ORCID Profile
0000-0001-8953-5068
Current Organisations
Washington University in St. Louis School of Medicine
,
University of Queensland
,
Research Institute for Future Health
,
Queensland University of Technology
,
Bond University
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Publications
Why is the skeleton still in the hospital closet? A look at the complex aetiology of protein-energy malnutrition and its implications for the nutrition care team
Publisher: Springer Science and Business Media LLC
Date: 2017
New Perspectives on Displaced Persons (DPs) in Austria
Publisher: Vandenhoeck & Ruprecht GmbH & Co, KG
Date: 09-05-2020
Does intensive multidisciplinary intervention for adults who elect bariatric surgery improve post‐operative weight loss, co‐morbidities, and quality of life? A systematic review and meta‐analysis
Publisher: Wiley
Date: 20-03-2020
DOI: 10.1111/OBR.13012
Choosing and following a very low calorie diet program in Australia: A quasi‐mixed methods study to understand experiences, barriers, and facilitators in a self‐initiated environment
Publisher: Wiley
Date: 06-12-2020
A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study)
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.CLNU.2017.09.022
Abstract: Malnutrition is a significant barrier to healthy and independent ageing in older adults who live in their own homes, and accurate diagnosis is a key step in managing the condition. However, there has not been sufficient systematic review or pooling of existing data regarding malnutrition diagnosis in the geriatric community setting. The current paper was conducted as part of the MACRo (Malnutrition in the Ageing Community Review) Study and seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of protein-energy malnutrition in the general older adult community. A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. There were 6412 records identified, of which 104 potentially eligible records were screened via full text. Eight papers were included two which evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six which evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95% CI: 1.55-2.39] P < 0.00001 n = 2013 participants n = 4 studies I Due to the small number of studies identified and no evaluation of the predictive validity of tools other than the MNA, there is insufficient evidence to recommend a particular nutrition assessment tool for diagnosing PEM in older adults in the community. High quality diagnostic accuracy studies are needed for all nutrition assessment tools used in older community s les, including measuring of health outcomes subsequent to nutrition assessment by the SGA and PG-SGA.
Therapeutic health effects of ginger (Zingiber officinale): updated narrative review exploring the mechanisms of action
Publisher: Oxford University Press (OUP)
Date: 23-01-2023
Abstract: Ginger (Zingiber officinale) has been investigated for its potentially therapeutic effect on a range of chronic conditions and symptoms in humans. However, a simplified and easily understandable examination of the mechanisms behind these effects is lacking and, in turn, hinders interpretation and translation to practice, and contributes to overall clinical heterogeneity confounding the results. Therefore, drawing on data from nonhuman trials, the objective for this narrative review was to comprehensively describe the current knowledge on the proposed mechanisms of action of ginger on conferring therapeutic health effects in humans. Mechanistic studies support the findings from human clinical trials that ginger may assist in improving symptoms and biomarkers of pain, metabolic chronic disease, and gastrointestinal conditions. Bioactive ginger compounds reduce inflammation, which contributes to pain promote vasodilation, which lowers blood pressure obstruct cholesterol production, which regulates blood lipid profile translocate glucose transporter type 4 molecules to plasma membranes to assist in glycemic control stimulate fatty acid breakdown to aid weight management and inhibit serotonin, muscarinic, and histaminergic receptor activation to reduce nausea and vomiting. Additional human trials are required to confirm the antimicrobial, neuroprotective, antineoplastic, and liver- and kidney-protecting effects of ginger. Interpretation of the mechanisms of action will help clinicians and researchers better understand how and for whom ginger may render therapeutic effects and highlight priority areas for future research.
Nutrient dense, low-cost foods can improve the affordability and quality of the new zealand diet—a substitution modeling study
Publisher: MDPI AG
Date: 27-07-2021
Abstract: The high prevalence of non-communicable disease in New Zealand (NZ) is driven in part by unhealthy diet selections, with food costs contributing to an increased risk for vulnerable population groups. This study aimed to: (i) identify the nutrient density-to-cost ratio of NZ foods (ii) model the impact of substituting foods with a lower nutrient density-to-cost ratio with those with a higher nutrient density-to-cost ratio on diet quality and affordability in representative NZ population s les for low and medium socioeconomic status (SES) households by ethnicity and (iii) evaluate food processing level. Foods were categorized, coded for processing level and discretionary status, analyzed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods were 56% unprocessed (vegetables, fruit, porridge, pasta, rice, nuts/seeds), 31% ultra-processed (vegetable dishes, fortified bread, breakfast cereals unfortified g sugars/100 g and fortified 15–30 g sugars/100 g), 6% processed (fruit juice), and 6% culinary processed (oils). Using substitution modeling, diet quality improved by 59% and 71% for adults and children, respectively, and affordability increased by 20–24%, depending on ethnicity and SES. The NZ diet can be made healthier and more affordable when nutritious, low-cost foods are selected. Processing levels in the healthier, modeled diet suggest that some non-discretionary ultra-processed foods may provide a valuable source of low-cost nutrition for food insecure populations.
Contribution of dietary snacking behaviours to discretionary energy intake and anthropometric measures in Australian adults: A comparison using an objective vs subjective definition for snacking
Publisher: Wiley
Date: 03-11-2021
Prevalence of malnutrition risk and poor food intake in older adults in Indian hospitals: A prospective observational nutritionDay study with novel mapping of malnutrition risk to the Malnu
Publisher: Wiley
Date: 28-09-2020
Supplemental prophylactic intervention for chemotherapy‐induced nausea and emesis (SPICE) trial: Protocol for a multicentre double‐blind placebo‐controlled randomised trial
Publisher: Wiley
Date: 23-07-2018
Abstract: There is significant recent interest in the role of ginger root (Zingiber officinale) as an adjuvant therapy for chemotherapy-induced nausea. The supplemental prophylactic intervention for chemotherapy-induced nausea and emesis (SPICE) trial aims to assess the efficacy by reduced incidence and severity of chemotherapy-induced nausea and vomiting, and enhanced quality of life, safety and cost effectiveness of a standardised adjuvant ginger root supplement in adults undergoing single-day moderate-to-highly emetogenic chemotherapy. Multisite, double-blind, placebo-controlled randomised trial with two parallel arms and 1:1 allocation. The target s le size is n = 300. The intervention comprises four capsules of ginger root (totalling 60 mg of active gingerols/day), commencing the day of chemotherapy and continuing for five days during chemotherapy cycles 1 to 3. The primary outcome is chemotherapy-induced nausea-related quality of life. Secondary outcomes include nutrition status anticipatory, acute and delayed nausea and vomiting fatigue depression and anxiety global quality of life health service use and costs adverse events and adherence. During the five-month recruitment period from October 2017 to April 2018 at site A only, a total of n = 33 participants (n = 18 female) have been enrolled in the SPICE trial. Recruitment is expected to commence at Site B in May 2018. The trial is designed to meet research gaps and could provide evidence to recommend specific dosing regimens as an adjuvant for chemotherapy-induced nausea and vomiting prevention and management.
The effect of high-polyphenol extra virgin olive oil on cardiovascular risk factors: A systematic review and meta-analysis.
Publisher: Informa UK Limited
Date: 13-11-2018
The Malnutrition Screening Tool in Geriatric Rehabilitation: A Comparison of Validity When Completed by Health Professionals With and Without Malnutrition Screening Training Has Implications for Practice
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.JAND.2017.03.019
Abstract: The validity of the Malnutrition Screening Tool (MST) in geriatric rehabilitation has been evaluated in a research environment but not in professional practice. In older adults admitted to rehabilitation, this study was undertaken to compare the MST scoring agreement (inter-rater reliability) between health professionals with and without malnutrition risk and screening training to evaluate the concurrent validity of the MST completed by the trained and untrained health professionals compared to the International Classification of Diseases, Tenth Revision, Australian Modification using different MST score cutoffs and to determine whether patient characteristics were associated with MST scoring accuracy when completed by health professionals without malnutrition risk and screening training. This was an observational, cross-sectional study. Fifty-seven older adults (mean age=79.1±7.3 years) were recruited from August 2013 to February 2014 from two rural rehabilitation units in New South Wales, Australia. MST, International Classification of Diseases, Tenth Revision, Australian Modification, classification of malnutrition, and patient characteristics were used to measure outcomes. Measures of diagnostic accuracy generated from a contingency table, receiver operating characteristic curve, and Spearman's correlation were used. The MST scores completed by health professionals with and without malnutrition risk and screening training showed moderate correlation and fair agreement (r The application of the MST by health professionals without malnutrition risk and screening training in rehabilitation may not provide sufficient accuracy in identifying patients with malnutrition risk. Using an MST score of ≥2 to indicate malnutrition risk is recommended, as increasing the MST cutoff score to ≥3 is likely to have insufficient accuracy, even when completed by health professionals with malnutrition risk and screening training. Research evaluating the impact of providing rehabilitation staff with regular and ongoing training in completing malnutrition screening and referral pathways is warranted.
