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Harbury C, Shrewsbury VA, Collins CE, Callister R. Feasibility and preliminary efficacy of an online nutrition education intervention for those with a sleeve gastrectomy: A pilot randomised control trial. J Hum Nutr Diet 2024; 37:1265-1276. [PMID: 39004917 DOI: 10.1111/jhn.13348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND A sleeve gastrectomy (SG) is a lifelong treatment that improves health and better outcomes are associated with follow-up. However, there is lack of access or high attrition to aftercare. This potentially contributes to sub-optimal dietary intake and a lack of evidence for nutrition interventions. The present study assessed the feasibility and preliminary efficacy of a nutrition intervention to improve diet quality in Australian adults living with a SG. METHODS Adults (n = 96) post-SG were recruited into a cross-sectional diet quality study, with 68 eligible for randomisation to an intervention or wait-list control group. Over 10 weeks, a Facebook group was used to post daily nutrition education. Feasibility outcomes included participant recruitment, engagement, retention and acceptability. Preliminary efficacy was assessed using change in Australian Recommended Food Score (ARFS). Linear mixed models were used to measure differences in mean outcome between the experimental groups over time. RESULTS Sixty-eight participants (97% female) aged 48.2 ± 9.8 years, body mass index 33.1 ± 5.8 kg/m2, and mean ± SD ARFS 39 ± 9 points were randomised to the intervention, with 66% retention at 10 weeks. At follow-up, diet quality increased for the intervention group (mean ARFS, 95% confidence interval = 0.2 [-1.5 to 1.9]) and decreased for the control group (mean ARFS, 95% confidence interval= -2.0 [-5.2 to 1.2]) with no between group difference (p = 0.2). Participants (n = 30) rated the intervention positively. CONCLUSIONS Recruiting and retaining adults post-SG into a nutrition intervention is feasible. Low-cost recruitment attracted strong interest from women to identify greater support to know what to eat following SG. A future fully powered trial to assess intervention efficacy is warranted.
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Affiliation(s)
- Cathy Harbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Vanessa A Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Robin Callister
- School of Biomedical Science and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
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Isbanner S, Carins J, Babakhani N, Kitunen A. Streamlining COM-B model: Insights from the Healthy Eating Context. Appetite 2024; 203:107693. [PMID: 39341347 DOI: 10.1016/j.appet.2024.107693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 09/24/2024] [Accepted: 09/25/2024] [Indexed: 10/01/2024]
Abstract
The global rise in diet-related diseases highlights the urgent need for effective behavioural interventions. While theoretical frameworks like the Capability, Opportunity, Motivation-Behaviour (COM-B) model are valuable for understanding and influencing healthy eating behaviours, their practical application is often hindered by complexity and extensive measurement demands. This study addresses these challenges by testing a simplified version of the COM-B model, focusing on a select set of items representing seven core constructs. We conducted a cross-sectional survey with 347 Australian young adults to validate this streamlined model, making it more accessible for researchers and practitioners. Our findings underscore the importance of automatic motivation, the physical environment, and physical capability as critical factors in promoting healthy eating behaviours. By simplifying the COM-B model, this research contributes to developing more practical and effective strategies for healthier eating, addressing a critical public health issue.
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Affiliation(s)
- Sebastian Isbanner
- Education for Sustainable Nutrition and Food Science, Technische Universität Berlin, Berlin, 10623, Germany.
| | - Julia Carins
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Nazila Babakhani
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
| | - Anna Kitunen
- Social Marketing @ Griffith, Griffith University, 170 Kessels Road, Nathan, QLD, 4111, Australia
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Collins RA, Ashton LM, Burrows TL, Hutchesson M, Adam MTP, Clarke ED, Collins CE. No Money No Time Culinary Nutrition Website eHealth Challenge: A Pre-Post Evaluation of Impact on Diet Quality, Food Expenditure, and Engagement. Nutrients 2024; 16:2950. [PMID: 39275264 PMCID: PMC11397432 DOI: 10.3390/nu16172950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 08/22/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024] Open
Abstract
No Money No Time (NMNT) is a culinary nutrition website designed to optimize diet quality. The primary aim was to evaluate the impact of an online targeted nutrition challenge email campaign that encouraged engagement with NMNT and goal setting to improve diet quality and weekly food expenditure. A secondary aim was to assess NMNT engagement. Australian adults ≥18 years were recruited to the eHealth nutrition challenge delivered via weekly emails. Diet quality was assessed using the Healthy Eating Quiz (HEQ) diet quality tool. Engagement was assessed using email open and click-through rates. Intention-to-treat (ITT) analysis was conducted using mixed effects linear regression. Of 481 adults (49.7 ± 13.9 years, 84% female) who enrolled 79 (16%) completed the challenge. ITT results indicated statistically significant 6-week increases in diet quality score (+3.8 points p ≤ 0.001, d = 0.58) with sub-scale improvements in vegetables (+0.9 points, p = 0.01, d = 0.32), fruit (+1.2 points, p ≤ 0.001, d = 0.55), and dairy (+0.9 points, p ≤ 0.001, d = 0.58). There were significant post-challenge reductions in household spending on takeaway/snacks/coffee of AUD 8.9 per week (p = 0.01, d = 0.29), body weight reduction (-0.6 kg, p = 0.03, d = 0.26), and BMI (-0.2 kg/m2p = 0.02, d = 0.28). The email open rate remained constant at around 67% (56% to 75%), with an average click-through rate of 18% (7.1% to 37.9%). The eHealth nutrition challenge significantly improved diet quality while reducing BMI and money spent on discretionary foods. Strategies to scale the challenge should be tested as an innovative population strategy for improving diet quality, health indicators, and managing household food budgets.
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Affiliation(s)
- Rebecca A Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Lee M Ashton
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- School of Education, College of Human & Social Futures, The University of Newcastle, Callaghan, NSW 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Melinda Hutchesson
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Marc T P Adam
- School of Information and Physical Sciences, College of Engineering, Science and Environment, The University of Newcastle, New Lambton Heights, NSW 2305, Australia
| | - Erin D Clarke
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW 2308, Australia
- Food and Nutrition Research Group, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
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Pannu PK, Scherini AJJ, Silva DT, Whalan S. The ORIGINS Project: A Cross-Sectional Analysis of the Nutrition Profile of Pregnant Women in a Longitudinal Birth Cohort. Nutrients 2024; 16:2571. [PMID: 39125450 PMCID: PMC11314159 DOI: 10.3390/nu16152571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 07/30/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024] Open
Abstract
Pregnancy is an opportunistic time for dietary intake to influence future disease susceptibility in offspring later in life. The ORIGINS Project was established to identify the factors that contribute to 'a healthy start to life' through a focus supporting childhood health and preventing disease (including non-communicable diseases). We aim to describe the dietary intakes of pregnant women in this cohort and to compare these to the Nutrient Reference Values (NRVs) and Australian Recommended Food Score (ARFS). The usual food and nutrient intakes of women were collected using the Australian Eating Survey (AES), a semi-quantitative food frequency questionnaire (FFQ). A total of 374 women completed the AES FFQ at both 20 weeks and 36 weeks of gestation between December 2016 and January 2023. Macronutrient, micronutrient, and food group intake were explored using descriptive statistics. Overall, it was found that the energy contribution from carbohydrates was low, while that from fat and saturated fat was high; participants were not meeting the recommendations for several key micronutrients (calcium, iron, iodine, and folate); and they had low diet quality scores for all food groups. These findings suggest that despite the ongoing promotion of healthy eating during pregnancy, further exploration into why dietary guidelines during pregnancy are not being adhered to is warranted.
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Affiliation(s)
- Poonam K. Pannu
- Telethon Kids Institute, Nedlands 6009, Australia; (A.J.J.S.); (D.T.S.); (S.W.)
| | | | - Desiree T. Silva
- Telethon Kids Institute, Nedlands 6009, Australia; (A.J.J.S.); (D.T.S.); (S.W.)
- Faculty of Science, Medical School, University of Western Australia, Crawley 6009, Australia
- Joondalup Health Campus, Joondalup 6027, Australia
| | - Sarah Whalan
- Telethon Kids Institute, Nedlands 6009, Australia; (A.J.J.S.); (D.T.S.); (S.W.)
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Leary M, Skinner JA, Pursey KM, Verdejo-Garcia A, Collins R, Collins C, Hay P, Burrows TL. The effectiveness of the TRACE online nutrition intervention in improving dietary intake, sleep quality and physical activity levels for Australian adults with food addiction: a randomised controlled trial. J Hum Nutr Diet 2024; 37:978-994. [PMID: 38652589 DOI: 10.1111/jhn.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/05/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three-arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian-led telehealth intervention at 3 months. METHODS Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non-core foods were reported. RESULTS The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) -0.0 to 12.9], p = 0.049), non-core foods (-6.4%/day [95% CI -12.9 to 0.0], p = 0.049), sweetened drinks (-1.7%/day [95% CI -2.9 to -0.4], p = 0.013), takeaway foods (-2.3%/day [95% CI -4.5 to -0.1], p = 0.045) and sodium (-478 mg/day [95% CI -765 to -191 mg], p = 0.001). CONCLUSIONS A dietitian-led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change.
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Affiliation(s)
- Mark Leary
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Janelle A Skinner
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Kirrilly M Pursey
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Rebecca Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Clare Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Penrith, NSW, Australia
- Mental Health Services, South Western Sydney Local Health District, Camden and Campbelltown Hospitals, NSW, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, University of Newcastle, New Lambton Heights, NSW, Australia
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Fenton S, Ashton LM, Lee DCW, Collins CE. Gender differences in diet quality and the association between diet quality and BMI: an analysis in young Australian adults who completed the Healthy Eating Quiz. J Hum Nutr Diet 2024; 37:943-951. [PMID: 38664922 DOI: 10.1111/jhn.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/29/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Many young adults report poor diet quality. However, research evaluating whether young adult males and females differ in diet quality is limited. Additionally, although diet quality has a known inverse association with body mass index (BMI), it is unclear whether this association is observed in young adults and whether it varies by gender. The present study aimed to evaluate gender differences in diet quality in young adults, as well as the associations between diet quality and BMI. METHODS Data collected via the Healthy Eating Quiz (HEQ) in respondents aged 18-35 years between July 2019 and December 2021 were analysed, including demographics, and diet quality calculated using the Australian Recommended Food Score (ARFS). Differences in characteristics were analysed using a two-sample t-test, chi-squared and one-way analysis of covariance. Linear regressions were performed to estimate associations between diet quality and BMI. An interaction term was included in the model to test differences between genders. RESULTS The respondents (n = 28,969) were predominantly female (70.8%) with a mean ± SD age of 25.9 ± 5.0 years and BMI of 24.6 ± 5.2 kg/m2. The mean ± SD ARFS was significantly different between females and males (33.1 ± 8.6 vs. 31.4 ± 9.3 points out of 70; p < 0.001). Diet quality had a small, significant inverse association with BMI in both genders. The interaction effect between diet quality score and gender in predicting BMI was significant (p < 0.001), suggesting the impact of diet quality on BMI varies by gender, with lower diet quality more strongly associated with higher BMI in females compared to males. CONCLUSION Interventions that target young adults are needed to improve diet quality and its potential contribution to BMI status. As a result of the small observed effect sizes, caution should be applied in interpreting these findings.
