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Thøgersen-Ntoumani C, Gucciardi DF, McVeigh JA, O'Sullivan TA, Dontje M, Stamatakis E, Eastwood PR, Straker L. Health behaviour profiles in young Australian adults in relation to physical and mental health: The Raine Study. Health Promot J Austr 2023. [PMID: 37968787 DOI: 10.1002/hpja.828] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/17/2023] Open
Abstract
ISSUES ADDRESSED We aimed to identify latent health behaviour profiles of young adults and examine their associations with physical and mental health outcomes. We also characterised the profiles by socio-demographic characteristics. METHODS Data were collected between 2012 and 2014. Participants (N = 476) were young adults (M age [SD] = 22.1 [.57] years) from Generation 2 of the Raine Study longitudinal cohort. Health behaviours were measured via ActiGraph GT3X waist monitors (physical activity, sedentary behaviour) and questionnaires (diet quality, alcohol, smoking and sleep). Physical and mental health were measured using clinical health assessments, blood biomarkers, and questionnaires. Latent Profile Analysis using Mplus (8.2) was employed to identify profiles. RESULTS Four latent profiles were identified: 'heavy drinkers with moderately unhealthy eating habits' (high takeaway foods; n = 135), 'unhealthy food abstainers' (low takeaway foods; n = 138), 'moderately sedentary alcohol abstainers' (n = 139) and 'physically active drinkers with unhealthy eating habits' (high takeaway foods and sugary drinks; n = 64). 'Physically active drinkers with unhealthy eating habits' had the poorest (physical and mental) health outcomes, yet the lowest insulin resistance. 'Unhealthy food abstainers' had the most favourable health outcomes (adiposity, health perceptions, blood pressure). Sex differed among the profiles. CONCLUSIONS The profiles identified among young adults are different to profiles with general adult populations. A novel finding was that 'physically active drinkers with unhealthy eating habits' had low insulin resistance. The findings also suggest that future interventions may need to be sex specific. SO WHAT Our findings suggest that health behaviour interventions for young adults should be targeted to distinct profile characteristics.
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Affiliation(s)
- Cecilie Thøgersen-Ntoumani
- Danish Centre for Motivation and Behaviour Science, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Daniel F Gucciardi
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Joanne A McVeigh
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Therese A O'Sullivan
- School of Medical and Health Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Manon Dontje
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Centre, Utrecht, The Netherlands
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and de Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Emmanuel Stamatakis
- Faculty of Medicine and Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Peter R Eastwood
- Health Futures Institute, Murdoch University, Perth, Western Australia, Australia
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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2
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Properzi C, Adams LA, Lo J, Sherriff JL, Jeffrey GP, O'Sullivan TA. Higher Overall Intakes Are the Defining Feature of Dietary Intakes in NAFLD and Compared to the General Population. Nutrients 2023; 15:2669. [PMID: 37375573 DOI: 10.3390/nu15122669] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
We aimed to compare the dietary intakes of Australian patients with non-alcoholic fatty liver disease (NAFLD) to general Australian population intake data and determine whether the intake of any nutrient or food group was able to predict the degree of steatosis. Dietary data from fifty adult patients with NAFLD were compared to intake data from the Australian Health Survey for energy, macronutrients, fat sub-types, alcohol, iron, folate, sugar, fibre, sodium and caffeine. Linear regression models adjusting for potential confounders (age, sex, physical activity and body mass index) were used to examine predictive relationships between hepatic steatosis (quantified via magnetic resonance spectroscopy) and dietary components. The mean percentage differences between NAFLD and Australian usual intakes were significant for energy, protein, total fat, saturated fat, monounsaturated and polyunsaturated fats (all p < 0.001). The contribution of fat and protein to total energy intake was significantly higher in the NAFLD cohort (p < 0.05). No individual nutrients or food groups were strongly related to hepatic fat in the adjusted models. Higher overall consumption appears to be a major feature of dietary intake in NAFLD when compared to the general population. A whole-diet approach to NAFLD treatment and prevention is likely to be more effective than focusing on single food components.