Dietary Strategies for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.CLNU.2022.08.003
Abstract: Chemotherapy-induced nausea and vomiting (CINV) is one of the most distressing cancer treatment side effects, affecting 20-70% of patients despite routine antiemetic prescription. Although dietary modifications are routinely recommended in clinical practice, there is lack of data synthesis to determine which dietary strategies for managing CINV are supported by quality evidence. This systematic review was conducted to examine the effect of dietary strategies on incidence and severity of CINV in adults compared with no intervention, usual care, or alternative strategies. Five electronic databases were searched from inception to 15th July 2021 for original research studies of interventional or observational design assessing dietary strategies for CINV. The quality of evidence was appraised, data were synthesized narratively, and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment of the certainty of the evidence was applied. Twenty-one studies were included, 10 (48%) interventional studies and 11 (52%) observational studies. Most interventional and observational studies had a high or neutral risk of bias (70% and 72%, respectively). Of the interventions studied, strongest evidence with highest certainty was found for the very large positive effect of CINV-specific education and support with a personalized meal plan from a dietician, implemented in person or in writing, for reducing the severity of nausea and overall CINV (effect size: very large GRADE: high). A statistically significant very large positive effect of ginger tea consumption was also found on overall CINV severity however, certainty in this effect was very low. Although confidence in the findings from observational studies was very low to low, a statistically significant positive association was also found between a moderate intake of alcohol and incidence of nausea, vomiting, or overall CINV as well as nausea severity the Mediterranean diet and nausea incidence and severity and adequate intake of energy, protein, fat, or carbohydrate and nausea or vomiting incidence. Improved CINV was associated with CINV-specific nutrition education and support from health professionals. Non-restrictive dietary patterns that include adequate energy and macronutrient intakes, particularly protein, and include ginger, and Mediterranean diet concepts may benefit CINV however, the confidence in the body of evidence to inform these conclusions is mostly very low to moderate. Future rigorous trials with adequate s le sizes, clearly defined dietary strategies, and valid outcome measures are warranted prior to dietary strategies being routinely prescribed alongside antiemetic regimens.
The essential menopause curriculum for healthcare professionals: A European Menopause and Andropause Society (EMAS) position statement
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.MATURITAS.2021.12.001
Abstract: The menopause, or the cessation of menstruation, is a stage of the life cycle which will occur in all women. Managing perimenopausal and postmenopausal health is a key issue for all areas of healthcare, not just gynecology. To provide recommendations for the curriculum of education programs for healthcare professionals worldwide, so that all can receive high quality training on menopause. Literature review and consensus of expert opinion. Training programs for healthcare professionals worldwide should include menopause and postmenopausal health in their curriculum. It should include assessment, diagnosis and evidence-based management strategies.
Orally consumed ginger and human health: an umbrella review
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1093/AJCN/NQAC035
Recognition memory and divergent cognitive profiles in prodromal genetic frontotemporal dementia
Publisher: Elsevier BV
Date: 06-2021
Do Endoscopic Bariatric Procedures Improve Postprocedural Quality of Life and Mental Health? A Systematic Review and Meta-analysis
Publisher: Springer Science and Business Media LLC
Date: 06-08-2020
Fish and omega-3 intake and health in older people
Publisher: Elsevier BV
Date: 09-2018
Multidisciplinary lifestyle intervention in children and adolescents - results of the project GRIT (Growth, Resilience, Insights, Thrive) pilot study
Publisher: Springer Science and Business Media LLC
Date: 20-04-2020
DOI: 10.1186/S12887-020-02069-X
Abstract: During childhood and adolescence leading behavioural risk factors for the development of cardiometabolic diseases include poor diet quality and sedentary lifestyle. The aim of this study was to determine the feasibility and effect of a real-world group-based multidisciplinary intervention on cardiorespiratory fitness, diet quality and self-concept in sedentary children and adolescents aged 9 to 15 years. Project GRIT (Growth, Resilience, Insights, Thrive) was a pilot single-arm intervention study. The 12-week intervention involved up to three outdoor High Intensity Interval Training (HIIT) running sessions per week, five healthy eating education or cooking demonstration sessions, and one mindful eating and Emotional Freedom Technique psychology session. Outcome measures at baseline and 12-week follow-up included maximal graded cardiorespiratory testing, the Australian Child and Adolescent Eating Survey, and Piers-Harris 2 children’s self-concept scale. Paired s les t-test or Wilcoxon signed-rank test were used to compare baseline and follow-up outcome measures in study completers only. Of the 38 recruited participants (median age 11.4 years, 53% male), 24 (63%) completed the 12-week intervention. Dropouts had significantly higher diet quality at baseline than completers. Completers attended a median 58 (IQR 55–75) % of the 33 exercise sessions, 60 (IQR 40–95) % of the dietary sessions, and 42% attended the psychology session. No serious adverse events were reported. Absolute VO 2 peak at 12 weeks changed by 96.2 ± 239.4 mL/min ( p = 0.06). As a percentage contribution to energy intake, participants increased their intake of healthy core foods by 6.0 ± 11.1% ( p = 0.02) and reduced median intake of confectionary (− 2.0 [IQR 0.0–3.0] %, p = 0.003) and baked products (− 1.0 [IQR 0.0–5.0] %, p = 0.02). Participants significantly improved self-concept with an increase in average T -Score for the total scale by 2.8 ± 5.3 ( p = 0.02) and the ‘physical appearance and attributes’ domain scale by median 4.0 [IQR 0.5–4.0] ( p = 0.02). The 12-week group-based multidisciplinary lifestyle intervention for children and adolescents improved diet quality and self-concept in study completers. Future practice and research should focus on providing sustainable multidisciplinary lifestyle interventions for children and adolescents aiming to improve long-term health and wellbeing. ANZCTR, ACTRN12618001249246 . Registered 24 July 2019 - Retrospectively registered
Effect of a standardized ginger root powder regimen on chemotherapy-induced nausea and vomiting: a multi-center double-blind placebo-controlled randomized trial
Publisher: Elsevier BV
Date: 09-2023
Effect of ginger root powder on gastrointestinal bacteria composition, gastrointestinal symptoms, mental health, fatigue, and quality of life: A double-blind placebo-controlled trial
Publisher: Elsevier BV
Date: 09-2023
Association between disordered eating and clinical outcomes following a surgical or endoscopic bariatric procedure: A real‐world exploratory study
Publisher: Wiley
Date: 06-07-2023
DOI: 10.1002/OSP4.691
Abstract: Disordered eating, such as binge, graze, and emotional eating, has been strongly linked to weight gain. Improved understanding of disordered eating by adults who elect bariatric weight loss procedures in a real‐world setting is required. To determine the association between the number and type of disordered eating patterns (DEPs), as described by healthcare professionals during routine care without standardized assessment, with clinical outcomes in adults who elected a bariatric weight loss procedure. An observational cohort study recruited laparoscopic sleeve gastrectomy (LSG) and endoscopic sleeve gastroplasty (ESG) patients. DEPs documented in the medical record during routine care were observed and tested for association with events (symptoms, side‐effects, or adverse events), micronutrient deficiencies, weight loss, and attrition. Data were observed up to 12‐month post‐procedure. 215 LSG and 32 ESG patients were recruited. The mean number of DEPs was 6.4 (SD: 2.1) and 6.4 (SD: 2.1) in the LSG and ESG cohorts, respectively. Night eating was associated with a higher number of events ( p 0.008) in the LSG cohort, and non‐hungry eating was associated with a higher number of events in the ESG cohort ( p 0.001). ESG patients who had a surgical or medical event by 6‐months post‐procedure had mean 1.78 (95%CI: 0.67, 2.89) more DEPs ( p = 0.004). DEPs were not associated with weight loss, micronutrient deficiencies, nor attrition. The treating healthcare team believed the LSG and ESG patients experienced a wide variety and high frequency of DEPs requiring multidisciplinary support. Non‐hungry eating and night eating were associated with poorer outcomes following an LSG or ESG. The study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000332729).
The development and evaluation of the Australian child and adolescent recommended food score: a cross-sectional study
Publisher: Springer Science and Business Media LLC
Date: 19-11-2012
Abstract: Diet quality tools have been developed to assess the adequacy of dietary patterns for predicting future morbidity and mortality. This study describes the development and evaluation of a brief food-based diet quality index for use with children at the in idual or population level. The Australian Child and Adolescent Recommended Food Score (ACARFS) was developed to reflect adherence to the Dietary Guidelines for Children and Adolescents in Australia and modelled on the approach of the US Recommended Food Score. The ACARFS has eight sub-scales and is scored from zero to 73. The diet quality score was evaluated by assessing correlation (Spearman’s correlations) and agreement (weighted κ statistics) between ACARFS scores and nutrient intakes, derived from a food frequency questionnaire in 691 children (mean age 11.0, SD 1.1) in New South Wales, Australia. Nutrient intakes for ACARFS quartiles were compared with the relevant Australian nutrient reference values. ACARFS showed slight to substantial agreement (κ 0.13-0.64) with nutrient intakes, with statistically significant moderate to strong positive correlations with all vitamins, minerals and energy intake (r = 0.42-0.70). ACARFS was not related to BMI.Participants who scored less than the median ACARFS were more likely to have sub-optimal intakes of fibre, folic acid and calcium. ACARFS demonstrated sufficient accuracy for use in future studies evaluating diet quality. Future research on its utility in targeting improvements in the nutritional quality of usual eating habits of children and adolescents is warranted.
Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.MATURITAS.2016.01.014
Abstract: Methods of identifying malnutrition in the rehabilitation setting require further examination so that patient outcomes may be improved. The purpose of this narrative review was to: (1) examine the defining characteristics of malnutrition, starvation, sarcopenia and cachexia (2) review the validity of nutrition screening tools and nutrition assessment tools in the rehabilitation setting and (3) determine the prevalence of malnutrition in the rehabilitation setting by geographical region and method of diagnosis. A narrative review was conducted drawing upon international literature. Starvation represents one form of malnutrition. Inadequate energy and protein intake are the critical factor in the aetiology of malnutrition, which is distinct from sarcopenia and cachexia. Eight nutrition screening tools and two nutrition assessment tools have been evaluated for criterion validity in the rehabilitation setting, and consideration must be given to the resources of the facility and the patient group in order to select the appropriate tool. The prevalence of malnutrition in the rehabilitation setting ranges from 14-65% worldwide with the highest prevalence reported in rural, European and Australian settings. Malnutrition is highly prevalent in the rehabilitation setting, and consideration must be given to the patient group when determining the most appropriate method of identification so that resources may be used efficaciously and the chance of misdiagnosis minimised.
