of intake to the Australian Dietary Guidelines. Group-based trajectory modelling was used to identify distinct dietary trajectories based on participant’s in idual dietary scores at up to four timepoints between age 4 and 11. Linear regression models examined the associations between dietary trajectories and BP measured at age 10/11. Models were adjusted for relevant covariates, and BMI or fat mass. Four dietary trajectories were identified: “never healthy” (4.3%) “moderately healthy” (23.1%) “becoming less healthy” (14.2%) and “always healthy” (58.4%). Children in the “always healthy” trajectory had a lower systolic (−2.19 mmHg 95% CI −3.78, −0.59) and diastolic BP (−1.71 −2.95, −0.47), compared with children in the “never healthy” trajectory after covariate adjustment. These associations were attenuated after additional adjustment for BMI or fat mass, but remained significant for diastolic BP. A dietary trajectory mostly aligned with the Australian Dietary Guidelines across childhood was associated with slightly lower BP at age 10/11, which was not fully explained by BMI or fat mass. These findings support the need to encourage and enable healthy dietary habits early in childhood to attenuate the increasing burden of cardio-metabolic disease.
Publisher: MDPI AG
Date: 04-11-2016
DOI: 10.3390/NU8110701
Publisher: MDPI AG
Date: 08-07-2020
DOI: 10.3390/NU12072026
Abstract: Given a global focus on salt reduction efforts to reduce cardiovascular risk, it is important to obtain accurate measures of salt intake on a population level. This study determined firstly whether adjustment for intra-in idual variation in urinary sodium (Na) excretion using three repeated 24 h collections affects daily estimates and whether the use of repeated spot urine s les results in better prediction of 24 h Na compared to a single collection. Twenty three community-dwelling men and women from South Africa (mean age 59.7 years (SD = 15.6)) participating in the World Health Organization Study on global AGEing and adult health (WHO-SAGE) Wave 3 study collected 24 h and spot early morning urine s les over three consecutive days to assess urinary Na excretion. INTERSALT, Tanaka, and Kawasaki prediction equations, with either average or adjusted spot Na values, were used to estimate 24 h Na and compared these against measured 24 h urinary Na. Adjustment was performed by using the ratio of between-person (sb) and total (sobs) variability obtained from repeated measures analysis of variance. Sensitivity of the equations to predict daily urinary Na values below 5 g salt equivalent was calculated. The sb/sobs for urinary Na using three repeated s les for spot and 24 h s les were 0.706 and 0.798, respectively. Correction using analysis of variance for 3 × 24 h collections resulted in contraction of the upper end of the distribution curve (90th centile: 157 to 136 mmoL/day 95th centile: 220 to 178 mmoL/day). All three prediction equations grossly over-estimated 24 h urinary Na excretion, regardless of whether a single spot urine or repeated collections corrected for intra-in idual variation were used. Sensitivity of equations to detect salt intake equivalent values of ≤5 g/day was 13% for INTERSALT, while the other two equations had zero sensitivity. Correcting for intra-in idual variability in Na excretion using three 24 h urine collections contracted the distribution curve for high intakes. Repeated collection of spot s les for urinary Na analysis does not improve the accuracy of predicting 24 h Na excretion. Spot urine s les are not appropriate to detect participants with salt intakes below the recommended 5 g/day.
Publisher: Wiley
Date: 23-12-2015
DOI: 10.1111/JHN.12353
Abstract: Fish and seafood are good sources of several nutrients that are important for foetal growth and development. Despite guidelines encouraging the eating of fish during pregnancy, research indicates that pregnant women may be limiting or avoiding these foods. Possible factors contributing to this include concerns regarding levels of mercury and other contaminants and pregnant women's purported heightened risk consciousness. The present study aimed to explore pregnant women's perceptions of consuming fish and seafood during pregnancy. Semi‐structured telephone interviews were conducted with 15 pregnant women across all three trimesters in New South Wales, Australia. Questions focussed on exploring nutrition information received during pregnancy, dietary changes made during pregnancy and, more specifically, perceptions of fish and seafood, as well as views on information of fish and seafood commonly provided to pregnant women. Data were collected, then transcribed and analysed using an inductive coding process, guided by the qualitative theory grounded approach. Multiple inter‐related themes were found to shape pregnant women's perceptions related to fish and seafood consumption during pregnancy namely, the understanding of fish and seafood as part of a healthy diet, external factors such as cost, in idual preferences such as taste, and confidence in choosing and preparing fish. The context of a risk adverse society permeated these themes. The present study provides insight into the inter‐related factors that influence pregnant women's consumption or avoidance of fish and seafood.
Publisher: Wiley
Date: 12-06-2019
Abstract: As a s le of research outputs supported by the nutrition and dietetics profession in Australia, the present study aimed to conduct a content analysis of Dietitians Association of Australia (DAA) conference abstracts to identify themes, methods and contribution by geographical location over time. Conference abstracts published during the period 2008-2018 (excluding those from the International Congress of Dietetics in 2012) were obtained. Key outcome data including topics of research and methodological approach were extracted. Leximancer, a computer-assisted content analysis program, was used in the development of concept maps. Thematic analysis was undertaken independently by two authors and consensus was obtained. A total of 2246 oral and poster presentation abstracts and 56 plenary abstracts were imported and synthesised. The most commonly utilised research designs were cross-sectional studies and evaluation research. There was a significant increase in the proportion of systematic literature reviews, and a decreasing proportion of randomised controlled trials presented across the study period. Output was greatest from authors in Queensland and New South Wales. A clear spike in abstracts was observed for the host state across all years. Since 2015 concept maps appeared more interconnected, suggesting a trend for research focus towards integrated nutrition topics. Overarching themes for emerging research topics included Indigenous nutrition and the curriculum for dietetics education. Food/foods emerged as a theme across multiple research methods and in a wide range of contexts and settings. The synthesis of findings suggests that research presented at the DAA conference is largely practice driven.
Publisher: Informa UK Limited
Date: 23-05-2017
DOI: 10.1080/21551197.2017.1321080
Abstract: There is a large burden on researchers and participants when attempting to accurately measure dietary flavonoid intake using dietary assessment. Minimizing participant and researcher burden when collecting dietary data may improve the validity of the results, especially in older adults with cognitive impairment. A short 14-item food frequency questionnaire (FFQ) to measure flavonoid intake, and flavonoid subclasses (anthocyanins, flavan-3-ols, flavones, flavonols, and flavanones) was developed and assessed for validity and reproducibility against a 24-hour recall. Older adults with mild-moderate dementia (n = 49) attended two interviews 12 weeks apart. With the assistance of a family carer, a 24-h recall was collected at the first interview, and the flavonoid FFQ was interviewer-administered at both time-points. Validity and reproducibility was assessed using the Wilcoxon signed-rank sum test, Spearman's correlation coefficient, Bland-Altman Plots, and Cohen's kappa. Mean flavonoid intake was determined (FFQ1 = 795 ± 492.7 mg/day, 24-h recall = 515.6 ± 384.3 mg/day). Tests of validity indicated the FFQ was better at estimating total flavonoid intake than in idual flavonoid subclasses compared with the 24-h recall. There was a significant difference in total flavonoid intake estimates between the FFQ and the 24-h recall (Wilcoxon signed-rank sum p < 0.001 Bland-Altman plots indicated large bias and wide limits of agreement), but they were well correlated (Spearman's correlation coefficient r = 0.74, p < 0.001 Cohen's kappa κ = 0.292, p < 0.001). The FFQ showed good reproducibility, with a small mean percentage difference (12.6%). The Wilcoxon signed-rank sum test showed no significant difference, Spearman's correlation coefficient indicated excellent reliability (r = 0.75, p < 0.001), Bland-Altman plots visually showed small, nonsignificant bias and wide limits of agreement, and Cohen's kappa indicated fair agreement (κ = 0.429, p < 0.001). A 14-item FFQ developed to easily measure flavonoid intake in older adults with dementia demonstrates fair validity against a 24-h recall and good reproducibility.
Publisher: Wiley
Date: 10-07-2023
DOI: 10.1111/JHN.13204
Abstract: Immediate action is needed to stabilise the climate. Dietitians require knowledge of how the therapeutic diets they prescribe may contribute to climate change. No previous research has quantified the climate footprint of therapeutic diets. This study sought to quantify and compare the climate footprint of two types of therapeutic diets for people with chronic kidney disease (CKD) with two reference diets. A usual diet for an in idual with CKD and a novel plant‐based diet for CKD were compared with the current Australian diet and the Australian‐adapted EAT Lancet Planetary Health Diet (PHD). The climate footprint of these diets was measured using the Global Warming Potential (GWP*) metric for a reference 71‐year‐old male. No diets analysed were climate neutral, and therefore, all contribute to climate change. The novel plant‐based diet for CKD (1.20 kg carbon dioxide equivalents [CO 2 e] per day) produced 35% less CO 2 e than the usual renal diet for an in idual with CKD (1.83 kg CO 2 e per day) and 50% less than the current Australian diet (2.38 kg CO 2 e per day). The Australian‐adapted EAT Lancet PHD (1.04 kg CO 2 e per day) produced the least amount of CO 2 e and 56% less than the current Australian diet. The largest contributors to the climate footprint of all four diets were foods from the meats and alternatives, dairy and alternatives and discretionary food groups. Dietetic advice to reduce the climate footprint of therapeutic diets for CKD should focus on discretionary foods and some animal‐based products. Future research is needed on other therapeutic diets.
Publisher: Springer Science and Business Media LLC
Date: 28-03-2015
Publisher: Springer Science and Business Media LLC
Date: 12-2013
Publisher: MDPI AG
Date: 16-09-2014
DOI: 10.3390/NU6093672
Publisher: Wiley
Date: 17-06-2020
DOI: 10.1111/AJAG.12806
Publisher: Wiley
Date: 08-1998
Publisher: Wiley
Date: 19-06-2023
DOI: 10.1111/JHN.13195
Abstract: Civil society organisations (CSOs) are increasingly participating in food system governance in ways that challenge the dominant industrialised profit‐driven system. An online survey of Australian CSOs that self‐identified as being involved in food system governance was conducted to identify their objectives and activities and the enablers of, and barriers to, their participation in food system governance. Respondents were nongovernment organisations/registered charities, social enterprises, businesses and collaborative research initiatives involved in food system governance in Australia ( n = 43). Organisations undertook activities across all dimensions of the food system (food growing roduction, distribution, sale, marketing, access and consumption) and had erse goals related to health, sustainability and social and economic development. They engaged in food system governance via activities such as advocacy and lobbying for policy and legislative change and guiding policy development. Key enablers of this engagement included funding, internal capacity, external supports and collaborations, and inclusive consultation processes and, when not present, were considered barriers. CSOs play an important role in food system governance in Australia, including by influencing policy outcomes, contributing to more inclusive and democratic forms of governance and leading community‐based food system policies. For CSOs to play a more central role, provision of longer‐term funding creation of dedicated food and nutrition policies at local, state and federal government levels and governance processes that are inclusive, accessible and minimise power differentials are required. This study's findings can be used to identify many opportunities for dietitians to engage with CSOs in education, research and advocacy roles for food system transformation.
