ORCID Profile
0000-0002-6474-0505
Current Organisations
Curtin University of Technology
,
Flinders University
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Publisher: Cambridge University Press (CUP)
Date: 20-05-2015
DOI: 10.1017/JIE.2015.4
Abstract: This article describes a review undertaken in 2012–2013 by Nutrition and Dietetics, Flinders University, to assess the Indigenous health curriculum of the Bachelor of Nutrition and Dietetics (BND) and Masters of Nutrition and Dietetics (MND). An action research framework was used to guide and inform inquiry. This involved four stages, each of which provided information to reach a final decision about how to progress forward. First, relevant information was collected to present to stakeholders. This included identification of acknowledged curriculum frameworks, a review of other accredited nutrition and dietetics courses in Australia, a review of Indigenous health topics at Flinders University, including liaison with the Poche Centre for Indigenous Health and Well-Being (Indigenous health teaching and research unit), and a review of BND and MND current curriculum related to Indigenous health. Second, input was sought from stakeholders. This involved a workshop with practising dietitians and nutritionists from South Australia and the Northern Territory and discussions with Flinders University Nutrition and Dietetics academic staff. Third, a new curriculum was developed. Nine areas were identified for this curriculum, including reflexivity, approach and role, history and health status, worldview, beliefs and values, systems and structures, relationship building and communication, food and food choice, appreciating and understanding ersity, and nutrition issues and health status. Fourth, a final outcome was achieved, which was the decision to introduce a core, semester-long Indigenous health topic for BND students. A secondary outcome was strengthening of Indigenous health teaching across the BND and MND. The process and findings will be useful to other university courses looking to assess and expand their Indigenous health curriculum.
Publisher: Wiley
Date: 17-01-2018
DOI: 10.1111/OBR.12660
Abstract: Adolescent obesity is a risk factor for obesity and other chronic disease in adulthood. Evidence for the effectiveness of community-based obesity treatment programs for adolescents is required to inform policy and clinical decisions. This systematic review aims to evaluate recent effective and scalable community-based weight management programs for adolescents (13-17 years) who are overweight or obese. Eight databases (Medline, Embase, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Informit, and Scopus) were searched for studies published between January 2011-2 March 2017 which are scalable in a community setting and reported primary outcome measures relating to weight. Following deduplication, 10,074 records were screened by title/abstract with 31 publications describing 21 programs included in this review. Programs were heterogeneous in nature (including length, number and frequency of sessions, parent-involvement and technology involvement). Reduction in adolescent BMIz ranged from 2 to 9% post-program and from 2 to 11% after varied lengths of follow-up. Study quality varied (n = 5 weak n = 8 moderate n = 8 high), and findings are limited by the risk of selection and retention bias in the included studies. Factors including the effectiveness and acceptability to the target population must be considered when selecting such community programs.
Publisher: Elsevier BV
Date: 07-2020
DOI: 10.1016/J.PLEFA.2019.102035
Abstract: Breast milk dried on filter paper is a useful collection device for the study of breast milk because it avoids the costs associated with cold-chain storage and transportation. Although the fatty acid profile of breast milks as dried spots is stable, changes to the composition of lipid classes of breast milk due to lipase activity have been reported and are best reflected by its free fatty acid (FFA) concentration. This study aimed to develop a robust dried milk spot (DMS) system where fats in the breast milk are stable at room temperature, and the FFA concentration of the milk can be accurately measured without interference by the high level of triglyceride, which normally constitutes around 98% of the fats in fresh milk. Our system involves applying a small amount breast milk (20 µL) on silica gel impregnated filter paper and microwaving at high power to denature lipases. At the time of analysis, the milk fats are eluted with acetone, re-constituted in heptane and injected directly into a gas chromatograph equipped with an acid modified polyethylene glycol column. This DMS method was validated against the conventional TLC method across a range of FFA concentrations. The breast milk fats collected using this DMS system are stable at room temperature for at least eight weeks which allows for transportation by post and has the potential for use in multi-centred international clinical trials.
Publisher: Wiley
Date: 16-04-2008
Publisher: MDPI AG
Date: 20-05-2015
Publisher: MDPI AG
Date: 11-05-2021
DOI: 10.20944/PREPRINTS202105.0237.V1
Abstract: Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight & le g and/or born & le weeks& rsquo gestation. Medline, PubMed, CINAHL and Scopus were searched, and comparisons grouped as: exclusive human milk (EHM) vs exclusive preterm formula (EPTF), any HM vs EPTF and higher vs lower doses of HM. We selected studies that used fortified HM and compared that with a PTF studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 (n =9,963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.