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Affiliation(s)
- Sasha Fenton
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Lee M Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- School of Education, College of Human and Social Futures, The University of Newcastle, Callaghan, NSW, Australia
| | - Daniel C W Lee
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Carroll BT, McNaughton SA, Parker KE, Marchese LE, Livingstone KM. Identifying the barriers and facilitators to fruit and vegetable consumption in rural Australian adults: a mixed methods analysis. Nutr J 2024; 23:69. [PMID: 38943157 PMCID: PMC11214237 DOI: 10.1186/s12937-024-00972-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/26/2024] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Low fruit and vegetable consumption is a leading contributor to non-communicable disease risk. However, understanding of barriers and facilitators to fruit and vegetable intake in rural settings is limited. This study used a mixed methods approach to determine the barriers and facilitators to increasing fruit and vegetable intake in rural Australian adults and to identify if these varied by gender. METHODS Quantitative and qualitative data were used from the 2019 Active Living Census, completed by adults living in north-west Victoria, Australia. Data were collected on fruit and vegetable intakes and barriers and facilitators to meeting fruit and vegetable recommendations. Multivariate logistic regression analyses were used to investigate the association between facilitators, classified using the socio-ecological framework, and meeting recommendations. Machine learning was used to automate content analysis of open ended information on barriers. RESULTS A total of 13,464 adults were included in the quantitative analysis (51% female; mean age 48 [SE 0.17] years) with 48% and 19% of participants consuming the recommended two serves of fruit and five serves of vegetables daily, respectively. Strongest facilitators to fruit consumption were at the individual level: never smoked (OR: 2.12 95% CI: 1.83-2.45) and not drinking alcohol (OR: 1.47 95% CI: 1.31-1.64). Strongest facilitators for vegetable consumption were found at all levels; i.e., individual level: used to smoke (OR: 1.48 95% CI: 1.21-1.80), social-environmental level: living with three or more people (OR: 1.41 95% CI: 1.22-1.63), and physical-environmental level: use community gardens (OR: 1.20 95% CI: 1.07-1.34). Qualitative analyses (fruit n = 5,919; vegetable n = 9,601) showed that barriers to fruit consumption included a preference for other snacks and desire to limit sugar content, whilst lack of time and unachievable guidelines were barriers for vegetables. Barriers and facilitators differed by gender; females experienced barriers due to having a more varied diet while males reported a dislike of the taste. CONCLUSIONS Barriers and facilitators to fruit and vegetable consumption among rural Australian adults were identified across all levels of the socio-ecological framework and varied between fruit and vegetables and by gender. Strategies that address individual, social, and physical-level barriers are required to improve consumption.
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Affiliation(s)
- Brooke T Carroll
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
- Health and Well-Being Centre for Research Innovation, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, 4067, Australia
| | - Kate E Parker
- City of Greater Bendigo, Active and Healthy Communities, Bendigo, VIC, 3552, Australia
| | - Laura E Marchese
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Melbourne, VIC, 3220, Australia.
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Kent K, Schumacher T, Kocar S, Seivwright A, Visentin D, Collins CE, Lester L. Increasing food insecurity severity is associated with lower diet quality. Public Health Nutr 2024; 27:e61. [PMID: 38311345 PMCID: PMC10897580 DOI: 10.1017/s1368980024000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Food insecurity may reduce diet quality, but the relationship between food insecurity severity and diet quality is under-researched. This study aimed to examine the relationship between diet quality and severity of household food insecurity. DESIGN A cross-sectional, online survey used the United States Department of Agriculture Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately or severely food insecure. The Australian Recommended Food Score (ARFS; scored 0–73) determined diet quality (ARFS total and sub-scale scores). Survey-weighted linear regression (adjusted for age, sex, income, education, location and household composition) was conducted. SETTING Tasmania, Australia. PARTICIPANTS Community-dwelling adults (aged 18 years and over). RESULTS The mean ARFS total for the sample (n 804, 53 % female, 29 % aged > 65 years) was 32·4 (sd = 9·8). As the severity of household food insecurity increased, ARFS total decreased. Marginally food-insecure respondents reported a mean ARFS score three points lower than food-secure adults (B = –2·7; 95 % CI (–5·11, –0·34); P = 0·03) and reduced by six points for moderately (B = –5·6; 95 % CI (–7·26, –3·90); P < 0·001) and twelve points for severely food-insecure respondents (B = –11·5; 95 % CI (–13·21, –9·78); P < 0·001). Marginally food-insecure respondents had significantly lower vegetable sub-scale scores, moderately food-insecure respondents had significantly lower sub-scale scores for all food groups except dairy and severely food-insecure respondents had significantly lower scores for all sub-scale scores. CONCLUSIONS Poorer diet quality is evident in marginally, moderately and severely food-insecure adults. Interventions to reduce food insecurity and increase diet quality are required to prevent poorer nutrition-related health outcomes in food-insecure populations in Australia.
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Affiliation(s)
- Katherine Kent
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong. Wollongong, NSW2522, Australia
| | - Tracy Schumacher
- Department of Rural Health, University of Newcastle, Tamworth, NSW2340, Australia
| | - Sebastian Kocar
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| | - Ami Seivwright
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
| | - Denis Visentin
- School of Health Sciences, University of Tasmania, Launceston, Tasmania7250, Australia
| | - Clare E Collins
- University of Newcastle, School of Health Sciences, College of Health, Medicine and Wellbeing, Callaghan, NSW2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW2305, Australia
| | - Libby Lester
- Institute for Social Change, University of Tasmania, Hobart, Tasmania7000, Australia
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Ashton LM, Adam MT, Whatnall M, Rollo ME, Burrows TL, Hansen V, Collins CE. Exploring the design and utility of an integrated web-based chatbot for young adults to support healthy eating: a qualitative study. Int J Behav Nutr Phys Act 2023; 20:119. [PMID: 37794368 PMCID: PMC10548711 DOI: 10.1186/s12966-023-01511-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/01/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND There is a lack of understanding of the potential utility of a chatbot integrated into a website to support healthy eating among young adults. Therefore, the aim was to interview key informants regarding potential utility and design of a chatbot to: (1) increase young adults' return rates and engagement with a purpose-built healthy eating website and, (2) improve young adults' diet quality. METHODS Eighteen qualitative, semi-structured interviews were conducted across three stakeholder groups: (i) experts in dietary behaviour change in young adults (n = 6), (ii) young adult users of a healthy eating website (n = 7), and (iii) experts in chatbot design (n = 5). Interview questions were guided by a behaviour change framework and a template analysis was conducted using NVivo. RESULTS Interviewees identified three potential roles of a chatbot for supporting healthy eating in young adults; R1: improving healthy eating knowledge and facilitating discovery, R2: reducing time barriers related to healthy eating, R3: providing support and social engagement. To support R1, the following features were suggested: F1: chatbot generated recommendations and F2: triage to website information or externally (e.g., another website) to address current user needs. For R2, suggested features included F3: nudge or behavioural prompts at critical moments and F4: assist users to navigate healthy eating websites. Finally, to support R3 interviewees recommended the following features: F5: enhance interactivity, F6: offer useful anonymous support, F7: facilitate user connection with content in meaningful ways and F8: outreach adjuncts to website (e.g., emails). Additional 'general' chatbot features included authenticity, personalisation and effective and strategic development, while the preferred chatbot style and language included tailoring (e.g., age and gender), with a positive and professional tone. Finally, the preferred chatbot message subjects included training (e.g., would you like to see a video to make this recipe?), enablement (e.g., healthy eating doesn't need to be expensive, we've created a budget meal plan, want to see?) and education or informative approaches (e.g., "Did you know bananas are high in potassium which can aid in reducing blood pressure?"). CONCLUSION Findings can guide chatbot designers and nutrition behaviour change researchers on potential chatbot roles, features, style and language and messaging in order to support healthy eating knowledge and behaviours in young adults.
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Affiliation(s)
- Lee M Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, 2308, Callaghan, NSW, Australia
- Active Living Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia
| | - Marc Tp Adam
- Food and Nutrition Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia
- School of Information and Physical Sciences, College of Engineering, Science and Environment, University of Newcastle, 2308, Callaghan, NSW, Australia
| | - Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia
| | - Megan E Rollo
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, 6845, Perth, WA, Australia
| | - Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia
| | - Vibeke Hansen
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, 2308, Callaghan, NSW, Australia.
- Food and Nutrition Research Program, Hunter Medical Research Institute, 2305, New Lambton Heights, NSW, Australia.
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Maneschi K, Geller T, Collins CE, Gordon A, Grech A. Maternal diet quality and nutrient intakes across preconception and pregnancy are not consistent with Australian guidelines: Results from the pilot BABY1000 study. Food Sci Nutr 2023; 11:4113-4123. [PMID: 37457169 PMCID: PMC10345671 DOI: 10.1002/fsn3.3401] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/01/2023] [Accepted: 04/12/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Maternal nutrition has profound and lasting effects on growth and health from infancy into adulthood. The aim of this manuscript was to assess diet quality and nutrient adequacy in preconception and pregnancy in BABY1000 pilot study participants (n = 171). STUDY DESIGN AND METHODS The Australian Eating Survey (AES) Food Frequency Questionnaire was administered to women based in Sydney, Australia, at preconception or 12 weeks' gestation (n = 158), and again at 36 weeks' gestation (n = 99). Primary outcomes were diet quality and nutrient intake. Diet quality was evaluated using the AES diet quality subscale, the Australian Recommended Food Score (ARFS). Nutrient intakes were compared to Australian Nutrient Reference Values. Diet quality and nutrient intakes were not consistent with Australian recommendations. Over 83% of women exceeded the suggested target limits for percentage energy from saturated fat. Median ARFS was 37 at baseline, and 38 in late pregnancy (maximum score 73). Inadequate micronutrient intakes from food were common; no participants met the Estimated Average Requirement for iron, 76%-84% for iodine, 70%-78% for calcium and 44%-50% for folate. Maternal diet quality and nutrient intakes in the current sample are inconsistent with pregnancy recommendations and therefore may not be supporting optimal perinatal or long-term offspring health. Stronger messaging around the importance of prenatal nutrition, prevalence of dietary inadequacy, and availability of reliable support and information specific to nutrition in pregnancy is crucial in supporting women to improve their nutrition both before and during pregnancy.
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Affiliation(s)
- Katie Maneschi
- School of Life and Environmental Sciences, Faculty of ScienceUniversity of SydneyCamperdownNew South WalesAustralia
| | - Taryn Geller
- School of Life and Environmental Sciences, Faculty of ScienceUniversity of SydneyCamperdownNew South WalesAustralia
| | - Clare E. Collins
- School of Health Sciences, Faculty of Health and MedicineUniversity of NewcastleCallaghanNew South WalesAustralia
- Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Adrienne Gordon
- Central Clinical School, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
- Charles Perkins CentreUniversity of SydneyCamperdownNew South WalesAustralia
| | - Allison Grech
- Central Clinical School, Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
- Charles Perkins CentreUniversity of SydneyCamperdownNew South WalesAustralia
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11
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Asher RC, Clarke ED, Bucher T, Shrewsbury VA, Roberts S, Collins CE. Impact and evaluation of an online culinary nutrition course for health, education and industry professionals to promote vegetable knowledge and consumption. J Hum Nutr Diet 2023; 36:967-980. [PMID: 36321462 PMCID: PMC10947242 DOI: 10.1111/jhn.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/16/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Poor diet, including inadequate vegetable intake, is a leading risk factor for noncommunicable disease. Culinary and nutrition education provided to trainee and practising health and education professionals is an emerging strategy to promote improved dietary intake, including vegetable consumption. We evaluated the impact and feasibility of an online culinary medicine and nutrition (CM/CN) short course for health, education and vegetable industry professionals. The course aimed to improve participants' skills and confidence to prepare vegetables, knowledge of evidence-based nutrition information and recommendations for improving vegetable consumption and diet quality. METHODS A pre-post study consisting of two separate groups participating in two course rounds recruited practising professionals (n = 30) working in health; community, adult and/or culinary education; and the vegetable industry. Evaluation assessed diet quality, vegetable consumption barriers, cooking and food skill confidence, nutrition knowledge and process measures. RESULTS Seventeen participants (68%) completed the programme. Pre- to postintervention statistically significant increases in vegetables (M 1.3, SD 2.2), fruit (M 1.6, SD 3.1), and breads and cereal (M 1.1, SD 1.7) intakes were observed. Statistically significant increases and large effect sizes for mean food skill confidence scores (M 8.9, SD 15.4, Cohen's d 0.56) and nutrition knowledge scores (M 6.2, SD 15.4, Cohen's d 0.83) were also observed pre- to postintervention. CONCLUSIONS The short online course was feasible and improved diet quality, food skill confidence and nutrition knowledge. Online CM/CN education for practising professionals represents a promising area of research. Future research involving a larger study sample and a more rigorous study design such as a randomised control trial is warranted.