Relationship between discretionary food intake and sex, body image, health, and geographical remoteness among Indigenous Australian adolescents
Publisher: Wiley
Date: 15-03-2023
Abstract: Determine the discretionary energy intake of Indigenous Australian adolescents and its relationship with sex, body image, health, and geographical remoteness. Cross‐sectional data from the 2012 to 2013 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey ( n = 264, 15–17 years). Dietary data were collected using an Automated Multiple‐Pass Method, anthropometric data by trained interviewers self‐perceived measures of body weight, level of satisfaction with current weight, and self‐assessed health were self‐reported. General linear models were used to investigate predictors. Discretionary energy intake contributed 35.4% and 54.2% of total energy intake for males and females, respectively, primarily from the sub‐groups: soft drinks pastries potatoes sugar, honey and syrups cordials and potato snacks. Discretionary energy intake was associated with higher energy intake ( p 0.001) and self‐perceived body weight ( p = 0.022), while sex had significant interactions with self‐assessed health ( p sex = 0.005), satisfaction with current weight ( p sex 0.001), and geographical remoteness ( p sex = 0.007). Contribution of discretionary energy intake to total energy intake was greatest for males with an increased risk of metabolic complications (50% vs. 37% p 0.05), those who perceived themselves to be overweight (56% vs. 27% p 0.001), and those who were dissatisfied with their weight (56% vs. 19% p 0.001), compared to females. No differences were found by dieting status, risk of metabolic complications, and under‐reporting of energy intake. Discretionary energy intake was excessive among Indigenous Australian adolescents and had relationships with self‐perceived health, weight satisfaction, and geographical remoteness, which was moderated by sex. To successfully reduce discretionary food intake among Indigenous Australian adolescents, further research is required to develop sex specific and culturally appropriate strategies.
Are informal carers and community care workers effective in managing malnutrition in the older adult community? A systematic review of current evidence
Publisher: Springer Science and Business Media LLC
Date: 17-05-2013
DOI: 10.1007/S12603-013-0341-Z
Abstract: Enhancing the effectiveness of the community and aged care workforce to prevent malnutrition and functional decline is important in reducing hospital and aged care facility demand. To investigate the impact of nutrition-related interventions delivered to or by informal carers and non-clinical community care workers on malnutrition-related health outcomes of community-dwelling older adults (≥65 years). Intervention studies were searched for using six electronic databases for English-language publications from January 1980 to 30 May 2012. Nine studies were eligible for inclusion. The strength and quality of the evidence was moderate (six studies with level II intervention evidence, five with positive quality). Types of interventions used were highly varied. The majority of interventions were delivered to informal carers (6 studies), with three of these studies also involving older adult care recipients. Five interventions were targeted at identifying, preventing and/or treating malnutrition specifically (two positive quality, three neutral quality, n=2368). As a result of these interventions, nutritional status improved or stabilized (two positive quality, two neutral quality, n=2333). No study reported an improvement in functional status but two successfully prevented further decline in their participants (two neutral quality, n=1097). Interventions targeted at identifying, preventing and/or treating malnutrition were able to improve or prevent decline in nutritional and functional status, without increasing informal carer burden. The findings of this review support the involvement of non-clinical community care workers and informal carers as part of the nutritional care team for community-dwelling older adults.
Effect of resveratrol supplementation on cognitive performance and mood in adults: a systematic literature review and meta-analysis of randomized controlled trials
Publisher: Oxford University Press (OUP)
Date: 27-03-2018
Abstract: The aim of this systematic review was to evaluate clinical trial data regarding the effect of resveratrol supplementation on cognitive performance and mood in populations that are healthy and in the clinical setting. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review of randomized controlled trials was conducted. A meta-analysis was also conducted to determine treatment effect on the following cognitive domains and mental processes: processing speed, number facility, memory, and mood. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool. Quality of the body of evidence was assessed by evidence for each outcome related to cognitive function for which data was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Ten studies were included. Three studies found resveratrol supplementation significantly improved some measures of cognitive performance, 2 reported mixed findings, and 5 found no effect. When data were pooled, resveratrol supplementation had a significant effect on delayed recognition (standardized mean difference [SMD], 0.39 95% confidence interval [CI], 0.08-0.70 I2 = 0% P = 0.01 n = 3 studies n = 166 participants) and negative mood (SMD, -0.18 95%CI, -0.31 to -0.05 I2 = 0% P = 0.006 n = 3 studies n = 163 participants). Included studies generally had low risk of bias and were of moderate or high quality. The results of this review indicate that resveratrol supplementation might improve select measures of cognitive performance however, the current literature is inconsistent and limited.
Balanced carbohydrate ratios are associated with improved diet quality in Australia: A nationally representative cross-sectional study
Publisher: Public Library of Science (PLoS)
Date: 09-07-2021
DOI: 10.1371/JOURNAL.PONE.0253582
Abstract: Carbohydrate quality influences major health outcomes however, the best criteria to assess carbohydrate quality remain unknown. The objectives were to: i) evaluate whether a diet that meets a carbohydrate ratio (simple, modified or dual ratio) is associated with higher nutrient intakes and diet quality, and ii) model the impact of substituting carbohydrate foods that meet the proposed ratios in place of foods that do not, on nutrient intakes. A secondary analysis of cross-sectional data from the 2011–12 Australian National Nutrition and Physical Activity Survey. National data from participants aged 2 years and older (n = 12,153). Ratios were defined as (i) simple ratio, 10:1 (10g carbohydrate:≥1g dietary fiber) (ii) modified ratio, 10:1:2 (10g carbohydrate:≥1g dietary fiber:≤2g free sugars) and (iii) dual ratio, 10:1 & 1:2 (10g carbohydrate:≥1g dietary fiber & ≤2g free sugars per 1g dietary fiber). Ratios were compared to nutrient intakes obtained via automated multiple-pass 24-hour dietary recall and diet quality calculated using the Australian Healthy Eating Index. Substitution dietary modelling was performed. Data were analyzed using paired and independent s le t-tests. Ratio adherence was highest for simple (50.2% adults 28.6% children), followed by dual (40.6% adults 21.7% children), then modified (32.7% adults 18.6% children) ratios. Participants who met any ratio reported higher nutrient intake and diet quality compared to those who failed to meet the respective ratio ( P .001 for all), with the greatest nutrient intakes found for those who met modified or dual ratios. Dietary modelling improved nutrient intakes for all ratios, with the greatest improvement found for the dual ratio. All carbohydrate ratios were associated with higher diet quality, with a free sugars constraint in the dual ratio providing the greatest improvements.
Reactivity of Polycyclic Aromatic Hydrocarbon Soot Precursors: Kinetics and Equilibria
Publisher: American Chemical Society (ACS)
Date: 17-11-2020
Diet quality indices and their associations with health-related outcomes in children and adolescents: an updated systematic review
Publisher: Springer Science and Business Media LLC
Date: 24-10-2020
DOI: 10.1186/S12937-020-00632-X
Abstract: To describe a-priori diet quality indices used in children and adolescents, appraise the validity and reliability of these indices, and synthesise evidence on the relationship between diet quality and physical and mental health, and growth-related outcomes. Five electronic databases were searched until January 2019. An a-priori diet quality index was included if it applied a scoring structure to rate child or adolescent (aged 0–18-years) dietary intakes relative to dietary or nutrient guidelines. Diagnostic accuracy studies and prospective cohort studies reporting health outcomes were appraised using the Academy of Nutrition and Dietetics Quality Criteria Checklist. From 15,577 records screened, 128 unique paediatric diet quality indices were identified from 33 countries. Half of the indices’ scores rated both food and nutrient intakes ( n = 65 indices). Some indices were age specific: infant ( 24-months n = 8 indices), child (2–12-years n = 16), adolescent (13–18 years n = 8), and child/adolescent ( n = 14). Thirty-seven indices evaluated for validity and/or reliability. Eleven of the 15 indices which investigated associations with prospective health outcomes reported significant results, such as improved IQ, quality of life, blood pressure, body composition, and prevalence of metabolic syndrome. Research utilising diet quality indices in paediatric populations is rapidly expanding internationally. However, few indices have been evaluated for validity, reliability, or association with health outcomes. Further research is needed to determine the validity, reliability, and association with health of frequently utilised diet quality indices to ensure data generated by an index is useful, applicable, and relevant. PROSPERO number: CRD42018107630 .
Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support
Publisher: Springer Science and Business Media LLC
Date: 05-02-2022
DOI: 10.1186/S12875-022-01629-7
Abstract: The laparoscopic sleeve gastrectomy (LSG) and the incisionless endoscopic sleeve gastroplasty (ESG) weight loss procedures require further investigation of their efficacy, safety and patient-centered outcomes in the Australian setting. The aim was to examine the 6- and 12-month weight loss efficacy, safety, and weight-related quality of life (QoL) of adults with obesity who received the ESG or LSG bariatric procedure with 12+ months of adjuvant multidisciplinary pre- and postprocedural support. Data were from a two-arm prospective cohort study that followed patients from baseline to 12-months postprocedure from a medical center in Queensland. Percent excess weight loss (%EWL) was the primary outcome. Secondary outcomes were body composition (fat mass, fat-free mass, android:gynoid ratio, bone mineral content) via dual energy X-ray absorptiometry, weight-related QoL, lipid, glycemic, and hepatic biochemistry, and adverse events. 16 ESG (19% attrition 81.2% female aged:41.4 (SD: 10.4) years BMI: 35.5 (SD: 5.2) kg/m 2 ) and 45 LSG (9% attrition 84.4% female aged:40.4 (SD: 9.0) years BMI: 40.7 (SD: 5.6) kg/m 2 ) participants were recruited. At 12-months postprocedure, ESG %EWL was 57% (SD: 32% p 0.01) and LSG %EWL was 79% (SD: 24% p 0.001). ESG and LSG cohorts improved QoL (19.8% in ESG [ p 0.05] 48.1% in LSG [ p 0.05]), liver function (AST: − 4.4 U/L in ESG [p 0.05] − 2.7 U/L in LSG [p 0.05]), HbA1c (− 0.5% in ESG [p 0.05] − 0.1% in LSG [p 0.05]) and triglycerides (− 0.6 mmol/L in ESG [p 0.05] − 0.4 mmol/L in LSG [ P 0.05]) at 12-months. Both cohorts reduced fat mass (p 0.05). The ESG maintained but LSG decreased fat-free mass at 6-months (p 0.05) and both cohorts lost fat-free mass at 12-months (p 0.05). There were no adverse events directly related to the procedure. The ESG reported 25% mild-moderate adverse events possibly related to the procedure, and the LSG reported 27% mild-severe adverse events possibly related to the procedure. In this setting, the ESG and LSG were safe and effective weight loss treatments for obese adults alongside multidisciplinary support. Patients who elected the ESG maintained fat-free mass at 6-months but both cohorts lost fat-free mass at 12-months postprocedure. Patients who elected the LSG had large and significant improvements to weight-related quality of life. Further well-powered studies are required to confirm these findings. This study was registered prospectively at the Australia New Zealand Clinical Trials Registry on 06/03/2018, Registration Number ACTRN12618000337279 .
Malnourished older adults admitted to rehabilitation in rural New South Wales remain malnourished throughout rehabilitation and once discharged back to the community: a prospective cohort study
Publisher: SERDI
Date: 2015
Abstract: Objectives: Understanding the nutritional journey that older adults make from rehabilitation to home will help to target nutrition screening and intervention programs. This study aimed to determine the nutritional status, physical function and health-related quality of life amongst malnourished older adults admitted to two rural rehabilitation units and 12 weeks post-discharge to the community. Design: Observational prospective cohort study, conducted August 2013 to February 2014. Setting: Rehabilitation units in rural New South Wales, Australia. Participants: Thirty community-dwelling, malnourished older adult inpatients (mean age 79.5±7.1 years, 57% female). Intervention: Observation of usual care: basic nutrition services typical to rural rehabilitation units. Measurements: Outcome assessments were measured at rehabilitation admission, discharge and 12 weeks post-discharge, with nutrition status via the Scored Patient-Generated Subjective Global Assessment as the primary outcome measure. Secondary outcome measures included physical function (Modified Barthel Index) and health-related quality of life (Assessment of Quality of Life-6D). Results: At admission, half of the rehabilitation patients were moderately malnourished and half were severely malnourished, with the cohort becoming and remaining moderately malnourished on discharge and 12 weeks post-discharge. Only four patients (24%) were well-nourished 12 weeks post-discharge. Following discharge, there was a trend showing decline in physical function. No improvement was found in health-related quality of life following discharge. Conclusion: Malnourished older adults admitted to rural rehabilitation units with basic nutrition care are likely to be discharged with moderate malnutrition, and remain moderately malnourished in the community for at least 12 weeks. Physical function and health-related quality of life remain poor in this population. Collaboration between health services and within the multidisciplinary team is essential to identify and treat malnourished older adults, and novel approaches for inpatient and post-discharge nutrition support is needed.
Role of dietary fibre in older adults with asymptomatic (AS) or symptomatic uncomplicated diverticular disease (SUDD): Systematic review and meta-analysis
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.MATURITAS.2019.10.006
Abstract: Dietary fibre and probiotics may play a role in the management of erticular disease. This systematic review synthesises the evidence on the effects of dietary fibre modifications, with or without the use of probiotics, on the incidence in older adults of asymptomatic (AS) or symptomatic uncomplicated erticular disease (SUDD), as well as on gastrointestinal function and symptoms. Five electronic databases were searched for studies through to December 2018. The body of evidence was appraised using the Cochrane Risk of Bias tool and GRADE. Nine studies were included, with mean s le ages ranging from 57 to 70 years, and three meta-analyses were performed. Only one study, with high risk of bias, measured the effect of dietary fibre on the incidence of erticulitis. Dietary fibre supplementation improved stool weight (MD: 42 g/day, P < 0.00001 GRADE level of evidence: low), but had no significant effect on gastrointestinal symptoms (SMD: -0.13, P = 0.16 GRADE level of evidence: low) or stool transit time (MD: -3.70, P = 0.32 GRADE level of evidence: low). There was "very low" confidence for the body of evidence supporting symbiotics for AS or SUDD. A high dietary fibre intake, in line with dietary guidelines, may improve gastrointestinal function and is recommended in patients with AS or SUDD. Dietary fibre supplementation should be considered on an in idualised basis to improve bowel function, while any recommendation on symbiotic supplements requires further well-designed research. Future studies should also measure the impact on the incidence of erticulitis.
Matched Endoscopic Sleeve Gastroplasty and Laparoscopic Sleeve Gastrectomy Cases: Formative Cohort Study
Publisher: JMIR Publications Inc.
Date: 24-11-2022
DOI: 10.2196/29713
Abstract: Bariatric weight-loss surgery rates are increasing internationally. Endoscopic sleeve gastroplasty (ESG) is a novel, minimally invasive endoscopic procedure thought to mimic some of the effects of a more common surgery, laparoscopic sleeve gastrectomy (LSG). Patient factors affecting procedural choice are unexplored. This formative study aimed to determine the preoperative and early postoperative characteristics of adults matched for age, sex, and BMI who chose ESG versus LSG. This prospective cohort study recruited ESG and matched LSG adults in Australia. Preoperative outcomes were medical history, glycemic biomarkers, blood lipids, liver function enzymes, albumin, blood pressure, hepatic steatosis index, the Gastrointestinal Symptom Rating Scale, the Impact of Weight on Quality of Life–Lite questionnaire, and body composition via dual-energy x-ray absorptiometry. Adverse events were recorded preoperatively and up to 2 weeks postoperatively. SPSS was used to test if there were differences between cohorts by comparing means or mean ranks, and binary regression was used to understand how characteristics might predict procedure choice. A total of 50 (including 25 ESG and 25 LSG) patients were recruited, who were primarily White (45/50, 90%) and female (41/50, 82%) with a mean age of 41.7 (SD 9.4) years. Participants had a mean of 4.0 (SD 2.2) active comorbid conditions, with the most common being nonalcoholic fatty liver disease (38/50, 76%), back pain (32/50, 64%), anxiety or depression (24/50, 48%), and joint pain (23/50, 46%). The LSG cohort had higher hemoglobin A1c (5.3%, SD 0.2%) than the ESG cohort (5%, SD 0.2% P=.008). There was a 2.4 kg/m2 difference in median BMI (P=.03) between the groups, but fat and fat-free mass had no meaningful differences. Comparing the LSG and ESG groups showed that the LSG group had lower total quality of life (49.5%, SD 10.6% vs 56.6%, SD 12.7% P=.045), lower weight-related self-esteem (10.7%, IQR 3.6%-25% vs 25%, IQR 17.9%-39.3% P=.02), and worse abdominal pain (38.9%, IQR 33.3%-50% vs 53.9%, SD 14.2%, P=.01). For every percent improvement in weight-related self-esteem, the odds for selecting ESG increased by 4.4% (95% CI 1.004-1.085 P=.03). For every percent worsening in hunger pain, the odds for selecting ESG decreased by 3.3% (95% CI 0.944-0.990 P=.004). There was very little evidence that Australian adults who chose an endoscopic versus surgical sleeve had different rates of comorbidities, body fat percentage, or weight-related quality of life. There was evidence against the test hypothesis, that is, there was evidence suggesting that lower self-esteem predicted choosing a more invasive sleeve (ie, LSG rather than ESG) Australia New Zealand Clinical Trials Registry ACTRN12618000337279 anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374595
Family in Rehabilitation, Empowering Carers for Improved Malnutrition Outcomes: Protocol for the FREER Pilot Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 30-10-2018
Abstract: nterventions to improve the nutritional status of older adults and the integration of formal and family care systems are critical research areas to improve the independence and health of aging communities and are particularly relevant in the rehabilitation setting. he primary outcome aimed to determine if the FREER (Family in Rehabilitation: EmpowERing Carers for improved malnutrition outcomes) intervention in malnourished older adults during and postrehabilitation improve nutritional status, physical function, quality of life, service satisfaction, and hospital and aged care admission rates up to 3 months postdischarge, compared with usual care. Secondary outcomes evaluated include family carer burden, carer services satisfaction, and patient and carer experiences. This pilot study will also assess feasibility and intervention fidelity to inform a larger randomized controlled trial. his protocol is for a mixed-methods two-arm historically-controlled prospective pilot study intervention. The historical control group has 30 participants, and the pilot intervention group aims to recruit 30 patient-carer pairs. The FREER intervention delivers nutrition counseling during rehabilitation, 3 months of postdischarge telehealth follow-up, and provides supportive resources using a novel model of patient-centered and carer-centered nutrition care. The primary outcome is nutritional status measured by the Scored Patient-Generated Subjective Global Assessment Score. Qualitative outcomes such as experiences and perceptions of value will be measured using semistructured interviews followed by thematic analysis. The process evaluation addresses intervention fidelity and feasibility. ecruitment commenced on July 4, 2018, and is ongoing with eight patient-carer pairs recruited at the time of manuscript submission. his research will inform a larger randomized controlled trial, with potential for translation to health service policies and new models of dietetic care to support the optimization of nutritional status across a continuum of nutrition care from rehabilitation to home. ustralian New Zealand Clinical Trials Registry Number (ACTRN) 12618000338268 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374608& isReview=true (Archived by WebCite at 4gtZplU2). RR1-10.2196/12647
A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex
Publisher: Oxford University Press (OUP)
Date: 05-09-2018
Abstract: protein-energy malnutrition is a major health concern in home-dwelling older adults, particularly in the context of an ageing population. Therefore, a systematic review and meta-analysis was undertaken to determine the prevalence of malnutrition among older adults living independently in the community according to geographical region, s ling frame, rurality and sex. six electronic databases were searched until September 2016. Original research studies which used the Mini Nutritional Assessment, Patient-Generated Subjective Global Assessment or Subjective Global Assessment to determine nutrition status in community s les with a mean age of ≥65 years were critically appraised and pooled using meta-analysis. Meta-regression was used to explore predictors of malnutrition prevalence in pooled statistics with high heterogeneity. 111 studies from 38 countries (n = 69,702 participants) were included. The pooled prevalence of malnutrition in the older community setting ranged from 0.8% (95% CI: 0.2-1.7%) in Northern Europe to 24.6% (95% CI: 0.0-67.9%) in South-East Asia. Of all s ling frames, participants receiving homecare services had the highest prevalence at 14.6% (95% CI: 9.9-20.0%). Malnutrition prevalence in rural communities (9.9% 95% CI: 4.5-16.8%) was double that in urban communities (5.7% 95% CI: 4.2-7.3%) and higher among females than males (odds ratio = 1.45 [95% CI: 1.27-1.66] P < 0.00001). the results of this review provide strategic insight to develop public and community health priorities for preventing malnutrition and associated poor health outcomes.