Publisher: Cambridge University Press (CUP)
Date: 07-11-2017
DOI: 10.1017/S1368980017002968
Abstract: To examine dietary Na and K intake at eating occasions in Australian adults and identify the contribution of major food sources to Na and K at different eating occasions. Secondary analysis of 24 h recall diet data from the Australian Health Survey (2011–2013). Nationally representative survey in Australia. Male and female Australians aged 18–84 years ( n 7818). Dinner contributed the greatest proportion to total daily Na intake (33 %) and K intake (35 %). Na density was highest at lunch (380 mg/MJ) and K density highest at between-meal time eating occasions (401 mg/MJ). Between-meal time eating occasions provided 20 % of daily Na intake and 26 % of daily K intake. The major food group sources of Na were different at meal times (breads and mixed dishes) compared with between-meal times (cakes, muffins, scones, cake-type desserts). The top food group sources of K at meal times were potatoes and unprocessed meat products and dishes. Foods which contributed to Na and K intake differed according to eating occasion. Major food sources of Na were bread and processed foods. Major food sources of K were potatoes and meat products and dishes. Public health messages that emphasise meal-based advice and diet patterns high in vegetables, fruits and unprocessed foods may also aid reduction in dietary Na intake and increase in dietary K intake.
Publisher: SAGE Publications
Date: 03-12-2019
Abstract: Sufficient information and support for breastfeeding mothers is vital to encourage optimal infant feeding practices. Infant feeding apps give breastfeeding instructions and access to information however, little is known about mothers’ perceptions about these resources. This study investigated mothers’ use and experiences of infant feeding apps with a feeding tracker component, including how information within these apps is used, initial reasons for downloading, the role of the app in infant feeding, and perceived benefits and disadvantages of infant feeding apps. In-depth interviews were conducted with nine Australian breastfeeding mothers who had used an infant feeding app in the last year. Interviews were recorded, transcribed verbatim and coded prior to thematic analysis. The findings revealed that infant feeding apps provide mothers with objective information to guide their breastfeeding decisions and other aspects of baby care. This objective approach to infant feeding gives mothers a perception of greater control, confidence and efficacy at a time of transition and stress in the early stages of parenting an infant. While, overall, the mothers were positive about infant feeding apps, they also expressed concerns regarding overreliance on the app, feeling overwhelmed with the data and questioning the credibility of the information.
Publisher: Springer Science and Business Media LLC
Date: 05-06-2017
Publisher: MDPI AG
Date: 18-06-2021
DOI: 10.3390/NU13062089
Abstract: Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight ≤1500 g and/or born ≤28 weeks’ gestation. Medline, PubMed, CINAHL, and Scopus were searched, and comparisons were grouped as exclusive human milk (EHM) vs. exclusive preterm formula (EPTF), any HM vs. EPTF, and higher vs. lower doses of HM. We selected studies that used fortified HM and compared that with a PTF studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 (n = 9963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs. any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.
Publisher: Cambridge University Press (CUP)
Date: 05-11-2019
Publisher: JMIR Publications Inc.
