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Beckett EL, Fayet-Moore F, Cassettari T, Starck C, Wright J, Blumfield M. Health effects of drinking 100% juice: an umbrella review of systematic reviews with meta-analyses. Nutr Rev 2024:nuae036. [PMID: 38679915 DOI: 10.1093/nutrit/nuae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024] Open
Abstract
CONTEXT Low fruit and vegetable intakes are major modifiable determinants of disease. One hundred percent juice may facilitate intake and deliver essential nutrients and bioactive compounds. However, the position of 100% juice in healthy eating guidelines remains controversial due to its lower dietary fiber and higher free-sugar contents compared with whole fruits and vegetables. OBJECTIVE To conduct an umbrella review of systematic literature reviews with meta-analyses (MAs) to summarize the health benefits of drinking 100% fruit and/or vegetable juice. DATA SOURCES Four databases (Medline, The Cochrane Library, EMBASE, and CINAHL) were systematically searched for MAs of 100% juice and any health outcomes. DATA ANALYSIS Screening, quality, risk of bias, and content overlap tools were applied, and extracted data were narratively synthesized. No eligible studies for vegetable juice were found. Fifteen systematic literature reviews (51 primary MAs, 6 dose-response, and 87 subanalyses; 50-1200 mL/day; hours to years of duration) were included. Ten MAs (19.6%) reported health benefits (4 for blood pressure, 2 for vascular function, 3 for inflammation, 1 for stroke mortality), 3 MAs (5.9%) reported adverse risks (1 each for cardiovascular disease mortality, prostate cancer, type 2 diabetes risk), while most (74.5%) reported no effect (blood lipids, body composition, liver function, metabolic health, cancers, and inflammation). Risks were limited to cohort studies and benefits were found in both cohort and intervention studies. CONCLUSION The findings collate evidence showing some potential health benefits associated with 100% juice consumption, with fewer potential risks. The balance of evidence does not support the exclusion of 100% juice from food-based guides to healthy eating, although caution may be warranted in certain groups or individuals, and the body of evidence is not yet conclusive. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022380588.
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Affiliation(s)
- Emma L Beckett
- FOODiQ Global, Sydney, New South Wales, Australia
- Food Science & Human Nutrition, School of Environmental and Life Sciences, The University of Newcastle, Central Coast, New South Wales, Australia
| | - Flávia Fayet-Moore
- FOODiQ Global, Sydney, New South Wales, Australia
- Food Science & Human Nutrition, School of Environmental and Life Sciences, The University of Newcastle, Central Coast, New South Wales, Australia
| | | | | | - Jutta Wright
- FOODiQ Global, Sydney, New South Wales, Australia
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Jones P, Blumfield M, Beckett E, Marshall S, Abbott K, Duve E, Fayet‐Moore F. Real world evidence on the characteristics of regular and intermittent users of a very-low calorie diet program and associations with measures of program success, health, and quality of life. Obes Sci Pract 2024; 10:e712. [PMID: 38264009 PMCID: PMC10804350 DOI: 10.1002/osp4.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 01/25/2024] Open
Abstract
Background Very low-calorie diet (VLCD) programs are readily available in Australia. However, there is a lack of real-world evidence describing the characteristics related to positive outcomes. Aims To examine the demographic, eating, self-efficacy and program engagement characteristics of VLCD users in Australia, and the associations between user characteristics and program success, weight loss, quality of life (QOL) and health. Method Cross-sectional data from Australian adults: regular users (n = 189: VLCD user ≥4 days/week for >4 weeks) and intermittent users (n = 111, VLCD user <4 weeks and/or <4 days/week). Self-reported data on demographics, VLCD program use, support, eating behavior, weight-related QOL, mental health, physical health, self-efficacy, and physical activity. Descriptive and inferential statistics were performed in R. Results Compared to regular users, intermittent users reported lower percentage weight loss (15.1% ± SD 9.8 vs. 9.9% ± SD 6.8, relative to starting weight), fewer reported their VLCD program as very successful (44% vs. 35%), higher depressive symptom scores (8.7 ± SD 2.8 vs. 6.7 ± SD 5.1), and lower general self-efficacy (23.9 ± SD 4.7 vs. 29.4 ± SD 5.7), nutrition self-efficacy (11.9 ± SD 2.0 vs. 14.5 ± SD 3.1) and weight-related QOL scores (60.9 ± SD 22.2 vs. 65.0 ± SD 11.8; p < 0.001 for all). In regular users, older age and longer program duration were associated with greater total weight loss, support, and program success (p < 0.001 for all). In intermittent users, program success was greater when dietitian support was used (odds ratio [OR] 6.50) and for those with higher BMIs (OR 1.08, p < 0.001 for all). In both groups, more frequent support was associated with better weight-related QOL (p < 0.001). Conclusion This study provides real-world evidence that regular VLCD users had greater success and weight loss than intermittent program users. These findings may be used to tailor and improve the delivery of VLCD programs in Australia and other countries with retail access to VLCDs.
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Affiliation(s)
- Patrice Jones
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
- Institute for Health and SportVictoria UniversityFootscrayVictoriaAustralia
| | - Michelle Blumfield
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Emma Beckett
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
- School of Environmental and Life SciencesUniversity of NewcastleOurimbahNew South WalesAustralia
| | - Skye Marshall
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
- Bond University Nutrition and Dietetics Research GroupFaculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia
| | - Kylie Abbott
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Emily Duve
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Flavia Fayet‐Moore
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
- School of Environmental and Life SciencesUniversity of NewcastleOurimbahNew South WalesAustralia
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Blumfield M, McConnell A, Petocz P, Rouf A, Duve E, Teasdale SB, Marshall S, Fayet-Moore F. Relationship between discretionary food intake and sex, body image, health, and geographical remoteness among Indigenous Australian adolescents. Nutr Diet 2023; 80:73-84. [PMID: 35293114 DOI: 10.1111/1747-0080.12732] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/30/2021] [Accepted: 02/09/2022] [Indexed: 11/30/2022]
Abstract
AIM Determine the discretionary energy intake of Indigenous Australian adolescents and its relationship with sex, body image, health, and geographical remoteness. METHODS Cross-sectional data from the 2012 to 2013 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (n = 264, 15-17 years). Dietary data were collected using an Automated Multiple-Pass Method, anthropometric data by trained interviewers; self-perceived measures of body weight, level of satisfaction with current weight, and self-assessed health were self-reported. General linear models were used to investigate predictors. RESULTS Discretionary energy intake contributed 35.4% and 54.2% of total energy intake for males and females, respectively, primarily from the sub-groups: soft drinks; pastries; potatoes; sugar, honey and syrups; cordials; and potato snacks. Discretionary energy intake was associated with higher energy intake (p < 0.001) and self-perceived body weight (p = 0.022), while sex had significant interactions with self-assessed health (psex = 0.005), satisfaction with current weight (psex < 0.001), and geographical remoteness (psex = 0.007). Contribution of discretionary energy intake to total energy intake was greatest for males with an increased risk of metabolic complications (50% vs. 37%; p > 0.05), those who perceived themselves to be overweight (56% vs. 27%; p < 0.001), and those who were dissatisfied with their weight (56% vs. 19%; p < 0.001), compared to females. No differences were found by dieting status, risk of metabolic complications, and under-reporting of energy intake. CONCLUSIONS Discretionary energy intake was excessive among Indigenous Australian adolescents and had relationships with self-perceived health, weight satisfaction, and geographical remoteness, which was moderated by sex. To successfully reduce discretionary food intake among Indigenous Australian adolescents, further research is required to develop sex specific and culturally appropriate strategies.
