ORCID Profile
0000-0002-8365-5023
Current Organisation
The University of Auckland
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Publisher: Informa UK Limited
Date: 02-05-2022
Publisher: Cambridge University Press (CUP)
Date: 05-02-2018
DOI: 10.1017/S1368980017004116
Abstract: Pre-school nutrition-related behaviours influence diet and development of lifelong eating habits. We examined the prevalence and congruence of recommended nutrition-related behaviours (RNB) in home and early childhood education (ECE) services, exploring differences by child and ECE characteristics. Telephone interviews with mothers. Online survey of ECE managers/head teachers. New Zealand. Children ( n 1181) aged 45 months in the Growing Up in New Zealand longitudinal study. A mean 5·3 of 8 RNB were followed at home, with statistical differences by gender and ethnic group, but not socio-economic position. ECE services followed a mean 4·8 of 8 RNB, with differences by type of service and health-promotion programme participation. No congruence between adherence at home and in ECE services was found half of children with high adherence at home attended a service with low adherence. A greater proportion of children in deprived communities attended a service with high adherence, compared with children living in the least deprived communities (20 and 12 %, respectively). Children, across all socio-economic positions, may not experience RNB at home. ECE settings provide an opportunity to improve or support behaviours learned at home. Targeting of health-promotion programmes in high-deprivation areas has resulted in higher adherence to RNB at these ECE services. The lack of congruence between home and ECE behaviours suggests health-promotion messages may not be effectively communicated to parents/family. Greater support is required across the ECE sector to adhere to RNB and promote wider change that can reach into homes.
Publisher: Wiley
Date: 27-10-2022
DOI: 10.1002/HPJA.549
Abstract: Hawke's Bay has one of the highest rates of childhood obesity in New Zealand. While several initiatives exist aiming to decrease obesity through physical activity, there are few nutritional interventions. This study adopted a systems science and mātauranga Māori approach to identify and target underlying drivers of rising childhood obesity and engage the community to improve the food environment. Cognitive mapping interviews (CM) with local stakeholders (school principals, Iwi and district health board representatives, education managers and local councillors) were conducted. The aim was to map participants’ mental models of the causes of rising childhood obesity and to identify key principles for engaging with the local community in a meaningful, impactful and culturally appropriate way for future action. Eleven interviews were conducted face‐to‐face and cognitive maps were constructed. Follow‐up interviews were carried out online, due to COVID restrictions, to present the maps and for interviewees to make any adjustments. Four composite themes emerged through centrality and cluster analysis of the resulting cognitive maps: the importance of building in mātauranga Māori (Māori knowledge and ways of being), the “hauora” of children, working with the community and integrating existing initiatives. Two contextual factors are also considered: the growing need for food security in our communities and the opportunity to start interventions in the school setting. Cognitive mapping can produce useful insights in the early stages of community engagement. The six “pou” (pillars) underscore the importance of incorporating indigenous knowledge when embarking on public health interventions, particularly around obesity and in regional communities. When designing a public health initiative with a community with a high indigenous population, indigenous knowledge should be promoted to focus on holistic health, working with the community and creating opportunities for cohesion. These founding principles will be used to structure future community actions to improve children's food environments in regional New Zealand.
Publisher: Oxford University Press (OUP)
Date: 08-2023
Abstract: In 2020, a government-funded healthy school lunch program was introduced in a quarter of New Zealand schools, selected due to high levels of socio-economic barriers. This study assesses the impact of the introduction of the school lunch program from family (whānau), student and school principal perspectives. Across four schools, we conducted five focus groups (two with secondary students and three with family members) and four school principal interviews. Participating schools represented a range of contexts: primary and secondary, schools with cooks in on-site kitchens and schools receiving meals delivered by external caterers. Thematic analysis was used to develop themes describing the health, wellbeing and nutritional impact of the program. Family participants were 82% Indigenous Māori and self-identified as having ‘borderline’ (73.5%) or no financial security (8.8%). Seven positive impact themes were identified: improved food security, enhanced equity, increased appreciation of healthy foods for students, enhanced mana (wellbeing) for all, reduced financial hardship/stress for families, opportunities for nutritional learning and recognition that appreciation and uptake happen over time. Four negative impact themes were identified: low uptake that created food waste, perception that healthy food is not palatable for students, lack of knowledge of the program and loss of agency for students. This is the largest intervention in nutrition and food security for children implemented in New Zealand since the 1930's. The first 2 years have offered wellbeing and financial benefits for students and families, particularly when school environments promote uptake. More involvement of students and family members in the program planning is essential.