Date: 10-10-2019
DOI: 10.2196/13340
Abstract: More than one-fourth of Australian adolescents are overweight or obese, with obesity in adolescents strongly persisting into adulthood. Recent evidence suggests that the mid-teen years present a final window of opportunity to prevent irreversible damage to the cardiovascular system. As lifestyle behaviors may change with increased autonomy during adolescence, this life stage is an ideal time to intervene and promote healthy eating and physical activity behaviors, well-being, and self-esteem. As teenagers are prolific users and innate adopters of new technologies, app-based programs may be suitable for the promotion of healthy lifestyle behaviors and goal setting training. This study aims to explore the reach, engagement, user experience, and satisfaction of the new app-based and Web-based Health Online for Teens (HOT) program in a s le of Australian adolescents above a healthy weight (ie, overweight or obese) and their parents. HOT is a 14-week program for adolescents and their parents. The program is delivered online through the Moodle app–based and website-based learning environment and aims to promote adolescents’ lifestyle behavior change in line with Australian Dietary Guidelines and Australia’s Physical Activity and Sedentary Behaviour Guidelines for Young People (aged 13-17 years). HOT aims to build parental and peer support during the program to support adolescents with healthy lifestyle behavior change. Data collection for this study is ongoing. To date, 35 adolescents and their parents have participated in one of 3 groups. HOT is a new online-only program for Australian adolescents and their parents that aims to reduce cardiovascular disease risk factors. This protocol paper describes the HOT program in detail, along with the methods to measure reach, outcomes, engagement, user experiences, and program satisfaction. Australian New Zealand Clinical Trials Registry ACTRN12618000465257 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374771 DERR1-10.2196/13340
Publisher: Cambridge University Press (CUP)
Date: 21-11-2016
DOI: 10.1017/S1368980016002883
Abstract: As numerous factors in the home environment have been related to children’s fruit and vegetable (F& V) consumption as a component of a healthy diet, the purpose of the present systematic review was to examine these factors specifically for children aged 6–12 years. Relevant observational studies published in English between January 2007 and December 2015 were obtained through electronic database searches. Studies were included if the researchers reported on a potentially modifiable measure of the home physical, political and sociocultural environment related to child F& V consumption. Of the thirty-three articles reviewed, overall methodological quality was poor with twenty studies rated as weak, mainly due to cross-sectional design (majority of studies), selection bias, convenience s ling and voluntary participation. Half of the studies had strong–moderate ratings for using valid and/or reliable tools while for the other half, psychometric properties were either not reported or weak. The most consistent evidence for children’s combined F& V consumption was found for availability and accessibility of F& V, parental role modelling of F& V and maternal intake of F& V. A vast array of home environment components and their influence on children’s consumption of fruits and/or vegetables have been studied in recent years. Specific components of the home environment may have more influence than others, but more compelling evidence is needed to draw strong conclusions. Recommendations are made for future studies to be based upon conceptual/theoretical models to provide consistency in defining the home environment and investigation of potential moderators, such as personal or contextual factors.
Publisher: Elsevier BV
Date: 06-2016
Publisher: Wiley
Date: 20-11-2020
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.PLEFA.2018.08.003
Abstract: Long chain polyunsaturated fatty acid (LCPUFA) intake during infancy has been associated with many health benefits, and the LCPUFA intake of breastfed infants is largely dependent on the composition of breast milk. The conventional method for breast milk fatty acid profiling is complicated by the need for cold-chain transportation and storage, and the newly developed dried milk spot (DMS) technology overcomes these difficulties. This study aimed to determine the accuracy, sensitivity and applicability of the DMS method developed based on the PUFAcoat™ technology. Two hundred breast milk s les were analyzed using the conventional method and compared with the DMS method. In order to evaluate the usefulness of DMS for large scale international studies, we analyzed another 786 breast milk s les collected from mothers of preterm infants who participated in a large clinical trial conducted in Australia, New Zealand and Singapore. Fatty acids were measured using capillary gas chromatography and results were reported as weight percentage of total fatty acids. Strong correlations and tight variation were observed in total saturated, monounsaturated, n-6 and n-3 PUFAs between the conventional and DMS methods. The DMS method proved to be sensitive in differentiating the breast milk fatty acid profiles of women consuming different habitual diets as evidenced by the differences between the breast milk fatty acid composition between Australian and Singaporean population. This study demonstrates that the DMS and the conventional method provide interchangeable results, and the DMS method is a particularly useful tool for large-scale studies.
Publisher: MDPI
Date: 09-08-2018
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.APPET.2016.05.007
Abstract: Women with children often fulfil multiple roles of running a household, raising a family and working outside the home. Good nutrition during this time is important to optimise their performance and prevent lifestyle diseases. Women also act as nutritional gatekeepers for their family. The dual burden of paid employment and unpaid family work may be associated with time scarcity in mothers which can impact food preparation and therefore nutritional adequacy. The aim of this study was to examine the diet of women who lived with children by comparison of hours worked. This was a secondary analysis of the Australian National Nutrition and Physical Activity Survey 2011-12. Subjects were women aged 18-65 years who resided with ≥1 child (<18 years). Women were grouped according to hours of employment: not working working 30% of energy coming from discretionary foods in all groups. Usual hours of employment per week have a minimal effect on diet quality in women with children. It is likely that different factors specific to each group contribute to the poor dietary intakes and should be further investigated.