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Affiliation(s)
- Michelle Blumfield
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Andrew McConnell
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Peter Petocz
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia.,Department of Statistics, Macquarie University, Sydney, New South Wales, Australia
| | - Anika Rouf
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Emily Duve
- Department of Translational Science, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Scott B Teasdale
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Skye Marshall
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia.,Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Flavia Fayet-Moore
- Department of Science, Nutrition Research Australia, New South Wales, Australia
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Bei B, Pinnington DM, Quin N, Shen L, Blumfield M, Wiley JF, Drummond SPA, Newman LK, Manber R. Improving perinatal sleep via a scalable cognitive behavioural intervention: findings from a randomised controlled trial from pregnancy to 2 years postpartum. Psychol Med 2023; 53:513-523. [PMID: 34231450 PMCID: PMC8738775 DOI: 10.1017/s0033291721001860] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sleep disturbance is common in gestational parents during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods. METHODS This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous females without severe medical/psychiatric conditions were randomised 1:1 to CBT or attention- and time-matched control. All participants received a 1 h telephone session and automated multimedia emails from the third trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12 and 24. RESULTS In total, 163 eligible participants (age M ± s.d. = 33.35 ± 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that compared to control, receiving CBT was associated with lower insomnia severity and sleep disturbance (two primary outcomes), and lower sleep-related impairment at the pregnancy endpoint (p values ⩽ 0.001), as well as at 24 months postpartum (p ranges 0.012-0.052). Group differences across the first postpartum year were non-significant. Participants with elevated insomnia symptoms at baseline benefitted substantially more from CBT (v. control), including having significantly lower insomnia symptoms throughout the first postpartum year. Group differences in symptoms of depression or anxiety were non-significant. CONCLUSIONS A scalable CBT sleep intervention is efficacious in buffering against sleep disturbance during pregnancy and benefitted sleep at 2-year postpartum, especially for individuals with insomnia symptoms during pregnancy. The intervention holds promise for implementation into routine perinatal care.
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Affiliation(s)
- Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Donna M. Pinnington
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Nina Quin
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Centre for Women’s Mental Health, Royal Women’s Hospital, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Lin Shen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Michelle Blumfield
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Victoria, Australia
| | - Joshua F. Wiley
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Sean P. A. Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Louise K. Newman
- Department of Psychiatry, University of Melbourne, Victoria, Australia
| | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
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Fayet‐Moore F, McConnell A, Tuck K, Petocz P, Cassettari T, Rahimi‐Ardabili H, Blumfield M, Marshall S. Patterns of discretionary food intake among Australian children and their association with socio-demographic, lifestyle, and adiposity measures. Nutr Diet 2022; 79:623-635. [PMID: 35708110 PMCID: PMC9796583 DOI: 10.1111/1747-0080.12741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/21/2022] [Accepted: 04/03/2022] [Indexed: 01/01/2023]
Abstract
AIM Australian children consume 35% of energy from discretionary food and beverages which increases their risk of non-communicable diseases like type 2 diabetes. Despite this concerning statistic, broad analysis of the profile of discretionary food intake has not been fully undertaken. This study asks: what is the discretionary food and beverage intake profile, contribution to nutrient intakes, and associations with demographic and health characteristics? METHODS Cross-sectional data from the 2011-12 National Nutrition and Physical Activity Survey (n = 2812, 2-18 years) were used to profile discretionary food consumption. Dietary intake was assessed by 24-h recall. General linear models tested the difference in respondent characteristics by age group, sex, and quartiles of discretionary food energy contribution. RESULTS Ninety-nine percent of respondents consumed discretionary foods, 74% exceeded the maximum discretionary food recommended serves. Among 10 eating occasions available to select: snack, dinner, lunch and morning tea appeared to contribute 76% of discretionary food energy, with snack and dinner contributing 24% each. Age and frequency of discretionary food consumption were positively associated with energy intake from discretionary foods (p < 0.001); while sex, socio-economic status, physical activity and body composition had no association. High discretionary food consumers chose specific discretionary food items in a large quantity (1.0-3.5-serves/discretionary food) compared to low discretionary food consumers (0.4-1.4-serves/discretionary food). CONCLUSIONS Nearly all Australian children and adolescents consumed discretionary food daily. No demographic or anthropometric characteristics beyond increasing age were associated with higher discretionary food. Targeted public health policy and community interventions are required to focus on addressing the largest contributors to discretionary food intake in terms of equivalent serve sizes, popularity, and eating occasion.
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Affiliation(s)
- Flavia Fayet‐Moore
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Andrew McConnell
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Kate Tuck
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Peter Petocz
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Tim Cassettari
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | | | - Michelle Blumfield
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia
| | - Skye Marshall
- Department of ScienceNutrition Research AustraliaSydneyNew South WalesAustralia,Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia
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6
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Starck C, Blumfield M, Abbott K, Cassettari T, Wright J, Duve E, Barclay AW, Fayet-Moore F. Methodology for the Review and Update of Nutrient Criteria Underpinning Front-of-Pack Labeling: Application to the Glycemic Index Symbol. Front Nutr 2022; 9:867349. [PMID: 35757261 PMCID: PMC9218624 DOI: 10.3389/fnut.2022.867349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background Nutrient criteria underlying front-of-pack food labeling programs can play an important role in improving dietary intakes. Currently, no methodology for the development or update of nutrient criteria has been published, nor the methods used by food regulatory bodies. The scientific publication of methodology outlining the development and update of nutrient criteria underpinning front-of-pack food labeling programs highlighting healthier food choices is needed. Objective To develop and provide a globally applicable and transparent methodology for researchers to follow when reviewing existing or developing new nutrient criteria for front-of-pack labeling. Methods The Nutrient Criteria Methodology involved five phases: Phase I, the development of guiding principles; Phase II, collection of information for subsequent phases, including a pre-scope of the literature and selection of food composition database(s) for modeling; Phase III, literature review of all possible nutrients relevant to the nutrient criteria; Phase IV, database modeling to set quantitative limits for each selected nutrient; Phase V, assessment of the criteria against an established nutritional quality assessment tool. As an example, the methodology was applied to the update of the GI Symbol Product Eligibility and Nutrient Criteria (PENC). Results A comprehensive and replicable methodology, based on best practice protocols and ensuring both scientific credibility and practicality of use by industry, was developed. Application of the five phases of the methodology to the GI Symbol PENC highlighted the ability of the methodology to uncover nutritional measures currently missing in many nutrient criteria for front-of-pack food labeling programs and other national food labeling systems, such as glycemic load and the unsaturated to saturated fat ratio. Foods achieving the PENC had a higher Health Star Rating than foods not achieving the PENC. Conclusion Our Nutrient Criteria Methodology can be applied to the development and update of global nutrient criteria underpinning front-of-pack food labeling programs. Further research into the implementation of additional nutritional measures found to be important for human health is recommended, with the goal of the prevention of diet-related disease.