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Affiliation(s)
- Roberta C. Asher
- School of Health Sciences, College of HealthMedicine and WellbeingCallaghanAustralia
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | - Erin D. Clarke
- School of Health Sciences, College of HealthMedicine and WellbeingCallaghanAustralia
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | - Tamara Bucher
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
- School of Environmental and Life Sciences, College of EngineeringScience and EnvironmentCallaghanAustralia
| | - Vanessa A. Shrewsbury
- School of Health Sciences, College of HealthMedicine and WellbeingCallaghanAustralia
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
| | | | - Clare E. Collins
- School of Health Sciences, College of HealthMedicine and WellbeingCallaghanAustralia
- Food and Nutrition Research Program, Hunter Medical Research InstituteNew Lambton HeightsNSWAustralia
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12
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Haslam RL, Baldwin JN, Pezdirc K, Truby H, Attia J, Hutchesson MJ, Burrows T, Callister R, Hides L, Bonevski B, Kerr DA, Kirkpatrick SI, Rollo ME, McCaffrey TA, Collins CE. Efficacy of technology-based personalised feedback on diet quality in young Australian adults: results for the advice, ideas and motivation for my eating (Aim4Me) randomised controlled trial. Public Health Nutr 2023; 26:1293-1305. [PMID: 36755380 PMCID: PMC10346011 DOI: 10.1017/s1368980023000253] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 11/01/2022] [Accepted: 01/19/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Web-based dietary interventions could support healthy eating. The Advice, Ideas and Motivation for My Eating (Aim4Me) trial investigated the impact of three levels of personalised web-based dietary feedback on diet quality in young adults. Secondary aims were to investigate participant retention, engagement and satisfaction. DESIGN Randomised controlled trial. SETTING Web-based intervention for young adults living in Australia. PARTICIPANTS 18-24-year-olds recruited across Australia were randomised to Group 1 (control: brief diet quality feedback), Group 2 (comprehensive feedback on nutritional adequacy + website nutrition resources) or Group 3 (30-min dietitian consultation + Group 2 elements). Australian Recommended Food Score (ARFS) was the primary outcome. The ARFS subscales and percentage energy from nutrient-rich foods (secondary outcomes) were analysed at 3, 6 and 12 months using generalised linear mixed models. Engagement was measured with usage statistics and satisfaction with a process evaluation questionnaire. RESULTS Participants (n 1005, 85 % female, mean age 21·7 ± 2·0 years) were randomised to Group 1 (n 343), Group 2 (n 325) and Group 3 (n 337). Overall, 32 (3 %), 88 (9 %) and 141 (14 %) participants were retained at 3, 6 and 12 months, respectively. Only fifty-two participants (15 % of Group 3) completed the dietitian consultation. No significant group-by-time interactions were observed (P > 0·05). The proportion of participants who visited the thirteen website pages ranged from 0·6 % to 75 %. Half (Group 2 = 53 %, Group 3 = 52 %) of participants who completed the process evaluation (Group 2, n 111; Group 3, n 90) were satisfied with the programme. CONCLUSION Recruiting and retaining young adults in web-based dietary interventions are challenging. Future research should consider ways to optimise these interventions, including co-design methods.
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Affiliation(s)
- Rebecca L Haslam
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Jennifer N Baldwin
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Kristine Pezdirc
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Melinda J Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Deborah A Kerr
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, Australia
| | | | - Megan E Rollo
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Tracy A McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan2308, Australia
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
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A Scoping Review of Approaches Used to Develop Plant-Based Diet Quality Indices. Curr Dev Nutr 2023. [DOI: 10.1016/j.cdnut.2023.100061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
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14
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Mastrogiovanni C, Rosenbaum S, Delbaere K, Tiedemann A, Teasdale S, McGavin A, Briggs N, McKeon G. A mental health-informed, online health promotion programme targeting physical activity and healthy eating for adults aged 60+ years: study protocol for the MovingTogether randomised controlled trial. Trials 2022; 23:1052. [PMID: 36575463 PMCID: PMC9793388 DOI: 10.1186/s13063-022-06978-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/02/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and associated social distancing regulations have led to an increased risk of social isolation and physical inactivity, particularly among older adults. The benefits of physical activity for reducing fall risk and improving mood and mental functioning have been well documented. The aim of this trial is to investigate the effect of the MovingTogether programme on psychological distress (primary outcome) and physical activity, social capital, cognition, concern about falling, loneliness, physical functioning, quality of life and physical activity enjoyment (secondary outcomes). METHODS A randomised controlled trial with a waitlist control will be conducted, recruiting 80 adults aged 60+ years with access to Facebook and a computer or tablet and not currently meeting the aerobic physical activity guidelines. Randomisation will be completed using REDCap. The intervention group (n = 40) will join a private Facebook group where allied health facilitators will provide targeted healthy lifestyle education throughout the 10-week programme with weekly telehealth group calls. Intervention participants will also be provided access to tailored strength and aerobic exercise guidance and an evidence-based eHealth balance exercise programme. Psychological distress and secondary outcomes will be assessed at baseline, 11 weeks (post-intervention) and 16 weeks (1-month follow-up). Linear mixed models will be applied for each outcome measure as per an intention-to-treat approach to determine the between-group differences. Secondary analyses are planned in people with greater adherence and those with higher psychological distress. DISCUSSION COVID-19 has highlighted the need for scalable, effective and novel methods to improve and protect the health of older adults. The integration of an evidence-based fall prevention programme with a mental health-informed online health promotion programme may help to improve mental and physical health outcomes among older adults. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001322820p. Registered on 29 September 2021.
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Affiliation(s)
- Chiara Mastrogiovanni
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia
| | - Simon Rosenbaum
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia
- School of Health Sciences, University of New South Wales, Sydney, NSW 2052 Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW 2031 Australia
- School of Population Health, University of New South Wales, Sydney, NSW 2052 Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Camperdown, NSW 2050 Australia
| | - Scott Teasdale
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia
- Mindgardens Neuroscience Network, Sydney, NSW 2052 Australia
| | - Annaliese McGavin
- School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - Nancy Briggs
- Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW 2052 Australia
| | - Grace McKeon
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, NSW 2052 Australia
- School of Population Health, University of New South Wales, Sydney, NSW 2052 Australia
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15
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Wilkinson SA, Schoenaker DAJM, de Jersey S, Collins CE, Gallo L, Rollo M, Borg D, Dekker Nitert M, Truby H, Barrett HL, Kumar S, Clifton V. Exploring the diets of mothers and their partners during pregnancy: Findings from the Queensland Family Cohort pilot study. Nutr Diet 2022; 79:602-615. [PMID: 35355379 PMCID: PMC9790493 DOI: 10.1111/1747-0080.12733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 12/30/2022]
Abstract
AIM Modifiable behaviours during the first 1000 days of life influence developmental trajectories of adult chronic diseases. Despite this, sub-optimal dietary intakes during pregnancy and excessive gestational weight gain are common. Very little is known about partners' dietary patterns and the influence on women's pregnancy dietary patterns. We aimed to examine dietary intake during pregnancy among women and their partners, and gestational weight gain patterns in the Queensland Family Cohort pilot study. METHODS The Queensland Family Cohort is a prospective, observational study piloted at a Brisbane (Australia) tertiary maternity hospital from 2018 to 2021. Participant characteristics, weight gain, dietary and nutrient intake were assessed. RESULTS Data were available for 194 pregnant women and their partners. Poor alignment with Australian Guide to Healthy Eating recommendations was observed. Highest alignment was for fruit (40% women) and meat/alternatives (38% partners) and lowest for breads/cereals (<1% women) and milk/alternatives (13% partners). Fewer women (4.4%-60.3%) than their partners (5.4%-92.3%) met guidelines for all micronutrient intakes from food alone, particularly folic acid, iodine, and iron. Women were more likely to meet daily recommendations for fruit, vegetables, dairy, bread/cereals, and meat/alternatives when their partners also met recommendations. Women with a higher pre-pregnancy body mass index were more likely to gain above recommended weight gain ranges. CONCLUSIONS In this contemporary cohort of pregnant women and their partners, sub-optimal dietary patterns and deficits in some nutrients were common. There is an urgent need for evidence-informed public health policy and programs to improve diet quality during pregnancy due to intergenerational effects.
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Affiliation(s)
- Shelley A. Wilkinson
- Faculty of Health and Behavioural Sciences, School of Human Movements and Nutrition SciencesThe University of QueenslandSt LuciaQueensland
| | - Danielle A. J. M. Schoenaker
- Faculty of Medicine, School of Primary Care, Population Sciences and Medical EducationUniversity of SouthamptonSouthamptonUK,NIHR Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK,School of Medical, Indigenous and Health SciencesUniversity of WollongongWollongongNew South WalesAustralia
| | - Susan de Jersey
- Faculty of Medicine, Centre for Clinical Research and Perinatal Research CentreThe University of QueenslandHerstonQueenslandAustralia,Department of Nutrition and Dietetics, Royal Brisbane and Women's HospitalMetro North Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and WellbeingUniversity of NewcastleCallaghanNew South WalesAustralia,Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleCallaghanNew South WalesAustralia
| | - Linda Gallo
- School of Biomedical SciencesThe University of QueenslandSt LuciaQueenslandAustralia
| | - Megan Rollo
- Priority Research Centre for Physical Activity and NutritionUniversity of NewcastleNewcastleAustralia,Faculty of Health and Medicine, School of Health SciencesUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Danielle Borg
- Queensland Family Cohort, Mater Research InstituteThe University of QueenslandSouth BrisbaneQueenslandAustralia
| | - Marloes Dekker Nitert
- School of Chemistry and Molecular BiosciencesThe University of QueenslandSt LuciaQueenslandAustralia
| | - Helen Truby
- Faculty of Health and Behavioural Sciences, School of Human Movements and Nutrition SciencesThe University of QueenslandSt LuciaQueensland
| | - Helen L. Barrett
- Department of Endocrinology, Mater Health, South Brisbane, Australia; Mater Research InstituteThe University of QueenslandSouth BrisbaneQueenslandAustralia
| | - Sailesh Kumar
- Mater Centre for Maternal Fetal MedicineMater Mothers HospitalBrisbaneQueenslandAustralia,Mater Research InstituteThe University of QueenslandSouth BrisbaneQueenslandAustralia,Faculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Vicki Clifton
- Mater Research InstituteThe University of QueenslandSouth BrisbaneQueenslandAustralia
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Nutritional Status and Habits among People on Vegan, Lacto/Ovo-Vegetarian, Pescatarian and Traditional Diets. Nutrients 2022; 14:nu14214591. [PMID: 36364853 PMCID: PMC9657343 DOI: 10.3390/nu14214591] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background: This study assessed the possible dependencies between nutritional habits and body composition among subjects with different dietary habits. Materials: A total of 196 healthy (aged 18−50 yrs) participants were enrolled in the study and divided into 4 groups according to their diet: vegans-VEGAN (n = 53), lacto/ovo-vegetarians—VEGE (n = 52), pescatarians-PESCA (n = 28), and omnivores-OMN (n = 43). Methods: The Food Frequency Questionnaire (FFQ) was used, and body composition was assessed on the In-Body120 analyzer. Results: Our result revealed in OMN + PESCA groups a higher average consumption frequency of sweets (p = 0.024), cheese/plant cheese (p < 0.001), eggs and egg dishes/egg substitutes (p < 0.001), butter, margarine/plant margarine (p < 0.001), cream /plant cream (p = 0.018), wine and cocktails (p = 0.028), vodka (p = 0.039) and lower of natural cottage cheese/tofu/tempeh (p < 0.001), vegetable oils (p = 0.036), legumes (p < 0.001) and nuts and seeds(p < 0.001) compared to the VEGAN + VEGE groups. The body composition analysis showed significant differences in skeletal muscle mass (SMM) (p = 0.019) and the content of minerals (p = 0.048) between groups. VEGAN disclosed the lowest average values of body fat mass (BFM), percentage body fat (PBF), and visceral adipose tissue (VAT) than other studied groups. Conclusions: The body composition analysis showed mean values within normal ranges in all of the groups, but some average results of OMN, PESCA, and VEGE compared to VEGAN were not highly satisfactory (in addition to eating behavior outcomes).