Publisher: Wiley
Date: 05-04-2022
DOI: 10.1002/HPJA.473
Abstract: This research aimed to develop and disseminate National Meal Guidelines for Australian home-delivered and centre-based meal programs. Development was led by a project group of dietitians and a steering group of representatives from the Australian Meals on Wheels Association. The process framework included three phases: (1) Review of existing standards and guidelines and systematic literature review (SLR), (2) stakeholder consultation conducted via six workshops, across six states (N = 212) and surveys with service providers, health professionals (N = 289) and customers (N = 337) and (3) review of the draft guidelines by stakeholders. The final guidelines address: nutritional needs of older adults meal and menu planning including nutrient requirements for meal components presentation and meal enjoyment special diets and enhancing the meal service. These guidelines provide consistent guidance to services providing home-delivered and centre-based meal programs. Further evaluation of their uptake and impact on service practices and customer nutrition and satisfaction is required. SO WHAT?: The National Meal Guidelines provide nationally consistent, evidence-based guidance on menu planning and nutritional quality of meals to services providing home-delivered and centre-based meal programs. The guideline development framework outlined here also provides a process for future food service guideline development.
Publisher: Elsevier BV
Date: 04-2020
Publisher: Springer Science and Business Media LLC
Date: 08-10-2021
DOI: 10.1007/S13668-021-00374-0
Abstract: The 2013 Australian Dietary Guidelines (ADG) have been criticised for making only brief reference to sustainability considerations. With the ADG currently under review, the purpose of this rapid review was to determine the environmental impacts associated with food consumption in Australia and New Zealand. Of the 20 articles included, greenhouse gas emissions (GHGe) were the most common environmental indicator (n = 12), followed by water use and water footprint (n = 7), and carbon footprint (n = 3). Whilst there are commonalities between different environmental indicators such as the large impact of discretionary food consumption on GHGe, cropland scarcity footprint, and water scarcity footprint, there is wide variation in these indicators for other food groups. Furthermore, modelling of current food consumption data to the recommended diet does not necessarily result in improvement of all indicators. The next iteration of the ADG should promote consumption of foods and dietary patterns that are associated with positive health and environmental outcomes.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.NUT.2013.07.014
Abstract: The aim of this study was to examine food patterns of Australian children ages 9 to 13 y in relation to ω-3 long-chain polyunsaturated fatty acid (ω-3 LCPUFA) intake. Secondary analysis was conducted on nationally representative food data of 1110 Australian children ages 9 to 13 y (525 boys and 585 girls) that was obtained using two 24-h recalls. Principle component factor analysis was used to identify food patterns. Discriminant function analysis was used to identify the relationship between the food patterns and total ω-3 LCPUFA intake. Four major food patterns emerged for each sex. For boys these were labeled: "snack foods," "soft drinks," "vegetables," and "pork and meat chops, steak, and mince." For girls they were labeled: "vegetables," "take-away," "tea, coffee, iced coffee drinks" and "canned meals and soup." Fish consumption bought from take-away outlets was more frequently consumed in the "soft drink" (r = 0.577) and take-away (r = 0.485) food pattern in boys and girls, respectively. In contrast, fish prepared at home was more often consumed in "vegetables" in both boys (r = 0.018) and girls (r = 0.106), as well as in the "pork and meat chops, steak and mince" food pattern in boys (r = 0.060). There was a trend that in boys, the "vegetables" group discriminated children who consumed ω-3 LCPUFA levels similar to adequate intakes (AI) (P = 0.067), whereas in girls, the take-away food pattern discriminated for being a fish consumer (P = 0.060). Dietary patterns associated with a high consumption of vegetables and "take-aways" food that include meat and fish are likely to positively influence dietary ω-3 LCPUFA intake in Australian children.
Publisher: Wiley
Date: 11-10-2017
DOI: 10.1111/JHN.12425
Abstract: The trend of added sugar (AS) intake has not been investigated in the Australian population, including in older adults. The present study aimed to assess trends and food sources of AS intake among a cohort of older Australians during 15 years of follow-up. Dietary data from participants of the Blue Mountains Eye Study (1264 men and 1614 women), aged ≥49 years at baseline, were collected. Dietary intakes were assessed at 5-yearly intervals (1992-94 to 2007-09) using a 145-item food frequency questionnaire (FFQ). AS content of FFQ food items was estimated using a stepwise systematic method. Trends for AS intake between baseline and the three follow-up periods were assessed using linear mixed modelling. In men, the mean (SEM) percentage of energy provided by AS intake (EAS%) declined from 10.4% (0.1%) at baseline to 9.4% (0.2%) at 15-year follow-up (P An overall downward trend was observed in AS intake in both genders, however, was only significant for men during 15 years of follow-up. Table sugar and sugar-containing spreads represent the major source of AS in this cohort of older Australians.
Publisher: Springer Science and Business Media LLC
Date: 31-10-2019
Publisher: Wiley
Date: 03-03-2021
DOI: 10.1111/AJAG.12916
Abstract: To investigate views and expectations of Australian Meals on Wheels (MOW) customers to inform the development of National Meal Guidelines and improve current services. A survey was designed through literature review and consultations with key stakeholders. National convenience s ling returned 337 surveys. Descriptive statistics and chi-squared analyses were applied to the survey data. Meals on Wheels customers reported satisfaction with their current service, with the meal itself found to be the most valuable aspect. People living in small country towns were more likely to value the social contact provided by MOW than those in major cities (P = .001). Delivery of pantry items was the most popular additional option for future services. Valuable information for inclusion in the development of the National Meal Guidelines was provided: nutritional content of meals, meal variety, packaging and presentation, opportunities for nourishing snacks and pantry items, and social contact.
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/09637480701331148
Abstract: To develop a reduced-sodium bread in which salt (NaCl) is partially replaced with potassium, magnesium and calcium salts. Experimental bread was compared against standard brown bread, after a drop test (to assess whether bread quality deteriorates with abuse) and after the usual baking practices for baking properties (volume, crust colour, crumb colour and cell structure), sensory properties and nutritional composition. Plant production feasibility was evaluated in an industrial plant. Breads produced there were subjected to sensory evaluation using triangulation tests in a panel of 122 consumers. Twenty-four s les of both standard and experimental bread were laboratory-analysed for sodium, potassium, magnesium and calcium content. A 32.3% reduced-sodium brown bread was developed that was acceptable in terms of baking qualities, appearance, texture and taste. The potassium, magnesium and calcium contents of the bread were increased by 55.2%, 69.0%, and 34.8%, respectively.
Publisher: Wiley
Date: 02-1999
Publisher: Informa UK Limited
Date: 02-04-2016
DOI: 10.1080/21551197.2016.1162259
Abstract: A pilot quasi-experimental study investigated whether provision of pork, a rich source of thiamin, as the main protein source in meals four times/week for 12 weeks resulted in improved muscle mass, body strength, and cognitive function in community-living older adults compared to similar meals containing chicken. Retirement villages were randomized to receive pre-prepared frozen meals containing either pork or chicken. Dietary intake was assessed by three-day food records and cognitive domains assessed using validated tests. Hand grip strength was measured and lower extremity performance assessed by the sit-to-stand test, get-up-and-go test and six-minute walk test. Forty-eight volunteers participated (78.2 ± 6.2 y). In linear mixed models, controlling for baseline physical activity and dietary protein and energy intake, no differences were found between pork (n = 19) and chicken (n = 12) groups. The chicken group had improved Rey Auditory Verbal Learning test scores (verbal learning and memory) at six weeks (p < 0.001). Provision of four pork meals a week did not result in improvements in cognitive function, nor measures of strength or physical function, compared to those receiving chicken meals in healthy older adults. This suggests that merely changing the type of dietary protein provided by meat does not impact physical or cognitive function.
Publisher: Elsevier BV
Date: 04-2013
DOI: 10.1016/J.NUT.2012.09.010
Abstract: Universal salt iodization is an effective strategy to optimize population-level iodine. At the same time as salt-lowering initiatives are encouraged globally, there is concern about compromised iodine intakes. This study investigated whether salt intakes at recommended levels resulted in a suboptimal iodine status in a country where salt is the vehicle for iodine fortification. Three 24-h urine s les were collected for the assessment of urinary sodium and one s le was taken for urinary iodine concentrations (UICs) in a convenience s le of 262 adult men and women in Cape Town, South Africa. Median UIC was compared across categories of sodium excretion equivalent to salt intakes lower than 5, 5 to 9, and greater than or equal to 9 g/d. The median UIC was 120 μg/L (interquartile range 75.3-196.3), indicating iodine sufficiency. Less one-fourth (23.2%) of subjects had urinary sodium excretion values within the desirable range (salt <5 g/d), 50.7% had high values (5-9 g/d), and 22.8% had very high values (≥9 g/d). No association between urinary iodine and mean 3 × 24-h urinary sodium concentration was found (r = 0.087, P = 0.198) and UIC status did not differ according to urinary sodium categories (P = 0.804). In a country with mandatory universal salt iodization, consumers with salt intakes within the recommended range (<5 g/d) are iodine replete, and median UIC does not differ across categories of salt intake. This indicates that much of the dietary salt is provided from non-iodinated sources, presumably added to processed foods.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.ORCP.2015.05.005
Abstract: Attrition causes analytical and efficacy issues in weight loss trials. Consistent predictors of attrition in weight loss trials have not been identified. Trial design could be improved if factors predicting attrition are accounted for. The aim of this study is to quantify the effect of easily measured pre study and early study variables to determine their relationship with attrition in dietary weight loss trials. Data was pooled from four previous dietary weight loss trials. Mixed effects logistic regression, Receiver Operator Curves and decision trees (classification and regression trees) were used to determine which of the variables (percent weight loss at 1 month, age, gender and baseline BMI) predicted dropout and to determine cutoffs useful for future trial design. The s le included 289 subjects, 73% female, with a mean age of 46.68±9.27years and average dropout of 25%. Percent weight loss at 1 month was the strongest predictor of dropout, those with a weight loss ≤2% were 4.99 times (95% CI 2.71, 9.18) more likely to drop out than those with a weight loss >2% in the first month (P 50 (P=0.006). Early weight loss and age were identified as significant variables for predicting attrition in weight loss trials. Trial designs maybe improved by incorporating these variables and developing interventions targeting these factors may improve participant retention.