Publisher: MDPI
Date: 18-03-2019
Publisher: MDPI AG
Date: 11-2021
DOI: 10.3390/NU13113917
Abstract: Research shows the shaping of food choices often occurs at home, with the family widely recognised as significant in food decisions. However, in this digital age, our eating habits and decision-making processes are also determined by smartphone apps, celebrity chefs, and social media. The ‘COVID Kai Survey’ online questionnaire assessed cooking and shopping behaviours among New Zealanders during the 2020 COVID-19 ‘lockdown’ using a cross-sectional study design. This paper examines how sources of food choice inspirations (cooking-related advice and the reasons for recipe selection) are related to dietary patterns before and during the lockdown. Of the 2977 participants, those influenced by nutrition and health experts (50.9% before 53.9% during the lockdown) scored higher for the healthy dietary pattern. Participants influenced by family and friends (35% before 29% during the lockdown) had significantly higher scores for the healthy and the meat dietary patterns, whereas participants influenced by celebrity cooks (3.8% before 5.2% during the lockdown) had significantly higher scores in the meat dietary pattern. There was no evidence that associations differed before and during the lockdown. The lockdown was related to modified food choice inspiration sources, notably an increase in ‘comforting’ recipes as a reason for recipe selection (75.8%), associated with higher scoring in the unhealthy dietary pattern during the lockdown. The lockdown in New Zealand saw an average decrease in nutritional quality of diets in the ‘COVID Kai Survey’, which could be partly explained by changes in food choice inspiration sources.
Publisher: MDPI
Date: 18-03-2019
Publisher: MDPI AG
Date: 19-04-2022
Abstract: Children’s nutrition is highly influenced by community-level deprivation and socioeconomic inequalities and the health outcomes associated, such as childhood obesity, continue to widen. Systems Thinking using community-based system dynamics (CBSD) approaches can build community capacity, develop new knowledge and increase commitments to health improvement at the community level. We applied the formal structure and resources of a Group Model Building (GMB) approach, embedded within an Indigenous worldview to engage a high deprivation, high Indigenous population regional community in New Zealand to improve children’s nutrition. Three GMB workshops were held and the youth and adult participants created two systems map of the drivers and feedback loops of poor nutrition in the community. Māori Indigenous knowledge (mātauranga) and approaches (tikanga) were prioritized to ensure cultural safety of participants and to encourage identification of interventions that take into account social and cultural environmental factors. While the adult-constructed map focused more on the influence of societal factors such as cost of housing, financial literacy in communities, and social security, the youth-constructed map placed more emphasis on in idual-environment factors such as the influence of marketing by the fast-food industry and mental wellbeing. Ten prioritized community-proposed interventions such as increasing cultural connections in schools, are presented with the feasibility and likely impact for change of each intervention rated by community leaders. The combination of community-based system dynamics methods of group model building and a mātauranga Māori worldview is a novel Indigenous systems approach that engages participants and highlights cultural and family issues in the systems maps, acknowledging the ongoing impact of historical colonization in our communities.