Post-discharge consequences of protein-energy malnutrition, sarcopenia, and frailty in older adults admitted to rehabilitation: A systematic review
Publisher: Elsevier BV
Date: 04-2023
Effects of functional remediation on neurocognitively impaired bipolar patients: enhancement of verbal memory
Publisher: Cambridge University Press (CUP)
Date: 21-09-2015
DOI: 10.1017/S0033291715001713
Abstract: Functional remediation is a novel intervention with demonstrated efficacy at improving functional outcome in euthymic bipolar patients. However, in a previous trial no significant changes in neurocognitive measures were detected. The objective of the present analysis was to test the efficacy of this therapy in the enhancement of neuropsychological functions in a subgroup of neurocognitively impaired bipolar patients. A total of 188 out of 239 DSM-IV euthymic bipolar patients performing below two standard deviations from the mean of normative data in any neurocognitive test were included in this subanalysis. Repeated-measures analyses of variance were conducted to assess the impact of the treatment arms [functional remediation, psychoeducation, or treatment as usual (TAU)] on participants’ neurocognitive and functional outcomes in the subgroup of neurocognitively impaired patients. Patients receiving functional remediation ( n = 56) showed an improvement on delayed free recall when compared with the TAU ( n = 63) and psychoeducation ( n = 69) groups as shown by the group × time interaction at 6-month follow-up [ F 2,158 = 3.37, degrees of freedom (df) = 2, p = 0.037]. However, Tukey post-hoc analyses revealed that functional remediation was only superior when compared with TAU ( p = 0.04), but not with psychoeducation ( p = 0.10). Finally, the patients in the functional remediation group also benefited from the treatment in terms of functional outcome ( F 2,158 = 4.26, df = 2, p = 0.016). Functional remediation is effective at improving verbal memory and psychosocial functioning in a s le of neurocognitively impaired bipolar patients at 6-month follow-up. Neurocognitive enhancement may be one of the active ingredients of this novel intervention, and, specifically, verbal memory appears to be the most sensitive function that improves with functional remediation.
The Mediterranean diet and menopausal health: An EMAS position statement
Publisher: Elsevier BV
Date: 09-2020
DOI: 10.1016/J.MATURITAS.2020.07.001
Abstract: Globally, 985 million women are aged 50 and over, leading to increasing concerns about chronic conditions such as cardiovascular disease, osteoporosis, dementia, and cognitive decline, which can adversely affect quality of life and independent living. To evaluate the evidence from observational studies and randomized trials on the effects of the Mediterranean diet on short- and long-term menopausal health: estrogen deficiency symptoms, cardiovascular disease, osteoporosis, cognitive and mental health, breast cancer, and all-cause mortality. Literature review and consensus of expert opinion. The Mediterranean diet is a non-restrictive dietary pattern common in the olive-growing areas of the Mediterranean basin. It may improve vasomotor symptoms, cardiovascular risk factors such as blood pressure, cholesterol and blood glucose levels, as well as mood and symptoms of depression. Long-term adherence may: improve cardiovascular risk and events, and death improve bone mineral density prevent cognitive decline and reduce the risk of breast cancer and all-cause mortality.
Efficacy of Ginger (Zingiber officinale) in Ameliorating Chemotherapy-Induced Nausea and Vomiting and Chemotherapy-Related Outcomes: A Systematic Review Update and Meta-Analysis
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.JAND.2019.06.009
Abstract: Ginger has been proposed as an adjuvant treatment for chemotherapy-induced nausea and vomiting. The aim of this systematic review with meta-analyses is to evaluate, in adult cancer patients receiving chemotherapy, the effects of ginger supplementation dose and duration on the incidence, duration, and severity of chemotherapy-induced nausea and vomiting and outcomes related to chemotherapy-induced nausea and vomiting (eg, quality of life and fatigue), compared with placebo or standard antiemetic medication. Five electronic databases were searched from database inception to April 2018. The quality of evidence was appraised with the Cochrane Risk of Bias tool and Grading of Recommendations, Assessment, Development, and Evaluation level. Data were pooled using Revman software. Eighteen articles were analyzed. The likelihood of acute vomiting was reduced by 60% with ginger supplementation ≤1 g/day for duration >3 days, compared with control groups (odds ratio 0.4, 95% CI 0.17 to 0.81 P=0.01 n=3 studies n=3 interventions n=301 participants I Ginger supplementation might benefit chemotherapy-induced vomiting as well as fatigue. Due to clinical heterogeneity, this systematic review update found no association between ginger and chemotherapy-induced nausea and other chemotherapy-induced nausea and vomiting-related outcomes. The results of this systematic review and meta-analysis provide a rationale for further research with stronger study designs, adequate s le sizes, standardized ginger products, and validated outcome measures to confirm efficacy of ginger supplementation and optimal dosing regimens.
Complementary and alternative medicine for women with cancer: How can health-care professionals provide realistic hope of improved wellbeing?
Publisher: Elsevier BV
Date: 05-2022
Role of domiciliary and family carers in individualised nutrition support for older adults living in the community
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.MATURITAS.2017.01.004
Abstract: Protein-energy malnutrition is common amongst people aged 65 years and older, has a multifactorial aetiology, and numerous negative outcomes. Domiciliary carers (non-clinical paid carers) and family carers (including family, friends and neighbours) are required to support the increasing demand for in-home assistance with activities of daily living due to the ageing population. This review provides insight into the role of both domiciliary and family carers in providing in idualised nutrition support for older, community-dwelling adults with malnutrition. Four electronic databases were searched for intervention studies from database inception to December 2016. Both domiciliary and family carers are well placed to monitor the dietary intake and nutritional status of older adults to assist with many food-related tasks such as the sourcing and preparation of meals, and assisting with feeding when necessary and to act as a conduit between the care recipient and formal nutrition professionals such as dietitians. There is moderate evidence to support the role of domiciliary carers in implementing nutrition screening and referral pathways, and emerging evidence suggests they may have a role in malnutrition interventions when supported by health professionals. Moderate evidence also supports the engagement of family carers as part of the nutrition care team for older adults with malnutrition. Interventions such as group education, skill-development workshops and telehealth demonstrate promise and have significantly improved outcomes in older adults with dementia. Further interventional and translational research is required to demonstrate the efficacy of engaging with domiciliary and family carers of older adults in the general community.