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Affiliation(s)
- Catherine Properzi
- Nutrition & Health Innovation Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Leon A Adams
- Medical School, The University of Western Australia, Nedlands, WA 6009, Australia
- Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Jill L Sherriff
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA 6102, Australia
| | - Gary P Jeffrey
- Medical School, The University of Western Australia, Nedlands, WA 6009, Australia
- Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Therese A O'Sullivan
- Nutrition & Health Innovation Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, WA 6027, Australia
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3
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Demirci JR, Glasser M, Bogen DL, Sereika SM, Ren D, Ray K, Bodnar LM, O'Sullivan TA, Himes K. Effect of antenatal milk expression education on lactation outcomes in birthing people with pre-pregnancy body mass index ≥25: protocol for a randomized, controlled trial. Int Breastfeed J 2023; 18:16. [PMID: 36927811 PMCID: PMC10019405 DOI: 10.1186/s13006-023-00552-6] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/19/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Birthing people with pre-pregnancy body mass indices (BMIs) ≥ 25 kg/m2, particularly those without prior breastfeeding experience, are at increased risk for suboptimal lactation outcomes. Antenatal milk expression (AME) may be one way to counteract the negative effects of early infant formula supplementation common in this population. METHODS This ongoing, randomized controlled trial in the United States evaluates the efficacy of a telelactation-delivered AME education intervention versus an attention control condition on lactation outcomes to 1 year postpartum among 280 nulliparous-to-primiparous, non-diabetic birthing people with pre-pregnancy BMI ≥ 25 kg/m2. The assigned study treatment is delivered via four weekly online video consultations between gestational weeks 37-40. Participants assigned to AME meet with study personnel and a lactation consultant to learn and practice AME. Instructions are provided for home practice of AME between study visits. Control group participants view videos on infant care/development at study visits. Participants complete emailed surveys at enrollment (340/7-366/7 gestational weeks) and 2 weeks, 6 weeks, 12 weeks, 6 months, and 12 months postpartum. Surveys assess lactation and infant feeding practices; breastfeeding self-efficacy, attitudes, and satisfaction; perception of insufficient milk; onset of lactogenesis-II; lactation support and problems; and reasons for breastfeeding cessation. Surveys also assess factors associated with lactation outcomes, including demographic characteristics, health problems, birth trauma, racial discrimination, and weight stigma. Health information and infant feeding data are abstracted from the pregnancy and birth center electronic health record. Milk samples are collected from the intervention group at each study visit and from both groups at each postpartum follow-up for future analyses. Qualitative interviews are conducted at 6 weeks postpartum to understand AME experiences. Primary outcomes of interest are breastfeeding exclusivity and breastfeeding self-efficacy scores at 2 weeks postpartum. Outcomes will be examined longitudinally with generalized linear mixed-effects modeling. DISCUSSION This is the first adequately powered trial evaluating the effectiveness of AME among U.S. birthing people and within a non-diabetic population with pre-pregnancy BMI ≥ 25 kg/m2. This study will also provide the first evidence of acceptability and effectiveness of telelactation-delivered AME. TRIAL REGISTRATION ClinicalTrials.gov: NCT04258709.