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17
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Is the Association between Age and Fertility Problems Modified by Diet Quality? Findings from a National Study of Reproductive Age Women in Australia. Nutrients 2022; 14:nu14204355. [PMID: 36297039 PMCID: PMC9606952 DOI: 10.3390/nu14204355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/14/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Increasing age is a strong risk factor for infertility, and there is accumulating evidence of the importance of a healthier diet for fertility. Whether a healthier diet modifies the association between increasing age and infertility has not been investigated. This study aimed to (i) examine if better diet quality could help reduce age-related infertility; and (ii) assess whether changes in diet quality over time are associated with fertility problems. Methods: Data were from Surveys 3 and 5 of the 1973−1978 birth cohort of the Australian Longitudinal Study on Women’s Health. Cross-sectional analysis with multivariable generalized linear models were used to examine the association between age and fertility status, adjusted for various confounders. Multiplicative and additive effect modification by diet quality was assessed, with additive effect modification evaluated with the relative risk for interaction (RERI). Results: In total, 3387 women were included from Survey 3 (age range 24−31 years) and 5614 women from Survey 5 (age range 30−38 years); 588 (17.4%) and 1321 (23.4%) self-reported to have fertility problems in the respective surveys. In Survey 3, compared to younger women with a good-quality diet, older women with a poor-quality diet had a 43% increased risk for fertility problems, with risk increasing after further adjustment for BMI (RR: 1.59; 95% CI: 1.07, 2.37) and PCOS (RR: 1.74; 95% CI: 1.15, 2.62). In Survey 5 in younger women (<33.9 years), there was no association between diet quality and risk for infertility problems. The RERI (across different adjusted models) was between −0.08 (−0.70, 0.55) to −0.39 (−1.40, 0.62) in survey 3 and 0.07 (−0.17, 0.31) to 0.08 (−0.17, 0.32) in Survey 5. Conclusions: There is little evidence to suggest effect modification on the effect of age and fertility problems with diet quality.
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Elma Ö, Brain K, Dong HJ. The Importance of Nutrition as a Lifestyle Factor in Chronic Pain Management: A Narrative Review. J Clin Med 2022; 11:5950. [PMID: 36233817 PMCID: PMC9571356 DOI: 10.3390/jcm11195950] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
In everyday clinical practice, healthcare professionals often meet chronic pain patients with a poor nutritional status. A poor nutritional status such as malnutrition, unhealthy dietary behaviors, and a suboptimal dietary intake can play a significant role in the occurrence, development, and prognosis of chronic pain. The relationship between nutrition and chronic pain is complex and may involve many underlying mechanisms such as oxidative stress, inflammation, and glucose metabolism. As such, pain management requires a comprehensive and interdisciplinary approach that includes nutrition. Nutrition is the top modifiable lifestyle factor for chronic non-communicable diseases including chronic pain. Optimizing one's dietary intake and behavior needs to be considered in pain management. Thus, this narrative review reports and summarizes the existing evidence regarding (1) the nutrition-related health of people experiencing pain (2) the underlying potential mechanisms that explain the interaction between nutrition and chronic pain, and (3) the role of nutrition screening, assessment and evaluation for people experiencing pain and the scope of nutrition practice in pain management. Future directions in the nutrition and chronic pain field are also discussed.
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Affiliation(s)
- Ömer Elma
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia
| | - Huan-Ji Dong
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 85 Linköping, Sweden
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Whatnall M, Clarke ED, Adam MTP, Ashton LM, Burrows T, Hutchesson M, Collins CE. Diet Quality of Adolescents and Adults Who Completed the Australian Healthy Eating Quiz: An Analysis of Data over Six Years (2016-2022). Nutrients 2022; 14:nu14194072. [PMID: 36235723 PMCID: PMC9570644 DOI: 10.3390/nu14194072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Diet quality is influenced by demographics and can change over time. This study aimed to (1) compare diet quality among adolescents/adults who completed the online Healthy Eating Quiz (HEQ) by demographic characteristics, and (2) to evaluate change in score over time for repeat completers. HEQ data collected between July 2016 and May 2022 were analysed, including demographics (age, gender, vegetarian status, socio-economic status, number of people main meals are shared with, country), and diet quality calculated using the Australian Recommended Food Score (ARFS) (range 0−73) for respondents aged ≥ 16 years. Differences in ARFS by demographic characteristics and change in score over time, adjusted for age, gender and vegetarian status, were tested by linear regression. The participants (n = 176,075) were predominantly female (70.4%), Australian (62.8%), and aged 18−24 years (27.7%), with 4.0% (n = 7087) repeat completers. Mean ± SD ARFS was 33.9 ± 9.4/73. Results indicate that ARFS was significantly lower among males and significantly higher with increasing age group, higher socio-economic status, in vegetarians, those who shared main meals with others, and those living in Australia (p-values < 0.001). Mean change in ARFS over time (2.3 ± 6.9) was significantly higher for those with lower baseline scores (p < 0.001). Publicly available, brief dietary assessment tools have the potential to improve diet quality at the population level.
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Affiliation(s)
- Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Erin D. Clarke
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Marc T. P. Adam
- School of Information and Physical Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
| | - Lee M. Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Melinda Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, Newcastle, NSW 2305, Australia
- Correspondence:
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Tang JS, Haslam RL, Ashton LM, Fenton S, Collins CE. Gender differences in social desirability and approval biases, and associations with diet quality in young adults. Appetite 2022; 175:106035. [PMID: 35405222 DOI: 10.1016/j.appet.2022.106035] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 01/05/2023]
Abstract
Social desirability and approval biases can influence self-report of diet, contributing to inaccurate assessment. Biases may be influenced by sex. This study examined gender differences in social desirability and approval, and diet quality in young adults, and relationships between social biases and diet quality. Data from 1003 young adults participating in the Advice, Ideas and Motivation for My Eating trial, median age 21.7 years, BMI 24.7 kg/m2 were included. Biases were measured using Marlowe-Crowne Social Desirability Scale Short-Form, Martin Larsen Approval Motivation Scale, and diet quality using the Australian Recommended Food Score. Pearson chi-square, t-test and Wilcoxon tests evaluated gender differences and Spearman's rank-order tested strengths of correlations between biases and diet quality. Social desirability did not differ by gender, however females reported higher social approval scores than males (p = 0.009). Among females, there was a positive correlation between social desirability and diet quality (p = 0.002), and between social approval and dairy sub-scale (p < 0.001); and a negative correlation between social approval and vegetable subscale (p = 0.045). Among males there were no correlations between social desirability or social approval and overall diet quality. Social approval may be more common in females and influence self-reported diet. To address bias and mis-reporting errors, future studies should account for participants' social desirability and/or social approval status, especially among young adult females. Further research is needed to explore gender differences in social desirability and approval in young adults, and associations between social biases and diet quality.
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Affiliation(s)
- Jei Sey Tang
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Rebecca L Haslam
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Lee M Ashton
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia; College of Human and Social Futures, School of Education, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Sasha Fenton
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - Clare E Collins
- College of Health, Medicine and Wellbeing, School of Health Sciences, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
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21
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Reay WR, Haslam R, Cairns MJ, Moschonis G, Clarke E, Attia J, Collins CE. Variation in cardiovascular disease risk factors among older adults in the Hunter Community Study cohort; a comparison of diet quality versus polygenic risk score. J Hum Nutr Diet 2022; 35:675-688. [PMID: 35560851 PMCID: PMC9542949 DOI: 10.1111/jhn.13031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/16/2022] [Indexed: 11/29/2022]
Abstract
Background The interplay between cardiovascular disease (CVD) genetic risk indexed by a polygenic risk score (PRS) and diet quality still requires further investigation amongst older adults or those with established or treated CVD. The present study aimed to evaluate the relative contribution of diet quality, measured using the Australian Recommended Food Score (ARFS) and PRS, with respect to explaining variation in plasma lipids CVD outcomes in the Hunter Cohort. Methods The study comprised a secondary analysis of cross‐sectional data from the Hunter Cohort study. Single‐nucleotide polymorphisms from previously derived polygenic scores (PGSs) for three lipid classes were obtained: low‐density lipoprotein, high‐density lipoprotein and triglycerides, as well as PRS for coronary artery disease (CAD) from the PGS catalogue. Regression modelling and odds ratios were used to determine associations between PRS, ARFS and CVD risk. Results In total, 1703 participants were included: mean ± SD age 66 ± 7.4 years, 51% female, mean ± SD total ARFS 28.1 ± 8 (out of 74). Total diet quality and vegetable subscale were not significantly associated with measured lipids. By contrast, PGS for each lipid demonstrated a markedly strong, statistically significant correlation with its respective measured lipid. There was a significant association between CAD PRS and 5/6 CVD phenotypes (all except atrial fibrillation), with the largest effect size shown with coronary bypass. Adding dietary intake as a covariate did not change this relationship. Conclusions Lipid PGS explained more variance in measured lipids than diet quality. However, the poor diet quality observed in the current cohort may have limited the ability to observe any beneficial effects. Future research should investigate whether the diet quality of older adults can be improved and also the effect of these improvements on changes in polygenic risk. The Australian Recommended Food Score (ARFS) had little association with lipid and cardiovascular disease (CVD) endpoints. Lipid polygenic score (PGS) explained more variance in measured lipids than diet quality. The lipid PGS was associated with all three lipid parameters and some CVD endpoints, especially high cholesterol. Coronary artery disease polygenic risk score was associated with CVD endpoints angina, coronary bypass, heart attack, high cholesterol and hypertension and some lipid parameters (high‐density lipoprotein cholesterol).
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Affiliation(s)
- William R Reay
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Rebecca Haslam
- Hunter Medical Research Institute, New Lambton, NSW, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle Callaghan, NSW, Australia
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - George Moschonis
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Erin Clarke
- Hunter Medical Research Institute, New Lambton, NSW, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle Callaghan, NSW, Australia
| | - John Attia
- Hunter Medical Research Institute, New Lambton, NSW, Australia.,School of Population Health and Medical Practice, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Clare Elizabeth Collins
- Hunter Medical Research Institute, New Lambton, NSW, Australia.,School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle Callaghan, NSW, Australia
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Post D, van Agteren J, Kasai D, Barrett A, Doyle M, Kernot J, Baker A, Parfitt G. Caring for carers: Understanding the physical and psychological well-being of carers of veterans in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e793-e803. [PMID: 34046983 DOI: 10.1111/hsc.13449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 04/07/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
Carers of veterans tend to put their own physical and psychological well-being needs behind the needs of the person they are caring for and often do not seek assistance for their own physical and psychological well-being. Combined, these factors lead to increased risk of acute and chronic illness and mental health issues. It is acknowledged that physical activity independently contributes to improved physical and mental health and may be a driver for mental well-being in carers. The aim of this pilot research was to understand how movement behaviour and health behaviours of carers of veterans in Australia relate to carers' physical and psychological well-being. Assessment occurred between February and July 2019 and included objective, validated measures to examine physical and psychological well-being. To assess the association between physical and psychological factors, correlational analyses were performed. Twenty-eight carers participated in the pilot study (96% female, mean age 61.6 years). Exercise capacity varied, and 84% of carers met the recommended 150 min of physical activity per week, with carers spending 8.6% of their time in moderate-to-vigorous physical activity; and 37.9% of the day sedentary. Psychological health outcomes reflect a population with high distress levels and lower than average mental well-being, but with normal resilience scores. Carers with higher levels of resilience had greater exercise capacity, covering further distance in the 6-min walk test, and as resilience increased, number of sedentary bouts decreased. This research demonstrates that there is a relationship between health behaviours and psychological well-being in carers of veterans and serving personnel. Based on the findings of this pilot study, programmes to support family carers should include information about physical activity, reducing sedentary time, and increasing resilience. Interventions designed to improve physical and psychological well-being should be trialled and evaluated for effectiveness.
