ORCID Profile
0000-0002-4511-7259
Current Organisation
Monash University
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Publisher: Wiley
Date: 21-09-2011
DOI: 10.1111/J.1440-1584.2011.01222.X
Abstract: To identify factors predicting suboptimal glycaemic control in rural adults during the initial five years post-type 2 diabetes diagnosis. Retrospective medical record audit. Quantitative study. Rural community-based primary health service, South Gippsland, Victoria, Australia. Two hundred and seventy-two de-identified medical records randomly selected from the type 2 diabetes outpatient database. Demographic, biochemical, anthropometric, pharmacological, co-morbidity and lifestyle data during the first five years post-diabetes diagnosis were retrospectively collected. Univariate analysis was performed to identify variables associated with poor diabetes control (HbA1c ≥ 7%). Independent predictors of poor glycaemic control in this rural cohort were elevated fasting glucose at diagnosis (odds ratio (OR) 1.97, 95% confidence interval (CI) 1.31-2.97, P < 0.001), weight gain during the initial 2.5 years of diabetes (OR 1.33, 95% CI 1.11-1.59, P < 0.01), excessive body weight at diagnosis (OR 1.07, 95% CI 1.03-1.12, P < 0.001) and younger age at diagnosis (OR 0.94, 95% CI 0.88-1.00, P < 0.05). These variables combined explained 48% of the variation in HbA1c. Gender, body mass index, waist circumference and lifestyle factors at diagnosis were not significant predictors of diabetes control. Young-middle-aged adults (≤58 years) with elevated fasting glucose (≥9.0 mmol L(-1) ) and excessive body weight (≥93.1 kg) at type 2 diabetes diagnosis and those unable to lose weight early in the course of the disease are more likely to experience a rapid deterioration in glucose control. Rural clinicians should target these in iduals for aggressive diabetes management from the time of diagnosis.
Publisher: Springer Science and Business Media LLC
Date: 26-03-2018
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2021-060520
Abstract: Shift workers are at an increased risk of developing obesity and type 2 diabetes. Eating and sleeping out of synchronisation with endogenous circadian rhythms causes weight gain, hyperglycaemia and insulin resistance. Interventions that promote weight loss and reduce the metabolic consequences of eating at night are needed for night shift workers. The aim of this study is to examine the effects of three weight loss strategies on weight loss and insulin resistance (HOMA-IR) in night shift workers. A multisite 18-month, three-arm randomised controlled trial comparing three weight loss strategies continuous energy restriction and two intermittent fasting strategies whereby participants will fast for 2 days per week (5:2) either during the day (5:2D) or during the night shift (5:2N). Participants will be randomised to a weight loss strategy for 24 weeks (weight loss phase) and followed up 12 months later (maintenance phase). The primary outcomes are weight loss and a change in HOMA-IR. Secondary outcomes include changes in glucose, insulin, blood lipids, body composition, waist circumference, physical activity and quality of life. Assessments will be conducted at baseline, 24 weeks (primary endpoint) and 18 months (12-month follow-up). The intervention will be delivered by research dietitians via a combination of face-to-face and telehealth consultations. Mixed-effect models will be used to identify changes in dependent outcomes (weight and HOMA-IR) with predictor variables of outcomes of group, time and group–time interaction, following an intention-to-treat approach. The study protocol was approved by Monash Health Human Research Ethics Committee (RES 19-0000-462A) and registered with Monash University Human Research Ethics Committee. Ethical approval has also been obtained from the University of South Australia (HREC ID: 202379) and Ambulance Victoria Research Committee (R19-037). Results from this trial will be disseminated via conference presentations, peer-reviewed journals and student theses. Australian New Zealand Clinical Trials Registry (ACTRN-12619001035112).