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Affiliation(s)
- Jill R Demirci
- Department of Health Promotion & Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
| | - Melissa Glasser
- Department of Health Promotion & Development, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Debra L Bogen
- Allegheny County Health Department, Pittsburgh, PA, USA
| | - Susan M Sereika
- Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Dianxu Ren
- Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Kristin Ray
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,UPMC Children's Community Pediatrics, Pittsburgh, PA, USA
| | - Lisa M Bodnar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Katherine Himes
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Maternal-Fetal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,UPMC Magee-Womens Hospital, Pittsburgh, PA, USA
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4
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O'Sullivan TA, Jayasuriya PH, Tsalis N, Calogero N, Manocha R. Nurses' understanding and management of iron deficiency in Australia: a cross-sectional, exploratory study. BMJ Open 2023; 13:e065706. [PMID: 36806134 PMCID: PMC9944295 DOI: 10.1136/bmjopen-2022-065706] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES To assess the experiences and knowledge of nurses in the area of iron deficiency. DESIGN A cross-sectional, exploratory study using online survey. SETTING Data were collected from nurses working at various primary, secondary and tertiary Australian health practices and organisations. PARTICIPANTS Australian nurses currently in practice. METHOD Australian nurses currently in practice were invited to complete an online survey about their work background, personal experiences with iron deficiency and iron-deficiency identification and treatment. The survey included a nine-item questionnaire to assess knowledge of iron-deficiency risk factors and biochemistry. RESULTS A total of 534 eligible nurses participated in the survey. Participants were more likely to be female, aged 55-64 years, and working in general practice. Just under half (45.1%) reported being diagnosed with iron deficiency themselves. Unusual fatigue or tiredness was the most frequent symptom that alerted nurses to potential iron deficiency in patients (reported by 91.9% of nurses). Nurses who had participated in formal training around iron deficiency in the last 5 years demonstrated a significantly higher knowledge score (4.2±2.1) compared with those who had not or were not sure about their formal training status (3.7±1.9, p=0.035). Knowledge around the understanding of functional iron deficiency was limited. CONCLUSIONS Nurses report personal experiences of iron deficiency and show good knowledge of symptoms, demonstrating the potential for them to take a leading role in managing iron deficiency in patients. Educational programmes are required to address knowledge gaps and should be offered via various methods to accommodate a diverse nurse cohort. Our research highlights the potential for an expanded scope of practice for nurses in the primary care setting in the area of iron deficiency.
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Affiliation(s)
- Therese A O'Sullivan
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | | | - Natalie Tsalis
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nina Calogero
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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5
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Wan F, Pan F, Ayonrinde O, Adams LA, Mori TA, Beilin LJ, O'Sullivan TA, Olynyk JK, Oddy WH. Prospective dietary polyunsaturated fatty acid intake is associated with trajectories of fatty liver disease: an 8 year follow-up study from adolescence to young adulthood. Eur J Nutr 2022; 61:3987-4000. [PMID: 35780424 PMCID: PMC9596520 DOI: 10.1007/s00394-022-02934-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 06/07/2022] [Indexed: 11/29/2022]
Abstract
Background and aim Dietary fat intake has long been associated with fatty liver. Our study aimed to determine the effect of dietary fats on longitudinal fatty liver index (FLI) trajectories from adolescence to young adulthood.
Methods Nine hundred eighty-five participants in the Raine Study, Perth, Western Australia, Australia, had cross-sectional assessments at ages 14, 17, 20 and 22 years, during which anthropometric measurements and blood tests were obtained. FLI trajectories were derived from the longitudinal FLI results. Dietary fat intake was measured with a semi-quantitative food frequency questionnaire at 14 years and log multinominal regression analyses were used to estimate relative risks.
Results Three FLI trajectories were identified and labelled as stable-low (79.1%, N = 782), low-to-high (13.9%, N = 132), and stable-high (7%, N = 71). The low-to-high group associated with an increased intake of the long-chain polyunsaturated fatty acids EPA, DPA and DHA (RR 1.27, 95% CI 1.10–1.48) relative to the stable-low group. Compared to the stable-low group, omega-6 and the ratio of omega-6 to omega-3 in the stable-high group were associated with an increased relative risk of 1.34 (95% CI 1.02–1.76) and 1.10 (95% CI 1.03–1.16), respectively.
Conclusion For those at high risk of fatty liver in early adolescence, high omega-6 fatty acid intake and a high ratio of omega-6 to omega-3 fatty acids are associated with increased risk of fatty liver. There should be caution in assuming these associations are causal due to possible undetected and underestimated confounding factors.
Supplementary Information The online version contains supplementary material available at 10.1007/s00394-022-02934-8.