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Affiliation(s)
- Carlene Starck
- Nutrition Research Australia, Sydney, NSW, Australia.,Riddet Institute, Massey University, Palmerston North, New Zealand
| | | | - Kylie Abbott
- Nutrition Research Australia, Sydney, NSW, Australia
| | | | - Jutta Wright
- Nutrition Research Australia, Sydney, NSW, Australia
| | - Emily Duve
- Nutrition Research Australia, Sydney, NSW, Australia
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Carr P, Keighley T, Petocz P, Blumfield M, Rich GG, Cohen F, Soni A, Maimone IR, Fayet-Moore F, Isenring E, Marshall S. Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support. BMC Prim Care 2022; 23:26. [PMID: 35123409 PMCID: PMC8817771 DOI: 10.1186/s12875-022-01629-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 01/19/2022] [Indexed: 02/07/2023]
Abstract
Background The laparoscopic sleeve gastrectomy (LSG) and the incisionless endoscopic sleeve gastroplasty (ESG) weight loss procedures require further investigation of their efficacy, safety and patient-centered outcomes in the Australian setting. Methods The aim was to examine the 6- and 12-month weight loss efficacy, safety, and weight-related quality of life (QoL) of adults with obesity who received the ESG or LSG bariatric procedure with 12+ months of adjuvant multidisciplinary pre- and postprocedural support. Data were from a two-arm prospective cohort study that followed patients from baseline to 12-months postprocedure from a medical center in Queensland. Percent excess weight loss (%EWL) was the primary outcome. Secondary outcomes were body composition (fat mass, fat-free mass, android:gynoid ratio, bone mineral content) via dual energy X-ray absorptiometry, weight-related QoL, lipid, glycemic, and hepatic biochemistry, and adverse events. Results 16 ESG (19% attrition; 81.2% female; aged:41.4 (SD: 10.4) years; BMI: 35.5 (SD: 5.2) kg/m2) and 45 LSG (9% attrition; 84.4% female; aged:40.4 (SD: 9.0) years; BMI: 40.7 (SD: 5.6) kg/m2) participants were recruited. At 12-months postprocedure, ESG %EWL was 57% (SD: 32%; p < 0.01) and LSG %EWL was 79% (SD: 24%; p < 0.001). ESG and LSG cohorts improved QoL (19.8% in ESG [p > 0.05]; 48.1% in LSG [p < 0.05]), liver function (AST: − 4.4 U/L in ESG [p < 0.05]; − 2.7 U/L in LSG [p < 0.05]), HbA1c (− 0.5% in ESG [p < 0.05]; − 0.1% in LSG [p < 0.05]) and triglycerides (− 0.6 mmol/L in ESG [p > 0.05]; − 0.4 mmol/L in LSG [P < 0.05]) at 12-months. Both cohorts reduced fat mass (p < 0.05). The ESG maintained but LSG decreased fat-free mass at 6-months (p < 0.05); and both cohorts lost fat-free mass at 12-months (p < 0.05). There were no adverse events directly related to the procedure. The ESG reported 25% mild-moderate adverse events possibly related to the procedure, and the LSG reported 27% mild-severe adverse events possibly related to the procedure. Conclusions In this setting, the ESG and LSG were safe and effective weight loss treatments for obese adults alongside multidisciplinary support. Patients who elected the ESG maintained fat-free mass at 6-months but both cohorts lost fat-free mass at 12-months postprocedure. Patients who elected the LSG had large and significant improvements to weight-related quality of life. Further well-powered studies are required to confirm these findings. Trial registration This study was registered prospectively at the Australia New Zealand Clinical Trials Registry on 06/03/2018, Registration Number ACTRN12618000337279. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01629-7.
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Affiliation(s)
- Prudence Carr
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Tim Keighley
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Peter Petocz
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Michelle Blumfield
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Graeme G Rich
- Bariatric Gastroenterologist & Director, Bariatrics Australia, Sydney Adventist Hospital, Wahroonga, Australia
| | - Felicity Cohen
- Weightloss Solutions Australia, Varsity Lakes, Queensland, Australia
| | - Asha Soni
- Weightloss Solutions Australia, Varsity Lakes, Queensland, Australia
| | | | - Flavia Fayet-Moore
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales
| | - Elizabeth Isenring
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Skye Marshall
- Department of Science, Nutrition Research Australia, Level 10, 20 Martin Place, Sydney, New South, Wales. .,Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia.
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Starck CS, Blumfield M, Keighley T, Marshall S, Petocz P, Inan-Eroglu E, Abbott K, Cassettari T, Ali A, Wham C, Kruger R, Kira G, Fayet-Moore F. Nutrient Dense, Low-Cost Foods Can Improve the Affordability and Quality of the New Zealand Diet-A Substitution Modeling Study. Int J Environ Res Public Health 2021; 18:7950. [PMID: 34360243 PMCID: PMC8345759 DOI: 10.3390/ijerph18157950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/09/2021] [Accepted: 07/20/2021] [Indexed: 12/16/2022]
Abstract
The high prevalence of non-communicable disease in New Zealand (NZ) is driven in part by unhealthy diet selections, with food costs contributing to an increased risk for vulnerable population groups. This study aimed to: (i) identify the nutrient density-to-cost ratio of NZ foods; (ii) model the impact of substituting foods with a lower nutrient density-to-cost ratio with those with a higher nutrient density-to-cost ratio on diet quality and affordability in representative NZ population samples for low and medium socioeconomic status (SES) households by ethnicity; and (iii) evaluate food processing level. Foods were categorized, coded for processing level and discretionary status, analyzed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods were 56% unprocessed (vegetables, fruit, porridge, pasta, rice, nuts/seeds), 31% ultra-processed (vegetable dishes, fortified bread, breakfast cereals unfortified <15 g sugars/100 g and fortified 15-30 g sugars/100 g), 6% processed (fruit juice), and 6% culinary processed (oils). Using substitution modeling, diet quality improved by 59% and 71% for adults and children, respectively, and affordability increased by 20-24%, depending on ethnicity and SES. The NZ diet can be made healthier and more affordable when nutritious, low-cost foods are selected. Processing levels in the healthier, modeled diet suggest that some non-discretionary ultra-processed foods may provide a valuable source of low-cost nutrition for food insecure populations.
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Affiliation(s)
- Carlene S. Starck
- Department of Translational Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (C.S.S.); (T.C.)
- Riddet Institute, Massey University, Palmerston North 4474, New Zealand
| | - Michelle Blumfield
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
| | - Tim Keighley
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
| | - Skye Marshall
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Peter Petocz
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
| | - Elif Inan-Eroglu
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (S.M.); (P.P.); (E.I.-E.)
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2000, Australia
| | - Kylie Abbott
- Nutrition Research Australia, Sydney, NSW 2000, Australia;
| | - Tim Cassettari
- Department of Translational Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (C.S.S.); (T.C.)
| | - Ajmol Ali
- School of Sport, Exercise and Nutrition, College of Health, Massey University, North Shore City, Auckland 0745, New Zealand; (A.A.); (C.W.); (R.K.)
| | - Carol Wham
- School of Sport, Exercise and Nutrition, College of Health, Massey University, North Shore City, Auckland 0745, New Zealand; (A.A.); (C.W.); (R.K.)
| | - Rozanne Kruger
- School of Sport, Exercise and Nutrition, College of Health, Massey University, North Shore City, Auckland 0745, New Zealand; (A.A.); (C.W.); (R.K.)