Publisher: Elsevier BV
Date: 06-2017
Publisher: SAGE Publications
Date: 12-05-2019
Abstract: Introduction: A clinician-researcher in translational research fulfils obligations in care provision and knowledge generation. Similarly, a bicultural clinician could struggle to switch between cultural paradigms. The purpose of this study was to explore the in-depth experience of multiple roles as a bicultural clinician-researcher in a translational research study. Methods: This study employed an autoethnographical method, where the first author, an Australian-trained Chinese researcher, was the research instrument who critically sought understanding of her experience in relation to culture in the context of translating an evidence-based culturally tailored Chinese diabetes education program into practice. Data were thematically analyzed and triangulated. Results: Specific research-to-practice dilemmas and personal and professional growth experiences were encountered. Learning to be flexible in addressing patients’ needs while concurrently collecting program evaluation data was complicated by self-doubt and inflexible colleagues. Implication: Despite challenges, conducting translational research with clinician-researcher can enhance understanding of the different stakeholder cultures, promoting rapid practice change.
Publisher: Elsevier BV
Date: 05-2022
Publisher: Springer Science and Business Media LLC
Date: 10-07-2014
Publisher: MDPI AG
Date: 08-08-2019
DOI: 10.3390/NU11081833
Abstract: Published evidence exploring the effects of dietary resistant starch (RS) on human cardiometabolic health is inconsistent. This review aimed to investigate the effect of dietary RS type 2 (RS2) supplementation on body weight, satiety ratings, fasting plasma glucose, glycated hemoglobin (HbA1c), insulin resistance and lipid levels in healthy in iduals and those with overweight/obesity, the metabolic syndrome (MetS), prediabetes or type 2 diabetes mellitus (T2DM). Five electronic databases were searched for randomized controlled trials (RCTs) published in English between 1982 and 2018, with trials eligible for inclusion if they reported RCTs involving humans where at least one group consumed ≥ 8 g of RS2 per day and measured body weight, satiety, glucose and/or lipid metabolic outcomes. Twenty-two RCTs involving 670 participants were included. Meta-analyses indicated that RS2 supplementation significantly reduced serum triacylglycerol concentrations (mean difference (MD) = −0.10 mmol/L 95% CI −0.19, −0.01, P = 0.03) in healthy in iduals (n = 269) and reduced body weight (MD = −1.29 kg 95% CI −2.40, −0.17, P = 0.02) in people with T2DM (n = 90). However, these outcomes were heavily influenced by positive results from a small number of in idual studies which contradicted the conclusions of the majority of trials. RS2 had no effects on any other metabolic outcomes. All studies ranged from 1–12 weeks in duration and contained small s le sizes (10–60 participants), and most had an unclear risk of bias. Short-term RS2 supplementation in humans is of limited cardiometabolic benefit.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1093/AJCN/NQAC134
Publisher: MDPI AG
Date: 22-01-2020
DOI: 10.3390/NU12020299
Abstract: Food-health claims are an important method of translating nutrition research to consumers. Whey and colostrum are thought to exert health benefits to adults, but it is unclear what measurable, objective health benefits they impart. This review aimed to identify the objective health benefits of bovine whey or colostrum-based beverages to healthy adults aged ≥35 years to substantiate a food-health claim. Seven databases were systematically searched. Eligible articles were RCTs that involved healthy adults aged ≥35 years, consuming whey or colostrum in beverage form and measuring objective health markers. Quality assessment and data extraction was conducted in duplicate. The searches identified 9943 papers and 16 were included in this review 13 studies, reported across 15 papers, related to whey, one study to colostrum. The outcomes identified were body composition, bone mineral density, biochemical markers, such as blood glucose and lipids, and muscle strength and synthesis. Heterogeneous outcomes, high risk of bias and inconsistent findings resulted in inconclusive evidence to substantiate a food-health claim. Clearer reporting and consensus on a minimum set of objective measures would allow for more robust recommendations regarding food-health claims. Protecting consumers from misleading health claims will require collaboration between regulators, researchers, and the food industry.