Publisher: Springer Science and Business Media LLC
Date: 22-04-2015
Publisher: Wiley
Date: 14-04-2019
DOI: 10.1111/JHN.12652
Abstract: The Health Star Rating (HSR) is a front-of-pack label designed to help Australian consumers identify healthier packaged foods. Price is an important determinant of food choice and yet no previous studies have examined the relationship between HSR and price. In the present study, we investigated whether (i) healthier packaged food products, as determined by HSR, are more expensive than less healthy alternatives and (ii) products displaying the HSR are more expensive than similar products that do not. Prices of three packaged foods categories (breakfast cereals, cereal-based bars and fruit juices) and nutrient data (to calculate HSR) were obtained from shopping receipts of approximately 1600 Australians between June 2014 and September 2016. Associations between HSR and price [per energy ($/100 kJ) and per unit ($/100 g)] for products of comparable package sizes were assessed by linear regression and the results are presented as differences in average price over the theoretical maximum range of HSR from 0.5 to 5 stars. The HSR of products was not consistently related to price. Small positive associations were observed for juice ($0.08/100 mL P = 0.03) and for cereal-based bars ($0.04/100 kJ P = 0.02). No other associations between HSR and price were observed (P ≥ 0.23). Products that displayed the HSR were no more expensive on average than products that received a similar HSR but did not display the HSR (P ≥ 0.16). In summary, the findings of the present study suggest that healthier packaged food products were not consistently more expensive than less healthy products and also that price is unlikely to be a barrier for consumers to use the HSR to select healthier packaged foods.
Publisher: BMJ
Date: 03-2018
DOI: 10.1136/BMJOPEN-2017-020404
Abstract: The WHO’s global targets for non-communicable disease reduction recommend consumption of g salt/day. In 2016, South Africa was the first country to legislate maximum salt levels in processed foods. South Africa’s salt iodisation fortification programme has successfully addressed iodine deficiency but information is dated. Simultaneous monitoring of sodium reduction and iodine status is required to ensure compatibility of the two public health interventions. A nested cohort design within WHO’s 2015 Study on global AGEing and adult health (n=2887) including in iduals from households across South Africa. Randomly selected adults (n=875) provided 24-hour and spot urine s les for sodium and iodine concentration analysis (the primary and secondary outcome measures, respectively). Median 24-hour urinary iodine excretion (UIE) and spot urinary iodine concentrations (UIC) were compared by salt intakes of g/day, 5–9g/dayand g/day. Median daily sodium excretion was equivalent to 6.3 g salt/day (range 1–43 g/day) 35% had urinary sodium excretion values within the desirable range ( g salt/day), 37% had high values (5–9 g salt/day) and 28% had very high values ( g salt/day). Median UIC was 130 µg/L (IQR=58–202), indicating population iodine sufficiency (≥100 µg/L). Both UIC and UIE differed across salt intake categories (p .001) and were positively correlated with estimated salt intake (r=0.166 and 0.552, respectively both p .001). Participants with salt intakes of g/day were not meeting the Estimated Average Requirement for iodine intake (95 µg/day). In a nationally representative s le of South African adults, the association between indicators of population iodine status (UIC and UIE) and salt intake, estimated using 24-hour urinary sodium excretion, indicate that low salt intakes may compromise adequacy of iodine intakes in a country with mandatory iodisation of table salt. The iodine status of populations undergoing salt reduction strategies needs to be closely monitored to prevent re-emergence of iodine deficiency.
Publisher: Elsevier BV
Date: 12-2011
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.JAND.2012.10.017
Abstract: Replacing full-fat dairy products with reduced-fat varieties is a dietetic strategy for reducing energy intake while maintaining nutritional adequacy. This study aimed to explore the dietary outcomes of this recommendation in the context of weight loss. This study involved a secondary analysis of diet-history data for 86 adults (23 males and 63 females body mass index=31.1±3.4) who had completed 3 months of a weight-loss trial in 2009, including advice to consume reduced-fat dairy products. Dairy food intake was categorized using the Australian 1995 National Nutrition Survey food hierarchy. Paired t tests and Wilcoxon signed rank tests determined dairy product consumption change after dietetic intervention. Total fat and energy per day from dairy products decreased significantly, from 14.1±1.2 g to 5.8±0.6 g and 283±20 kcal to 223±14 kcal, respectively, and total carbohydrate from dairy products increased significantly (P=0.04). Only 19.7% of participants met their dietary target of two to three servings of dairy foods per day at 3 months. When analyzed by sex, males decreased their intake of dairy products significantly, from 377.63±62.3 g/day to 357.3±46.7 g/day. Despite consuming less fat from dairy products, females did not significantly reduce energy intake from these foods (P=0.05). This study indicated that men and women responded differently to advice to change from regular to reduced-fat dairy products. Of more concern, however, is that in a weight-loss context, both men and women might choose to consume fewer servings of this food category with significant nutritional implications. Overall, this research highlights the need to consider the impact of sex and the background diet when recommending reduced-fat dairy products in the weight-loss context.
Publisher: MDPI AG
Date: 16-11-2021
DOI: 10.3390/NU13114104
Abstract: The vitamin D status of the United Kingdom (UK) African-Caribbean (AC) population remains under-researched, despite an increased risk of vitamin D deficiency due to darker skin phenotypes and living at a high latitude. This cross-sectional study explored the vitamin D status and intake of AC in iduals (n = 4046 with a valid serum 25(OH)D measurement) from the UK Biobank Cohort, aged ≥40 years at baseline (2006–2010). Over one third of the population were deficient ( nmol/L), 41.1% were insufficient (25–50 nmol/L) and 15.9% were sufficient ( nmol/L). Median (IQR) 25(OH)D was 30.0 (20.9) nmol/L. Logistic regression showed that brown/black skin phenotype, winter blood draw, not consuming oily fish and not using vitamin D supplements predicted increased odds of vitamin D deficiency, whilst older age and a summer or autumn blood draw were significantly associated with reduced odds of vitamin D deficiency. Vitamin D deficiency and insufficiency were prevalent in this AC population and is of considerable concern given the in idual and societal implications of increased morbidity. Public health messaging for this group should focus on year-round vitamin D supplementation and increasing intakes of culturally appropriate vitamin D-rich foods. These data also support the urgent requirement for a revised vitamin D RNI for ethnic groups.
Publisher: Elsevier BV
Date: 07-2021
Publisher: Springer Science and Business Media LLC
Date: 07-1997
Abstract: To determine the prevalence of anaemia and the haemopoietic nutrient status of older mixed ancestry (coloured) South Africans. A cross-sectional analytic study. A random s le of 200 non-institutionalized subjects aged > or = 65 y of age, resident in urban Cape Town, was drawn using a two-stage cluster design. Trained fieldworkers interviewed subjects to obtain demographic and lifestyle data. Dietary intake was assessed using a validated food frequency questionnaire. Fasting blood s les were drawn for the determination of haematological parameters, serum vitamin B12, serum folate, RBC folate and a full blood count. The prevalence of anaemia was 13.9. Eight of the 26 cases of anaemia (31) were associated with suboptimal haemopoietic nutrient status 2(25) and 3(38) cases of these 8 anaemic subjects had suboptimal vitamin B12 and folate status, respectively. Iron deficiency anaemia accounted for 5(63) of the subjects with nutrition-related anaemia. Ten men and two women (6.5 of subjects) had raised serum ferritin concentrations, half of whom had abnormal biochemical parameters indicative of alcohol abuse. Older coloured South Africans, particularly women, should be encouraged to eat diets with a high nutrient density and to consume adequate amounts of foods high in iron, folate and vitamin B12. Further investigation regarding the high prevalence of hyperferritinaemia found in the men in this population is indicated.
Publisher: Wiley
Date: 07-02-2017
DOI: 10.1111/JHN.12448
Abstract: Traditional methods for predicting weight loss success use regression approaches, which make the assumption that the relationships between the independent and dependent (or logit of the dependent) variable are linear. The aim of the present study was to investigate the relationship between common demographic and early weight loss variables to predict weight loss success at 12 months without making this assumption. Data mining methods (decision trees, generalised additive models and multivariate adaptive regression splines), in addition to logistic regression, were employed to predict: (i) weight loss success (defined as ≥5%) at the end of a 12-month dietary intervention using demographic variables [body mass index (BMI), sex and age] percentage weight loss at 1 month and (iii) the difference between actual and predicted weight loss using an energy balance model. The methods were compared by assessing model parsimony and the area under the curve (AUC). The decision tree provided the most clinically useful model and had a good accuracy (AUC 0.720 95% confidence interval = 0.600-0.840). Percentage weight loss at 1 month (≥0.75%) was the strongest predictor for successful weight loss. Within those in iduals losing ≥0.75%, in iduals with a BMI (≥27 kg m Data mining methods can provide a more accurate way of assessing relationships when conventional assumptions are not met. In the present study, a decision tree provided the most parsimonious model. Given that early weight loss cannot be predicted before randomisation, incorporating this information into a post randomisation trial design may give better weight loss results.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.NUTRES.2017.08.006
Abstract: Consumption of anthocyanins from fruit sources may exert protection against hypertension and improve cognition. However, the effect of dose timing in studies is rarely considered. We hypothesized that timed-dose consumption of juice from an anthocyanin-rich Japanese plum variety (Queen Garnet plum, QGP) will have acute and dose-timing effects on cardiovascular responses, cognition, and urinary anthocyanin excretion profiles. Our study objective was to investigate the impact of plum juice on these health parameters. Twelve older (65+ years) and 12 younger (18-45 years) adults participated in an acute crossover study. Participants received, randomly, either 1 × 300 mL or 3 × 100 mL plum juice over 3 hours on 2 different occasions with a 2-week washout period. A battery of cognitive tasks was administered at 0 and 6 hours on each study day. Blood pressure (BP) and urinary anthocyanin/metabolite excretion profiles were measured over 24 hours. Area under the curve for BP was calculated (0-6 hours). A significant reduction in BP and cardiovascular responses was observed in both age groups which was more obvious in the older age group on the single dose for systolic BP, diastolic BP, mean arterial pressure, and heart rate (P values = .035, .028, .017, and .006, respectively). No significant difference was observed between dose-timing regimens for either age group. There was no observed effect on cognition. Native QGP anthocyanins, as well as methylated/glucuronidated metabolites, were detected in urine with no significant differences between age groups or dose timing. High-anthocyanin plum juice significantly reduced BP, but dose timing did not appear to be a significant factor in the potential acute BP-lowering effect of QGP juice.