| | - Geoff Kira
- School of Health Sciences, College of Health, Massey University, Palmerston North 4474, New Zealand;
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Blumfield M, Starck C, Keighley T, Petocz P, Roesler A, Abbott K, Cassettari T, Marshall S, Fayet-Moore F. Diet and Economic Modelling to Improve the Quality and Affordability of the Australian Diet for Low and Medium Socioeconomic Households. Int J Environ Res Public Health 2021; 18:5771. [PMID: 34072176 PMCID: PMC8198747 DOI: 10.3390/ijerph18115771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/07/2021] [Accepted: 05/22/2021] [Indexed: 12/14/2022]
Abstract
Food costs are a barrier to healthier diet selections, particularly for low socioeconomic households who regularly choose processed foods containing refined grains, added sugars, and added fats. In this study, the objectives were to: (i) identify the nutrient density-to-cost ratio of Australian foods; (ii) model the impact of substituting foods with lower nutrient density-to-cost ratio with those with the highest nutrient density-to-cost ratio for diet quality and affordability in low and medium socioeconomic households; and (iii) evaluate food processing levels. Foods were categorized, coded for processing level, analysed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods included 54% unprocessed (vegetables and reduced fat dairy), 33% ultra-processed (fortified wholegrain bread and breakfast cereals <20 g sugars/100 g), and 13% processed (fruit juice and canned legumes). Using substitution modelling, diet quality improved by 52% for adults and 71% for children across all households, while diet affordability improved by 25% and 27% for low and medium socioeconomic households, respectively. The results indicate that the quality and affordability of the Australian diet can be improved when nutritious, low-cost foods are selected. Processing levels in the healthier modelled diets suggest that some ultra-processed foods may provide a beneficial source of nutrition when consumed within national food group recommendations.
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Affiliation(s)
- Michelle Blumfield
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (P.P.); (A.R.); (S.M.)
| | - Carlene Starck
- Department of Translational Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (C.S.); (T.C.)
- Riddet Institute, Massey University, Palmerston North 4474, New Zealand
| | - Tim Keighley
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (P.P.); (A.R.); (S.M.)
| | - Peter Petocz
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (P.P.); (A.R.); (S.M.)
| | - Anna Roesler
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (P.P.); (A.R.); (S.M.)
| | - Kylie Abbott
- Nutrition Research Australia, Sydney, NSW 2000, Australia;
| | - Tim Cassettari
- Department of Translational Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (C.S.); (T.C.)
| | - Skye Marshall
- Department of Science, Nutrition Research Australia, Sydney, NSW 2000, Australia; (M.B.); (T.K.); (P.P.); (A.R.); (S.M.)
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
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Bei B, Pinnington D, Quin N, Shen L, Blumfield M, Wiley J, Drummond S, Newman L, Manber R. 340 Improving maternal sleep via cognitive behavioral intervention: A randomised controlled trial from pregnancy to 2 years postpartum. Sleep 2021. [DOI: 10.1093/sleep/zsab072.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Maternal sleep disturbance is common during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods.
Methods
This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous women without major medical/psychiatric conditions were randomised 1:1 to CBT or active control of equal frequency/duration. All participants received a 1-hr telephone session and automated multimedia emails from the 3rd trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12, and 24.
Results
163 eligible participants (age M +/- SD = 33.35 +/- 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that compared to active control, receiving CBT was associated with lower insomnia severity and sleep disturbance (two primary outcomes), and lower sleep-related impairment at the pregnancy endpoint (p-values ≤ .001), as well as at 24 months postpartum (p ranges .012-.052). Group differences across the first postpartum year were nonsignificant. Women with elevated insomnia symptoms at baseline benefitted substantially more from CBT (vs control), including having significantly lower insomnia symptoms throughout the first postpartum year. Group differences in symptoms of depression or anxiety were nonsignificant.
Conclusion
A scalable CBT sleep intervention is efficacious in buffering against sleep disturbance during pregnancy, with long-term benefits to maternal sleep, especially for women with sleep complaints during pregnancy. The intervention holds promise for implementation into routine perinatal care.
Support (if any)
Data collection was supported by Rob Pierce Grant-in-Aid and Helen Bearpark Scholarship from Australasian Sleep Association, Strategic Grant Scheme from Monash University, and the Royal Women’s Hospital Foundation. Intervention materials were adapted from those developed via a National Institute of Health R01 grant (NR013662). Bei (APP1140299) and Wiley (APP1178487) are supported by National Health and Medical Research Council Fellowships, and Pinnington, Quin, Shen by Australian Postgraduate Awards by Department of Education and Training. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
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Roesler A, Marshall S, Rahimi‐Ardabili H, Duve E, Abbott K, Blumfield M, Cassettari T, Fayet‐Moore F. Choosing and following a very low calorie diet program in Australia: A quasi‐mixed methods study to understand experiences, barriers, and facilitators in a self‐initiated environment. Nutr Diet 2020; 78:202-217. [DOI: 10.1111/1747-0080.12645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 10/03/2020] [Accepted: 10/08/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Anna Roesler
- Nutrition Research Australia Sydney New South Wales Australia
| | - Skye Marshall
- Nutrition Research Australia Sydney New South Wales Australia
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Science and Medicine Bond University Gold Coast Queensland Australia
| | | | - Emily Duve
- Nutrition Research Australia Sydney New South Wales Australia
| | - Kylie Abbott
- Nutrition Research Australia Sydney New South Wales Australia
| | | | - Tim Cassettari
- Nutrition Research Australia Sydney New South Wales Australia
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Fayet‐Moore F, McConnell A, Petocz P, Cassettari T, Tuck K, Blumfield M, Warner M, Marshall S. Contribution of dietary snacking behaviours to discretionary energy intake and anthropometric measures in Australian adults: A comparison using an objective vs subjective definition for snacking. Nutr Diet 2020; 78:154-164. [DOI: 10.1111/1747-0080.12648] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/24/2020] [Accepted: 10/01/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Peter Petocz
- Nutrition Research Australia Sydney New South Wales Australia
| | - Tim Cassettari
- Nutrition Research Australia Sydney New South Wales Australia
| | - Kate Tuck
- Nutrition Research Australia Sydney New South Wales Australia
| | | | - Molly Warner
- Nutrition Research Australia Sydney New South Wales Australia
| | - Skye Marshall
- Nutrition Research Australia Sydney New South Wales Australia
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine Bond University Gold Coast Queensland Australia
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Marshall S, Petocz P, Duve E, Abbott K, Cassettari T, Blumfield M, Fayet-Moore F. The Effect of Replacing Refined Grains with Whole Grains on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with GRADE Clinical Recommendation. J Acad Nutr Diet 2020; 120:1859-1883.e31. [DOI: 10.1016/j.jand.2020.06.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 01/08/2023]
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Fayet-Moore F, Wibisono C, Carr P, Duve E, Petocz P, Lancaster G, McMillan J, Marshall S, Blumfield M. An Analysis of the Mineral Composition of Pink Salt Available in Australia. Foods 2020; 9:E1490. [PMID: 33086585 PMCID: PMC7603209 DOI: 10.3390/foods9101490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 11/16/2022] Open
Abstract
Little is known about the mineral composition of pink salt. The aim of this study was to evaluate for the first time the mineral composition of pink salt available for purchase in Australia and its implications for public health. Pink salt samples were purchased from retail outlets in two metropolitan Australian cities and one regional town. Color intensity, salt form, and country of origin were coded. A mass spectrometry scan in solids was used to determine the amount of 25 nutrients and non-nutritive minerals in pink salt (n = 31) and an iodized white table salt control (n = 1). A wide variation in the type and range of nutrients and non-nutritive minerals across pink salt samples were observed. One pink salt sample contained a level of lead (>2 mg/kg) that exceeded the national maximum contaminant level set by Food Standards Australia New Zealand. Pink salt in flake form, pink salt originating from the Himalayas, and darker colored pink salt were generally found to contain higher levels of minerals (p < 0.05). Despite pink salt containing nutrients, >30 g per day (approximately 6 teaspoons) would be required to make any meaningful contribution to nutrient intake, a level that would provide excessive sodium and potential harmful effects. The risk to public health from potentially harmful non-nutritive minerals should be addressed by Australian food regulations. Pink salt consumption should not exceed the nutrient reference values for Australia and New Zealand guidelines of <5 g of salt per day.