Publisher: Oxford University Press (OUP)
Date: 20-03-2013
DOI: 10.1111/IJPP.12025
Abstract: Multiple drug combination therapy aimed at controlling glucose, blood pressure, lipids and fibrinolysis significantly reduces micro- and macrovascular morbidity and mortality in patients with type 2 diabetes. The aims of this study were to (1) identify gaps between current medication management and evidence-based treatment targets in a rural cohort of Australian adults with type 2 diabetes and (2) determine patient factors associated with the prescribing of medications to patients with type 2 diabetes. Two hundred and seventy-two medical records were randomly selected from a regional health service type 2 diabetes database. Demographic, biochemical, anthropometric, pharmacological, co-morbidity and lifestyle data during the initial 5 years post diagnosis were collected and analysed. Five years post type 2 diabetes diagnosis only 12% of the cohort were meeting optimal targets for glucose, blood pressure, low-density lipoprotein, high-density lipoprotein and triglyceride. Younger age (odds ratio, OR 0.96 95% confidence interval, CI 0.94–0.99 P & 0.05) and elevated urinary microalbumin (OR 1.02 95% CI 1.01–1.03 P & 0.05) were significantly associated with anti-diabetic medication treatment. The only independent factor associated with pharmacological treatment for hypertension was elevated HbA1c (OR 1.4 95% CI 1.0–2.0 P & 0.05). Patient factors associated with prescription of lipid-lowering agents were a past history of cardiovascular disease (OR 5.0 95% CI 2.0–12.5 P & 0.001), concurrent use of anti-hypertensive agents (OR 2.6 95% CI 1.2–5.8 P & 0.05) and elevated triglyceride (OR 1.9 95% CI 1.2–3.1 P & 0.01). Treatment targets were not being translated into clinical practice in this cohort of patients with type 2 diabetes. Patients with acceptable HbA1c levels, with no history of cardiovascular disease and those taking few medications were at risk of being overlooked for the pharmacotherapy they required.
Publisher: MDPI AG
Date: 30-08-2022
DOI: 10.3390/NU14173573
Abstract: Chinese immigrants living in Western countries are at increased risk for cardiometabolic diseases. Dietary acculturation has been implicated as a potential contributor, but little is known about why diets change post-migration. The purpose of this qualitative research study was to explore how and why diets change post-migration for Chinese immigrants living in Australia. Eleven participants undertook semi-structured interviews exploring and comparing their diets when they lived in China to their post-migration diets. Thematic analysis revealed that participants exhibited changed social structures of meal preparation, and made unacknowledged dietary changes, such as recipe modification, to maintain their traditional Chinese diet post-migration. Implications of both deliberate and unrecognized dietary changes post-migration include connections to increased risk for metabolic disease post-migration.
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1093/AJCN/NQAC153
Publisher: Elsevier BV
Date: 03-2019
Publisher: MDPI AG
Date: 05-05-2017
DOI: 10.3390/NU9050461
Abstract: The metabolic effects of probiotic administration in women with gestational diabetes mellitus (GDM) is unknown. The objective of this review was to investigate the effect of probiotics on fasting plasma glucose (FPG), insulin resistance (HOMA-IR) and LDL-cholesterol levels in pregnant women diagnosed with GDM. Seven electronic databases were searched for RCTs published in English between 2001 and 2017 investigating the metabolic effects of a 6–8 week dietary probiotic intervention in pregnant women following diagnosis with GDM. Eligible studies were assessed for risk of bias and subjected to qualitative and quantitative synthesis using a random effects model meta-analyses. Four high quality RCTs involving 288 participants were included in the review. Probiotic supplementation was not effective in decreasing FBG (Mean Difference = −0.13 95% CI −0.32, 0.06, p = 0.18) or LDL-cholesterol (−0.16 95% CI −0.45, 0.13, p = 0.67) in women with GDM. However, a significant reduction in HOMA-IR was observed following probiotic supplementation (−0.69 95% CI −1.24, −0.14, p = 0.01). There were no significant differences in gestational weight gain, delivery method or neonatal outcomes between experimental and control groups, and no adverse effects of the probiotics were reported. Probiotic supplementation for 6–8 weeks resulted in a significant reduction in insulin resistance in pregnant women diagnosed with GDM. The use of probiotic supplementation is promising as a potential therapy to assist in the metabolic management of GDM. Further high quality studies of longer duration are required to determine the safety, optimal dose and ideal bacterial composition of probiotics before their routine use can be recommended in this patient group.