Publisher: Springer Science and Business Media LLC
Date: 29-11-2017
Publisher: Mary Ann Liebert Inc
Date: 11-2020
Publisher: Wiley
Date: 28-12-2020
DOI: 10.1111/JPC.14742
Abstract: This study sought to establish research priorities in human milk banking and use of pasteurised donor human milk. It aimed to (i) collaborate with national stakeholders, including parents of preterm infants, human milk donors and health-care professionals, to identify evidence uncertainties and (ii) agree by consensus on a consolidated prioritised list of research questions. A consensus approach modelled on the James Lind Alliance was used. A steering group was formed, and key stakeholder organisations identified. Evidence uncertainties were gathered through an online survey and literature search. An iterative process was used to consolidate and rank questions. A final workshop was held to identify the top 10 research priorities. A total of 391 evidence uncertainties were gathered from 202 respondents (38% parents of preterm infants/milk donors, 50% health-care professionals, 12% who identified as both a parent of preterm and health professional) and a further 15 were identified from literature. The steering group consolidated these to 39 evidence uncertainties, which were ranked via another survey. The top 24 questions were workshopped by 13 participants (four parents and nine clinicians) to determine the top 10 research priorities. These included the risks and benefits of using donor milk, optimum techniques for processing and the effects of these on the properties of milk, the nutrient profile of the milk and clinical criteria for prioritising receipt of milk. The top 10 research priorities in human milk banking and use of donor milk were identified and can be used to guide researchers.
Publisher: Wiley
Date: 04-2008
Publisher: MDPI AG
Date: 31-05-2018
DOI: 10.3390/NU10060707
Publisher: Wiley
Date: 16-09-2017
Abstract: Optimal glycaemic control is important in children and adolescents with type 1 diabetes (T1D) to reduce the risk of developing microvascular complications. Modest reductions in HbA1c translate to significant risk reductions of these complications. Research indicates that targeted dietetic care using evidence-based guidelines improves HbA1c levels. The aim of this study was to audit the dietetic care provided to patients with T1D at the Women's and Children's Hospital (WCH) and compare the service provided to the International Society for Paediatric and Adolescent Diabetes (ISPAD) nutrition guidelines. A retrospective medical records audit of the dietetic service was conducted on 410 (99% of eligible) patients who attended the WCH Diabetes Outpatient Clinic between 1 January 2010 and 30 June 2013. These data were then compared to the ISPAD nutrition guidelines, with a focus on the key service delivery targets. Of the newly diagnosed patients (n = 128), 100% received initial dietary advice by a paediatric diabetes dietitian 61% of these patients then received a follow-up appointment within one month of diagnosis. Of those who were >1 year post-diagnosis (n = 389), only 6% were seen annually 79% of patients were identified with a condition requiring more frequent review, of whom 23% were seen more frequently. This large and comprehensive audit, conducted for a 3.5-year period, has shown that the dietetic care of newly diagnosed children and adolescents is mostly in line with ISPAD guidelines, but there is suboptimal follow-up after diagnosis.
Publisher: Wiley
Date: 18-12-2015
Publisher: JMIR Publications Inc.
Date: 10-01-2019
Abstract: ore than one-fourth of Australian adolescents are overweight or obese, with obesity in adolescents strongly persisting into adulthood. Recent evidence suggests that the mid-teen years present a final window of opportunity to prevent irreversible damage to the cardiovascular system. As lifestyle behaviors may change with increased autonomy during adolescence, this life stage is an ideal time to intervene and promote healthy eating and physical activity behaviors, well-being, and self-esteem. As teenagers are prolific users and innate adopters of new technologies, app-based programs may be suitable for the promotion of healthy lifestyle behaviors and goal setting training. his study aims to explore the reach, engagement, user experience, and satisfaction of the new app-based and Web-based Health Online for Teens (HOT) program in a s le of Australian adolescents above a healthy weight (ie, overweight or obese) and their parents. OT is a 14-week program for adolescents and their parents. The program is delivered online through the Moodle app–based and website-based learning environment and aims to promote adolescents’ lifestyle behavior change in line with Australian Dietary Guidelines and Australia’s Physical Activity and Sedentary Behaviour Guidelines for Young People (aged 13-17 years). HOT aims to build parental and peer support during the program to support adolescents with healthy lifestyle behavior change. ata collection for this study is ongoing. To date, 35 adolescents and their parents have participated in one of 3 groups. OT is a new online-only program for Australian adolescents and their parents that aims to reduce cardiovascular disease risk factors. This protocol paper describes the HOT program in detail, along with the methods to measure reach, outcomes, engagement, user experiences, and program satisfaction. ustralian New Zealand Clinical Trials Registry ACTRN12618000465257 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374771 ERR1-10.2196/13340
Publisher: F1000 Research Ltd
Date: 24-03-2017
Abstract: This article was migrated. The article was marked as recommended. In health professions education there is a call for global health practitioners while in higher education there is a complementary call for internationalisation of the curriculum. However, implementation has not matched aspiration partly because of a lack of practical tools and illustrative ex les. This paper takes an interdisciplinary approach and presents the design and development of a practical tool: the curriculum design compass. The curriculum design compass covers four design spaces: What do students need to know about global health? What do students need to be taught in order to develop cultural ersity awareness and intercultural competence? How do we teach to facilitate and demonstrate intercultural learning? and How do we bring students into contact with the wider world?The design compass was trialled with a Nutrition and Dietetics program and generalisability was confirmed with an unrelated profession. The programs studied were able to readily understand the tool and to use it to identify areas of existing good practice and areas for improvement. Therefore, it was both a review tool and a design tool enabling programs to manageably and holistically better prepare global health practitioners.