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Affiliation(s)
- Dannielle Post
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Joep van Agteren
- South Australian Health and Medical Research Institute (SAHMRI) Wellbeing and Resilience Centre, Adelaide, SA, Australia
| | - Daiki Kasai
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Alison Barrett
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Matthew Doyle
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Jocelyn Kernot
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Amy Baker
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Gaynor Parfitt
- Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition, and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
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23
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Characterizing the Health of Older Rural Australians Attending Rural Events: Implications for Future Health Promotion Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053011. [PMID: 35270704 PMCID: PMC8910001 DOI: 10.3390/ijerph19053011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 02/04/2023]
Abstract
This paper describes the health of older Australians (>65 years) attending rural events to inform health promotion interventions for rural populations. This cross-sectional study collected survey data and objective health measures between 2017 and 2020 at two events held in rural New South Wales, Australia. Participants included in the analysis were adults > 65 years of age. Data included demographic and health information, anthropometric measures (height, weight, waist circumference), and dietary and physical activity data. A total of 256 people > 65 years participated. Our sample, which was mostly male (59.0%), contained people aged between 66 and 75 years (72.3%). Participants lived in either a large rural (34.0%) or small rural town (22.3%), with low levels of education (60.9% did not complete high school). Dietary quality was rated as below average. All but 17.2% of the participants reported having a health condition. The risk of a health condition was associated with increasing age, lower education, and higher waist circumference, but not remoteness. Rural events may provide an opportunity to access, engage with, and understand the health of older rural Australians, especially males. They may offer ideal contexts for health and nutrition promotion opportunities in rural areas where access to health professionals is limited.
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A Comparison of Diet Quality in a Sample of Rural and Urban Australian Adults. Nutrients 2021; 13:nu13114130. [PMID: 34836385 PMCID: PMC8624345 DOI: 10.3390/nu13114130] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 01/22/2023] Open
Abstract
The diet quality of rural Australians is under researched. Characterising disparities in diet quality between rural and urban populations may inform targeted interventions in at- risk groups. A cross-sectional study aimed to determine the relationship between diet quality, rurality and sociodemographic characteristics in a sample of Australian adults. Participants were recruited at rural and regional events between 2017 and 2020, in New South Wales, Australia. Diet quality was measured using the Healthy Eating Quiz or Australian Eating Survey to generate an Australian Recommended Food Score (ARFS). ARFS was compared by rurality and sociodemographic characteristics using multivariate regression. Participants (n = 247; 53% female) had a mean ± SD ARFS of 34.5 ± 9.0. There was no significant effect of rurality on ARFS (β-coefficient = −0.4; 95%CI −3.0, 2.3). Compared to participants aged 18–30 years, higher ARFS was evident for those aged 31–50 (β = 5.4; 95%CI 0.3, 10.4), 51–70 (β = 4.4; 95%CI 0.3, 8.5) and >71 years (β = 6.5; 95% CI 1.6–11.4). Compared to those living alone, participants living with a partner (β = 5.2; 95%CI 2.0, 8.4) and families with children (β = 5.6; 95%CI 1.4, 9.8) had significantly higher ARFS. ARFS was significantly lower with each additional self-reported chronic health condition (β = −1.4; 95%CI −2.3, −0.4). Our results indicate that diet quality as defined by the ARFS was classified as ‘getting there’ and that age, living arrangements and chronic health conditions, but not rurality, influenced diet quality in a sample of Australian adults.
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Nutrition literacy is associated with income and place of residence but not with diet behavior and food security in the Palestinian society. BMC Nutr 2021; 7:78. [PMID: 34789324 PMCID: PMC8600769 DOI: 10.1186/s40795-021-00479-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Palestinian society is going through health transition that is associated with increase in chronic diseases due to poor dietary habits so adequate integration of nutrition information is important. AIMS The aim of this study is to find the association between nutrition literacy and diet behavior among a group of Palestinian participants. METHODS A sample of 101 Palestinian participants were recruited to participate in the study. An online survey was used to collect study data. Newest Vital Sign quiz was used to collect information on nutrition literacy and Short Format of the Diet Health and Knowledge Survey (SFDHKS) was used to collect information on diet behavior and USDA food security questionnaire was used to collect data on food security. Data was analyzed utilizing SPSS 21. RESULTS This study included 101 participants, mean age 22.7 y ± 8.7 y, mainly females (females were 83.2% and males were 16.8%). 5.7% of the study participants were obese, 13.8% overweight and 10.3% were underweight. The prevalence of adequate nutrition literacy was 29%. There was minimal association between diet behavior and nutrition literacy, food security and BMI categories, but significant association with income and living in city relative to village (p < 0.05). Only 11 participants had some form of food insecurity. CONCLUSION There is low prevalence of adequate nutrition literacy. Nutrition literacy depends on social and economic aspects but further research is need to understand its relationship to diet behavior.
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Brain K, Burrows TL, Bruggink L, Malfliet A, Hayes C, Hodson FJ, Collins CE. Diet and Chronic Non-Cancer Pain: The State of the Art and Future Directions. J Clin Med 2021; 10:5203. [PMID: 34768723 PMCID: PMC8584994 DOI: 10.3390/jcm10215203] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/27/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022] Open
Abstract
Nutrition plays an important role in pain management. Healthy eating patterns are associated with reduced systemic inflammation, as well as lower risk and severity of chronic non-cancer pain and associated comorbidities. The role of nutrition in chronic non-cancer pain management is an emerging field with increasing interest from clinicians and patients. Evidence from a number of recent systematic reviews shows that optimising diet quality and incorporating foods containing anti-inflammatory nutrients such as fruits, vegetables, long chain and monounsaturated fats, antioxidants, and fibre leads to reduction in pain severity and interference. This review describes the current state of the art and highlights why nutrition is critical within a person-centred approach to pain management. Recommendations are made to guide clinicians and highlight areas for future research.
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Affiliation(s)
- Katherine Brain
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Tracy L. Burrows
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Laura Bruggink
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Anneleen Malfliet
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
- Pain in Motion International Research Group, 1000 Brussels, Belgium
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Chris Hayes
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Fiona J. Hodson
- Hunter Integrated Pain Service, Newcastle, NSW 2300, Australia; (L.B.); (C.H.); (F.J.H.)
| | - Clare E. Collins
- School of Health Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia; (K.B.); (T.L.B.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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27
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Kaur K, Sculley D, Veysey M, Lucock M, Wallace J, Beckett EL. Bitter and sweet taste perception: relationships to self-reported oral hygiene habits and oral health status in a survey of Australian adults. BMC Oral Health 2021; 21:553. [PMID: 34715836 PMCID: PMC8555166 DOI: 10.1186/s12903-021-01910-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022] Open
Abstract
Background Oral health, an essential part of general health and well-being, is influenced by multiple factors, including oral hygiene habits and dietary factors. Dietary preferences are influenced by variation in taste perceptions and threshold tasting. Polymorphisms in specific genes for sweet and bitter taste receptors and bitter taste perception have been associated with dental caries. However, taste is complex with multiple receptors, each with multiple potential polymorphisms contributing to taste perception as well as social, cultural, and environmental influences. Additionally, these association studies have been conducted in restricted cohorts (e.g., children only). Furthermore, outcomes have been limited to dental caries and studies between taste perception and oral hygiene habits have not been completed. Methods A cross-sectional online survey was conducted to investigate the relationships between bitter and sweet taste perception (liking and intensity of index food items), self-reported oral hygiene habits and oral health (n = 518). Results Higher mean intensity scores for bitter (16–21%) and sweet (< 5%-60%) were seen with higher frequencies of oral hygiene habits (brushing, use of mouthwash, chewing gum and tongue cleaning). Lower mean bitter liking scores (18–21%) were seen with higher frequencies of oral hygiene habits (brushing, mouthwash use, floss use and chewing gum). Sweet liking scores varied by reported frequency of mouthwash use and flossing only, with mixed patterns of variance. Mean bitter and sweet intensity perception scores varied with the number of dental caries ((13–20% higher in those with 3 or more caries, compared to none). Conclusions While there were numerous relationships identified between liking and perception of sweet and bitter and oral health outcomes, the magnitude and direction of associations varied by outcome. The direction of the associations cannot be inferred due to the cross-sectional nature of the study. The demonstrated relationships justify further future investigations, which could help better understand if taste liking and perception is impacted by oral hygiene and health, or vice versa. This could be important in understanding the causation and progression of oral health diseases or the development of novel therapeutics for oral health. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01910-8.
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Affiliation(s)
- Kiranjit Kaur
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia
| | - Dean Sculley
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Ourimbah, NSW, Australia
| | - Martin Veysey
- School of Medicine and Public Health, The University of Newcastle, Ourimbah, NSW, Australia
| | - Mark Lucock
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia
| | - Janet Wallace
- School of Health Sciences, The University of Newcastle, Ourimbah, NSW, Australia
| | - Emma L Beckett
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia. .,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia. .,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Ourimbah, NSW, Australia.
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Barriers and Facilitators to the Uptake of Online and Telephone Services Targeting Health Risk Behaviours among Vocational Education Students: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179336. [PMID: 34501922 PMCID: PMC8430979 DOI: 10.3390/ijerph18179336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022]
Abstract
Uptake of online and telephone services targeting health behaviours is low among vocational education students and barriers and facilitators are unknown. This study aimed to explore barriers and facilitators to uptake of online and telephone services for smoking, nutrition, alcohol, and physical activity (SNAP) risk behaviours via semi-structured individual telephone interviews with fifteen vocational education students. Two authors independently completed thematic analysis, classified themes according to the COM-B (Capability, Opportunity, Motivation, Behaviour) framework, and discussed disagreements until consensus was reached. Facilitators to uptake of online (e.g., desire to learn something new, cost-free, accessible) and telephone services (e.g., prefer to talk to provider, complements online support) primarily related to capability and opportunity. For telephone services, difficulty understanding accent/language was a capability-related barrier. Opportunity-related barriers for online and telephone services were preference for face-to-face interaction and lack of time, while preference for apps/online programs was a barrier for telephone services. For online and telephone services, not wanting to change SNAP behaviours was a motivation-related barrier and being able to change SNAP risk behaviours themselves was a motivation-related barrier for online services. Barriers and facilitators to online and telephone services are relevant for designing interventions vocational education students are more likely to use.
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Fenton S, Burrows TL, Collins CE, Rayward AT, Murawski B, Duncan MJ. Efficacy of a Multi-Component m-Health Diet, Physical Activity, and Sleep Intervention on Dietary Intake in Adults with Overweight and Obesity: A Randomised Controlled Trial. Nutrients 2021; 13:nu13072468. [PMID: 34371975 PMCID: PMC8308779 DOI: 10.3390/nu13072468] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 12/14/2022] Open
Abstract
This three-arm randomised controlled trial evaluated whether (1) a multi-component weight loss intervention targeting diet, physical activity (PA), and sleep was effective at improving dietary intake over six months and 12 months, compared with a control, and (2) the enhanced diet, PA, and sleep intervention was more effective at improving dietary intake than the traditional diet and PA intervention. A total of 116 adults (70% female, 44.5 years, BMI 31.7 kg/m2) were randomised to either traditional diet and PA intervention; enhanced diet, PA, and sleep intervention; or wait-list control. To examine between-group differences, intervention groups were pooled and compared with the control. Then, the two intervention groups were compared. At six months, the pooled intervention group consumed 1011 fewer kilojoules/day (95% CI −1922, −101), less sodium (−313.2 mg/day; 95% CI −591.3, −35.0), and higher %EI from fruit (+2.1%EI; 95% CI 0.1, 4.1) than the controls. There were no differences in intake between the enhanced and traditional groups at six months. At 12 months, the pooled intervention and control groups reported no significant differences. However, compared to the traditional group, the enhanced reported higher %EI from nutrient-dense foods (+7.4%EI; 95% CI 1.3, 13.5) and protein (+2.4%EI; 95% CI 0.1, 4.6), and reduced %EI from fried/takeaway foods (−3.6%EI; 95% CI −6.5, −0.7), baked sweet products (−2.0%EI; 95% CI −3.6, −0.4), and packaged snacks (−1.1%EI; 95% CI −2.2, −0.3). This weight loss intervention reduced total energy and sodium intakes as well as increased fruit intake in adults at six months. The enhanced intervention group reported improved dietary intake relative to the traditional group at 12 months.