Publisher: Oxford University Press (OUP)
Date: 15-09-2015
Abstract: Advanced glycation end products (AGEs) formed via the Maillard reaction during the thermal processing of food contributes to the flavor, color, and aroma of food. A proportion of food-derived AGEs and their precursors is intestinally absorbed and accumulates within cells and tissues. AGEs have been implicated in the pathogenesis of diabetes-related complications and several chronic diseases via interaction with the receptor for AGEs, which promotes the transcription of genes that control inflammation. The dicarbonyls, highly reactive intermediates of AGE formation, are also generated during food processing and may incite inflammatory responses through 1) the suppression of protective pathways, 2) the incretin axis, 3) the modulation of immune-mediated signaling, and 4) changes in gut microbiota profile and metabolite sensors. In animal models, restriction of dietary AGEs attenuates chronic low-grade inflammation, but current evidence from human studies is less clear. Here, the emerging relationship between excess dietary AGE consumption and inflammation is explored, the utility of dietary AGE restriction as a therapeutic strategy for the attenuation of chronic diseases is discussed, and possible avenues for future investigation are suggested.
Publisher: MDPI AG
Date: 14-01-2022
DOI: 10.3390/NU14020346
Abstract: Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, ProQuest, and China National Knowledge Infrastructure database (CNKI) were searched from database inception to 1 April 2021. Studies were included if they involved qualitative research methods, were written in English or Chinese, investigated the factors influencing food choices, and targeted Chinese mainlanders or Chinese immigrants living in Western countries. Twenty-five studies (24 in English, 1 in Chinese) were included, involving 2048 participants. Four themes were identified (1) the principles of traditional Chinese medicine (TCM), (2) perceptions of a healthy diet in Chinese culture (e.g., regular eating, eating in moderation, and emphasis on food freshness), (3) the desire to maintain harmony in families/communities, and (4) physical/social environmental factors all significantly influenced Chinese people’s food choices. It is important to acknowledge these factors when developing culturally appropriate nutrition programs for promoting health in Chinese mainlanders and Chinese immigrants.
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/PY10030
Abstract: Time constraints and lack of awareness of risk factors for future chronic disease development prevent many young adults from accessing lifestyle programs offered by local health services. This study aimed to determine the effectiveness of a rural pharmacy-based multidisciplinary healthy lifestyle pilot program on reducing risk factors for chronic disease development among young adults. In iduals under the age of 50 with chronic disease risk factors were referred to the program. All subjects were provided with free after-hours nutritional counselling from a dietitian at the local community pharmacy, a comprehensive medication review conducted by the pharmacist, gym membership and access to cooking classes and supermarket tours. Selected participants also received bulk-billed GP appointments and assistance with establishing a home vegetable garden. Body weight, waist circumference, fruit and vegetable consumption and physical activity were assessed at baseline and after program conclusion. Forty participants regularly attended the program between March 2009 and March 2010. At program conclusion, mean body weight was reduced by 3.8 ± 6.7 kg (P 0.001) and waist circumference reduced by 3.9 ± 6.5 cm (P 0.001). Fruit consumption increased by 1.2 ± 0.2 serves/day (P 0.001) and vegetable intake increased by 1.6 ± 1.0 serves/day (P 0.001). Participants also spent an average of 88.0 ± 47.7 more min/week (P 0.001) engaged in physical activity on completion of the program. The community pharmacy provided an accessible location for the delivery of a successful chronic disease risk reduction program targeting young adults in a rural area.