Publisher: SAGE Publications
Date: 2014
Abstract: Objective. This review aimed to investigate the relationship between varying levels of enteral protein intake and growth in preterm infants, regardless of feeding method. Data Sources. Electronic databases were searched for relevant studies, as were review articles, reference lists, and text books. Study Selection. Trials were included if they were randomized or quasirandomized, participants were weeks gestation at birth, and protein intakes were intentionally or statistically different between study groups. Trials reporting weight, length, and head circumference gains in infants fed formula, human milk, or fortified human milk were included. Data Extraction. Studies were categorized by feeding-type and relevant data were extracted into summary tables by one reviewer and cross-checked by a second. Data Synthesis. A meta-analysis could not be conducted due to extensive variability among studies thus, results were synthesized graphically and narratively. Twenty-four trials met the inclusion criteria and were included in a narrative synthesis and 19 in a graphical synthesis of study results. Conclusions. There was extensive variability in study design, participant characteristics, and study quality. Nonetheless, results are fairly consistent that higher protein intake results in increased growth with graphical representation indicating a potentially linear relationship. Additionally, intakes as high as 4.5 g/kg/day were shown to be safe in infants weighing g.
Publisher: Elsevier BV
Date: 05-2008
DOI: 10.1016/J.NUT.2008.01.014
Abstract: We investigated the relative contribution of macronutrients to postnatal growth in preterm infants born <33 wk of gestation. An audit of daily parenteral and enteral intakes of protein, carbohydrate, fat, energy, and growth (daily weight, weekly length, and head circumference) from birth to discharge home in 138 infants at <33 wk of gestation admitted to an Australian tertiary hospital was done. A mixed-model analysis of variance with random effects (slope and intercept) for subject and controlling for time, sex, gestational age, and total energy was used to determine the relative contribution of macronutrients to growth. A higher energy intake (kilocalories per day) had a positive influence on growth. With total energy held constant, the contribution of carbohydrate to total energy had a positive relation to weight, length, and head circumference gains protein had no relation and fat was negatively associated. For every 1% increase in energy from carbohydrate, there was a 2.3-g/d increase in weight (95% confidence interval 1.6-3.0, P < 0.0001), a 0.013-cm/d increase in length (95% confidence interval 0.003-0.022, P = 0.007), and a 0.015-cm/d increase in head circumference (95% confidence interval 0.009-0.022, P < 0.0001). A re-examination of the macronutrient balance in the diet of preterm infants is required in relation to optimizing growth.
Publisher: MDPI AG
Date: 07-06-2018
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.JNEB.2019.07.007
Abstract: This study aimed to overcome barriers to access and attendance, and improve recruitment and engagement, through delivery and evaluation of the Parenting, Eating and Activity for Child Health (PEACH) child weight management program, as a facilitated group-based online healthy lifestyle program, PEACH Lifestyle. Pre-post feasibility study of an online intervention comprising a website with 10 self-directed learning modules and 6 facilitated group-based video conferencing sessions with parents (n = 79) of children (7.9 ± 2.9 years, 25% healthy weight, 23% obese). Three enrollees were from remote locations. Half of the parents (n = 38) attended ≥1 video conferencing session (median = 3 participants per session [Range, 0-7]). Thirty percent (n = 7 of 21) completed all 10 online modules. Technical issues, time, and family commitments were barriers to engagement. Reframing and delivering a weight management program as a healthy lifestyle program online in real-time did not address barriers to engagement in PEACH Lifestyle.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.PLEFA.2019.04.008
Abstract: This review evaluated the effect of various storage and handling conditions on the fat composition of expressed breast milk (EBM). Three databases PubMed, Embase and Scopus were searched in April 2019 with words from the three key components: human milk, handling process (i.e. storage and/or pasteurization), and fatty acid composition. The comparisons were EBM subjected to handling processes versus fresh EBM or versus EBM subjected to another handling processes. Both intervention and observational studies were included, and the outcomes measured included total fat and lipid classes of the EBM. We included 42 studies (43 reports), 41 of which were assessed to be of good quality. Relative changes to the fat composition of EBM subjected to handling processes were calculated based on the data provided in the included studies, and the results were synthesized narratively. The total fat content and total fatty acid composition of EBM was not generally influenced by storage and handling process, with most changes less than 10%, which is likely a result of methodological variation. A reduction in EBM triglyceride concentration and concomitant increase in free fatty acid concentration were seen after exposing to various conditions, probably due to endogenous lipase.