Publisher: Springer Science and Business Media LLC
Date: 30-07-2015
Publisher: Wiley
Date: 06-2008
Publisher: MDPI AG
Date: 08-09-2023
DOI: 10.3390/NU15183912
Publisher: Wiley
Date: 14-02-2001
DOI: 10.1046/J.1440-6047.2001.00195.X
Abstract: A cross-sectional analytical study was undertaken to describe the nutritional status and dietary intake of the elderly black population of Cape Town. A stratified proportional s le of 148 men and women aged 60 years and older (mean = 68.9+/-5.7) was selected from informal and formal peri-urban settlements. The study population was predominantly urbanized, although most subjects had migrated from non-urban areas. Trained fieldworkers conducted a 24-h recall dietary assessment and performed anthropometrical measurements. Mean energy intakes fell below the recommended dietary allowance (RDA) for both men and women 27% and 36% of men and women, respectively, had energy intakes or =30). We concluded that older black subjects in Cape Town have energy profiles in line with prudent dietary guidelines and more favorable than other elderly groups in the country, with regard to atherogenic risk. However, micronutrient and dietary fiber intake is inadequate, largely due to low reported energy intakes, particularly in women.
Publisher: MDPI AG
Date: 15-10-2021
Abstract: Experiential learning is the process where learners create meaning from direct experience. This systematic review aimed to examine the effects of experiential learning activities on dietary outcomes (knowledge, attitudes, behaviors) in children. Four databases: Education Research Complete, Scopus, Web of Science and PsychINFO were searched from database inception to 2020. Eligible studies included children 0–12 years, assessed effect of experiential learning on outcomes of interest compared to non-experiential learning and were open to any setting. The quality of studies was assessed using the revised Cochrane risk of bias tool by two independent reviewers and effect size was calculated on each outcome. Nineteen studies were conducted in primary school, six in pre-school and one in an outside-of-school setting and used nine types of experiential learning strategies. Cooking, taste-testing, games, role-playing, and gardening were effective in improving nutrition outcomes in primary school children. Sensory evaluation, games, creative arts, and storybooks were effective for preschool children. Multiple strategies involving parents, and short/intense strategies are useful for intervention success. Experiential learning is a useful strategy to improve children’s knowledge, attitudes, and behaviors towards healthy eating. Fewer studies in pre-school and outside of school settings and high risk of bias may limit the generalizability and strength of the findings.
Publisher: Wiley
Date: 24-08-2020
Abstract: This research aimed to use a consensus process to develop a framework and definition for nutrition and dietetic research, and to identify dietetic research priorities for Australia for the period 2020 to 2030. A three‐round Delphi process was selected to enable dietitians with demonstrated research expertise to contribute to the national priority development. All Fellows of the Dietitians Association of Australia, Advanced Accredited Practising Dietitians and research leaders were invited to participate (n = 84). The questionnaire was distributed electronically using a 7‐point Likert scale. Rounds 1 and 2 asked participants to comment on the proposed research framework, definition of dietetic research and to rate a set of priorities categorised within seven themes. Fields were available for comments for revisions to each section. Approval was considered when ≥70% of participants ranked priorities as Agree or Strongly agree . In Round 3, participants were asked to rank the resultant priorities within themes. Through this Delphi process, Australian dietitians with demonstrated expertise contributed to and confirmed a framework and definition for dietetic Research. A ranked list of 15 priorities within five themes for dietetic Research in Australia for the period 2020‐2030 was developed: Healthy ageing Vulnerable populations Food systems and health/nutrition promotion Informatics and evidence based practice and Achieving a balance between prevention and treatment approaches . It is anticipated that results will lead to the development of a research strategy to focus future dietetic research efforts, including the development of professional position papers as well as informing research competencies for dietetic education.
Publisher: Elsevier BV
Date: 03-2021
DOI: 10.1053/J.JRN.2020.07.008
Abstract: The objective of the study was to evaluate associations among diet quality, serum uremic toxin concentrations, and the gut microbiota profile in adults undergoing hemodialysis therapy. This is a cross-sectional analysis of baseline data from a clinical trial involving adults receiving hemodialysis therapy. Usual dietary intake was determined using a diet history method administered by Accredited Practising Dietitians. Two approaches were used for diet quality assessment: (1) using three a priori defined plant-based diet indices-an overall plant-based diet index (PDI), a healthy PDI, and an unhealthy PDI and (2) classification of food group intake. Serum uremic toxins (p-cresyl sulfate and indoxyl sulfate (IS) free and total) were determined by ultra-performance liquid chromatography. Gut microbiota composition was established through sequencing the 16S rRNA gene in stool s les. Twenty-two adults (median age 70.5 [interquartile range: 59-76], 64% male) were included in the final analysis. Higher adherence to the PDI was associated with lower total IS levels (P = .028), independent of dialysis adequacy, urinary output, and blood albumin levels. In contrast, higher adherence to the unhealthy PDI was associated with increases in both free and total IS. Several other direct and inverse associations between diet quality with uremic toxins, microbial relative abundances, and ersity metrics were also highlighted. Diet-associated taxa showed significantly different trends of association with serum uremic toxin concentrations (P < .05). Higher adherence to the PDI was negatively associated with relative abundances of Haemophilus and Haemophilus parainfluenzae that were related to elevated total IS levels. In contrast, increased intake of food items considered unhealthy, such as animal fats, sweets and desserts, were associated with bacteria linked to higher IS and p-cresyl sulfate (total and free) concentrations. The quality of diet and food selections may influence uremic toxin production by the gut microbiota in adults receiving hemodialysis. Well-designed dietary intervention trials that adopt multi-omic technologies appropriate for the functional annotation of the gut microbiome are needed to validate our findings and establish causality.
Publisher: Universidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA)
Date: 09-07-2020
DOI: 10.11606/S1518-8787.2020054002545
Abstract: The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.
Publisher: AMPCo
Date: 11-2013
DOI: 10.5694/MJA13.10708
Publisher: Oxford University Press (OUP)
Date: 08-2005
DOI: 10.1097/01.HJR.0000170265.22938.D1
Abstract: To determine any differences in the urinary excretion and dietary intake of sodium, potassium, magnesium and calcium intake in three South African ethnic groups, and to assess whether the blood pressure-cation association varies according to ethnic status. A cross-sectional study of 325 black, white and mixed-ancestry men and women, conveniently s led in Cape Town. Twenty-four-hour urine s les were collected on three separate occasions for assessment of urinary electrolytes, and three 24-h dietary recalls for the corresponding urine collection times were administered by two trained fieldworkers. Para-amino benzoic acid was used as a marker of the completeness of urine collection. Mean urinary sodium values equate to a daily salt (sodium chloride) intake of 7.8, 8.5 and 9.5 g in black, mixed-ancestry and white in iduals, respectively. In normotensive in iduals, black and mixed-ancestry subjects had significantly lower median urinary sodium concentrations than white subjects, but these differences were not evident between black and white hypertensive subjects. No ethnic differences were found for urinary potassium, except for mixed-ancestry normotensive in iduals having a lower excretion than white normotensive in iduals. Urinary magnesium excretion did not differ across ethnic groups. In both normotensive and hypertensive in iduals, urinary calcium concentrations differed between all three groups, with black subjects having the lowest values, approximately less than half those of white subjects. White normotensive subjects in Cape Town have higher habitual intakes of sodium, but also higher calcium intakes than their black and mixed-ancestry counterparts. Dietary differences may contribute to ethnic-related differences in blood pressure.
Publisher: Wiley
Date: 24-01-2019
Abstract: To investigate the relationship between nutritional status, functional ability and frailty in older adults participating in a 12-week Transitional Aged Care Service program. A retrospective analysis of a clinical cohort of older adults aged 65+ years after hospital discharge. At entry into the program and at completion, nutritional status was measured using the Mini Nutritional Assessment (MNA), frailty status was measured using the Groningen Frailty Indicator and functional ability was measured using the Modified Barthel Index (MBI). Demographic data were obtained from electronic medical records. Baseline data were available for 115 participants (mean age = 81.7 (SD =7.9) years 20.9% classified as malnourished and 89.6% as frail). A positive association was found between nutritional status and frailty (r = 0.298 P = 0.001), and frailty and functional ability (r = 0.204 P = 0.029). Multiple regression analysis, accounting for the cofounders of baseline MNA, MBI, age, gender, length of hospital stay and living situation, found that nutritional status and functional ability were able to indicate the presence of frailty on admission to the program (P = 0.002, P = 0.007, respectively). In those program completers (n = 79), significant improvements were found in nutritional status, frailty and functional ability (P < 0.0005). Nutrition status, frailty and functional ability are closely and positively related, and should therefore be considered simultaneously in rehabilitation for older adults. A post-hospital transitional program with a multidisciplinary approach significantly improved all three outcomes, suggesting its value in enabling frail older people to remain independent for as long as possible.
Publisher: Elsevier BV
Date: 06-2013
Publisher: Wiley
Date: 11-10-2016
DOI: 10.1111/JHN.12431
Abstract: Preclinical evidence suggests that the anthocyanins, which comprise a subclass of dietary flavonoids providing the purple and red pigmentation in plant-based foods, may have a beneficial impact on cognitive outcomes. A systematic review was conducted to identify the published literature on food-based anthocyanin consumption and cognitive outcomes in human intervention trials. The literature search followed PRISMA guidelines and included six databases, as well as additional hand searching. Seven studies were included in this review, comprising acute trials (n = 4) and longer-term (n = 3) interventions that assessed multiple cognitive outcomes in children, adults and older adults with cognitive impairment. Six of seven studies reported improvements in either a single, or multiple, cognitive outcomes, including verbal learning and memory, after anthocyanin-rich food consumption. As a result of methodological limitations and the large clinical and methodological ersity of the studies, the pooling of data for quantitative analysis was not feasible. The impact of food-based anthocyanin consumption on both acute and long-term cognition appears promising. However, adequately powered studies that include sensitive cognitive tasks are needed to confirm these findings and allow the translation of research into dietary messages.
Publisher: Wiley
Date: 03-10-2014
Publisher: Springer Science and Business Media LLC
Date: 07-02-2019
Publisher: Cambridge University Press (CUP)
Date: 2008
DOI: 10.1017/S1368980007000146
Abstract: To develop and validate a short food-frequency questionnaire to assess habitual dietary salt intake in South Africans and to allow classification of in iduals according to intakes above or below the maximum recommended intake of 6 g salt day −1 . Cross-sectional validation study in 324 conveniently s led men and women. Repeated 24-hour urinary Na values and 24-hour dietary recalls were obtained on three occasions. Food items consumed by % of the s le and which contributed ≥50 mg Na serving −1 were included in the questionnaire in 42 categories. A scoring system was devised, based on Na content of one index food per category and frequency of consumption. Positive correlations were found between Na content of 35 of the 42 food categories in the questionnaire and total Na intake, calculated from 24-hour recall data. Total Na content of the questionnaire was associated with Na estimations from 24-hour recall data ( r = 0.750 P 0.0001 n = 328) and urinary Na ( r = 0.152 P = 0.0105 n = 284). Urinary Na was higher for subjects in tertile 3 than tertile 1 of questionnaire Na content ( P 0.05). Questionnaire Na content of and ≥2400 mg day −1 equated to a reference cut-off score of 48 and corresponded to mean (standard deviation) urinary Na values of 145 (68) and 176 (99) mmol day −1 , respectively ( P 0.05). Sensitivity and specificity against urinary Na ≥100 and mmol day −1 was 12.4% and 93.9%, respectively. A 42-item food-frequency questionnaire has been shown to have content-, construct- and criterion-related validity, as well as internal consistency, with regard to categorising in iduals according to their habitual salt intake however, the devised scoring system needs to show improved sensitivity.