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Affiliation(s)
- Fuzhen Wan
- Nutritional Epidemiology, Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Feng Pan
- Nutritional Epidemiology, Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Oyekoya Ayonrinde
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch University, Perth, WA, Australia.,Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Leon A Adams
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Trevor A Mori
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Lawrence J Beilin
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Therese A O'Sullivan
- School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia
| | - John K Olynyk
- Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Murdoch University, Perth, WA, Australia.,School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia
| | - Wendy H Oddy
- Nutritional Epidemiology, Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
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Charng J, Ansari AS, Bondonno NP, Hunter ML, O'Sullivan TA, Louca P, Hammond CJ, Mackey DA. Association between dietary niacin and retinal nerve fibre layer thickness in healthy eyes of different ages. Clin Exp Ophthalmol 2022; 50:736-744. [DOI: 10.1111/ceo.14120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Jason Charng
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute) The University of Western Australia Perth Australia
- Department of Optometry The University of Western Australia Perth Australia
| | - Abdus Samad Ansari
- Section of Academic Ophthalmology School of Life Course Sciences, FoLSM, King's College London UK
| | - Nicola P. Bondonno
- Institute for Nutrition Research School of Medical and Health Sciences, Edith Cowan University Perth Australia
- The Danish Cancer Society Research Centre Copenhagen Denmark
| | - Michael L. Hunter
- School of Population and Global Health The University of Western Australia Perth Australia
- Busselton Population Medical Research Institute Inc. Perth Australia
| | - Therese A. O'Sullivan
- Institute for Nutrition Research School of Medical and Health Sciences, Edith Cowan University Perth Australia
| | - Panayiotis Louca
- Department of Twin Research & Genetic Epidemiology School of Life Course Sciences, FoLSM, King's College London London UK
| | - Chris J. Hammond
- Section of Academic Ophthalmology School of Life Course Sciences, FoLSM, King's College London UK
| | - David A. Mackey
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute) The University of Western Australia Perth Australia
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Middeke J, Palmer K, Lövestam E, Vivanti A, Orrevall Y, Steiber A, Lyons-Wall P, Lo J, Devine A, Lieffers J, Papoutsakis C, Lang NR, Thoresen L, Lloyd L, O'Sullivan TA. Predictors of nutrition care process knowledge and use among dietitians internationally. J Hum Nutr Diet 2021; 35:466-478. [PMID: 34812563 DOI: 10.1111/jhn.12961] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem-solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated which factors predict NCP/T knowledge and use among dietetic professionals in an international cohort, aiming to understand how implementation can be strengthened. METHODS The validated International NCP Implementation Survey was disseminated to dietitians in 10 countries via professional networks. Implementation, attitudes and knowledge of the NCP/T along with workplace and educational data were assessed. Independent predictive factors associated with higher NCP/T knowledge and use were identified using backward stepwise logistic regression. RESULTS Data from 6149 respondents was used for this analysis. Enablers that were independent predictors of both high knowledge and frequent use of NCP/T were peer support, recommendation from national dietetic association and workplace requirements (all p < 0.001). Country of residence and working in clinical settings (p < 0.001) were demographic characteristics that were independent predictors of high knowledge and frequent use of NCP/T. A high knowledge score was an independent predictor of frequent NCP/T use (p = 0.002). CONCLUSIONS Important modifiable enablers for NCP knowledge and use rely on organisational management. National dietetic organisations and key stakeholders such as employers are encouraged to integrate active NCP/T support in their leadership initiatives. This could take the form of policies, formalised and structured training strategies, and informatics initiatives for the integration in electronic health records.