Publisher: Cambridge University Press (CUP)
Date: 30-05-2018
DOI: 10.1017/S0007114518001083
Abstract: Parenting, Eating and Activity for Child Health (PEACH) is a multi-component lifestyle intervention for families with overweight and obese children. PEACH was translated from an efficacious randomised-controlled trial (RCT) and delivered at scale as PEACH Queensland (QLD) in Queensland, Australia. The aim of this study is to explore pre–post changes in parenting, and child-level eating, activity and anthropometry, in the PEACH QLD service delivery project. PEACH QLD enrolled 926 overweight/obese children (817 families). Pre-programme evaluation was completed for 752 children and paired pre–post-programme evaluation data were available for 388 children. At baseline, children with pre–post-programme data were (mean) 8·8 years old, and at follow-up were 9·3 years old, with mean time between pre–post-programme measures of 0·46 years. Outcomes reflected each domain of the PEACH programme: parenting, eating behaviour of the child and activity behaviours (means reported). Parents reported improvements in parenting self-efficacy (3·6 to 3·7, P =0·001). Children had improved eating behaviours: eating more daily serves of vegetables (2·0 to 2·6, P =0·001) and fewer non-milk sweetened beverages (0·9 to 0·6, P =0·001) and discretionary foods (2·2 to 1·5, P =0·001). Children spent more time in moderate-to-vigorous physical activity (86 to 105 min/d, P =0·001) and less time in sedentary screen-based behaviours (190 to 148 min/d, P =0·001). Consequently, there were significant improvements in mean BMI z (−0·112 P ·001) and weight status (healthy weight/overweight/obese/morbidly obese prevalence from 0/22/33/45 % to 2/27/34/37 %, P ·001). When delivered at scale, PEACH remains an effective family-based, multi-component, lifestyle weight management programme for overweight and obese children whose families engage in the programme.
Publisher: MDPI AG
Date: 17-05-2018
DOI: 10.3390/NU10050634
Publisher: Elsevier BV
Date: 03-2012
Abstract: Preterm human milk-fed infants often experience suboptimal growth despite the use of human milk fortifier (HMF). The extra protein supplied in fortifiers may be inadequate to meet dietary protein requirements for preterm infants. We assessed the effect of human milk fortified with a higher-protein HMF on growth in preterm infants. This is a randomized controlled trial in 92 preterm infants born at <31 wk gestation who received maternal breast milk that was fortified with HMF containing 1.4 g protein/100 mL (higher-protein group) or 1.0 g protein/100 mL (current practice) until discharge or estimated due date, whichever came first. The HMFs used were isocaloric and differed only in the amount of protein or carbohydrate. Length, weight, and head-circumference gains were assessed over the study duration. Length gains did not differ between the higher- and standard-protein groups (mean difference: 0.06 cm/wk 95% CI: -0.01, 0.12 cm/wk P = 0.08). Infants in the higher-protein group achieved a greater weight at study end (mean difference: 220 g 95% CI: 23, 419 g P = 0.03). Secondary analyses showed a significant reduction in the proportion of infants who were less than the 10th percentile for length at the study end in the higher-protein group (risk difference: 0.186 95% CI: 0.370, 0.003 P = 0.047). A higher protein intake results in less growth faltering in human milk-fed preterm infants. It is possible that a higher-protein fortifier than used in this study is needed. This trial was registered with the Australian New Zealand Clinical Trials Registry (www.anzctr.org.au/) as ACTRN12606000525583.
No related grants have been discovered for Jacqueline Miller.