Patterns of discretionary food intake among Australian children and their association with socio‐demographic, lifestyle, and adiposity measures
Publisher: Wiley
Date: 16-06-2022
Abstract: Australian children consume 35% of energy from discretionary food and beverages which increases their risk of non‐communicable diseases like type 2 diabetes. Despite this concerning statistic, broad analysis of the profile of discretionary food intake has not been fully undertaken. This study asks: what is the discretionary food and beverage intake profile, contribution to nutrient intakes, and associations with demographic and health characteristics? Cross‐sectional data from the 2011–12 National Nutrition and Physical Activity Survey ( n = 2812, 2–18 years) were used to profile discretionary food consumption. Dietary intake was assessed by 24‐h recall. General linear models tested the difference in respondent characteristics by age group, sex, and quartiles of discretionary food energy contribution. Ninety‐nine percent of respondents consumed discretionary foods, 74% exceeded the maximum discretionary food recommended serves. Among 10 eating occasions available to select: snack, dinner, lunch and morning tea appeared to contribute 76% of discretionary food energy, with snack and dinner contributing 24% each. Age and frequency of discretionary food consumption were positively associated with energy intake from discretionary foods ( p 0.001) while sex, socio‐economic status, physical activity and body composition had no association. High discretionary food consumers chose specific discretionary food items in a large quantity (1.0–3.5‐serves/discretionary food) compared to low discretionary food consumers (0.4–1.4‐serves/discretionary food). Nearly all Australian children and adolescents consumed discretionary food daily. No demographic or anthropometric characteristics beyond increasing age were associated with higher discretionary food. Targeted public health policy and community interventions are required to focus on addressing the largest contributors to discretionary food intake in terms of equivalent serve sizes, popularity, and eating occasion.
Examining the health effects and bioactive components in Agaricus bisporus mushrooms: a scoping review
Publisher: Elsevier BV
Date: 10-2020
Efficacy and safety of biophenol‐rich nutraceuticals in adults with inflammatory gastrointestinal diseases or irritable bowel syndrome: A systematic literature review and meta‐analysis
Publisher: Wiley
Date: 07-05-2022
Abstract: Biophenol‐rich nutraceuticals may be an adjuvant treatment for Crohn's disease (CD), ulcerative colitis (UC), symptomatic uncomplicated erticular disease (SUDD), and irritable bowel syndrome (IBS). This systematic review and meta‐analysis aimed to determine the efficacy and safety of biophenol‐rich nutraceutical supplementation on CD, UC, SUDD, and IBS on gastrointestinal symptoms (GIS), quality of life (QoL), inflammatory and oxidative stress biomarkers, and adverse events compared to usual care or placebo. PubMed, Embase, CINAHL, and CENTRAL were searched for randomised controlled trials until 27 April 2020. Outcomes were GIS, inflammatory and oxidative stress markers, QoL, and adverse events. The Cochrane Risk of Bias tool and GRADE were used to appraise studies. Data were pooled using Revman. Twenty‐three trials in CD, UC, and IBS patients were included. Compared with placebo, biophenol‐rich nutraceuticals improved GIS (SMD: 0.43 [95%CI: 0.22, 0.63] GRADE: very low) in UC, CD, and IBS participants. In UC and CD participants, biophenol‐rich nutraceuticals improved CRP by 1.6 mg/L [95%CI:0.08, 3.11 GRADE: low], malondialdehyde by 1 mmol/L [95%CI:0.55, 1.38 GRADE: low] but only resveratrol improved QoL (SMD: −0.84 [95%CI: −1.24, −0.44 GRADE: high). Resveratrol (for UC and CD participants) and peppermint oil (for IBS participants) had greater certainty in the evidence for improving GIS and QoL (GRADE: moderate to high). There was no effect on adverse events ( P .05). Biophenol‐rich nutraceuticals may be an effective and safe adjuvant treatment for the management of CD, UC, and IBS with higher certainty of evidence for resveratrol for UC and CD and peppermint oil for IBS.
The consequences of malnutrition following discharge from rehabilitation to the community: a systematic review of current evidence in older adults
Publisher: Wiley
Date: 30-11-2014
DOI: 10.1111/JHN.12167
Abstract: The prevalence of malnutrition in the rehabilitation setting is estimated to be 30-50%, with older adults at higher nutritional risk. Malnutrition also exists in the community setting, where 10-30% of adults are malnourished however, the relationship between the two settings has been little explored. The present study aimed to determine the association between malnutrition in older adults admitted for rehabilitation and nutrition status, functional status, quality of life, institutionalisation, acute care admissions and mortality once discharged to the community. Six electronic databases were searched for relevant publications (1990-2013) using controlled vocabulary. Longitudinal papers were included in which older adults (≥65 years) were admitted for rehabilitation if nutrition assessment was performed during admission with relevant outcomes measured following discharge to the community. Five observational studies were eligible for review which had similar populations. The five reviews comprised 1020 participants in total and, once discharged, follow-up ranged from immediate to 26 months. Malnutrition during rehabilitation was negatively associated with physical function and quality of life, and positively associated with risk of institutionalisation, hospitalisation and mortality. Although these studies were of high quality and strength, the overall contribution to the evidence is limited as a result of the small number of heterogenic studies. No intervention studies were identified. Malnutrition in older adults admitted for rehabilitation has a negative effect on functional recovery and quality of life following discharge to the community. This review highlights an evidence gap along the continuum of care for malnourished older adults, where further observational and intervention research is needed following discharge from rehabilitation to the community.
What is the efficacy of dietary, nutraceutical, and probiotic interventions for the management of gastroesophageal reflux disease symptoms? A systematic literature review and meta-analysis
Publisher: Elsevier BV
Date: 12-2022
The Effect of Replacing Refined Grains with Whole Grains on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with GRADE Clinical Recommendation
Publisher: Elsevier BV
Date: 11-2020
Austrian-Jewish Refugees in Pre-and Wartime Australia
Publisher: Vandenhoeck & Ruprecht GmbH & Co, KG
Date: 12-04-2021
Is telehealth effective in managing malnutrition in community-dwelling older adults? A systematic review and meta-analysis
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.MATURITAS.2018.02.012
Abstract: Telehealth offers a feasible method to provide nutrition support to malnourished older adults. This systematic review and meta-analysis aims to determine the efficacy of telehealth methods in delivering malnutrition-related interventions to community-dwelling older adults. Studies in any language were searched in five electronic databases from inception to 2nd November 2017. Quality of the evidence was assessed using the Cochrane Risk of Bias tool and the GRADE approach. Nine studies were identified, with results published across 13 included publications, which had mostly low to unclear risk of bias. There were two interventions delivered to disease-specific groups, one with kidney disease and one with cancer the remaining seven interventions were delivered to patients with mixed morbidities following discharge from an inpatient facility. Seven studies delivered telehealth via telephone consultations and two used internet-enabled telemedicine devices. Ten meta-analyses were performed. Malnutrition-focused telehealth interventions were found to improve protein intake in older adults by 0.13 g/kg body weight per day ([95%CI: 0.01-0.25] P = .03 n = 2 studies n = 200 participants I
Systematic review of diet quality indices and their associations with health-related outcomes in children and adolescents
Publisher: Wiley
Date: 13-02-2014
DOI: 10.1111/JHN.12208
Abstract: Diet quality indices add an important dimension to dietary assessment. The aim of this systematic review was to: (i) identify and describe the attributes and applications of diet quality indices developed for use or used in paediatric populations (ii) describe associations between these diet quality indices and health-related variables in paediatric populations and (iii) identify factors that are associated with diet quality in paediatric populations worldwide. Studies were identified by searching electronic databases for relevant papers from 1980 to October 2013 using keywords. Inclusion criteria were original studies that utilised a quantitative measure of diet quality in children and adolescents aged 0-18 years. One hundred and nineteen studies met the inclusion criteria, from which 80 different diet quality indices were identified. The majority of studies had >1000 participants and were of acceptable quality. Of the 56 studies that investigated health-related outcomes, weight status was the most researched. Europe produced the most number of diet quality indices (n = 27 indices). Of the 119 studies, seven intervention studies were identified. Paediatric diet quality indices were found to be associated with environmental, behavioural and maternal factors. The use of diet quality indices in paediatric populations is a rapidly expanding area of research in erse populations internationally. In economically disadvantaged countries, diet quality indices may be predictive of child growth. However, prospective cohort, intervention and validation studies are required to draw stronger conclusions concerning risk of future disease in paediatric populations in general.
Comparing Characteristics of Malnutrition, Starvation, Sarcopenia and Cachexia in Older Adults
Publisher: Springer International Publishing
Date: 2017
Evidence for Dietary Fibre Modification in the Recovery and Prevention of Reoccurrence of Acute, Uncomplicated Diverticulitis: A Systematic Literature Review
Publisher: MDPI AG
Date: 27-01-2018
DOI: 10.3390/NU10020137
Genome Sequences of Three Agrobacterium Biovars Help Elucidate the Evolution of Multichromosome Genomes in Bacteria
Publisher: American Society for Microbiology
Date: 15-04-2009
DOI: 10.1128/JB.01779-08
Abstract: The family Rhizobiaceae contains plant-associated bacteria with critical roles in ecology and agriculture. Within this family, many Rhizobium and Sinorhizobium strains are nitrogen-fixing plant mutualists, while many strains designated as Agrobacterium are plant pathogens. These contrasting lifestyles are primarily dependent on the transmissible plasmids each strain harbors. Members of the Rhizobiaceae also have erse genome architectures that include single chromosomes, multiple chromosomes, and plasmids of various sizes. Agrobacterium strains have been ided into three biovars, based on physiological and biochemical properties. The genome of a biovar I strain, A. tumefaciens C58, has been previously sequenced. In this study, the genomes of the biovar II strain A. radiobacter K84, a commercially available biological control strain that inhibits certain pathogenic agrobacteria, and the biovar III strain A. vitis S4, a narrow-host-range strain that infects grapes and invokes a hypersensitive response on nonhost plants, were fully sequenced and annotated. Comparison with other sequenced members of the Alphaproteobacteria provides new data on the evolution of multipartite bacterial genomes. Primary chromosomes show extensive conservation of both gene content and order. In contrast, secondary chromosomes share smaller percentages of genes, and conserved gene order is restricted to short blocks. We propose that secondary chromosomes originated from an ancestral plasmid to which genes have been transferred from a progenitor primary chromosome. Similar patterns are observed in select Beta - and Gammaproteobacteria species. Together, these results define the evolution of chromosome architecture and gene content among the Rhizobiaceae and support a generalized mechanism for second-chromosome formation among bacteria.