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Affiliation(s)
- Sasha Fenton
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Tracy L. Burrows
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Clare E. Collins
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Anna T. Rayward
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Education, College of Human and Social Futures, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Beatrice Murawski
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Mitch J. Duncan
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (T.L.B.); (C.E.C.); (A.T.R.); (B.M.)
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- Correspondence:
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Amadieu C, Leclercq S, Coste V, Thijssen V, Neyrinck AM, Bindels LB, Cani PD, Piessevaux H, Stärkel P, de Timary P, Delzenne NM. Dietary fiber deficiency as a component of malnutrition associated with psychological alterations in alcohol use disorder. Clin Nutr 2021; 40:2673-2682. [PMID: 33933733 DOI: 10.1016/j.clnu.2021.03.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/03/2021] [Accepted: 03/17/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Chronic alcohol consumption can cause malnutrition that may contribute to alcohol-induced organ injury and psychological disorders. We evaluated the link between nutrient intake, especially dietary fibers (DF) and different parameters reflecting mental health and well being, namely anxiety, depression, alcohol craving, sociability, fatigue and intestinal comfort in alcohol use disorder (AUD) patients. METHODS Cross-sectional data from 50 AUD patients, hospitalized for a 3-week detoxification program were used. Three 24-h recalls allowed to calculate dietary habits and nutrient intakes, that was also assessed in healthy subjects (HS). Diet quality was measured using the NOVA score. Psychological factors and intestinal discomfort were evaluated using validated self-administered questionnaires. RESULTS Energy intake (excluding alcoholic beverage), total fat, monounsaturated and polyunsaturated fatty acids, protein and DF intakes were lower in AUD subjects compared to HS. Ninety percent of patients had a DF intake below the recommendation. AUD patients consumed more than twice as much ultra-processed food than HS. Fructan intake was negatively associated with anxiety (p = 0.04) adjusted for main confounders. Total DF, insoluble, soluble DF and galacto-oligosaccharide intakes were associated with higher sociability score. Soluble DF intake was associated with better satisfaction of bowel function (p = 0.02) and a lower intestinal discomfort (p = 0.04). CONCLUSIONS This study reveals that insufficient DF intake is part of AUD-related malnutrition syndrome, and is associated with higher anxiety, lower sociability score and intestinal discomfort. Our results suggest that an adequate intake of DF might be beneficial for recovery from AUD. TRIAL REGISTRATION NCT03803709, https://clinicaltrials.gov/ct2/show/NCT03803709.
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Affiliation(s)
- Camille Amadieu
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, UCLouvain, Brussels, Belgium; Institute of Neuroscience, Université catholique de Louvain, UCLouvain, Brussels, Belgium
| | - Sophie Leclercq
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, UCLouvain, Brussels, Belgium; Institute of Neuroscience, Université catholique de Louvain, UCLouvain, Brussels, Belgium
| | - Valentin Coste
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, UCLouvain, Brussels, Belgium
| | - Victoria Thijssen
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, UCLouvain, Brussels, Belgium
| | - Audrey M Neyrinck
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, UCLouvain, Brussels, Belgium
| | - Laure B Bindels
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, UCLouvain, Brussels, Belgium
| | - Patrice D Cani
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, UCLouvain, Brussels, Belgium; WELBIO- Walloon Excellence in Life Sciences and BIOtechnology, UCLouvain, Brussels, Belgium
| | - Hubert Piessevaux
- Institute of Experimental and Clinical Research, Laboratory of Hepato-Gastroenterology, Université catholique de Louvain, UCLouvain, Belgium; Department of Hepato-Gastroenterology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Peter Stärkel
- Institute of Experimental and Clinical Research, Laboratory of Hepato-Gastroenterology, Université catholique de Louvain, UCLouvain, Belgium; Department of Hepato-Gastroenterology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Philippe de Timary
- Institute of Neuroscience, Université catholique de Louvain, UCLouvain, Brussels, Belgium; Department of Adult Psychiatry, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Nathalie M Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, UCLouvain, Brussels, Belgium.
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Ashton LM, Rollo ME, Adam M, Burrows T, Shrewsbury VA, Collins CE. Process Evaluation of the 'No Money No Time' Healthy Eating Website Promoted Using Social Marketing Principles. A Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073589. [PMID: 33808432 PMCID: PMC8038032 DOI: 10.3390/ijerph18073589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
Background: Reaching and engaging individuals, especially young adults, in web-based prevention programs is challenging. ‘No Money No Time’ (NMNT) is a purpose built, healthy eating website with content and a social marketing strategy designed to reach and engage a young adult (18–34 year olds) target group. The aim of the current study was to conduct a process evaluation of the 12-month social marketing strategy to acquire and engage NMNT users, particularly young adults. Methods: a process evaluation framework for complex interventions was applied to investigate the implementation of the social marketing strategy component, mechanisms of impact and contextual factors. Google Analytics data for the first 12 months of operation (17 July 2019 to 17 July 2020) was evaluated. Results: in year one, 42,413 users from 150+ countries accessed NMNT, with 47.6% aged 18–34 years. The most successful channel for acquiring total users, young adults and return users was via organic search, demonstrating success of our marketing strategies that included a Search Engine Optimisation audit, a content strategy, a backlink strategy and regular promotional activities. For engagement, there was a mean of 4.46 pages viewed per session and mean session duration of 3 min, 35 s. Users clicked a ‘call-to-action’ button to commence the embedded diet quality tool in 25.1% of sessions. The most common device used to access NMNT (63.9%) was smartphone/mobile. Engagement with ‘quick, cheap and healthy recipes’ had the highest page views. Conclusions: findings can inform online nutrition programs, particularly for young adults, and can apply to other digital health programs.
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Affiliation(s)
- Lee M. Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
- School of Education, College of Human and Social Futures, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia
- Correspondence: ; Tel.: +61-(2)-4913-8034
| | - Megan E. Rollo
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Marc Adam
- School of Electrical Engineering and Computing, College of Engineering, Science and Environment, University of Newcastle, Callaghan, 2308 Newcastle, Australia;
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Vanessa A. Shrewsbury
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
| | - Clare E. Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, 2308 Newcastle, Australia; (M.E.R.); (T.B.); (V.A.S.); (C.E.C.)
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Lower Vegetable Variety and Worsening Diet Quality Over Time Are Associated With Higher 15-Year Health Care Claims and Costs Among Australian Women. J Acad Nutr Diet 2021; 121:655-668. [PMID: 33487591 DOI: 10.1016/j.jand.2020.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 11/30/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The relationship between diet quality and health care costs is unclear. OBJECTIVE The aim of this study was to investigate the relationship between baseline diet quality and change in diet quality over time, with 15-year cumulative health care claims/costs. DESIGN Data from a longitudinal cohort study were analyzed. PARTICIPANTS/SETTING Data for survey 3 (2001) (n = 7,868) and survey 7 (2013) (n = 6,349 both time points) from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health were analyzed. MAIN OUTCOME MEASURES Diet quality was assessed using the Australian Recommended Food Score (ARFS). Fifteen-year cumulative Medicare Benefits Schedule (Australia's universal health care coverage) data were reported by baseline ARFS quintile and category of diet quality change ("diet quality worsened" [ARFS change ≤ -4 points], "remained stable" [-3 ≤ change in ARFS ≤3 points], or "improved" [ARFS change ≥4 points]). STATISTICAL ANALYSES Linear regression analyses were conducted adjusting for area of residence, socioeconomic status, lifestyle factors, and private health insurance status. RESULTS Consuming a greater variety of vegetables at baseline but fewer fruit and dairy products was associated with lower health care costs. For every 1-point increment in the ARFS vegetable subscale, women made 3.3 (95% CI, 1.6-5.0) fewer claims and incurred AU$227 (95% CI, AU$104-350 [US$158; 95% CI, US$72-243]) less in costs. Women whose diet quality worsened over time made more claims (median, 251 claims; quintile 1, quintile 3 [Q1; Q3], 168; 368 claims) and incurred higher costs (AU$15,519; Q1; Q3, AU$9,226; AU$24,847 [US$10,793; Q1; Q3, US$6,417; US$17,281]) compared with those whose diet quality remained stable (median, 236 claims [Q1; Q3, 158; 346 claims], AU$14,515; Q1; Q3, AU$8,539; AU$23,378 [US$10,095; Q1; Q3, US$5,939; US$16,259]). CONCLUSIONS Greater vegetable variety was associated with fewer health care claims and costs; however, this trend was not consistent across other subscales. Worsening diet quality over 12 years was linked with higher health care claims and costs.
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Atorkey P, Paul C, Bonevski B, Wiggers J, Mitchell A, Byrnes E, Lecathelinais C, Tzelepis F. Uptake of Proactively Offered Online and Telephone Support Services Targeting Multiple Health Risk Behaviors Among Vocational Education Students: Process Evaluation of a Cluster Randomized Controlled Trial. J Med Internet Res 2021; 23:e19737. [PMID: 33404504 PMCID: PMC7817359 DOI: 10.2196/19737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/22/2020] [Accepted: 11/11/2020] [Indexed: 01/21/2023] Open
Abstract
Background A high proportion of vocational education students smoke tobacco, have inadequate nutrition (ie, low fruit and vegetable intake), drink alcohol at risky levels, or are physically inactive. The extent to which vocational education students will sign up for proactively offered online and telephone support services for multiple health risk behaviors is unknown. Objective The aim of this study is to examine the uptake of proactively offered online and telephone support services for smoking, nutrition, alcohol consumption, and physical activity risk behaviors, individually and in combination, among vocational education students in the Technical and Further Education (TAFE) setting. The characteristics associated with the uptake of online or telephone services for smoking, nutrition, alcohol consumption, and physical activity risk behaviors were also examined. Methods Vocational education students enrolled in a TAFE class in New South Wales, Australia, which ran for 6 months or more, were recruited to participate in a cluster randomized controlled trial from May 2018 to May 2019. In the intervention arm, participants who did not meet the Australian health guidelines for each of the smoking, nutrition, alcohol consumption, and physical activity risk behaviors were provided electronic feedback and proactively offered online and telephone support services. Uptake of support was measured by whether participants signed up for the online and telephone services they were offered. Results Vocational education students (N=551; mean age 25.7 years, SD 11.1; 310/551, 56.3% male) were recruited into the intervention arm. Uptake of the proactive offer of either online or telephone services was 14.5% (59/406) for fruit and vegetables, 12.7% (29/228) for physical activity, 6.8% (13/191) for smoking, and 5.5% (18/327) for alcohol use. Uptake of any online or telephone service for at least two health behaviors was 5.8% (22/377). Participants who were employed (odds ratio [OR] 0.10, 95% CI 0.01-0.72) and reported not being anxious (OR 0.11, 95% CI 0.02-0.71) had smaller odds of signing up for online or telephone services for smoking, whereas participants who reported not being depressed had greater odds (OR 10.25, 95% CI 1.30-80.67). Participants who intended to change their physical activity in the next 30 days had greater odds (OR 4.01, 95% CI 1.33-12.07) of signing up for online or telephone services for physical activity. Employed participants had smaller odds (OR 0.18, 95% CI 0.06-0.56) of signing up for support services for at least two behaviors. Conclusions Although the uptake of proactively offered online and telephone support services is low, these rates appear to be higher than the self-initiated use of some of these services in the general population. Scaling up the proactive offer of online and telephone services may produce beneficial health outcomes. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12618000723280; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375001.