Publisher: MDPI AG
Date: 26-11-2021
DOI: 10.3390/NU13124262
Abstract: This study aimed to describe the prevalence, severity and socio-demographic predictors of food insecurity in Australian households during the COVID-19 pandemic in 2020, from the perspective of women. A cross-sectional online survey of Australian (18–50 years) women was conducted. The survey collected demographic information and utilised the 18-item US Department of Agriculture Household Food Security Survey Module and the Kessler Psychological Distress Scale (K10). A multivariable regression was used to identify predictors of food security status. In this cohort (n = 1005), 19.6% were living in households experiencing food insecurity with 11.8% experiencing low food-security and 7.8% very low food-security. A further 13.7% of households reported marginal food-security. Poor mental health status (K10 score ≥ 20) predicted household food insecurity at all levels. The presence of more than three children in the household was associated with low food-security (OR 6.24, 95% CI: 2.59–15.03). Those who were renting were 2.10 (95% CI: 1.09–4.05) times likely to experience very low food-security than those owning their own home. The COVID-19 pandemic may have contributed to an increased prevalence of household food insecurity. This study supports the need for a range of responses that address mental health, financial, employment and housing support to food security in Australia.
Publisher: Springer Science and Business Media LLC
Date: 27-06-2017
DOI: 10.1007/S00394-017-1495-Y
Abstract: Advanced glycation endproducts (AGEs) are produced endogenously and also enter the body during the consumption of AGEs present in heat-processed food. It is unknown whether AGEs of dietary origin accumulate within the body of healthy in iduals. AGEs can deposit within skin tissue long-term by crosslinking extracellular matrix proteins. The fluorescent nature of many AGEs enables their detection within the skin by non-invasively measuring skin autofluorescence (SAF). This study aimed to identify habitual dietary and lifestyle behaviours cross-sectionally associated with SAF in an adult population s le. 251 Healthy adult volunteers completed validated food frequency and physical activity questionnaires. Waist circumference, BMI, blood pressure and blood glucose was also measured. SAF was measured using an AGE Reader. Significant positive correlations were found between SAF and chronological age (r = 0.63, P < 0.001), waist circumference (r = 0.28, P < 0.01), body weight (r = 0.24, P < 0.05), BMI (r = 0.23, P < 0.05) and consumption of meat and meat products (r = 0.22, P < 0.05). A negative correlation was found between SAF and cereal consumption (r = -0.21, P < 0.05). Cigarette smokers also had a significantly higher SAF than non-smokers (2.4 vs 2.0 U, P < 0.05). Regression analysis identified age, cigarette smoking, waist circumference and intake of meat products as significant predictors of SAF. The regression model explained 48% of the variation in SAF. Age, cigarette smoking, waist circumference and dietary consumption of meat/meat products were positively associated with SAF in this s le. Further research is required to determine whether frequent consumption of foods containing large quantities of dietary AGEs contribute to pathological disease processes in healthy in iduals.
Publisher: MDPI AG
Date: 16-11-2019
DOI: 10.3390/NU11112798
Abstract: A client-centred approach sits at the core of modern healthcare. Exploration of the patients’ role within the education of nutrition and dietetic students has not previously been undertaken. This review aimed to synthesise the learning outcomes that result from involvement of patients in nutrition and dietetic student education, and to consider whether these interactions promote patient-centred care. Five electronic databases were searched, supported by hand-searching of references of included studies. Screening of title/abstract and then full text papers was undertaken key characteristics and outcomes were extracted and synthesised narratively. The likely impact of interventions was evaluated using Kirkpatrick’s Hierarchy study quality was assessed using the Medical Education Research Study Quality Instrument and Critical Appraisal Skills Programme checklist. Of 7436 studies identified through database searching, and one additional study located through hand searching of reference lists, the final library consisted of 13 studies. All studies reported benefits for student learning from patient involvement, while one paper identified patient benefits from student interventions. Patients as recipients of care mostly contributed in a passive role in student education activities. Quality assessment identified methodological limitations in most studies. Patient involvement in the education of dietitians supports skill development and therefore progression to professional practice. Although nutrition and dietetics education has a focus on client-centred care, the translation of these concepts into an interactive student educational experience has been investigated to a limited extent. Collaboration with patients in student education is an area for further development.