Publisher: Elsevier BV
Date: 08-2016
Abstract: To investigate written policies, equipment, strategies and barriers to children's activity in early childhood education settings, including participation in health promotion programs and reported time children spend in active play and using screens while in care. Cross-sectional online survey of licensed childcare services in Auckland and Waikato. Policies were scored using a validated tool (WellCCAT-NZ). Results were analysed using descriptive statistics and multivariate regression. Managers, head teachers or similar from 237 services completed the survey (28% of invited services). Of these, 35% had a written activity policy most policies scored low on the WellCCAT-NZ. Comprehensive and strongly worded policies were associated with a lower adult-to-child ratio (p=0.03, adjusted for ECE characteristics). No policies addressed screen use. Children were reported to have teacher-led activity 80 minutes/day, and child-led activity five hours/day (indoor and outdoor). Children watched television daily in 2% and weekly in 11% the services and used computers daily in 11% and weekly in 22% of services. Fewer than half of services participated in health promotion programs with a physical activity component. Childcare services reported having adequate equipment, space and time for physical activity of children however, there are low participation rates in activity programs and a notable absence of written policy.
Publisher: Cambridge University Press (CUP)
Date: 11-04-2022
DOI: 10.1017/S000711452200112X
Abstract: A nationally generalisable cohort ( n 5770) was used to determine the prevalence of non-timely (early/late) introduction of complementary food and core food groups and associations with maternal sociodemographic and health behaviours in New Zealand (NZ). Variables describing maternal characteristics and infant food introduction were sourced, respectively, from interviews completed antenatally and during late infancy. The NZ Infant Feeding Guidelines were used to define early (≤ 4 months) and late (≥ 7 months) introduction. Associations were examined using multivariable multinomial regression, presented as adjusted relative risk ratios and 95 % confidence intervals (RRR 95% CI). Complementary food introduction was early for 40·2 % and late for 3·2 %. The prevalence of early food group introduction were fruit/vegetables (23·8 %), breads/cereals (36·3 %), iron-rich foods (34·1 %) and of late were meat/meat alternatives (45·9 %), dairy products (46·2 %) and fruits/vegetables (9·9 %). Compared with infants with timely food introduction, risk of early food introduction was increased for infants: breastfed 6months (2·52 2·19–2·90), whose mothers were 30 years old (1·69 1·46–1·94), had a diploma/trade certificate v. tertiary education (1·39 1·1–1·70), of Māori v. European ethnicity (1·40 1·12–1·75) or smoked during pregnancy (1·88 1·44–2·46). Risk of late food introduction decreased for infants breastfed 6 months (0·47 0.27–0·80) and increased for infants whose mothers had secondary v. tertiary education (2·04 1·16–3·60) were of Asian v. European ethnicity (2·22 1·35, 3·63) or did not attend childbirth preparation classes (2·23 1·24–4·01). Non-timely food introduction, specifically early food introduction, is prevalent in NZ. Interventions to improve food introduction timeliness should be ethnic-specific and support longer breast-feeding.
Publisher: Informa UK Limited
Date: 16-11-2020
Publisher: Cambridge University Press (CUP)
Date: 02-07-2021
DOI: 10.1017/S0007114521001720
Abstract: Using data from a nationally generalisable birth cohort, we aimed to: (i) describe the cohort’s adherence to national evidence-based dietary guidelines using an Infant Feeding Index (IFI) and (ii) assess the IFI’s convergent construct validity, by exploring associations with antenatal maternal socio-demographic and health behaviours and with child overweight/obesity and central adiposity at age 54 months. Data were from the Growing Up in New Zealand cohort ( n 6343). The IFI scores ranged from zero to twelve points, with twelve representing full adherence to the guidelines. Overweight/obesity was defined by BMI-for-age (based on the WHO Growth Standards). Central adiposity was defined as waist-to-height ratio 90th percentile. Associations were tested using multiple linear regression and Poisson regression with robust variance (risk ratios, 95 % CI). Mean IFI score was 8·2 ( sd 2·1). Maternal characteristics explained 29·1 % of variation in the IFI score. Maternal age, education and smoking had the strongest independent relationships with IFI scores. Compared with children in the highest IFI tertile, girls in the lowest and middle tertiles were more likely to be overweight/obese (1·46, 1·03, 2·06 and 1·56, 1·09, 2·23, respectively) and boys in the lowest tertile were more likely to have central adiposity (1·53, 1·02, 2·30) at age 54 months. Most infants fell short of meeting national Infant Feeding Guidelines. The associations between IFI score and maternal characteristics, and children’s overweight/obesity/central adiposity, were in the expected directions and confirm the IFI’s convergent construct validity.