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Affiliation(s)
- Flavia Fayet-Moore
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
| | - Cinthya Wibisono
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
| | - Prudence Carr
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
| | - Emily Duve
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
| | - Peter Petocz
- Department of Statistics, Macquarie University, Sydney 2109, Australia;
| | - Graham Lancaster
- Environmental Analysis Laboratory, Southern Cross University, Lismore 2480, Australia;
| | - Joanna McMillan
- Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora Victoria 3086, Australia;
| | - Skye Marshall
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD 4226, Australia
| | - Michelle Blumfield
- Nutrition Research Australia, Level 10, 20 Martin Place, Sydney 2000, Australia; (C.W.); (P.C.); (E.D.); (S.M.); (M.B.)
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Blumfield M, Abbott K, Duve E, Cassettari T, Marshall S, Fayet-Moore F. Examining the health effects and bioactive components in Agaricus bisporus mushrooms: a scoping review. J Nutr Biochem 2020; 84:108453. [PMID: 32653808 DOI: 10.1016/j.jnutbio.2020.108453] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/19/2020] [Accepted: 06/08/2020] [Indexed: 12/25/2022]
Abstract
There is evidence from both in vitro and animal models that the consumption of edible mushrooms has beneficial effects on health. It is unclear whether similar effects exist in humans and which bioactive compounds are present. This review synthesises the evidence on the world's most commonly consumed mushroom, Agaricus bisporus to (i) examine its effect on human health outcomes; and (ii) determine the nutrient density of its bioactive compounds, which may explain their health effects. A systematic literature search was conducted on the consumption of A. bisporus, without date and study design limits. Bioactive compounds included ergosterol, ergothioneine, flavonoids, glucans and chitin. Two authors independently identified studies for inclusion and assessed methodological quality. Beneficial effects of A. bisporus on metabolic syndrome, immune function, gastrointestinal health and cancer, with the strongest evidence for the improvement in Vitamin D status in humans, were found. Ultraviolet B (UVB) exposed mushrooms may increase and maintain serum 25(OH)D levels to a similar degree as vitamin D supplements. A. bisporus contain beta-glucans, ergosterol, ergothioneine, vitamin D and an antioxidant compound usually reported as flavonoids; with varying concentrations depending on the type of mushroom, cooking method and duration, and UVB exposure. Further research is required to fully elucidate the bioactive compounds in mushrooms using vigorous analytical methods and expand the immunological markers being tested. To enable findings to be adopted into clinical practice and public health initiatives, replication of existing studies in different population groups is required to confirm the impact of A. bisporus on human health.
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Affiliation(s)
- Michelle Blumfield
- BNutrDiet (Hons), PhD, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Kylie Abbott
- BNutrDiet (Hons), PhD, Nutrition Research Australia, Sydney, New South Wales, Australia; Nutraceuticals Research Group, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
| | - Emily Duve
- BPESS, MPH, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Tim Cassettari
- BSc(Hons), BAppSc, Nutrition Research Australia, Sydney, New South Wales, Australia
| | - Skye Marshall
- BNutrDiet (Hons), PhD, Nutrition Research Australia, Sydney, New South Wales, Australia; Bond University, Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Flavia Fayet-Moore
- BSc(Hons), MNutrDiet, PhD, Nutrition Research Australia, Sydney, New South Wales, Australia.
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Blumfield M, McConnell A, Campos V, Lê KA, Fayet-Moore F. Carbohydrate Quality Metrics and Their Association with Population Nutrient Intakes and Diet Quality in Australia. Curr Dev Nutr 2020. [DOI: 10.1093/cdn/nzaa046_010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Carbohydrate (CHO) quality is important for health, yet it is unclear how to best define CHO quality. The aim of this study was to investigate whether diets that meet one of three CHO quality ratios, that include a combination of grams of CHO, fiber or free sugars, are associated with improved diet quality in Australia.
Methods
National data from the 2011–12 Australian National Nutrition and Physical Activity Survey were assessed (n = 12,153; age 49.0 ± 16.4y adults, 9.5 ± 5.0y children). Three CHO quality ratios were defined: (i) Simple ratio, 10:1 (10 g CHO: ³1 g fiber); (ii) Modified ratio, 10:1:2 (10 g CHO: ³1 g fiber: £2 g free sugars); and (iii) Dual ratio, 10:1 & 1:2 (10 g CHO: ³1 g fiber & £2 g free sugars per 1 g fiber). Participants were defined as having met or not met each ratio in terms of total daily nutrient intakes. Dietary data were collected using a validated Automated Multiple-Pass Method. Nutrient intakes and food group data were compared to Australian Nutrient Reference Values and an Australian Healthy Eating Index (HEIFA-2013).
Results
Prevalence of ratio adherence was: simple ratio (45%), modified ratio (30%) and dual ratio (36%). After adjusting for energy intake, adults and children who met a ratio reported lower energy intakes, higher fiber and micronutrient intakes, higher HEIFA-2013 scores (adults only) and lower intakes of total sugars, added sugars and sodium (P < .001 for all), compared to those who failed to meet any ratio. Compared to the simple ratio, modified and dual ratios further decreased adult intakes of total sugars (95 g modified, 71 g dual vs 116 g simple; P < .001), added sugars (36 g, 16 g vs 57 g; P < .001) and free sugars (50 g, 26 g vs 72 g; P < .001), and increased HEIFA-2013 scores (56, 59 vs 51; P < .001), with similar findings in children.
Conclusions
All three CHO quality metrics identified diets with higher nutrient intakes and HEIFA-2013 scores, with the addition of a free sugars constraint resulting in further improvements in diet quality. Utility of a CHO quality metric, based on CHO, fiber and free sugars, may offer a simple, standardized approach to improve total diet quality, which has potential for high public health impact.
Funding Sources
Nestlé Research.