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Affiliation(s)
- Prince Atorkey
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Christine Paul
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - John Wiggers
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Aimee Mitchell
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Emma Byrnes
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Christophe Lecathelinais
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Hendrie GA, Lyle G, Mauch CE, Haddad J, Golley RK. Understanding the Variation within a Dietary Guideline Index Score to Identify the Priority Food Group Targets for Improving Diet Quality across Population Subgroups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E378. [PMID: 33418998 PMCID: PMC7825319 DOI: 10.3390/ijerph18020378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 11/18/2022]
Abstract
Globally, population dietary intakes fall below the guideline recommendations and large-scale interventions have had modest success in improving diet quality. To inform the development of more targeted approaches, this study analysed the variations in self-reported data from an online survey of Australian adults collected between 2015 and 2020, to identify common combinations of low scoring components within a dietary guideline index. A low score was defined as meeting less than half the guideline recommendations (a score <50 out of 100). Among 230,575 adults, a single component analysis showed that 79.5% had a low score for discretionary choices, 72.2% for healthy fats and 70.8% for dairy. The combinations approach showed 83.0% of individuals had two to five low scoring components, with men, younger adults aged 18-30 years and individuals with obesity (BMI ≥ 30) more likely to have five or more. The most common dietary pattern combination included low scores for discretionary choices, dairy and healthy fats. There was a considerable but systematic variation in the low scoring components within the dietary patterns, suggesting that interventions with the flexibility to address particular combinations of key food groups across subgroups could be an effective and resource efficient way to improve diet quality in the population.
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Affiliation(s)
- Gilly A. Hendrie
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
| | - Greg Lyle
- School of Public Health, Curtin University, Bentley Campus, Perth, WA 6102, Australia;
| | - Chelsea E. Mauch
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
| | - Joyce Haddad
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia;
| | - Rebecca K. Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia;
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Diet Quality of Elite Australian Athletes Evaluated Using the Athlete Diet Index. Nutrients 2020; 13:nu13010126. [PMID: 33396371 PMCID: PMC7823332 DOI: 10.3390/nu13010126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/23/2020] [Accepted: 12/28/2020] [Indexed: 11/22/2022] Open
Abstract
While athletes’ nutrient intakes have been widely reported, few studies have assessed the diet quality of athletes. This is the first study to evaluate the diet quality of athletes using the purpose-built Athlete Diet Index (ADI). A convenience sample of 165 elite athletes from Australian sporting institutions completed the ADI online, with subsequent automated results provided to their respective accredited sports dietitians (ASDs). At the completion of athlete participation, ASDs (n = 12) responded to a range of survey items using a Likert scale (i.e., 1 = strongly agree to 5 = strongly disagree) to determine the suitability of the ADI in practice. Differences in ADI scores for demographics and sport-specific variables were investigated using independent t-tests, analysis of variance (ANOVA) and Bonferroni multiple comparisons. Spearman’s rank correlation was used to assess the association between total scores and demographics. The mean total ADI score was 91.4 ± 12.2 (range 53–117, out of a possible 125). While there was no difference in total scores based on demographics or sport-specific variables; team sport athletes scored higher than individual sport athletes (92.7 vs. 88.5, p < 0.05). Athletes training fewer hours (i.e., 0–11 h/week) scored higher on Dietary Habits sub-scores compared with athletes training more hours (≥12 h/week; p < 0.05), suggesting that athletes who train longer may be at risk of a compromised dietary pattern or less than optimal nutrition practices that support training. Most (75%) ASDs surveyed strongly agreed with the perceived utility of the ADI for screening athletes and identifying areas for nutrition support, confirming its suitability for use in practice.
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Diet Quality Indices Used in Australian and New Zealand Adults: A Systematic Review and Critical Appraisal. Nutrients 2020; 12:nu12123777. [PMID: 33317123 PMCID: PMC7763901 DOI: 10.3390/nu12123777] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 12/24/2022] Open
Abstract
Distilling the complexity of overall diet into a simple measure or summative score by data reduction methods has become a common practice in nutritional epidemiology. Recent reviews on diet quality indices (DQI) have highlighted the importance of sound construction criteria and validation. The aim of this current review was to identify and critically appraise all DQI used within Australian and New Zealand adult populations. Twenty-five existing DQI were identified by electronic searching in Medline and hand searching of reference lists. DQI were constructed based on the respective national dietary guidelines and condition-specific recommendations. For preferable features of DQI, six captured the dimensions of adequacy, moderation and balance; five had a nested structure; 12 consisted of foods, food groups and nutrients; 11 used metric scoring systems and most of those with metric scales used normative cutoff points. Food frequency questionnaires, either alone or with other methods, were the most common dietary assessment method used in 20 DQI. For evaluation of DQI, construct validity and relative validity are reported. Based on our critical appraisal, Dietary Guideline Index (DGI), Dietary Guideline Index-2013 (DGI-2013), Total Diet Score (TDS), Healthy Eating Index for Australian Adults-2013 (HEIFA-2013), and Aussie-Diet Quality Index (Aussie-DQI) were the preferred DQI used in Australian adults according to dimension, indicator selection, scoring criteria and evaluation. Further work is needed to enhance the construction of all Australian and New Zealand DQI, especially in terms of dimension and structure, for alignment with recommended construction criteria.
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Duncan MJ, Fenton S, Brown WJ, Collins CE, Glozier N, Kolt GS, Holliday EG, Morgan PJ, Murawski B, Plotnikoff RC, Rayward AT, Stamatakis E, Vandelanotte C, Burrows TL. Efficacy of a Multi-component m-Health Weight-loss Intervention in Overweight and Obese Adults: A Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6200. [PMID: 32859100 PMCID: PMC7503928 DOI: 10.3390/ijerph17176200] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND This study compared the efficacy of two multi-component m-health interventions with a wait-list control group on body weight (primary outcome), and secondary outcomes of cardiovascular risk factors, lifestyle behaviours, and mental health. METHODS Three-arm randomised controlled trial (Enhanced: physical activity, diet, sleep, Traditional: physical activity, diet, Control) with assessments conducted at baseline, 6 and 12 months. Participants (n = 116) were overweight or obese adults aged 19-65 (M = 44.5 [SD = 10.5]). The 6-month intervention was delivered via a smartphone app providing educational materials, goal-setting, self-monitoring and feedback, and also included one face-to-face dietary consultation, a Fitbit and scales. The trial was prospectively registered and conducted between May 2017 and September 2018. Group differences on primary and secondary outcomes were examined between the Pooled Intervention groups (Pooled Intervention = Enhanced and Traditional) and Control groups, and then between Enhanced and Traditional groups. RESULTS Nineteen participants (16.4%) formally withdrew from the trial. Compared with the Control group, average body weight of the Pooled Intervention group did not differ at 6 (between-group difference = -0.92, (95% CI -3.33, 1.48)) or 12 months (0.00, (95% CI -2.62, 2.62)). Compared with the Control group, the Pooled Intervention group significantly increased resistance training (OR = 7.83, (95% CI 1.08, 56.63)) and reduced energy intake at 6 months (-1037.03, (-2028.84, -45.22)), and improved insomnia symptoms at 12 months (-2.59, (-4.79, -0.39)). Compared with the Traditional group, the Enhanced group had increased waist circumferences (2.69, (0.20, 5.18)) and sedentary time at 6 months (105.66, (30.83, 180.48)), and improved bed time variability at 12 months (-1.08, (-1.86, -0.29)). No other significant differences were observed between groups. CONCLUSIONS Relative to Controls, the Pooled Intervention groups did not differ on body weight but improved resistance training, and reduced energy intake and insomnia symptom severity. No additional weight loss was apparent when targeting improvements in physical activity, diet and sleep in combination compared with physical activity and diet.
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Affiliation(s)
- Mitch J. Duncan
- School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (E.G.H.); (B.M.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (C.E.C.); (P.J.M.); (R.C.P.); (A.T.R.); (T.L.B.)
| | - Sasha Fenton
- School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (E.G.H.); (B.M.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (C.E.C.); (P.J.M.); (R.C.P.); (A.T.R.); (T.L.B.)
| | - Wendy J. Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD 4067, Australia;
| | - Clare E. Collins
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (C.E.C.); (P.J.M.); (R.C.P.); (A.T.R.); (T.L.B.)
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Nicholas Glozier
- Brain and Mind Centre, Central Clinical School, The University of Sydney, 94 Mallett St, Camperdown, NSW 2050, Australia;
| | - Gregory S. Kolt
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia;
| | - Elizabeth G. Holliday
- School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (E.G.H.); (B.M.)
| | - Philip J. Morgan
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (C.E.C.); (P.J.M.); (R.C.P.); (A.T.R.); (T.L.B.)
- School of Education, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Beatrice Murawski
- School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (S.F.); (E.G.H.); (B.M.)
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (C.E.C.); (P.J.M.); (R.C.P.); (A.T.R.); (T.L.B.)
| | - Ronald C. Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (C.E.C.); (P.J.M.); (R.C.P.); (A.T.R.); (T.L.B.)
- School of Education, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Anna T. Rayward
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (C.E.C.); (P.J.M.); (R.C.P.); (A.T.R.); (T.L.B.)
- School of Education, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Faculty of Medicine and Health, School of Health Sciences, Sydney 2006, Australia;
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Science, Central Queensland University, Rockhampton, QLD 4700, Australia;
| | - Tracy L. Burrows
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (C.E.C.); (P.J.M.); (R.C.P.); (A.T.R.); (T.L.B.)
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
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Haslam RL, Pezdirc K, Truby H, Attia J, Hutchesson M, Burrows T, Callister R, Hides L, Bonevski B, Kerr DA, Lubans D, Kirkpatrick S, Rollo M, McCaffrey T, Collins CE. Investigating the Efficacy and Cost-Effectiveness of Technology-Delivered Personalized Feedback on Dietary Patterns in Young Australian Adults in the Advice, Ideas, and Motivation for My Eating (Aim4Me) Study: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e15999. [PMID: 32441659 PMCID: PMC7275255 DOI: 10.2196/15999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 01/17/2023] Open
Abstract
Background Web-based health interventions may be easier to access and time efficient relative to face-to-face interventions and therefore may be the most appropriate mode to engage young adults. Objective This study aims to investigate the impact of 3 different levels of personalized web-based dietary feedback and support on changes in diet quality. Methods The Advice, Ideas, and Motivation for My Eating (Aim4Me) study is a 12-month assessor-blinded, parallel-group randomized controlled trial evaluating the impact of 3 levels of web-based feedback on diet quality, measured using the Australian Recommended Food Score (ARFS). Participants (N=2570) will primarily be recruited via web-based methods and randomized to 1 of 3 groups. Group 1 (control) will receive the Healthy Eating Quiz, a web-based dietary assessment tool that generates a brief feedback report on diet quality. Individuals randomized to this group can use the brief feedback report to make positive dietary changes. Group 2 will receive the Australian Eating Survey, a web-based dietary assessment tool that generates a comprehensive feedback report on diet quality as well as macro- and micronutrient intake. Group 2 will use the comprehensive feedback report to assist in making positive dietary changes. They will also have access to the Aim4Me website with resources on healthy eating and tools to set goals and self-monitor progress. Group 3 will receive the same intervention as Group 2 (ie, the comprehensive feedback report) in addition to a tailored 30-min video consultation with an accredited practicing dietitian who will use the comprehensive feedback report to assist individuals in making positive dietary changes. The self-determination theory was used as the framework for selecting appropriate website features, including goal setting and self-monitoring. The primary outcome measure is change in diet quality. The completion of questionnaires at baseline and 3, 6, and 12 months will be incentivized with a monetary prize draw. Results As of December 2019, 1277 participants have been randomized. Conclusions The web-based delivery of nutrition interventions has the potential to improve dietary intake of young adults. However, the level of support required to improve intake is unknown. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12618000325202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374420 International Registered Report Identifier (IRRID) DERR1-10.2196/15999
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Affiliation(s)
- Rebecca L Haslam
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Kristine Pezdirc
- Faculty of Health and Medicine, University of Newcastle, North Sydney, Australia
| | - Helen Truby
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - John Attia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Melinda Hutchesson
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Tracy Burrows
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Billie Bonevski
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - Deborah A Kerr
- School of Public Health, Faculty of Health Sciences, Curtin Institute of Technology, Perth, Australia
| | - David Lubans
- Priority Research Centre for Physical Activity and Nutrition, School of Education, University of Newcastle, Callaghan, Australia
| | - Sharon Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Megan Rollo
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - Tracy McCaffrey
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle, Callaghan, Australia
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Parker HW, Vadiveloo MK. Diet quality of vegetarian diets compared with nonvegetarian diets: a systematic review. Nutr Rev 2020; 77:144-160. [PMID: 30624697 DOI: 10.1093/nutrit/nuy067] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective Vegetarian diets are consistently associated with improved health outcomes, and higher diet quality may contribute to improved health outcomes. This systematic review aims to qualitatively compare the a priori diet quality of vegetarian and nonvegetarian diets. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, 2 online databases (Web of Science and PubMed) were searched for English language studies comparing diet quality among vegetarian and nonvegetarian adults using an a priori diet quality index. Two reviewers assessed study eligibility. Comparisons were made between total and component (when available) diet quality scores among the 12 studies meeting inclusion criteria. Conclusions Lacto-ovo vegetarians or vegans had higher overall diet quality (4.5-16.4 points higher on the Healthy Eating Index 2010 [HEI-2010]) compared with nonvegetarians in 9 of 12 studies. Higher HEI-2010 scores for vegetarians were driven by closer adherence to recommendations for total fruit, whole grains, seafood and plant protein, and sodium. However, nonvegetarians had closer adherence to recommendations for refined grains and total protein foods. Higher diet quality in vegetarian diets may partially explain improvements in health outcomes compared with nonvegetarians; however, more research controlling for known confounders like health consciousness is needed.