Publisher: Wiley
Date: 23-12-2016
DOI: 10.1111/JHN.12439
Abstract: The present study aimed to develop a food frequency questionnaire (FFQ) assessing dietary omega-3 long chain polyunsaturated fatty acid (n-3 LCPUFA) intake in Australian children and to validate the FFQ against a 7-day food diary. The investigation comprised a cross-sectional and validation study. The study setting was two private primary schools in the in the Illawarra region of New South Wales. Twenty-two Australian children, aged 9-13 years, who were not on a special diet or receiving medical care that limited their food choice in the 3 months prior to recruitment, were recruited into the study. A total of 131 items, classified according to seven food group categories, was included in the n-3 LCPUFA FFQ, as identified from published dietary surveys and a supermarket survey. Good correlations between the FFQ and the 7-day food diary were observed for eicosapentaenoic acid (EPA) [r = 0.691, 95% confidence interval (CI) = 0.51-0.83, P < 0.001], docosahexaenoic acid (DHA) (r = 0.684, 95% CI = 0.45-0.84, P < 0.001) and total n-3 LCPUFA (r = 0.687, 95% CI = 0.48-0.85, P < 0.001). Bland-Altman plots showed an acceptable limit of agreement between the FFQ and the average 7-day food diary. However, the mean EPA, DHA and total n-3 LCPUFA intakes estimated from the FFQ were significantly higher than those from the average 7-day food diary estimates (P < 0.001). A novel n-3 LCPUFA FFQ that has been developed to estimate dietary n-3 LCPUFA intakes in Australian children has been shown to have relative validity. The FFQ provides a useful contribution to dietary assessment methodology in this age group however, reproducibility remains to be demonstrated.
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1111/J.1753-6405.2010.00566.X
Abstract: Strategies that aim to facilitate reduction of the salt content of foods in Australia are h ered by sparse and outdated data on habitual salt intakes. This study assessed habitual sodium intake through urinary excretion analyses, and identified food sources of dietary sodium, as well as knowledge and practices related to salt use in healthy women. Cross-sectional, convenient s le of 76 women aged 20 to 55 years, Wollongong, NSW. Data included a 24 hour urine s le, three-day food diary and a self-administered questionnaire. Mean Na excretion equated to a NaCl (salt) intake of 6.41 (SD=2.61) g/day 43% had values <6 g/day. Food groups contributing to dietary sodium were: bread and cereals (27%) dressings/sauces (20%) meat/egg-based dishes (18%) snacks/desserts/extras (11%) and milk and dairy products (11%). Approximately half the s le reported using salt in cooking or at the table. Dietary practices reflected a high awareness of salt-related health issues and a good knowledge of food sources of sodium. These findings from a s le of healthy women in the Illawarra indicate that dietary sodium intakes are lower in this group than previously reported in Australia. However, personal food choices and high levels of awareness of the salt reduction messages are not enough to achieve more stringent dietary targets of <4 g salt per day. Urinary Na excretion data are required from a larger nationally representative s le to confirm habitual salt intakes. The bread and cereals food group are an obvious target for sodium reduction strategies in manufactured foods.
Publisher: Elsevier
Date: 2010
Publisher: Springer Science and Business Media LLC
Date: 08-04-2009
DOI: 10.1038/EJCN.2009.19
Abstract: Most dietary interventions have metabolic effects in the short term, but long-term effects may require dietary fat changes to influence body composition and insulin action. This study assessed the effect of sustained high polyunsaturated fatty acids (PUFA) intake through walnut consumption on metabolic outcomes in type II diabetes. Fifty overweight adults with non-insulin-treated diabetes (mean age 54+/-8.7 years) were randomized to receive low-fat dietary advice +/-30 g per day walnuts targeting weight maintenance (around 2000 kcal, 30% fat) for 1 year. Differences between groups were assessed by changes in anthropometric values (body weight, body fat, visceral adipose tissue) and clinical indicators of diabetes over treatment time using the general linear model. The walnut group consumed significantly more PUFA than the control (P=0.035), an outcome attributed to walnut consumption (contributing 67% dietary PUFA at 12 months). Most of the effects were seen in the first 3 months. Despite being on weight maintenance diets, both groups sustained a 1-2 kg weight loss, with no difference between groups (P=0.680). Both groups showed improvements in all clinical parameters with significant time effects (P<0.004), bar triacylglycerol levels, but these were just above normal to begin with. The walnut group produced significantly greater reductions in fasting insulin levels (P=0.046), an effect seen largely in the first 3 months. Dietary fat can be manipulated with whole foods such as walnuts, producing reductions in fasting insulin levels. Long-term effects are also apparent but subject to fluctuations in dietary intake if not of the disease process.
Publisher: BMJ
Date: 05-2016
Publisher: Cambridge University Press (CUP)
Date: 26-04-2022
DOI: 10.1017/S1368980022000969
Abstract: Health inequities such as chronic disease are significantly higher among in iduals living with disadvantage compared with the general population and many are reported to be attributable to preventable dietary risk factors. This study provides an overview of the current nutrition interventions for in iduals living with extreme disadvantage, in supported residential settings, to develop insights into the development and implementation of policies and practices to promote long-term nutritional health and well-being. A scoping review searched Scopus, ProQuest, CINAHL Plus, MEDLINE, and Web of Science databases using the terms ‘resident’, ‘nutrition’, ‘disadvantage’, ‘intervention’ and their synonyms, with particular emphasis on interventions in residential settings. Residential services providing nutrition provision and support. People experiencing extreme disadvantage. From 5262 articles, seven were included in final synthesis. Most interventions focused on building food literacy knowledge and skills. Study designs and outcome measures varied however, all reported descriptive improvements in behaviour and motivation. In addition to food literacy, it was suggested that interventions need to address behaviour and motivations, programme sustainability, long-term social, physical and economic barriers and provide support for participants during transition into independent living. Socio-economic issues remain key barriers to long-term health and well-being. In addition to food literacy education, future research and interventions should consider utilising an academic-community partnership, addressing nutrition-related mental health challenges, motivation and behaviour change and a phased approach to improve support for in iduals transitioning into independent living.
Publisher: Cambridge University Press (CUP)
Date: 25-10-2022
DOI: 10.1017/S1368980021004432
Abstract: This scoping review sought to describe the policy actions that urban local governments globally have implemented to facilitate healthy and environmentally sustainable diet-related practices. Urban local government authorities. Five databases were searched to identify publications which cited policies being implemented by local governments within the 199 signatory cities of the Milan Urban Food Policy Pact (MUFPP) that targeted at least one healthy and sustainable diet-related practice. Grey literature was then searched to retrieve associated policy documentation. Data from both sources were charted against the MUFPP’s monitoring framework to analyse the policy actions included in each overarching policy. From 2624 screened peer-reviewed studies, 27 met inclusion criteria and cited 36 relevant policies amongst signatory cities to the MUFPP. Most were from high income countries ( n 29 81 %), considered health ( n 31 86 %), equity ( n 29 81 %) and the broader food system beyond dietary consumption ( n 34 94 %). Of the 66 policy actions described, the most common involved food procurement within public facilities ( n 16 44 %) and establishing guidelines for school-feeding programs ( n 12 33 %). This review has demonstrated that urban local government authorities are implementing policies that consider multiple phases of the food supply chain to facilitate population-wide uptake of healthy and sustainable diet-related practices. Opportunities exist for local governments to leverage the dual benefits to human and planetary health of policy actions, such as those which discourage the overconsumption of food including less meat consumption and the regulation of ultra-processed foods.
Publisher: Elsevier BV
Date: 09-2003
DOI: 10.1016/S0899-9007(03)00101-1
Abstract: We wanted to develop and validate a test that assesses the knowledge and practices of health professionals (HPs) with regard to the role of nutrition, physical activity, and smoking cessation (lifestyle modification) in chronic diseases of lifestyle. A descriptive cross-sectional validation study was carried out. The validation design consisted of two phases, namely 1) test planning and development and 2) test evaluation. The study s le consisted of five groups of HPs: dietitians, dietetic interns, general practitioners, medical students, and nurses. The overall response rate was 58%, resulting in a s le size of 186 participants. A test was designed to evaluate the knowledge and practices of HPs. The test was first evaluated by an expert group to ensure content, construct, and face validity. Thereafter, the questionnaire was tested on five groups of HPs to test for criterion validity. Internal consistency was evaluated by Cronbach's alpha. An expert panel ensured content, construct, and face validity of the test. Groups with the most training and exposure to nutrition (dietitians and dietetic interns) had the highest group mean score, ranging from 61% to 88%, whereas those with limited nutrition training (general practitioners, medical students, and nurses) had significantly lower scores, ranging from 26% to 80%. This result demonstrated criterion validity. Internal consistency of the overall test demonstrated a Cronbach's alpha of 0.99. Most HPs identified the mass media as their main source of information on lifestyle modification. These HPs also identified lack of time, lack of patient compliance, and lack of knowledge as barriers that prevent them from providing counseling on lifestyle modification. The results of this study showed that this test instrument identifies groups of health professionals with adequate training (knowledge) in lifestyle modification and those who require further training (knowledge).
Publisher: Cambridge University Press (CUP)
Date: 16-02-2016
DOI: 10.1017/S0007114516000040
Abstract: The aim of this study was to demonstrate the use of testing for equivalence in combination with the Bland and Altman method when assessing agreement between two dietary methods. A s le data set, with eighty subjects simulated from previously published studies, was used to compare a FFQ with three 24 h recalls (24HR) for assessing dietary I intake. The mean I intake using the FFQ was 126·51 ( sd 54·06) µg and using the three 24HR was 124·23 ( sd 48·62) µg. The bias was −2·28 ( sd 43·93) µg with a 90 % CI 10·46, 5·89 µg. The limits of agreement (LOA) were −88·38, 83·82 µg. Four equivalence regions were compared. Using the conventional 10 % equivalence range, the methods are shown to be equivalent both by using the CI (−12·4, 12·4 µg) and the two one-sided tests approach (lower t =−2·99 (79 df), P =0·002 upper t =2·06 (79 df), P =0·021). However, we make a case that clinical decision making should be used to set the equivalence limits, and for nutrients where there are potential issues with deficiency or toxicity stricter criteria may be needed. If the equivalence region is lowered to ±5 µg, or ±10 µg, these methods are no longer equivalent, and if a wider limit of ±15 µg is accepted they are again equivalent. Using equivalence testing, acceptable agreement must be assessed a priori and justified this makes the process of defining agreement more transparent and results easier to interpret than relying on the LOA alone.