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Bennett C, Mansfield D, Mo L, Hodge A, Joham A, Cain S, Blumfield M, Teede H, Moran LJ. MON-043 Sleep Disturbances in Women with and Without Polycystic Ovary Syndrome (PCOS) and Their Association with Lifestyle Factors (Diet, Physical Activity and Sitting Time). J Endocr Soc 2020. [PMCID: PMC7207944 DOI: 10.1210/jendso/bvaa046.093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Sleep disturbances in women with and without polycystic ovary syndrome (PCOS) and their association with lifestyle factors (diet, physical activity and sitting time) Bennett C1, Mansfield DR2, Mo L2, Hodge A3, Joham A4, 5, Cain SW6, Blumfield M1, Teede H4, 5, Moran LJ4 1. Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria 2. Monash Lung and Sleep, Monash Health, Clayton, Victoria 3. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria 4. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 5. Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria 6. Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria Sleep disturbances are a risk factor for poorer lifestyle behaviours. While PCOS is associated with a higher prevalence of sleep disturbances, the relationship between sleep and lifestyle behaviours is unknown in PCOS. Self-reported data from the Australian Longitudinal Study on Women’s Health young cohort (31–36 years, n=6067, n=464 PCOS, n=5603 non-PCOS) were collected on PCOS, anthropometry, physical activity, sedentary behaviour, diet (74-item validated food frequency questionnaire) and sleeping behaviour (sleep quantity and adverse sleep symptoms). Multivariate regression models controlled for sleeping behaviour, BMI, age, marital status, education, income and area of residence. Women with PCOS reported greater adverse sleep symptoms, higher energy intake, diet quality (dietary guidelines index (DGI)), fibre intake and sedentary time and lower glycaemic index, compared to women without PCOS. This was not maintained for energy intake and sedentary behaviour on adjustment for confounders. For diet quality, there was an interaction between PCOS and sleep disturbances. Only for women with fewer sleep disturbances (~8 hours sleep/no adverse sleep symptoms) was PCOS associated with better diet quality (DGI higher by 3.14±0.86, p<0.001), with no differences in diet quality for women with poorer sleep. Lifestyle behaviours in women with PCOS appear to be influenced by sleep quality and quantity. Nothing to disclose: CB, DM, LM, AH, AJ, SC, MB, HT, LM
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Affiliation(s)
| | | | - Lin Mo
- Monash Health, Melbourne, Australia
| | | | | | - Sean Cain
- Monash University, Melbourne, Australia
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Gibson S, Adamski M, Blumfield M, Dart J, Murgia C, Volders E, Truby H. Promoting Evidence Based Nutrition Education Across the World in a Competitive Space: Delivering a Massive Open Online Course. Nutrients 2020; 12:nu12020344. [PMID: 32012993 PMCID: PMC7071325 DOI: 10.3390/nu12020344] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 01/14/2023] Open
Abstract
The internet is the fastest growing source of nutrition information for consumers. Massive Open Online Courses (MOOCs) provide and avenue for nutrition professionals’ urgent need to respond to consumer demand for low-cost, accessible and engaging information. This research aimed to evaluate learner participation and perceptions in an evidence-based nutrition MOOC and provide recommendations for engaging international online lay audiences. Learners completed pre and post course surveys including quantitative and open-ended questions. Pre-course surveys collected demographic data, prior nutrition knowledge and motivations for doing the course. Post-course surveys evaluated their preferred learning modes and learners’ opinions of the course. Quantitative were analyzed using descriptive statistics. Conventional content analysis was conducted on learners’ responses to open-ended survey questions using an inductive approach. Learners represented 158 countries from a range of educational backgrounds. There were 3799 qualitative comments related to learners’ learning and course content preferences. Qualitative analysis identified key themes related to (1) online interaction, the (2) value of the evidence presented by nutrition experts and (3) the course structure and practical aspects. Divergent opinions were expressed within these themes. Satisfying the needs of large international audiences with diverse backgrounds is challenging in promoting sound evidence-based nutrition messages. MOOCs provide a means for delivering evidence based global nutrition education in the online space crowded with food advertising and nutrition conjecture. Recommendations are made as to how to construct and engage diverse on-line audiences.
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Bei B, Pinnington DM, Shen L, Blumfield M, Drummond SPA, Newman LK, Manber R. A scalable cognitive behavioural program to promote healthy sleep during pregnancy and postpartum periods: protocol of a randomised controlled trial (the SEED project). BMC Pregnancy Childbirth 2019; 19:254. [PMID: 31331286 PMCID: PMC6647256 DOI: 10.1186/s12884-019-2390-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 06/30/2019] [Indexed: 12/31/2022] Open
Abstract
Background Poor sleep, including symptoms of insomnia are common during pregnancy and postpartum periods. Poor sleep during the perinatal period is linked to impaired daytime functioning, mood disturbance, and risk for chronic insomnia. Cognitive behavioural therapy (CBT) is consistently shown to be efficacious in treating insomnia, but it is largely inaccessible to new mothers, and surprisingly, not part of current perinatal care. This study aims to evaluate the feasibility and efficacy of a scalable CBT-based intervention for better sleep quality. Methods In this single-blind randomised controlled trial, eligible nulliparous women are randomised in a 1:1 ratio to either the intervention (CBT) or active control (healthy diet) condition. The interventions are provided from the third trimester till 6 months postpartum. The primary outcome is maternal sleep quality and secondary outcomes are maternal sleep-related impairment, mood, health-related quality of life, relationship satisfaction, and mother-infant-relationship, all assessed using validated instruments at 30- (baseline) and 35 weeks gestation (pregnancy endpoint), and 1.5, 3, and 6 months (postpartum endpoint) after childbirth, with follow-up assessments conducted at 1-year and 2-year postpartum. Discussion This study has the potential to address the need for an evidence-based, non-pharmacological sleep intervention tailored for the pregnancy and postpartum periods. The intervention is designed to maximise reach and minimise cost, with the potential to scale up and incorporate in routine perinatal care. With outcomes measured at 8 time points, from the third trimester of pregnancy to 2-year postpartum, this study has the potential to examine both short- and long-term impact on maternal sleep and wellbeing. Trial registration ACTRN12616001462471; retrospectively registered on 19/10/2016. Electronic supplementary material The online version of this article (10.1186/s12884-019-2390-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria, 3800, Australia. .,Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Melbourne, Victoria, Australia.
| | - Donna M Pinnington
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria, 3800, Australia.,Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Lin Shen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria, 3800, Australia
| | - Michelle Blumfield
- Department of Nutrition, Dietetics, Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria, 3800, Australia
| | - Louise K Newman
- Centre for Women's Mental Health, Department of Psychiatry, University of Melbourne, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Rachel Manber
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
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Mo L, Mansfield DR, Joham A, Cain SW, Bennett C, Blumfield M, Teede H, Moran LJ. Sleep disturbances in women with and without polycystic ovary syndrome in an Australian National Cohort. Clin Endocrinol (Oxf) 2019; 90:570-578. [PMID: 30585648 DOI: 10.1111/cen.13922] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. Sleep disturbances may be more prevalent in PCOS. It is not known if this relationship is independent of other factors. AIM To examine the prevalence of sleep disturbances in a large community-based cohort study in women with and without PCOS and its relationship to clinical, demographic and comorbid factors. METHODS We examined data from survey 5 (2009) of the Australian Longitudinal Study on Women's Health (n = 6578, n = 484 PCOS and n = 6094 non-PCOS). Sleep duration and disturbances were self-reported. Three classes of sleep pattern were derived during latent class analysis (normal sleep duration with average sleep, normal sleep duration with sleep symptoms and short sleep duration with sleep symptoms) and compared between women with and without PCOS using multivariate regression, adjusting for body mass index (BMI), depressive symptoms, demographic and comorbid factors. RESULTS Women with PCOS had similar sleep duration but were more likely to experience difficulty sleeping often (RRR 1.67, 1.20-2.33, P = 0.003) and sometimes (RRR 1.39, 1.07-1.80, P = 0.015), with restless sleep reported occasionally (RRR, 1.35 1.00-1.83, P = 0.049). They reported severe tiredness often (RRR 1.48, 95% CI 1.08-2.04, P = 0.016) and described more sleep difficulties within the last 12 months (OR 1.29, 1.04-1.60, P = 0.018) on adjusted analyses. Compared to the class of average sleep duration with no sleep disturbances, PCOS was associated with increased relative risk of having average sleep duration with sleep symptoms (RRR 1.40, 95%CI 1.11-1.77, P = 0.004) and short sleep duration with sleep symptoms (RRR 1.46, 95%CI 1.07-1.99, P = 0.016) on adjusted analyses. CONCLUSION Sleep disturbances are more prevalent amongst women with PCOS after adjusting for BMI, depressive symptoms, demographic and comorbid factors. Targeted screening and management of sleep disturbances is warranted in PCOS.