An Analysis of the Mineral Composition of Pink Salt Available in Australia
Publisher: MDPI AG
Date: 19-10-2020
DOI: 10.3390/FOODS9101490
Abstract: Little is known about the mineral composition of pink salt. The aim of this study was to evaluate for the first time the mineral composition of pink salt available for purchase in Australia and its implications for public health. Pink salt s les were purchased from retail outlets in two metropolitan Australian cities and one regional town. Color intensity, salt form, and country of origin were coded. A mass spectrometry scan in solids was used to determine the amount of 25 nutrients and non-nutritive minerals in pink salt (n = 31) and an iodized white table salt control (n = 1). A wide variation in the type and range of nutrients and non-nutritive minerals across pink salt s les were observed. One pink salt s le contained a level of lead ( mg/kg) that exceeded the national maximum contaminant level set by Food Standards Australia New Zealand. Pink salt in flake form, pink salt originating from the Himalayas, and darker colored pink salt were generally found to contain higher levels of minerals (p 0.05). Despite pink salt containing nutrients, g per day (approximately 6 teaspoons) would be required to make any meaningful contribution to nutrient intake, a level that would provide excessive sodium and potential harmful effects. The risk to public health from potentially harmful non-nutritive minerals should be addressed by Australian food regulations. Pink salt consumption should not exceed the nutrient reference values for Australia and New Zealand guidelines of g of salt per day.
“It's natural so it shouldn't hurt me”: Chemotherapy patients' perspectives, experiences, and sources of information of complementary and alternative medicines
Publisher: Elsevier BV
Date: 05-2021
Cost-effectiveness of food, supplement and environmental interventions to address malnutrition in residential aged care: A systematic review
Publisher: Oxford University Press (OUP)
Date: 05-01-2018
Abstract: observational studies have shown that nutritional strategies to manage malnutrition may be cost-effective in aged care but more robust economic data is needed to support and encourage translation to practice. Therefore, the aim of this systematic review is to compare the cost-effectiveness of implementing nutrition interventions targeting malnutrition in aged care homes versus usual care. residential aged care homes. systematic literature review of studies published between January 2000 and August 2017 across 10 electronic databases. Cochrane Risk of Bias tool and GRADE were used to evaluate the quality of the studies. eight included studies (3,098 studies initially screened) reported on 11 intervention groups, evaluating the effect of modifications to dining environment (n = 1), supplements (n = 5) and food-based interventions (n = 5). Interventions had a low cost of implementation (<£2.30/resident/day) and provided clinical improvement for a range of outcomes including weight, nutritional status and dietary intake. Supplements and food-based interventions further demonstrated a low cost per quality adjusted life year or unit of physical function improvement. GRADE assessment revealed the quality of the body of evidence that introducing malnutrition interventions, whether they be environmental, supplements or food-based, are cost-effective in aged care homes was low. this review suggests supplements and food-based nutrition interventions in the aged care setting are clinically effective, have a low cost of implementation and may be cost-effective at improving clinical outcomes associated with malnutrition. More studies using well-defined frameworks for economic analysis, stronger study designs with improved quality, along with validated malnutrition measures are needed to confirm and increase confidence with these findings.
Efficacy and Effectiveness of Carnitine Supplementation for Cancer-Related Fatigue: A Systematic Literature Review and Meta-Analysis
Publisher: MDPI AG
Date: 07-11-2017
DOI: 10.3390/NU9111224
Family in Rehabilitation, Empowering Carers for Improved Malnutrition Outcomes: Protocol for the FREER Pilot Study
Publisher: JMIR Publications Inc.
Date: 30-04-2019
DOI: 10.2196/12647
The Impact of Systematic Review Automation Tools on Methodological Quality and Time Taken to Complete Systematic Review Tasks: Case Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 18-09-2020
Abstract: ystematic reviews (SRs) are considered the highest level of evidence to answer research questions however, they are time and resource intensive. hen comparing SR tasks done manually, using standard methods, versus those same SR tasks done using automated tools, (1) what is the difference in time to complete the SR task and (2) what is the impact on the error rate of the SR task? case study compared specific tasks done during the conduct of an SR on prebiotic, probiotic, and synbiotic supplementation in chronic kidney disease. Two participants (manual team) conducted the SR using current methods, comprising a total of 16 tasks. Another two participants (automation team) conducted the tasks where a systematic review automation (SRA) tool was available, comprising of a total of six tasks. The time taken and error rate of the six tasks that were completed by both teams were compared. he approximate time for the manual team to produce a draft of the background, methods, and results sections of the SR was 126 hours. For the six tasks in which times were compared, the manual team spent 2493 minutes (42 hours) on the tasks, compared to 708 minutes (12 hours) spent by the automation team. The manual team had a higher error rate in two of the six tasks—regarding i Task 5: Run the systematic search /i , the manual team made eight errors versus three errors made by the automation team regarding i Task 12: Assess the risk of bias /i , 25 assessments differed from a reference standard for the manual team compared to 20 differences for the automation team. The manual team had a lower error rate in one of the six tasks—regarding i Task 6: Deduplicate search results /i , the manual team removed one unique study and missed zero duplicates versus the automation team who removed two unique studies and missed seven duplicates. Error rates were similar for the two remaining compared tasks—regarding i Task 7: Screen the titles and abstracts /i and i Task 9: Screen the full text /i , zero relevant studies were excluded by both teams. One task could not be compared between groups— i Task 8: Find the full text /i . or the majority of SR tasks where an SRA tool was used, the time required to complete that task was reduced for novice researchers while methodological quality was maintained.
How should we judge edible oils and fats? An umbrella review of the health effects of nutrient and bioactive components found in edible oils and fats
Publisher: Informa UK Limited
Date: 11-03-2021
DOI: 10.1080/10408398.2021.1882382
Abstract: Dietary guidelines for many Western countries base their edible oil and fat recommendations solely on saturated fatty acid content. This study aims to demonstrate which nutritional and bioactive components make up commonly consumed edible oils and fats and explore the health effects and strength of evidence for key nutritional and bioactive components of edible oils. An umbrella review was conducted in several stages. Food composition databases of Australia and the United States of America, and studies were examined to profile nutrient and bioactive content of edible oils and fats. PUBMED and Cochrane databases were searched for umbrella reviews, systematic literature reviews of randomized controlled trials or cohort studies, in idual randomized controlled trials, and in idual cohort studies to examine the effect of the nutrient or bioactive on high-burden chronic diseases (cardiovascular disease, type 2 diabetes mellitus, obesity, cancer, mental illness, cognitive impairment). Substantial systematic literature review evidence was identified for fatty acid categories, tocopherols, biophenols, and phytosterols. Insufficient evidence was identified for squalene. The evidence supports high mono- and polyunsaturated fatty acid compositions, total biophenol content, phytosterols, and possibly high α-tocopherol content as having beneficial effects on high-burden health comes. Future dietary guidelines should use a more sophisticated approach to judge edible oils beyond saturated fatty acid content.
The nutrition and food-related roles, experiences and support needs of female family carers of malnourished older rehabilitation patients
Publisher: Wiley
Date: 14-07-2017
DOI: 10.1111/JHN.12397
Abstract: To improve perceived value of nutrition support and patient outcomes, the present study aimed to determine the nutrition and food-related roles, experiences and support needs of female family carers of community-dwelling malnourished older adults admitted to rehabilitation units in rural New South Wales, Australia, both during admission and following discharge. Four female family carers of malnourished rehabilitation patients aged ≥65 years were interviewed during their care-recipients' rehabilitation admission and again at 2 weeks post-discharge. The semi-structured interviews were audiotaped, transcribed and analysed reflecting an interpretative phenomenological approach by three researchers. A series of 'drivers' relevant to the research question were agreed upon and discussed. Three drivers were identified. 'Responsibility' was related to the agency who assumed responsibility for providing nutrition support and understanding family carer obligation to provide nutrition support. 'Family carer nutrition ethos' was related to how carer nutrition beliefs, knowledge and values impacted the nutrition support they provided, the high self-efficacy of family carers and an incongruence with an evidence-based approach for treating malnutrition. 'Quality of life' was related to the carers' focus upon quality of life as a nutrition strategy and outcome for their care-recipients, as well as how nutrition support impacted upon carer burden. Rehabilitation units and rehabilitation dietitians should recognise and support family carers of malnourished patients, which may ultimately lead to an improved perceived benefit of care and patient outcomes. Intervention research is required to make strong recommendations for practice.