Publisher: Cambridge University Press (CUP)
Date: 06-2002
DOI: 10.1079/PHN2001320
Abstract: Household food insecurity is a major determinant of undernutrition, yet there is little information on its prevalence in the South African population. This paper assesses household food insecurity in South Africa using a quantitative and objective measure, known as food poverty, and provides prevalence estimates by geographic area and socio-economic condition. Secondary data analysis combining two sources: Statistics South Africa's household-based 1995 Income and Expenditure Survey and the University of Port Elizabeth's Household Subsistence Level series, a nationally-conducted, market-based survey. South Africa. A nationally representative s le of the entire country – stratified by race, province, and urban and non-urban areas – consisting of 28 704 households. A household is defined to be in food poverty when monthly food spending is less than the cost of a nutritionally adequate very low-cost diet. The prevalence of food poverty in South Africa in 1995 was 43%. Food poverty rates were highest among households headed by Africans, followed by coloureds, Indians and whites. Higher food poverty rates were found with decreasing income, increasing household size, and among households in rural areas or those headed by females. The widespread nature of household food insecurity in South Africa is documented here. Prevalence rates by geographic and socio-economic breakdown provide the means for targeting of nutritional interventions and for monitoring progress in this field. The corroboration of these findings with both internal validation measures and external sources suggests that food poverty is a useful, objective measure of household food insecurity.
Publisher: Elsevier BV
Date: 12-2017
Publisher: MDPI AG
Date: 26-09-2023
DOI: 10.3390/NU15194148
Publisher: Wiley
Date: 03-2015
Publisher: MDPI AG
Date: 17-06-2014
DOI: 10.3390/NU6062305
Publisher: Springer Science and Business Media LLC
Date: 29-09-2020
DOI: 10.1186/S40795-020-00379-Y
Abstract: Though Ghana has high hypertension prevalence, the country lacks current national salt consumption data required to build and enhance advocacy for salt reduction. We explored the characteristics of a randomly selected sub s le that had valid urine collection, along with matched survey, anthropometric and BP data ( n = 839, mean age = 60y), from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE), Ghana Wave 3, n = 3053). We also investigated the relationship between salt intake and blood pressure (BP) among the cohort. BP was measured in triplicate and 24 h urine was collected for the determination of urinary sodium (Na), potassium (K), creatinine (Cr) and iodine levels. Hypertension prevalence was 44.3%. Median salt intake was 8.3 g/day, higher in women compared to men (8.6, interquartile range (IQR) 7.5 g/day vs 7.5, IQR 7.4 g/day, p 0.01), younger participants (18–49 y) compared to older ones (50+ y) (9.7, IQR 7.9 g/day vs 8.1, IQR 7.1 g/day, p 0.01) and those with higher Body Mass Index (BMI) ( 30 kg/m 2 ) compared to a healthy BMI (18.5–24.9 kg/m 2 ) (10.04, IQR 5.1 g/day vs 6.2, IQR 5.6 g/day, p 0.01). More than three quarters (77%, n = 647) of participants had salt intakes above the WHO maximum recommendation of 5 g/d, and nearly two thirds (65%, n = 548) had daily K intakes below the recommended level of 90 mmol. Dietary sodium to potassium (Na: K) ratios above 2 mmol/mmol were positively associated with increasing BP with age. Population-based interventions to reduce salt intake and increase K consumption are needed.
Publisher: Informa UK Limited
Date: 13-12-2016
DOI: 10.3109/09637486.2015.1121472
Abstract: A pilot cross-over study assessed the acute effects on blood pressure and plasma biomarkers associated with consumption of a 300 ml anthocyanin-rich fruit juice, provided in differing dose-intervals. Young adults (n = 6) and older adults (n = 7) received in random order, either a single 300 ml dose or 3 × 100 ml doses of high-flavonoid cherry juice provided at 0, 1 and 2 h. Blood pressure and plasma levels of phenolic metabolites were measured at 0, 2 and 6 h.The single 300 ml dose of cherry juice resulted in a significant reduction in systolic (p = 0.002), and diastolic blood pressure (p = 0.008) and heart-rate (p = 0.033) 2 h after consumption, before returning to baseline levels at 6 h post-consumption. The 3 × 100 ml dose provided over 2 h did not result in significant blood pressure reductions. Plasma phenolic metabolites increased at 2 and 6 h however, fluctuations were higher after the single 300 ml dose in older adults. These findings have implications for design of intervention studies that investigate vascular effects associated with flavonoid-rich foods.
Publisher: Wiley
Date: 16-03-2016
DOI: 10.1002/PTR.5581
Abstract: In recent times, plums have been described as foods with health-promoting properties. Research on the health effects of plum continue to show promising results on its antiinflammatory, antioxidant and memory-improving characteristics. The increased interest in plum research has been attributed to its high phenolic content, mostly the anthocyanins, which are known to be natural antioxidants. A systematic review of literature was carried out to summarize the available evidence on the impact of plums (Prunus species domestica and salicina) on disease risk factors and health outcomes. A number of databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for relevant studies on plum health effects in vitro, animal studies and clinical trials. A total of 73 relevant peer-reviewed journal articles were included in this review. The level of evidence remains low. Of the 25 human studies, 6 were confirmatory studies of moderate quality, while 19 were exploratory. Plums have been shown to possess antioxidant and antiallergic properties, and consumption is associated with improved cognitive function, bone health parameters and cardiovascular risk factors. Most of the human trials used the dried version of plums rather than fresh fruit, thus limiting translation to dietary messages of the positioning of plums in a healthy diet. Evidence on the health effect of plums has not been extensively studied, and the available evidence needs further confirmation. Copyright © 2016 John Wiley & Sons, Ltd.
Publisher: BMJ
Date: 2014
Publisher: Public Library of Science (PLoS)
Date: 08-01-2021
DOI: 10.1371/JOURNAL.PONE.0244807
Abstract: The prevalence of hypertension is increasing in low- and middle-income countries, however statistics are generally derived from cross sectional surveys that utilize different methodologies and population s les. We investigated blood pressure (BP) changes over 11–12 years in a large cohort of adults aged 50 years and older (n = 820) included in the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE Ghana) Wave 1 (2007/8) with follow up in Wave 3 (2019). Participants’ BP were measured in triplicate and a survey completed at both time points. Survey instruments collected information on sociodemographic characteristics, lifestyle, health behaviors and chronic conditions. While no significant difference was found in systolic BP between Waves 1 and 3, diastolic BP decreased by 9.7mmHg (mean = 88.6, 15.4 to 78.9, 13.6 respectively) and pulse pressure increased by 9.5mmHg (44.8, 13.7 to 54.3, 14.1). Awareness of hypertension increased by 37%, from (20% to 57%), but no differences were found for the proportion of hypertensives receiving treatment nor those that had controlled BP. Mixed effects modelling showed a decrease in diastolic BP was associated with increasing age, living in rural areas and having health insurance. Factors associated with an increased awareness of hypertension were residing in urban areas, having health insurance and increasing body mass index. While diagnosis of hypertension has improved over time in Ghana, there is an ongoing need to improve its treatment in older adults.
Publisher: Springer Science and Business Media LLC
Date: 05-06-2014
Publisher: Springer Science and Business Media LLC
Date: 10-2010
DOI: 10.1007/S12603-010-0307-3
Abstract: Routine nutrition screening is recommended for all older patients admitted to hospital however data on the prevalence of malnutrition in rehabilitation settings is sparse. This study assessed the nutritional status of older patients admitted to rehabilitation hospitals over a 5 year period and described the association between nutritional status and length of hospital stay (LOS) in this context. The usefulness of a recently revised version of the shortened MNA (MNA-SF) was also investigated. A retrospective analysis was conducted of patients aged 65 + y admitted to two rehabilitation hospitals in New South Wales, Australia between 1st March 2003-30th June 2004, and 11th January 2005-10th December 2008. Nutritional status was determined on admission by trained dietitians using the full MNA instrument and the MNA-SF. Information on diagnosis-related grouping and length of stay (LOS) was obtained. Data was available for 2076 patients with a mean age of 80.6 (27.7) y. Thirty-three percent and 51.5% of patients were classified as malnourished and at nutritional risk, respectively. Controlling for date of admission and diagnosis related grouping, LOS was higher in malnourished and at risk groups compared to their well nourished peers (P < 0.001) by 18.5 and 12.4 days, respectively. MNA-SF demonstrated high sensitivity but relatively low specificity against the full MNA. The majority of older patients in the rehabilitation setting are nutritionally compromised which adversely influences LOS. In order to encourage more widespread screening, the MNA-SF may be able to replace the full MNA.
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1016/J.NUT.2009.03.008
Abstract: We evaluated the effectiveness of the growth monitoring and promotion (GMP) program in Zambia. A 3-mo prospective study of growth outcomes was undertaken at randomly selected health facilities and community posts within the Lusaka district. Children <2 y old (n=698) were purposively s led from three health facilities (n=459) and four community posts (n=77) where health workers had undergone training in GMP and three health facilities where staff had not received training (n=162). Qualitative data on knowledge, attitudes, and practices of GMP were collected from health facility managers (n=6), health workers (n=35), and mothers whose children attended all follow-up visits (n=27). Anthropometric status of children in all groups deteriorated, with children at community posts having the worst outcomes (change in weight-for-age Z-score -0.8+/-0.7), followed by trained (-0.5+/-0.6) and untrained (-0.3+/-0.47 P<0.05) health facilities. A similar trend was seen for weight for length. The overall dropout rate was 74.1%. Weight-for-age Z-scores were higher at 1- and 2-mo follow-up visits for children who did not complete the study at trained health facilities and community posts compared with those who remained in the study. Mothers/caregivers identified GMP as important in attending the under-five clinic, associated their child's weight with overall health status, and expressed a willingness to comply with health workers' advice. However, health care providers were poorly motivated, inadequately supervised, and demonstrated poor practices. The GMP program in Lusaka is functioning suboptimally, even in facilities with trained staff.