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Affiliation(s)
- Julia Middeke
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
| | - Kayla Palmer
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
| | - Elin Lövestam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Angela Vivanti
- Research & Development Dietitian, Princess Alexandra Hospital, Brisbane, QLD, Australia.,School of Human Movement and Nutrition Studies, University of Queensland, St Lucia, Queensland, Australia
| | - Ylva Orrevall
- Department of Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden.,Department of Bioscience and Nutrition, Karolinska Institute, Stockholm, Sweden
| | - Alison Steiber
- Division of Nutrition and Dietetics, Collage of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SA, Canada
| | - Philippa Lyons-Wall
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, WA, Australia
| | - Amanda Devine
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
| | - Jessica Lieffers
- Division of Nutrition and Dietetics, Collage of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SA, Canada
| | | | - Nanna R Lang
- Department of Nutrition and Health, VIA University College, Horsens, Denmark
| | | | - Lyn Lloyd
- Auckland City Hospital, Auckland, New Zealand
| | - Therese A O'Sullivan
- School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia
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Nicholl A, Deering KE, Evelegh K, Lyons-Wall P, Lawrence D, Mori TA, Kratz M, O'Sullivan TA. Whole-fat dairy products do not adversely affect adiposity or cardiometabolic risk factors in children in the Milky Way Study: a double-blind randomized controlled pilot study. Am J Clin Nutr 2021; 114:2025-2042. [PMID: 34633422 PMCID: PMC8634568 DOI: 10.1093/ajcn/nqab288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Limited evidence supports the common public health guideline that children >2 y of age should consume dairy with reduced fat content. OBJECTIVES We aimed to investigate the effects of whole-fat compared with reduced-fat dairy intake on measures of adiposity and biomarkers of cardiometabolic risk in healthy 4- to 6-y-old children. METHODS The Milky Way Study enrolled 49 children (mean ± SD age: 5.2 ± 0.9 y; 47% girls) who were habitual consumers of whole-fat dairy, then randomly assigned them in a double-blind fashion to remain on whole-fat dairy or switch their dairy consumption to reduced-fat products for 3 mo. Primary endpoints included measures of adiposity, body composition, blood pressure, fasting serum lipids, blood glucose, glycated hemoglobin (HbA1c), and C-reactive protein (CRP) and were assessed at baseline and study end. Pre- and postintervention results were compared using linear mixed models, adjusted for growth, age, and sex. RESULTS Dairy fat intake was reduced by an adjusted (mean ± SEM) 12.9 ± 4.1 g/d in the reduced-fat compared with the whole-fat dairy group (95% CI: -21.2, -4.6 g/d; P = 0.003), whereas dietary energy intakes remained similar (P = 0.936). We found no significant differential changes between dairy groups in any measure of adiposity, body composition, blood pressure, or fasting serum lipids, glucose, HbA1c, and CRP. CONCLUSIONS Our results suggest that although changing from whole-fat to reduced-fat dairy products does reduce dairy fat intake, it does not result in changes to markers of adiposity or cardiometabolic disease risk in healthy children.This trial was registered at www.anzctr.org.au as ACTRN12616001642471.
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Affiliation(s)
| | - Kane E Deering
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Kate Evelegh
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Philippa Lyons-Wall
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - David Lawrence
- Graduate School of Education, Faculty of Arts, Business, Law and Education, University of Western Australia, Perth, Western Australia, Australia
| | - Trevor A Mori
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Mario Kratz
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Therese A O'Sullivan
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
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9
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Wan F, Pan F, Ayonrinde OT, Adams LA, Mori TA, Beilin LJ, O'Sullivan TA, Olynyk JK, Oddy WH. Validation of fatty liver disease scoring systems for ultrasound diagnosed non-alcoholic fatty liver disease in adolescents. Dig Liver Dis 2021; 53:746-752. [PMID: 33334704 DOI: 10.1016/j.dld.2020.11.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing in young populations. However, there are inadequate data regarding diagnosis of NAFLD. We aimed to validate three scoring systems against a previous standard of suprailiac skinfold thickness for diagnosing NAFLD in population-based adolescents. METHODS Seventeen-year-old adolescents (n = 899), participating in the Raine Study, attended a cross-sectional follow-up. NAFLD was diagnosed using liver ultrasound. Scores for Fatty liver index (FLI), Hepatic Steatosis Index (HSI) and Zhejiang University index (ZJU index) were calculated. Diagnostic accuracy of these diagnostic tests was evaluated through discrimination and calibration. RESULTS NAFLD was diagnosed 9% in males and 15% in females. The three scoring systems demonstrated better discrimination performance for NAFLD in males (AUC was FLI:0.82, HSI: 0.83 and ZJU index: 0.83) compared to females (AUC was FLI: 0.67, HSI: 0.67 and ZJU index: 0.67). Suprailiac skinfold performed better than the scoring systems (overall AUC: 0.82; male AUC:0.88; female AUC:0.73). FLI had best calibration performance. CONCLUSION Suprailiac skinfold thickness was a better predictor of ultrasound-diagnosed NAFLD than the three diagnostic scoring systems investigated. The higher performance characteristics of the algorithmic scoring systems in males compared with females may have implications for use in population assessments.