Should We ‘Eat a Rainbow’? An Umbrella Review of the Health Effects of Colorful Bioactive Pigments in Fruits and Vegetables
Publisher: MDPI AG
Date: 24-06-2022
DOI: 10.3390/MOLECULES27134061
Abstract: Health promotion c aigns have advocated for in iduals to ‘eat a rainbow’ of fruits and vegetables (FV). However, the literature has only focused on in idual color pigments or in idual health outcomes. This umbrella review synthesized the evidence on the health effects of a variety of color-associated bioactive pigments found in FV (carotenoids, flavonoids, betalains and chlorophylls), compared to placebo or low intakes. A systematic search of PubMed, EMBASE, CINAHL and CENTRAL was conducted on 20 October 2021, without date limits. Meta-analyzed outcomes were evaluated for certainty via the GRADE system. Risk of bias was assessed using the Centre for Evidence-Based Medicine critical appraisal tools. A total of 86 studies were included, 449 meta-analyzed health outcomes, and data from over 37 million participants were identified. A total of 42% of health outcomes were improved by color-associated pigments (91% GRADE rating very low to low). Unique health effects were identified: n = 6 red, n = 10 orange, n = 3 yellow, n = 6 pale yellow, n = 3 white, n = 8 purple/blue and n = 1 green. Health outcomes associated with multiple color pigments were body weight, lipid profile, inflammation, cardiovascular disease, mortality, type 2 diabetes and cancer. Findings show that color-associated FV variety may confer additional benefits to population health beyond total FV intake.
Diet and Economic Modelling to Improve the Quality and Affordability of the Australian Diet for Low and Medium Socioeconomic Households
Publisher: MDPI AG
Date: 27-05-2021
Abstract: Food costs are a barrier to healthier diet selections, particularly for low socioeconomic households who regularly choose processed foods containing refined grains, added sugars, and added fats. In this study, the objectives were to: (i) identify the nutrient density-to-cost ratio of Australian foods (ii) model the impact of substituting foods with lower nutrient density-to-cost ratio with those with the highest nutrient density-to-cost ratio for diet quality and affordability in low and medium socioeconomic households and (iii) evaluate food processing levels. Foods were categorized, coded for processing level, analysed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods included 54% unprocessed (vegetables and reduced fat dairy), 33% ultra-processed (fortified wholegrain bread and breakfast cereals g sugars/100 g), and 13% processed (fruit juice and canned legumes). Using substitution modelling, diet quality improved by 52% for adults and 71% for children across all households, while diet affordability improved by 25% and 27% for low and medium socioeconomic households, respectively. The results indicate that the quality and affordability of the Australian diet can be improved when nutritious, low-cost foods are selected. Processing levels in the healthier modelled diets suggest that some ultra-processed foods may provide a beneficial source of nutrition when consumed within national food group recommendations.
Microstratigraphic preservation of ancient faunal and hominin DNA in Pleistocene cave sediments
Publisher: Proceedings of the National Academy of Sciences
Date: 27-12-2021
Abstract: DNA preserved in sediments has emerged as an important source of information about past ecosystems, independent of the discovery of skeletal remains. However, little is known about the sources of sediment DNA, the factors affecting its long-term preservation, and the extent to which it may be translocated after deposition. Here, we show that impregnated blocks of intact sediment are excellent archives of DNA. DNA distribution is highly heterogeneous at the microscale in the cave sediment we studied, suggesting that postdepositional movement of DNA is unlikely to be a common phenomenon in cases where the stratigraphy is undisturbed. Combining micromorphological analysis with microstratigraphic retrieval of ancient DNA therefore allows genetic information to be associated with the detailed archaeological and ecological record preserved in sediments.
The Effect of Polyphenol-Rich Interventions on Cardiovascular Risk Factors in Haemodialysis: A Systematic Review and Meta-Analysis
Publisher: MDPI AG
Date: 11-12-2017
DOI: 10.3390/NU9121345
The Impact of Systematic Review Automation Tools on Methodological Quality and Time Taken to Complete Systematic Review Tasks: Case Study
Publisher: JMIR Publications Inc.
Date: 31-05-2021
DOI: 10.2196/24418
Abstract: Systematic reviews (SRs) are considered the highest level of evidence to answer research questions however, they are time and resource intensive. When comparing SR tasks done manually, using standard methods, versus those same SR tasks done using automated tools, (1) what is the difference in time to complete the SR task and (2) what is the impact on the error rate of the SR task? A case study compared specific tasks done during the conduct of an SR on prebiotic, probiotic, and synbiotic supplementation in chronic kidney disease. Two participants (manual team) conducted the SR using current methods, comprising a total of 16 tasks. Another two participants (automation team) conducted the tasks where a systematic review automation (SRA) tool was available, comprising of a total of six tasks. The time taken and error rate of the six tasks that were completed by both teams were compared. The approximate time for the manual team to produce a draft of the background, methods, and results sections of the SR was 126 hours. For the six tasks in which times were compared, the manual team spent 2493 minutes (42 hours) on the tasks, compared to 708 minutes (12 hours) spent by the automation team. The manual team had a higher error rate in two of the six tasks—regarding Task 5: Run the systematic search, the manual team made eight errors versus three errors made by the automation team regarding Task 12: Assess the risk of bias, 25 assessments differed from a reference standard for the manual team compared to 20 differences for the automation team. The manual team had a lower error rate in one of the six tasks—regarding Task 6: Deduplicate search results, the manual team removed one unique study and missed zero duplicates versus the automation team who removed two unique studies and missed seven duplicates. Error rates were similar for the two remaining compared tasks—regarding Task 7: Screen the titles and abstracts and Task 9: Screen the full text, zero relevant studies were excluded by both teams. One task could not be compared between groups—Task 8: Find the full text. For the majority of SR tasks where an SRA tool was used, the time required to complete that task was reduced for novice researchers while methodological quality was maintained.
Nutrition Screening in Geriatric Rehabilitation: Criterion (Concurrent and Predictive) Validity of the Malnutrition Screening Tool and the Mini Nutritional Assessment-Short Form
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.JAND.2015.06.012
Abstract: Nutrition screening is required for early identification and treatment of patients at risk for malnutrition so that clinical outcomes can be improved and health care costs reduced. To determine the criterion (concurrent and predictive) validity of the Malnutrition Screening Tool (MST) and Mini Nutritional Assessment-Short Form (MNA-SF) in older adults admitted to inpatient rehabilitation facilities. Observational, prospective cohort. Participants were 57 adults aged 65 years and older (mean±standard deviation age=79.1±7.3 years) from two rural rehabilitation units in New South Wales, Australia. MST MNA-SF International Statistical Classification of Diseases and Health Related Problems, 10th revision, Australian Modification (ICD-10-AM) classification of malnutrition rehospitalization admission to a residential aged care facility (institutionalization) and discharge location. Measures of diagnostic accuracy with 95% CIs generated from a contingency table, Mann-Whitney U test, and χ(2) test. When compared with the ICD-10-AM criteria, the MST showed stronger diagnostic accuracy (sensitivity 80.8%, specificity 67.7%) than the MNA-SF (sensitivity 100%, specificity 22.6%). Neither the MST nor the MNA-SF was able to predict rehospitalization, institutionalization, or discharge location. The MST showed good concurrent validity and can be considered an appropriate nutrition screening tool in geriatric rehabilitation. The MNA-SF may overestimate the risk of malnutrition in this population. The predictive validity could not be established for either screening tool.
Malnutrition in Geriatric Rehabilitation: Prevalence, Patient Outcomes, and Criterion Validity of the Scored Patient-Generated Subjective Global Assessment and the Mini Nutritional Assessment
Publisher: Elsevier BV
Date: 05-2016
DOI: 10.1016/J.JAND.2015.06.013
Abstract: Accurate identification and management of malnutrition is essential so that patient outcomes can be improved and resources used efficaciously. In malnourished older adults admitted to rehabilitation: 1) report the prevalence, health and aged care use, and mortality of malnourished older adults 2) determine and compare the criterion (concurrent and predictive) validity of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and the Mini Nutritional Assessment (MNA) in diagnosing malnutrition and 3) identify the Scored PG-SGA score cut-off value associated with malnutrition. Observational, prospective cohort. Participants were 57 older adults (65 years and older mean±standard deviation age=79.1±7.3 years) from two rural rehabilitation units in New South Wales, Australia. Scored PG-SGA MNA and the International Statistical Classification of Diseases and Health Related Problems, 10th revision, Australian Modification (ICD-10-AM) classification of malnutrition were compared to establish concurrent validity and report malnutrition prevalence. Length of stay, discharge location, rehospitalization, admission to a residential aged care facility, and mortality were measured to report health-related outcomes and to establish predictive validity. Malnutrition prevalence varied according to assessment tool (ICD-10-AM: 46% Scored PG-SGA: 53% MNA: 28%). Using the ICD-10-AM as the reference standard, the Scored PG-SGA ratings (sensitivity 100%, specificity 87%) and score (sensitivity 92%, specificity 84%, ROC AUC [receiver operating characteristics area under the curve]=0.910±0.038) showed strong concurrent validity, and the MNA had moderate concurrent validity (sensitivity 58%, specificity 97%, receiver operating characteristics area under the curve=0.854±0.052). The Scored PG-SGA rating, Scored PG-SGA score, and MNA showed good predictive validity. Malnutrition can increase the risk of longer rehospitalization length of stay, admission to a residential aged care facility, and discharge to hospital or residential aged care facility instead of home. Malnutrition prevalence in the geriatric rural rehabilitation population is high, and is associated with increased health and aged care use. The Scored PG-SGA ratings and score are suitable for nutrition assessment in geriatric rehabilitation. The MNA may be suitable for nutrition assessment in geriatric rehabilitation, but care should be taken to ensure all malnourished patients are identified. Additional examination of the criterion validity of the Scored PG-SGA and MNA will lend confidence to these findings.
Real world evidence on the characteristics of regular and intermittent users of a very‐low calorie diet program and associations with measures of program success, health, and quality of life
Publisher: Wiley
Date: 06-10-2023
DOI: 10.1002/OSP4.712
Related Organisations
Washington University In St. Louis School Of Medicine
Location: United States of America
Related Funding Activities
No related grants have been discovered for Skye Marshall.