Publisher: Wiley
Date: 03-2015
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.APPET.2015.08.007
Abstract: There is a paucity of literature about the nutritional status and energy and protein intakes of Meals on Wheels (MOW) clients. The current study aimed to determine the nutritional status and the adequacy of energy and protein intakes of MOW clients. Forty-two clients were recruited from two MOW services in the Illawarra region of Australia for assessment of their nutritional status, using the Mini Nutritional Assessment (MNA(®)). Estimated energy and protein intakes for a MOW day were compared to a non-MOW day and average daily energy and protein intakes were assessed against estimated daily requirements. A single dietitian performed all assessments and home based interviews to explore the client's perception of the service. Mean daily energy intake (7593 (±2012) kJ) was not significantly different to estimated requirements (7720 (±975) kJ) (P = 0.480), while mean daily protein intake was higher (78.7 (±23.4) g) than calculated requirements (68.4 (±10.8) g P = 0.009). However 16 clients were identified as at risk of malnutrition and 2 were malnourished consuming 2072 kJ (P = 0.000) less energy and 20.4 g less protein (P = 0.004) per day compared to well-nourished clients. MOW clients are at risk of being poorly nourished and meals delivered by the service provide an important contribution to overall intakes. These findings support the need for regular nutrition screening and dietary monitoring in this high risk group, to identify those for whom additional strategies may be indicated.
Publisher: Elsevier BV
Date: 11-2013
Publisher: Cambridge University Press (CUP)
Date: 16-11-2012
DOI: 10.1017/S1368980012004946
Abstract: To develop an FFQ for estimating culture-specific maize intake that can distinguish between home-grown and commercial maize. Home-grown maize is more likely to be contaminated with fumonisins, mycotoxins that are associated with increased risk of oesophageal cancer. An existing FFQ developed for use in urban Xhosa populations was used as the initial framework for the maize-specific FFQ (M-FFQ). The existing questionnaire contained 126 food items ided into ten food groups (bread, cereals, vegetables, fruit, meat, dairy, snacks, condiments, beverages and fat). The M-FFQ was developed based on additional data obtained from a literature search, 24 h recalls ( n 159), in-depth interviews ( n 4), focus group discussions ( n 56) and expert consultation. Food items available in local shops ( n 3) were compared with information obtained from focus group discussions. Five villages in two rural isiXhosa-speaking areas of the Eastern Cape Province, known to have a high incidence of oesophageal cancer, were randomly selected. Women aged 18–55 years were recruited by snowball s ling and invited to participate. The final M-FFQ comprised twenty-one maize-based food items, including traditional Xhosa dishes and beverages. The questionnaire focused on maize-specific dishes and distinguished between home-grown maize and commercial maize consumption. A culturally specific dietary assessment method was designed to determine maize consumption and therefore fumonisin exposure. The questionnaire will be tested against 24 h recalls and other methods to determine its validity, after which it will be used in various epidemiological studies to determine fumonisin exposure.
Publisher: MDPI AG
Date: 18-03-2015
DOI: 10.3390/NU7032001
Publisher: Springer Science and Business Media LLC
Date: 03-11-2011
Publisher: Cambridge University Press (CUP)
Date: 08-2005
DOI: 10.1079/PHN2005814
Abstract: We sought to validate questionnaires concerning body image perception, body size dissatisfaction and weight-related beliefs in multi-ethnic South African mothers and their daughters. Settings and subjects: Girls attending primary school (ages 9–12 years, n = 333) and their mothers (n = 204) were interviewed regarding their demographics and body image. Weight, height and skinfold thicknesses were measured. Body image questions and body mass index (BMI) were compared with silhouettes adapted from the Pathways Study for girls and Stunkard's body image figures for mothers. A Feel–Ideal Difference (FID) index score was created by subtracting the score of the silhouette selected by the participants as ‘ Ideal ’ from the one selected as most closely representing their current appearance or ‘ Feel ’. We hypothesised that a higher FID index score would be associated with greater body size dissatisfaction. BMI percentiles in girls (r = 0.46, P 0.05) and BMI in mothers (r = 0.68, P 0.05) were positively correlated with the selected silhouettes based on size. Participants who reported feelings of being ‘fat’ and those who perceived that their family and friends were more dissatisfied with their body size had significantly higher FID index scores. Scores were lower in black than white girls (all P 0.05). No differences were found in FID index scores between ethnic groups of mothers. Internal reliability of the ‘thin’ and ‘fat’ belief constructs for girls was demonstrated by standardised Cronbach's α values ≥0.7. Silhouettes, FID index, ‘fat’ and ‘thin’ belief constructs (in girls) are age-appropriate, culturally sensitive and can be used in further intervention studies to understand body image.
Publisher: Wiley
Date: 17-06-2021
DOI: 10.1002/HPJA.498
Abstract: To determine the affordability of a healthy food basket (HFB) for welfare recipients and average income earners in 2019 and to compare trends from 2011. Fifty‐seven food items’ prices were collected from fifteen stores across five suburbs representing low, medium and high socio‐economic status. Costs were compared with average weekly income and welfare payments to assess the baskets’ affordability for a family of four and five. In 2019, a HFB was affordable (below 30% of household income) for a five‐person reference family with a pensioner, representing 24.8% of weekly welfare payments, but not for a four‐person reference family (33.0%). The cost of the HFB increased slightly over time from AU$288.91 in 2011 to AU$291.79 in 2019. The food affordability improved for a family of five including a pensioner over this period due to an increase of average weekly earnings and welfare payments. In 2019, the HFB was affordable for a five‐person family however, a four‐person family receiving welfare benefits would have experienced significant “food stress,” with the food basket costing above 30% of household income. Inequity in the affordability of healthy food is a major public health concern and one that demands recognition and national action. The impact of policies affecting welfare support and wages needs to be considered, as well as food pricing strategies and possible food subsidies for those at greatest risk of food insecurity.
Publisher: MDPI AG
Date: 20-04-2017
DOI: 10.3390/NU9040404
Publisher: Springer Science and Business Media LLC
Date: 19-10-2015
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/PY19075
Abstract: Nutrition care is an important component of primary health care as a way to promote positive lifestyle behaviours and reduce risks of chronic disease. Despite this, it appears that primary healthcare settings, including antenatal care, miss opportunities to deliver nutrition care. Time constraints, lack of nutrition knowledge and lack of confidence have been identified as barriers for primary healthcare providers in delivering nutrition care. Nutrition training to upskill primary healthcare providers to deliver nutrition care in a timely manner therefore appears warranted. This forum article discusses models and methods of continuing professional development (CPD) and the effectiveness of nutrition CPD for primary healthcare professionals. It includes a case study as an ex le of developing nutrition CPD for midwives using adult learning theory and concludes with implications for developing nutrition education resources for primary healthcare providers.
Publisher: Cambridge University Press (CUP)
Date: 09-2004
DOI: 10.1079/PHN2004611
Abstract: (1) To identify the major sources of nutrition information, and the perceived credibility thereof, among urban black South African women and (2) to determine the level of knowledge regarding nutrition, particularly regarding the topic of obesity. A cross–sectional descriptive study that was both qualitative (focus groups) and quantitative (in idual questionnaires). Three hundred and ninety–four black women aged 17–49 years were conveniently s led from the Western Cape and Gauteng provinces in South Africa. Four focus groups were held with 39 women to identify common themes relating to nutrition knowledge. Based on these data, a questionnaire instrument was developed and administered to 394 women by trained fieldworkers. The most frequently encountered source of nutrition information was the media, particularly the radio and TV (73.4% and 72.1% of subjects, respectively, obtained information from this source in the past year), followed by family/friends (64.6%). Despite only 48.5% of subjects having received nutrition information from a health professional, this was the most highly credible information source. Factors being most influential in choice of foods were taste, preferences of the rest of the family, and price. A lack of knowledge on certain aspects of nutrition was identified, as well as misconceptions regarding diet and obesity. To improve nutrition knowledge and the effectiveness of nutrition education activities in South Africa, it is recommended that health and nutrition educators become more actively involved with the training of health professionals, particularly those engaged in delivery of services at primary care level, and in turn encourage health professionals to engage more with media sources. Nutrition messages delivered from health professionals via the media will enable public exposure to nutrition information which is not only easily accessible but also perceived to be highly credible.
Publisher: Cambridge University Press (CUP)
Date: 09-2004
DOI: 10.1079/PHN2004612
Abstract: There is a paucity of data on the micronutrient status of low-income, lactating South African women and their infants under 6 months of age. The aim of this study was to elucidate the level of anaemia and vitamin A deficiency (VAD) in peri-urban breast-feeding women and their young infants. Cross-sectional study including anthropometric, biochemical and infant feeding data. Peri-urban settlement in Cape Town, South Africa. Breast-feeding women ( n = 113) and their infants (aged 1–6 months) attending a peri-urban clinic. Mean (standard deviation (SD)) haemoglobin (Hb) of the lactating mothers was 12.4 (1.3) gdl −1 , with 32% found to be anaemic (Hb 12 g dl −1 ). Maternal serum retinol was 49.8 (SD 13.3) μg dl −1 , with 4.5% VAD. Using breast milk, mean (SD) retinol concentration was found to be 70.6 (24.6) μg dl −1 and 15.7 (8.3) μg/g milk fat, with 13% below the cut-off level of μg/g fat. There was no correlation found between breast milk retinol and infant serum retinol. Z -scores (SD) of height-for-age, weight-for-age and weight-for-height were –0.69 (0.81), 0.89 (1.01) and 1.78 (0.83), respectively. Mean (SD) infant Hb was 10.9 (1.1) g dl −1 , with the prevalence of anaemia being 50%, 33% and 12% using Hb cut-offs below 11 g dl −1 , 10.5 g dl −1 and 9.5 g dl −1 , respectively. Mean (SD) infant serum retinol was 26.9 (7.2) μg dl −1 , with 10% being VAD. None of the infants was exclusively breast-fed, 22% were predominantly breast-fed and 787percnt received complementary (mixed) breast-feeding. Thirty-two per cent of infants received weaning foods at an exceptionally young age (≤1 month old). A high rate of anaemia is present in lactating women residing in resource-poor settings. Moreover, their seemingly healthy infants under 6 months of age are at an elevated risk of developing early-onset anaemia and at lower risk of VAD.