Publisher: Cambridge University Press (CUP)
Date: 13-11-2013
DOI: 10.1017/S0007114513003607
Abstract: Complex relationships exist between the gut microflora and their human hosts. Emerging evidence suggests that bacterial dysbiosis within the colon may be involved in the pathogenesis of the metabolic syndrome, type 2 diabetes and CVD. The use of dietary prebiotic supplements to restore an optimal balance of intestinal flora may positively affect host metabolism, representing a potential treatment strategy for in iduals with cardiometabolic disorders. The present review aimed to examine the current evidence supporting that dietary prebiotic supplementation in adults has beneficial effects on biochemical parameters associated with the development of metabolic abnormalities including obesity, glucose intolerance, dyslipidaemia, hepatic steatosis and low-grade chronic inflammation. Between January 2000 and September 2013, eight computer databases were searched for randomised controlled trials published in English. Human trials were included if at least one group received a dietary prebiotic intervention. In the present review, twenty-six randomised controlled trials involving 831 participants were included. Evidence indicated that dietary prebiotic supplementation increased self-reported feelings of satiety in healthy adults (standardised mean difference − 0·57, 95 % CI − 1·13, − 0·01). Prebiotic supplementation also significantly reduced postprandial glucose ( − 0·76, 95 % CI − 1·41, − 0·12) and insulin ( − 0·77, 95 % CI − 1·50, − 0·04) concentrations. The effects of dietary prebiotics on total energy intake, body weight, peptide YY and glucagon-like peptide-1 concentrations, gastric emptying times, insulin sensitivity, lipids, inflammatory markers and immune function were contradictory. Dietary prebiotic consumption was found to be associated with subjective improvements in satiety and reductions in postprandial glucose and insulin concentrations. Additional evidence is required before recommending prebiotic supplements to in iduals with metabolic abnormalities. Large-scale trials of longer duration evaluating gut microbial growth and activity are required.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Wiley
Date: 19-02-2023
DOI: 10.1111/JHN.13147
Abstract: The present study aimed to qualitatively explore the food choice determinants of both Chinese immigrants living in Australia and Chinese people living in mainland China. Eight Chinese Australian participants (female, n = 5 male, n = 3) and ten mainland Chinese participants (female, n = 5 male, n = 5) were recruited from Australia (primarily in Melbourne, Victoria) and China (predominantly in Zhengzhou, Henan province) between June 2021 and March 2022. Participants were erse in age, socio‐economic background, occupation and health status. Semi‐structured in‐depth interviews were conducted in Mandarin either face‐to‐face or using online video/voice calls. Interviews were audio‐recorded and transcribed verbatim. Investigator triangulation was used to enhance scientific rigour. Four themes were identified: (1) food choice determinants were shaped by traditional and modern nutrition perceptions and personal food philosophy (2) physiological responses to food provide direct feedback that impacts future food choices (3) consideration of convenience was a predominant influencer of food choice and (4) the differences in food environments between China and Australia promoted distinctive food choice determinants for Chinese people. Chinese Australian and mainland Chinese participants' food choices are shaped by traditional Chinese nutrition philosophy, modern Western nutrition science and the contemporary food environment. There are clear cultural characteristics in their food choice determinants that should be considered by health educators, nutrition professionals and nutrition policymakers when developing culturally appropriate health interventions for Chinese people.