Publisher: Cambridge University Press (CUP)
Date: 15-10-2015
DOI: 10.1017/S1368980015002955
Abstract: To describe nutrition environments in formal child care for 3- and 4-year-olds. Cross-sectional online survey of nutrition-related child-care policy and practice. Written nutrition policies were analysed using the Wellness Child Care Assessment Tool. Licensed child-care services in the Auckland, Counties Manukau and Waikato regions of New Zealand. Eight hundred and forty-seven services (private and community day care, kindergartens and playcentres). Managers/head teachers of 257 child-care services completed the survey. Of services, 82·4 % had a written food, nutrition or wellness policy. Most policies did not refer to the national Food and Nutrition Guidelines and lacked directives for staff regarding recommended behaviours to promote healthy eating. Food was provided daily to children in 56·4 % of child-care services, including 33·5 % that provided lunch and at least two other meals/snacks every day. Teachers talked to children about food, and cooked with children, at least weekly in 60 % of child-care services. Nearly all services had an edible garden (89·5 %). Foods/beverages were sold for fundraising in the past 12 months by 37·2 % of services. The most commonly reported barrier to promoting nutrition was a lack of support from families (20·6 %). Although the majority of child-care services had a written nutrition policy, these were not comprehensive and contained weak statements that could be difficult to action. Foods served at celebrations and for fundraising were largely high in sugar, salt and/or saturated fat. Most services promoted some healthy eating behaviours but other widespread practices encouraged children to overeat or form unhealthy food preferences.
Publisher: MDPI AG
Date: 13-04-2022
Abstract: Healthy food environments in early childhood play an important role in establishing health-promoting nutritional behaviours for later life. We surveyed Early Learning Services (ELS) in the Hawke’s Bay region of New Zealand and describe common barriers and facilitators to providing a healthy food environment, through descriptive survey analysis and thematic analysis of open-ended questions. We used a policy analysis tool to assess the strength and comprehensiveness of the in idual centre’s nutrition policies and we report on the healthiness of menus provided daily in the centres. Sixty-two centres participated and 96.7% had policies on nutrition compared to 86.7% with policies on drinks. Of the 14 full policies provided for analysis, identified strengths were providing timelines for review and encouraging role modelling by teachers. The main weaknesses were communication with parents and staff, lack of nutrition training for staff and absence of policies for special occasion and fundraising food. With regard to practices in the ELS, food for celebrations was more likely to be healthy when provided by the centre rather than brought from home. Food used in fundraising was more likely to be unhealthy than healthy, though % of centres reported using food in fundraising. Only 40% of menus analysed met the national guidelines by not including any ‘red’ (unhealthy) items. Centre Managers considered the biggest barriers to improving food environments to be a lack of parental support and concerns about food-related choking. These results highlight the need for future focus in three areas: policies for water and milk-only, celebration and fundraising food increased nutrition-focused professional learning and development for teachers and communication between the centre and parents, as a crucial pathway to improved nutrition for children attending NZ early childhood education and care centres.