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Affiliation(s)
- Lin Mo
- Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia
| | - Darren R Mansfield
- Monash Lung and Sleep, Monash Health, Clayton, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Anju Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia
| | - Sean W Cain
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Christie Bennett
- Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michelle Blumfield
- Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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Walker R, Mazza D, Blumfield M, Bennett C, Truby H. Maternal gestational weight gain during pregnancy: prioritising the conversation. Aust J Prim Health 2019; 24:4-8. [PMID: 29262983 DOI: 10.1071/py17111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/12/2017] [Indexed: 12/15/2022]
Abstract
Pregnancy is a critical stage of life requiring urgent attention when taking a lifespan approach to obesity prevention. Excessive gestational weight gain (GWG) is highly predictive of overweight and obesity later in life for women and their offspring. This discussion describes the challenges faced by health professionals (general practitioners, midwives, allied health) in primary care in Australia when addressing GWG, presents evidence that supports re-prioritising GWG and highlights strategies that can be used to address GWG. The revised National Health and Medical Research Council antenatal care guidelines (to be formally released in early 2018) indicate it will be the responsibility of health professionals in antenatal care to initiate conversations about GWG with women. Women are open to discussing this sensitive topic and health professionals in primary care have an opportunity to be proactive in addressing barriers that have hindered conversations about GWG in the past so that women are supported to manage their weight during pregnancy.
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Affiliation(s)
- Ruth Walker
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Danielle Mazza
- Department of General Practice, School of Primary Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Michelle Blumfield
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Christie Bennett
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
| | - Helen Truby
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia
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Walker R, Bennett C, Kumar A, Adamski M, Blumfield M, Mazza D, Truby H. Evaluating Online Continuing Professional Development Regarding Weight Management for Pregnancy Using the New World Kirkpatrick Model. J Contin Educ Health Prof 2019; 39:210-217. [PMID: 31318720 DOI: 10.1097/ceh.0000000000000261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Clinical practice guidelines advocate the importance of continuing professional development (CPD) that supports health professionals (HPs) to discuss the sensitive topic of maternal weight management with women. However, there is a lack of accredited CPD related to this important area of preconception and antenatal care. Therefore, aims were to evaluate HPs' reactions to accredited online CPD regarding weight management for pregnancy and their knowledge, attitudes, confidence, and commitment to provide women with advice after completing the course. METHODS A mixed-methods evaluation was based on the New World Kirkpatrick Model (NWKM). Accredited online CPD was developed by experts in maternal nutrition and weight management. Participants completed a questionnaire before (n = 136) and after (n = 65) the weight management components of the course. McNemar and Wilcoxon signed-rank tests were used to evaluate paired data (n = 36) (p < .05). Deductive content analyses explored free-text responses (n = 65). RESULTS Participants' reactions to the online CPD were encouraging, facilitating increases in perceptions of the importance of weight management for pregnancy and confidence to provide advice. Quantitative measures assessed no change in participants' knowledge; however, qualitative analyses revealed an increase in participants' knowledge of communication strategies that they intend to apply in practice. DISCUSSION The NWKM facilitated an evaluation of HPs' encouraging reactions to online CPD and the affective constructs of education including attitudes, confidence, and commitment to provide advice. Online CPD should be developed with collaboration between universities/professional associations and health care providers, so that evaluation of organizational change and clinical outcomes is possible.
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Affiliation(s)
- Ruth Walker
- Dr. Walker: Accredited Practicing Dietitian and Research Fellow, Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia. Ms. Bennett: Accredited Practicing Dietitian and PhD Candidate,Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia. Dr. Kumar: Academic Obstetrician and Gynecologist,Department of Obstetrics and Gynaecology, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia. Ms. Adamski: Accredited Practicing Dietitian and PhD Candidate,Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia. Dr. Blumfield: Accredited Practicing Dietitian,Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia. Dr. Mazza: Professor, Department of General Practice, School of Primary and Allied Health Care, Monash University, Notting Hill, VIC, Australia. Dr. Truby: Professor, Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
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Walker R, Bennett C, Blumfield M, Gwini S, Ma J, Wang F, Wan Y, Truby H. Attenuating Pregnancy Weight Gain-What Works and Why: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:E944. [PMID: 30037126 PMCID: PMC6073617 DOI: 10.3390/nu10070944] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/18/2018] [Accepted: 07/20/2018] [Indexed: 11/26/2022] Open
Abstract
Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up to May 2018 (no date or language restrictions). Keywords and MeSH terms for diet, GWG, intervention, lifestyle, maternal, physical activity, and pregnancy were used to locate randomized-controlled trials (RCTs). The Cochrane Collaboration tool for assessing risk of bias was applied. Eighty-nine RCTs were included. Meta-analysis (60 trials) estimated that women in diet only (WMD: -3.27; 95% CI: -4.96, -1.58, p < 0.01), physical activity (PA) (WMD: -1.02; 95% CI: -1.56, -0.49, p < 0.01), and lifestyle interventions (combining diet and PA) (WMD: -0.84; 95% CI: -1.29, -0.39, p < 0.01) gained significantly less weight than controls. The three eHealth interventions favored neither intervention nor control (WMD: -1.06; 95% CI: -4.13, 2.00, p = 0.50). Meta-regression demonstrated no optimal duration, frequency, intensity, setting, or diet type. Traditional face to face delivery of weight management interventions during pregnancy can be successful. Delivery via eHealth has potential to extend its reach to younger women but needs further evaluation of its success.
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Affiliation(s)
- Ruth Walker
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Christie Bennett
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Michelle Blumfield
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
| | - Stella Gwini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne VIC 3004, Australia.
| | - Jianhua Ma
- Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Fenglei Wang
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China.
| | - Yi Wan
- Department of Food Science and Nutrition, Zhejiang University, Hangzhou 310058, China.
| | - Helen Truby
- Department of Nutrition and Dietetics and Food, School of Clinical Sciences, Monash University, Clayton VIC 3168, Australia.
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Walker R, Blumfield M, Truby H. Beliefs and advice-seeking behaviours for fertility and pregnancy: a cross-sectional study of a global sample. J Hum Nutr Diet 2018; 31:486-495. [PMID: 29659064 DOI: 10.1111/jhn.12554] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Pregnancy can motivate individuals to adopt lifestyle behaviours that protect the health of their offspring. The aims of the present study were to explore men's and women's beliefs about lifestyle, fertility and pregnancy, as well as where they seek advice. METHODS Participants (2185 women and 221 men, six unspecified) from 104 countries completed a questionnaire that explored their beliefs about what was important for a healthy pregnancy and their advice-seeking behaviours. Recruitment was via a Massive Open Online Course entitled 'Food as Medicine', with food, nutrient and health content. Comparisons of categorical data were performed using a chi-squared test (P = 0.05). RESULTS Eating a variety of fruits and vegetables and not smoking (both 93.7%) were the most frequently and equally ranked in the top-five factors for a healthy pregnancy. Taking prenatal supplements (26.8%) was considered to be less important. Participants in Westernised countries ranked not smoking or drinking alcohol as being significantly more important than those in other countries. Overall, doctors (47.7%) were the most common source of fertility and pregnancy advice. Larger proportions of those aged <40 years used the Internet (<40 years 44.1%, >40 years 18.2% χ2 = 152.7, P < 0.01) and social media (<40 years 16.1%, >40 years 3.6%; χ2 = 110.18, P < 0.01) for health information. CONCLUSIONS There is disconnection between beliefs and actions regarding the lifestyle behaviours considered to be important for a healthy pregnancy, particularly nutrition. Pregnancy advice-seeking has evolved, with younger men and women utilising the Internet and social media. Health professionals must consider new communication strategies to deliver evidence-based lifestyle advice, particularly for younger men and women and where access to healthcare is limited.