Publisher: Springer Science and Business Media LLC
Date: 30-01-2013
Abstract: The benefits of advanced glycation end-product (AGE)-restricted diets in humans are unclear. This review aimed to determine the effect of dietary AGE restriction on the inflammatory profiles of healthy adults and adults with diabetes or renal failure. Eight computer databases were searched for controlled feeding trials published in English between January 1997 and December 2012. Human trials were included if at least one group received an AGE-restricted dietary intervention. A total of 12 trials reporting on 289 participants were included in the review. Five trials (42%) were of high methodological quality. Meta-analysis of two long-term (16 week) trials provided evidence favoring an AGE-restricted diet for the reduction of 8-isoprostanes (standardized mean difference 0.9 95% confidence interval (CI): 0.3-1.5) and tumor necrosis factor-α (1.3 95% CI: 0.6-1.9) in healthy adults. Intermediate-term dietary AGE restriction in adults with chronic renal failure reduced serum VCAM-1 (0.9 95% CI: 0.1-1.7). In idual trials provided some evidence that long-term dietary AGE restriction reduces HOMA-IR (1.4 95% CI: 0.3-2.6) and AGE-modified low-density lipoprotein (2.7 95% CI: 1.6-3.9) in adults with type 2 diabetes. Generalisability is limited, as 75% of studies were of less than 6 weeks duration and more than half were of low methodological quality. Evidence quality ranged from low to very low, limiting the conclusions that can be drawn from this review. There is currently insufficient evidence to recommend dietary AGE restriction for the alleviation of the proinflammatory milieu in healthy in iduals and patients with diabetes or renal failure. Additional long-term high-quality RCTs with larger s le sizes measuring patient-important outcomes are required to strengthen the evidence supporting the effects of AGE-restricted diets.
Publisher: American Association for the Advancement of Science (AAAS)
Date: 02-04-2021
Abstract: This study shows how highly processed foods can cause innate immune inflammation that promotes chronic microvascular disease.
Publisher: Hindawi Limited
Date: 28-05-2020
DOI: 10.1111/HSC.13046
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1093/AJCN/NQZ200
Publisher: MDPI AG
Date: 06-10-2019
DOI: 10.3390/NU11102383
Abstract: There is evidence to indicate that the central biological clock (i.e., our endogenous circadian system) plays a role in physiological processes in the body that impact energy regulation and metabolism. Cross-sectional data suggest that energy consumption later in the day and during the night is associated with weight gain. These findings have led to speculation that when, as well as what, we eat may be important for maintaining energy balance. Emerging literature suggests that prioritising energy intake to earlier during the day may help with body weight maintenance. Evidence from tightly controlled acute experimental studies indicates a disparity in the body’s ability to utilise (expend) energy equally across the day and night. Energy expenditure both at rest (resting metabolic rate) and after eating (thermic effect of food) is typically more efficient earlier during the day. In this review, we discuss the key evidence for a circadian pattern in energy utilisation and balance, which depends on meal timing. Whilst there is limited evidence that simply prioritising energy intake to earlier in the day is an effective strategy for weight loss, we highlight the potential benefits of considering the role of meal timing for improving metabolic health and energy balance. This review demonstrates that to advance our understanding of the contribution of the endogenous circadian system toward energy balance, targeted studies that utilise appropriate methodologies are required that focus on meal timing and frequency.
Publisher: Elsevier
Date: 2018
Publisher: Wiley
Date: 13-12-2019
DOI: 10.1111/MEDU.13782
Abstract: The skills and qualities of effective clinical educators are linked to improved student learning and ultimately patient care however, within allied health these have not yet been systematically summarised in the literature. To identify and synthesise the skills and qualities of clinical educators in allied health and their effect on student learning and patient care. A systematic search of the literature was conducted across five electronic databases in November 2017. Study identification, data extraction and quality appraisal were performed in duplicate. Qualitative and quantitative data were extracted separately but analysed together using a thematic analysis approach whereby items used in quantitative surveys and themes from qualitative approaches were interpreted together. Data revealed seven educator skills and qualities: (i) intrinsic and personal attributes of clinical educators (ii) provision of skillful feedback (iii) teaching skills (iv) fostering collaborative learning (v) understanding expectations (vi) organisation and planning and (vii) clinical educators in their professional role. Across all themes was the concept of taking time to perform the clinical educator role. No studies used objective measurements as to how these skills and qualities affect learning or patient care. Despite much primary evidence of clinical educator skills and qualities, this review presents the first synthesis of this evidence in allied health. There is a need to examine clinical education from new perspectives to develop deeper understanding of how clinical educator qualities and skills influence student learning and patient care.
Publisher: Elsevier BV
Date: 05-2021
Start Date: 2019
End Date: 2015
Funder: National Health and Medical Research Council
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