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Affiliation(s)
- Haley W Parker
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, Rhode Island, USA
| | - Maya K Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, Rhode Island, USA
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Baldwin JN, Forder PM, Haslam RL, Hure AJ, Loxton DJ, Patterson AJ, Collins CE. Change in Diet Quality over 12 Years in the 1946-1951 Cohort of the Australian Longitudinal Study on Women's Health. Nutrients 2020; 12:E147. [PMID: 31947981 PMCID: PMC7019671 DOI: 10.3390/nu12010147] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/17/2019] [Accepted: 01/02/2020] [Indexed: 12/18/2022] Open
Abstract
Understanding patterns of dietary change over time can provide important information regarding population nutrition behaviours. The aims were to investigate change in diet quality over 12 years in a nationally representative sample of women born in 1946-1951 and to identify characteristics of women whose diet quality changed over time. The Australian Recommended Food Score (ARFS) was measured in 2001 (n = 10,629, mean age 52.1 years) and 2013 (n = 9115; n = 8161 for both time points) for the mid-aged cohort from the Australian Longitudinal Study on Women's Health. Participants were categorised by tertiles of baseline diet quality and also classified as 'diet quality worsened' (ARFS decrease ≤ -4 points, n = 2361), 'remained stable' (-3 ≤ change in ARFS ≤ 3 points, n = 3077) or 'improved' (ARFS increase ≥ 4 points, n = 2723). On average, ARFS total and subscale scores remained relatively stable over time (mean [SD] change 0.3 [7.6] points) with some regression to the mean. Women whose diet quality worsened were more likely to be highly physically active at baseline compared with women whose diet quality improved (p < 0.001). Among women with poor diet quality initially (lowest baseline ARFS tertile, n = 2451, mean [SD] baseline ARFS 22.8 [4.5] points), almost half (47%, n = 1148) had not improved after 12 years, with women less likely to be in the healthy weight range (41% compared to 44%) and be never smokers (56% versus 62%, p < 0.05) compared with those whose diet improved. Diet quality remained relatively stable over 12 years' follow up among mid-aged women. Almost half of those with poor baseline diet quality remained poor over time, emphasizing the need to target high-risk groups for nutrition interventions.
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Affiliation(s)
- Jennifer N. Baldwin
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (J.N.B.); (R.L.H.); (A.J.P.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Peta M. Forder
- Research Centre for Generational Health & Ageing, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (P.M.F.); (A.J.H.); (D.J.L.)
| | - Rebecca L. Haslam
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (J.N.B.); (R.L.H.); (A.J.P.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Alexis J. Hure
- Research Centre for Generational Health & Ageing, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (P.M.F.); (A.J.H.); (D.J.L.)
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Deborah J. Loxton
- Research Centre for Generational Health & Ageing, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (P.M.F.); (A.J.H.); (D.J.L.)
| | - Amanda J. Patterson
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (J.N.B.); (R.L.H.); (A.J.P.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
- Research Centre for Generational Health & Ageing, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (P.M.F.); (A.J.H.); (D.J.L.)
| | - Clare E. Collins
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia; (J.N.B.); (R.L.H.); (A.J.P.)
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW 2308, Australia
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Lavelle F, Bucher T, Dean M, Brown HM, Rollo ME, Collins CE. Diet quality is more strongly related to food skills rather than cooking skills confidence: Results from a national cross‐sectional survey. Nutr Diet 2019; 77:112-120. [DOI: 10.1111/1747-0080.12583] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/29/2019] [Accepted: 08/20/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Fiona Lavelle
- Institute for Global Food Security, School of Biological SciencesQueen's University Belfast Belfast UK
| | - Tamara Bucher
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and MedicineThe University of Newcastle Newcastle New South Wales Australia
- Priority Research Centre for Physical Activity and NutritionThe University of Newcastle Newcastle New South Wales Australia
| | - Moira Dean
- Institute for Global Food Security, School of Biological SciencesQueen's University Belfast Belfast UK
| | - Hannah M. Brown
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and MedicineThe University of Newcastle Newcastle New South Wales Australia
- Priority Research Centre for Physical Activity and NutritionThe University of Newcastle Newcastle New South Wales Australia
| | - Megan E. Rollo
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and MedicineThe University of Newcastle Newcastle New South Wales Australia
- Priority Research Centre for Physical Activity and NutritionThe University of Newcastle Newcastle New South Wales Australia
| | - Clare E. Collins
- Nutrition and Dietetics, School of Health Sciences, Faculty of Health and MedicineThe University of Newcastle Newcastle New South Wales Australia
- Priority Research Centre for Physical Activity and NutritionThe University of Newcastle Newcastle New South Wales Australia
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Whatnall MC, Patterson AJ, Burrows TL, Hutchesson MJ. Higher diet quality in university students is associated with higher academic achievement: a cross‐sectional study. J Hum Nutr Diet 2019; 32:321-328. [DOI: 10.1111/jhn.12632] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- M. C. Whatnall
- School of Health Sciences Faculty of Health and Medicine and Priority Research Centre for Physical Activity and Nutrition University of Newcastle Callaghan NSW Australia
| | - A. J. Patterson
- School of Health Sciences Faculty of Health and Medicine and Priority Research Centre for Physical Activity and Nutrition University of Newcastle Callaghan NSW Australia
| | - T. L. Burrows
- School of Health Sciences Faculty of Health and Medicine and Priority Research Centre for Physical Activity and Nutrition University of Newcastle Callaghan NSW Australia
| | - M. J. Hutchesson
- School of Health Sciences Faculty of Health and Medicine and Priority Research Centre for Physical Activity and Nutrition University of Newcastle Callaghan NSW Australia
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The Effect of a Pilot Dietary Intervention on Pain Outcomes in Patients Attending a Tertiary Pain Service. Nutrients 2019; 11:nu11010181. [PMID: 30654479 PMCID: PMC6357136 DOI: 10.3390/nu11010181] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 01/13/2023] Open
Abstract
The aim of this study was to examine the effect of a six-week 2 × 2 design on pain scores, quality of life, and dietary intake in patients attending an Australian tertiary pain clinic. The two intervention components were (1) personalized dietary consultations or waitlist control, and (2) active or placebo dietary supplement (fruit juice). Sixty participants were randomized into one of four groups at baseline (68% female, mean age 49 ± 15 years) with 42 completing the study (70% retention). All groups had statistically significant improvements in three of five pain outcomes. The personalized dietary consultation groups had clinically important improvements in three of five pain outcomes compared to the waitlist control groups. All groups had a statistically significant improvement in six of eight quality-of-life categories post intervention. All groups increased percentage energy from nutrient-dense foods (+5.2 ± 1.4%, p < 0.001) with a significant group-by-time effect for percentage energy from total fat (p = 0.024), with the personalized dietary consultations plus placebo fruit juice reporting the largest reduction (−5.7 ± 2.3%). This study indicates that dietitian-delivered dietary intervention can improve pain scores, quality of life, and dietary intake of people experiencing chronic pain. Future research should evaluate efficacy in a full-powered randomized control trial.
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Wu C, Han X, Yan X, Keel S, Shang X, Zhang L, He M. Impact of Diet on the Incidence of Cataract Surgery among Diabetic Patients: Findings from the 45 and Up Study. Curr Eye Res 2018; 44:385-392. [PMID: 30433817 DOI: 10.1080/02713683.2018.1548024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine the impact of diet on the incidence of cataract surgery among the working-aged diabetic population in Australia. METHODS This cohort study was conducted among 8,752 participants with diabetes aged 45-65 years who were recruited to the 45 and Up Study from 2006 to 2016. The data was linked to the Medicare Benefits Schedule to obtain data on cataract surgery. Diabetes was defined as self-reported on questionnaire or diabetes medication history based on Pharmaceutical Benefits Scheme. Diet was assessed at baseline, using a self-administered questionnaire and healthy diet scores were calculated based on Australian Dietary Guidelines. Cox regression was used to evaluate the association between diet and the incidence of cataract surgery during the follow-up. RESULTS During a mean follow-up of 8.4 years (73,431 person-years), 914 diabetic participants underwent cataract surgery with a corresponding rate of 12.4 cases per 1,000 person-years. After adjusting for age and gender, the hazard ratios (HR) of cataract surgery for the highest compared to the lowest intake quintile of red meat and poultry were 1.24 (95% CI, 1.00-1.55) and 1.24 (95% CI, 1.02-1.51), respectively. Further adjustment for demographic, lifestyle and dietary factors resulted in no significant difference between cataract surgery risk and healthy diet scores or specific diet groups. In gender-stratified analyses, increasing consumption of red meat (HR for highest versus lowest quintile, 1.39; 95% CI, 1.00-1.93; P for trend = 0.01) and poultry (HR for highest versus lowest quintile, 1.40; 95% CI, 1.05-1.87; P for trend = 0.01) were associated with a higher risk of cataract surgery in women after adjustment of age, gender, income, education level, body mass index, hypertension, cardiovascular disease, family history of diabetes, diabetes duration, insulin use, lifestyle, and other dietary factors. CONCLUSION Higher consumption of red meat and poultry is related to an elevated risk of cataract surgery in the working-aged female population with diabetes.
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Affiliation(s)
- Changfan Wu
- a Department of Ophthalmology , Yijishan Hospital of Wannan Medical College , Wuhu , China.,b Centre for Eye Research Australia; Ophthalmology, Department of Surgery , University of Melbourne; Royal Victorian Eye and Ear Hospital , Melbourne , Australia
| | - Xiaotong Han
- b Centre for Eye Research Australia; Ophthalmology, Department of Surgery , University of Melbourne; Royal Victorian Eye and Ear Hospital , Melbourne , Australia.,c State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center , Sun Yat-sen University , Guangzhou , China
| | - Xixi Yan
- b Centre for Eye Research Australia; Ophthalmology, Department of Surgery , University of Melbourne; Royal Victorian Eye and Ear Hospital , Melbourne , Australia.,d Eye Center , Renmin Hospital of Wuhan University, Eye Institute of Wuhan University , Wuhan , China
| | - Stuart Keel
- b Centre for Eye Research Australia; Ophthalmology, Department of Surgery , University of Melbourne; Royal Victorian Eye and Ear Hospital , Melbourne , Australia
| | - Xianwen Shang
- b Centre for Eye Research Australia; Ophthalmology, Department of Surgery , University of Melbourne; Royal Victorian Eye and Ear Hospital , Melbourne , Australia
| | - Lei Zhang
- b Centre for Eye Research Australia; Ophthalmology, Department of Surgery , University of Melbourne; Royal Victorian Eye and Ear Hospital , Melbourne , Australia.,e Melbourne Sexual Health Centre , Alfred Health , Melbourne , Australia.,f Central Clinical School, Faculty of Medicine , Monash University , Melbourne , Australia.,g Department of epidemiology, School of Public Health , Xi'an Jiaotong University , Xi'an , China
| | - Mingguang He
- b Centre for Eye Research Australia; Ophthalmology, Department of Surgery , University of Melbourne; Royal Victorian Eye and Ear Hospital , Melbourne , Australia.,c State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center , Sun Yat-sen University , Guangzhou , China
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