Publisher: Springer Science and Business Media LLC
Date: 19-09-2012
Abstract: Older malnourished patients experience increased surgical complications and greater morbidity compared with their well-nourished counterparts. This study aimed to assess whether nutritional status at hospital admission predicted clinical outcomes at 18 months follow-up. A retrospective analysis of N=2076 patient admissions (65+ years) from two subacute hospitals, New South Wales, Australia. Analysis of outcomes at 18 months, according to nutritional status at index admission, was performed in a subs le of n = 476. Nutritional status was determined within 72 h of admission using the Mini Nutritional Assessment (MNA). Outcomes, obtained from electronic patient records, included hospital readmission rate, total Length of Stay (LOS), change in level of care at discharge and mortality. Survival analysis, using a Cox proportional hazards model, included age, sex, Major Disease Classification, mobility and LOS at index admission as covariates. At baseline, 30% of patients were malnourished and 53% were at risk of malnutrition. LOS was higher in malnourished and at risk, compared with well-nourished patients (median (interquartile range): 34 (21, 58) 26 (15, 41) 20 (14, 26) days, respectively P<0.001). Hazard rate for death in the malnourished group is 3.41 (95% confidence interval: 1.07-10.87 P = 0.038) times the well-nourished group. Discharge to a higher level of residential care was 33.1%, 16.9% and 4.9% for malnourished, at-risk and well-nourished patients, respectively P ≤ 0.001). Malnutrition in elderly subacute patients predicts adverse clinical outcomes and identifies a need to target this population for nutritional intervention following hospital discharge.
Publisher: Wiley
Date: 15-01-2017
Abstract: The use of concentrated oral nutrition supplements dispensed in small volumes throughout the day at medication rounds is a common nutrition support strategy. Often termed 'Nutrition as Medication' or NAM, it is associated with excellent rates of patient consumption. However, administration of NAM has been described as suboptimal. The aim of the present study was to identify and explore factors influencing the efficacy of the NAM program from a qualitative perspective. This included exploring issues relating to knowledge, administration and patient consumption from a patient and health professional perspective. Semistructured interviews with patients (n = 7) and eight focus groups with nursing, medical, pharmacy and dietetic staff (n = 63) were conducted. Interviews were conducted in the workplace and were recorded and transcribed verbatim. Data were analysed from a realist theoretical position using the thematic framework approach. Five themes were identified that impact on the efficacy of the NAM program. These include the need for clear role delineation among health professionals regarding responsibility for each aspect of NAM. Other themes that emerged included misconceptions about the importance and relevance of the treatment perceptions of poor palatability and issues associated with the logistics of providing the supplements within the hospital setting. Dietitians should be aware that there are a range of factors that influence the efficacy of the NAM strategy, including the knowledge and values of in idual health professional staff. In addition, increased awareness is required by dietitians regarding the structural barriers to administration and receiving of NAM at the ward level.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2011
Publisher: Wiley
Date: 27-03-2019
DOI: 10.1111/JHN.12647
Abstract: Anthocyanins represent an important subgroup of non-nutritive components of food as evidence continues to build related to their beneficial bioactive effects. Using a recently developed Australian anthocyanin database, the present study aimed to estimate the intake of both total anthocyanins and their subclasses, identify food sources of anthocyanins, and determine associations between anthocyanin intake and measured blood pressure (BP). The present study comprised a secondary analysis of the 2011-12 National Nutrition and Physical Activity component of the Australian Health Survey. Anthocyanin intake was estimated using an Australian anthocyanin database. Usual anthocyanin intake, as estimated from 24-h diet recall data, was computed using multiple source methods, whereas food sources were determined by calculating contribution of food groups to total anthocyanin intake. Regression analysis, adjusted for covariates (age, gender, body mass index, high BP diagnosis, smoking status and physical activity) assessed the relationship between anthocyanin intake and BP in adults aged ≥50 years. Mean anthocyanin intake was 24.17 ± 0.32 mg day In comparison with the world composite database, anthocyanin intake in the Australian population was above average [mean (SD): 24.17 (0.32) mg day
Publisher: Wiley
Date: 24-07-2013
DOI: 10.1007/S11745-013-3812-4
Abstract: Secondary analysis of the 2007 Australian National Children's Nutrition and Physical Activity survey was undertaken to assess the intake and food sources of EPA, DPA and DHA (excluding supplements) in 4,487 children aged 2-16 years. An average of two 24-h dietary recalls was analysed for each child and food sources of EPA, DPA and DHA were assessed using the Australian nutrient composition database called AUSNUT 2007. Median (inter quartile range, IQR) for EPA, DPA and DHA intakes (mg/day) for 2-3, 4-8, 9-13, 14-16 year were: EPA 5.3 (1.5-14), 6.7 (1.8-18), 8.7 (2.6-23), 9.8 (2.7-28) respectively DPA 6.2 (2.2-14), 8.2 (3.3-18), 10.8 (4.3-24), 12.2 (5-29) respectively and DHA 3.9 (0.6-24), 5.1 (0.9-26), 6.8 (1.1-27), 7.8 (1.5-33) respectively. Energy-adjusted intakes of EPA, DPA and DHA in children who ate fish were 7.5, 2 and 16-fold higher, respectively (P < 0.001) compared to those who did not eat fish during the 2 days of the survey. Intake of total long chain n-3 PUFA was compared to the energy adjusted suggested dietary target (SDT) for Australian children and 20 % of children who ate fish during the 2 days of the survey met the SDT. Fish and seafood products were the largest contributors to DHA (76 %) and EPA (59 %) intake, while meat, poultry and game contributed to 56 % DPA. Meat consumption was 8.5 times greater than that for fish/seafood. Australian children do not consume the recommended amounts of long chain omega-3 fatty acids, especially DHA, which could be explained by low fish consumption.
Publisher: Wiley
Date: 24-02-2019
DOI: 10.1111/AJAG.12618
Abstract: To describe referral source, meal ordering patterns and the nutrient composition of meals from a regional Meals on Wheels (MOW) service. Referral sources were obtained via retrospective chart audit and compared for 2008 and 2012. Nutrient content of the three most common meal combinations was compared against MOW recommendations of one-third daily energy and one-half daily protein requirements. There was a decline in overall uptake and referrals from hospitals. The "main meal" alone was the most popular meal choice, but did not meet energy requirements for men or women, nor protein requirements for men. The combination of a soup, main and dessert met the MOW recommendations for women only. Investigation into how older people access MOW services is required. Innovative strategies are required to increase the nutrient content of meals, within the context of meal ordering preferences of consumers.
Publisher: MDPI AG
Date: 26-08-2015
DOI: 10.3390/NU7095327
Publisher: Cambridge University Press (CUP)
Date: 24-02-2020
DOI: 10.1017/S0029665119001538
Abstract: Vitamin D is a fundamentally critical nutrient that the human body requires to function properly. It plays an important role in musculoskeletal health due to its involvement in the regulation of calcium and phosphorus. Having a low level of vitamin D in the body may be detrimental for a wide range of health outcomes, including risk of osteoporotic and stress fractures, risk of CVD and some cancers, and lowering of the capability of the immune system. Vitamin D is an unusual nutrient it is not a vitamin, in the true sense of the word but a pro-hormone. The main source of vitamin D is UV exposure, not dietary intake. Interestingly, there are two forms of vitamin D, vitamin D 2 and vitamin D 3 , both of which are metabolised into 25-hydroxyvitamin D (25(OH)D) in the liver, the biomarker of vitamin D status. Vitamin D deficiency is a global public health problem, especially amongst older people and ethnic minority groups. The newest publication from the UK Government's Public Health England Department recommends that vitamin D intake should be 10 μg daily and this recommendation compares well (albeit lower) with other guidelines such as the Institute of Medicine recommendation of 15 μg for those aged 1–70 years and 20 μg for those 70 years or over. Few countries, however, have a specific vitamin D policy to prevent deficiency in populations. Finland leads the way, demonstrating impressive results in reducing population-level vitamin D deficiency through mandatory food fortification programmes. Collaboration between academia, government and industry, including countries from varying latitudes, is essential to identify long-term solutions to the global issue of vitamin D deficiency. This paper provides a narrative review of the evidence related to the role of vitamin D deficiency in health outcomes, outlines controversies regarding setting levels of adequacy, identifies the prevalence of vitamin D deficiency across the globe, and identifies population-level strategies adopted by countries to prevent vitamin D deficiency.
Publisher: Elsevier BV
Date: 02-2019
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.YPMED.2013.03.007
Abstract: In order to address population-level mild iodine deficiency in Australia, a mandatory iodine fortification programme of salt used in bread was introduced in late 2009. A before-after study was conducted to assess changes in median urinary iodine concentration (MUIC) measurements, according to supplement use, in convenience s les of pregnant women attending a public antenatal clinic in a regional area of New South Wales, Australia in 2008 (n=139), 2011 (n=147) and 2012 (n=114). Knowledge and practices related to iodine nutrition were investigated in 2012, using self-administered questionnaires. The mild iodine deficiency confirmed pre-fortification (MUIC (IQR)=87.5 (62-123.5 n=110)) has steadily improved to 145.5 μg/L (91-252) in 2011 (n=106) and 166 (97-237) in 2012 (n=95) (sufficiency ≥ 150 μg/L). However, only women taking supplements containing iodine had MUIC indicative of sufficiency in both years surveyed post fortification (2011: 178 μg/L vs. 109 μg/L, P<0.001 2012: 202 μg/L vs. 124 μg/L, P<0.05). Despite bread being the vehicle for iodine fortification, dairy foods remained major contributors to total iodine intake (58%). Overall knowledge regarding health implications of iodine deficiency was poor. Iodine status of women has improved since the introduction of mandatory iodine fortification however supplementation is indicated during pregnancy.
Publisher: South African Medical Association NPC
Date: 21-12-2016
Publisher: Elsevier BV
Date: 02-2011
Publisher: Elsevier BV
Date: 07-2007
DOI: 10.1016/J.NUT.2007.04.015
Abstract: We compared the validity of existing nutrition screening tools for use in older South Africans. This was a cross-sectional study in 283 free-living and institutionalized black South Africans > or = 60 y of age. Trained fieldworkers administered a 24-h recall, the DETERMINE and Mini-Nutritional Assessment (MNA) screening tools, and performed anthropometric measurements and physical function tests. Biochemical indicators assessed included serum albumin, hemoglobin, ferritin, vitamin B12, red blood cell folate, cholesterol, and vitamin C. The six-item Cognitive Impairment Test was used to assess cognitive function. The MNA score was positively and significantly associated with anthropometric measurements, cognitive function, instrumental activities of daily living and, in women only, percentage of body fat, handgrip strength, and activities of daily living. Compared with the MNA, the DETERMINE instrument had a low positive predictive value (55.6%) and specificity (11.2%), resulting in a high rate of false positives classified as being malnourished. The MNA, but not the DETERMINE, screening tool is appropriate for use in identifying older black South Africans who are malnourished or at risk of malnutrition.
Publisher: MDPI AG
Date: 20-09-2012
DOI: 10.3390/NU4091317
Publisher: Wiley
Date: 25-05-2010
Start Date: 2019
End Date: 12-2022
Amount: $422,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 06-2023
End Date: 06-2027
Amount: $1,066,940.00
Funder: Australian Research Council
View Funded Activity