Publisher: Wiley
Date: 19-07-2022
DOI: 10.1111/MCN.13402
Abstract: New Zealand (NZ) lacks nationally representative or generalisable information on the dietary intakes of pre‐schoolers. We used Growing Up in New Zealand cohort data to i) develop child feeding indexes (CFIs) based on National Food and Nutrition Guidelines for 2‐ and 4.5‐year‐olds ii) describe the cohort adherence to the guidelines at 2 ( n = 6046) and 4.5 years ( n = 5889) and iii) assess the CFIs’ convergent construct validity, by exploring associations with maternal sociodemographic and health behaviours and with child body mass index for age (BMI/age) and the waist‐to‐height ratio at 4.5 years. The CFIs scores ranged from 0 to 11, with 11 representing full adherence to the guidelines. Associations were tested using multiple linear regressions and Poisson regressions with robust variance (risk ratios [RR], 95% confidence intervals, 95% CI). The CFIs mean scores (SD) at 2 and 4.5 years were, respectively, 6.13 (1.21) and 6.22 (1.26) points. Maternal characteristics explained, respectively, 27.2% and 31.9% of the variation in the CFIs scores at 2 and 4.5 years. In the adjusted model at the 4.5‐year interview, in relation to girls ranked in the 5th quintile, those in the 2nd (RR, 95% CI: 1.48 1.03 1.24) and 4th (1.53 1.05 2.23) quintiles of the CFI were more likely to have BMI/age +2z (World Health Organization growth standards) at 4.5 years. At 2 and 4.5 years, most children fell short of meeting national guidelines. The associations between the CFIs scores at both time points with maternal characteristics and with children's body size at 4.5 years were in the expected directions, confirming the CFIs’ convergent construct validity among NZ pre‐schoolers.
Publisher: MDPI AG
Date: 07-09-2021
DOI: 10.3390/SU131810006
Abstract: Food waste is a crisis of our time, yet it remains a data gap in Aotearoa New Zealand’s (NZ’s) environmental reporting. This research contributes to threshold values on NZ’s food waste and seeks to understand the impact of the 2020 COVID-19 lockdown on household food waste in NZ. The data presented here form part of the ‘Covid Kai Survey’, an online questionnaire that assessed cooking and food planning behaviours during the 2020 lockdown and retrospectively before lockdown. Of the 3028 respondents, 62.5% threw out food ‘never’/‘rarely’ before lockdown, and this number increased to 79.0% during lockdown. Participants who wasted food less frequently during lockdown were more likely to be older, work less than full-time, and have no children. During lockdown, 30% and 29% of those who ‘frequently’ or ‘sometimes’ struggled to have money for food threw out food ‘sometimes or more’ compared with 20% of those who rarely struggled to have money for food (p 0.001). We found that lower levels of food waste correlated with higher levels of cooking confidence (p 0.001), perceived time (p 0.001), and meal planning behaviours (p 0.001). Understanding why food waste was generally considerably lower during lockdown may inform future initiatives to reduce food waste, considering socio-economic and demographic disparities.
Publisher: Elsevier BV
Date: 08-2017
Abstract: To describe food provision and evaluate menus in New Zealand childcare services, determining associations with service characteristics and/or cost of menu. Licensed services in three regions of New Zealand participated in an online survey, uploading a weekly menu where applicable. Menus were scored for compliance with guidelines on quantity, variety and quality of foods served. Bivariate and multivariate associations between menu score and service characteristics were analysed. A total of 257 services participated (30% of 847 services invited). Food was provided daily in 56%, with 34% providing lunch and snacks daily. Of the 57 full menus analysed, only three (5%) met all 10 scoring criteria (mean score of 6.8/10). Higher menu scores were statistically associated with employing a cook, high and low (not medium) neighbourhood deprivation, the Heart Foundation's Healthy Heart Award program there was no association with food costs. The Healthy Heart Award remained statistically associated with higher menu score after adjustment for other service characteristics. Most menus did not meet current nutrition guidelines for quantity, variety, and limiting 'sometimes' and 'occasional' foods. Implications for public health: This study provides a baseline for monitoring menu compliance in New Zealand and evidence for nutrition promotion and menu improvement programmes in early education.
Publisher: Informa UK Limited
Date: 06-04-2022
Publisher: MDPI
Date: 20-04-2022
No related grants have been discovered for Sarah Gerritsen.