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Affiliation(s)
- R Walker
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - M Blumfield
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - H Truby
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
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Affiliation(s)
- R. Walker
- Monash University; Melbourne Victoria Australia
| | - A. Kumar
- Monash University; Melbourne Victoria Australia
| | | | - H. Truby
- Monash University; Melbourne Victoria Australia
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Truby H, Adamski M, Dart J, Volders E, Blumfield M, Murgia C, Kannar D, Devey A, Gibson S. Engaging the public in nutrition: Extending reach and influence. Journal of Nutrition & Intermediary Metabolism 2017. [DOI: 10.1016/j.jnim.2017.04.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Walker R, Truby H, Blumfield M. A healthy pregnancy: Beliefs and advice-seeking behaviours from an international sample. Journal of Nutrition & Intermediary Metabolism 2017. [DOI: 10.1016/j.jnim.2017.04.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Vincze L, Rollo ME, Hutchesson MJ, Burrows TL, MacDonald-Wicks L, Blumfield M, Collins CE. A cross sectional study investigating weight management motivations, methods and perceived healthy eating and physical activity influences in women up to five years following childbirth. Midwifery 2017; 49:124-133. [PMID: 28131329 DOI: 10.1016/j.midw.2017.01.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/25/2016] [Accepted: 01/05/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE to explore motivations for weight change, weight loss methods used and factors perceived to influence healthy eating and physical activity for weight management following childbirth, and to evaluate differences by socio-demographic, weight status and pregnancy characteristics. DESIGN cross-sectional online survey completed from May to August 2013. PARTICIPANTS Australian women (n=874, aged 32.8±4.5 years, pre-pregnancy Body Mass Index 25.6±5.7kg/m2) aged 18-40 years who had given birth in the previous 5 years MEASUREMENTS: women self-reported socio-demographic, weight status and pregnancy characteristics. Those who reported being unhappy at their current weight ranked their most to least important reasons for wanting to change their weight from a list of nine options. Weight control methods used in the previous two years were reported from a list of 12 options. Perceived healthy eating and physical activity factors influencing weight management were assessed across 20 items using a five-point Likert scale. FINDINGS the most prevalent motivators reported for weight change were to improve health (26.1%) and lift mood (20.3%). Three-quarters (75.7%) of women reported having used at least one weight loss method in the previous two years. Time constraints due to family commitments, enjoyment of physical activity and healthy eating, motivation and cost were factors most commonly reported to influence weight management. Body mass index, parity, education, household income and time since last birth were related to motivations for weight change, weight loss methods used and/or factors perceived to influence weight management. IMPLICATIONS FOR PRACTICE weight management support provided by health professionals should consider women's expressed motivators and factors influencing weight management, along with differences in sociodemographic, pregnancy and weight status characteristics, in order to engage women at this life-stage and facilitate adoption of healthy lifestyle behaviours.
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Affiliation(s)
- Lisa Vincze
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Australia.
| | - Megan E Rollo
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Australia.
| | - Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Australia.
| | - Lesley MacDonald-Wicks
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Australia.
| | - Michelle Blumfield
- Department of Nutrition and Dietetics, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Australia.
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Blumfield M, Hure A, MacDonald-Wicks L, Smith R, Simpson S, Raubenheimer D, Collins C. The association between the macronutrient content of maternal diet and the adequacy of micronutrients during pregnancy in the Women and Their Children’s Health (WATCH) study. Nutrients 2012; 4:1958-76. [PMID: 23222964 PMCID: PMC3546616 DOI: 10.3390/nu4121958] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 11/23/2012] [Accepted: 11/29/2012] [Indexed: 12/30/2022] Open
Abstract
Nutrition during pregnancy can induce alterations in offspring phenotype. Maternal ratio of protein to non-protein (P:NP) energy has been linked to variations in offspring body composition and adult risk of metabolic disease. This study describes the dietary patterns of pregnant women by tertiles of the P:NP ratio and compares diet to Australian recommendations. Data are from 179 Australian women enrolled in the Women and Their Children's Health Study. Diet was assessed using a validated 74-item food frequency questionnaire. Food group servings and nutrient intakes were compared to the Australian Guide to Healthy Eating and Australian Nutrient Reference Values. Higher maternal P:NP tertile was positively associated with calcium (P = 0.003), zinc (P = 0.001) and servings of dairy (P = 0.001) and meat (P = 0.001) food groups, and inversely associated with the energy dense, nutrient poor non-core (P = 0.003) food group. Micronutrient intakes were optimized with intermediate protein (18%E-20%E), intermediate fat (28%E-30%E) and intermediate carbohydrate (50%E-54%E) intakes, as indicated in tertile two. Results suggest a moderate protein intake may support pregnant women to consume the largest variety of nutrients across all food groups.
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Affiliation(s)
- Michelle Blumfield
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales 2308, Australia; E-Mails: (M.B.); (L.M.-W.)
- Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, Level 3, Endocrinology, Locked Bag 1, Hunter Region Mail Centre, New South Wales 2310, Australia; E-Mail:
| | - Alexis Hure
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, New South Wales 2308, Australia; E-Mail:
| | - Lesley MacDonald-Wicks
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales 2308, Australia; E-Mails: (M.B.); (L.M.-W.)
| | - Roger Smith
- Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, Level 3, Endocrinology, Locked Bag 1, Hunter Region Mail Centre, New South Wales 2310, Australia; E-Mail:
- School of Medicine and Public Health, Faculty of Health, University of Newcastle, Callaghan, New South Wales 2308, Australia; E-Mail:
| | - Stephen Simpson
- School of Biological Sciences, University of Sydney, Sydney, New South Wales 2006, Australia; E-Mail:
| | - David Raubenheimer
- Institute of Natural Sciences, Massey University, Albany 0632, New Zealand; E-Mail:
| | - Clare Collins
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales 2308, Australia; E-Mails: (M.B.); (L.M.-W.)
- Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, Level 3, Endocrinology, Locked Bag 1, Hunter Region Mail Centre, New South Wales 2310, Australia; E-Mail:
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Tapp E, Blumfield M. The parenchymal cells of the rat pineal gland. Acta Morphol Neerl Scand 1970; 8:119-31. [PMID: 4099489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Blumfield M, Tapp E. Measurements of pineal parenchymal cells and their nuclei in the albino rat at different ages. Acta Morphol Neerl Scand 1970; 8:1-8. [PMID: 5487418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Abstract
A series of 150 pineal glands removed at routine postmortems in a general hospital have been examined. Statistical analysis of the weights of 147 of these glands from patients aged between 45 and 90 years, shows that the glands from patients dying of malignant disease are significantly lighter than those where the cause of death was non-malignant. These results are almost the exact reverse of those described recently in a similar series in America.After decalcification very little difference in the weight of the gland can be detected between the two groups and it would appear that the higher weight of the glands from non-malignant patients is due, at least in part, to the presence of a greater amount of mineral in these glands.
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