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Affiliation(s)
- Fuzhen Wan
- Menzies Institute for Medical Research, University of Tasmania
| | - Feng Pan
- Menzies Institute for Medical Research, University of Tasmania
| | - Oyekoya T Ayonrinde
- Medical School, The University of Western Australia, Perth, Western Australia; Department of Gastroenterology, Fiona Stanley Fremantle Hospital Group, Murdoch, Western Australia
| | - Leon A Adams
- Medical School, The University of Western Australia, Perth, Western Australia
| | - Trevor A Mori
- Medical School, The University of Western Australia, Perth, Western Australia
| | - Lawrence J Beilin
- Medical School, The University of Western Australia, Perth, Western Australia
| | | | - John K Olynyk
- Department of Gastroenterology, Fiona Stanley Fremantle Hospital Group, Murdoch, Western Australia; School of Medical and Health Sciences, Edith Cowan University
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania.
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10
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Panossian C, Lyons-Wall P, Whitehouse A, Oddy WH, Lo J, Scott J, O'Sullivan TA. Young Adults with High Autistic-Like Traits Displayed Lower Food Variety and Diet Quality in Childhood. J Autism Dev Disord 2021; 51:685-696. [PMID: 32617793 PMCID: PMC7835288 DOI: 10.1007/s10803-020-04567-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study explored the association between autistic-like traits in young adults and dietary intake in early childhood in the Gen2 Raine Study cohort. Data were available from 811 participants at years 1, 2 and 3 for the assessment of dietary intake, and at year 20 for measurement of autistic-like traits. Results showed as autistic-like traits increased, total food variety, core food variety and dairy variety decreased (p < 0.05), with a lower consumption of citrus fruits and yoghurt (both p = 0.04). As autistic-like traits increased, diet quality decreased, this trend was significant at 2 years (p = 0.024). Our results suggest that young adults with higher autistic-like traits were more likely to have had lower food variety and diet quality in early childhood.
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Affiliation(s)
- Catherine Panossian
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Philippa Lyons-Wall
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Andrew Whitehouse
- Telethon Kids Institute, The University of Western Australia, Perth Children's Hospital, Northern Entrance, 15 Hospital Avenue, Nedlands, WA, 6009, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Churchill Avenue, Hobart, TAS, 7005, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Jane Scott
- School of Public Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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11
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Butcher LM, O'Sullivan TA, Ryan MM, Lo J, Nyanjom J, Wilkins HC, Devine A. To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security. Health Promot J Austr 2020; 32 Suppl 2:267-282. [PMID: 32991748 PMCID: PMC8597035 DOI: 10.1002/hpja.427] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 11/18/2022] Open
Abstract
Issue addressed Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside and outside of the home. Methods An online survey was completed by adults (n = 1292) residing in one of five Australian states. The questionnaire comprised of the six‐item US Household Food Security Survey Module, 12 socio‐demographic variables and 32 questions related to elements of food literacy. Results Food insecure respondents were more likely to frequent fast food vs (P = .002), takeaway (P < .001) and food courts (P < .001) than their food secure counterparts. Food secure respondents reported greater use of raw (P = .043) and fresh, pre‐prepared produce (P = .002) when cooking, whereas food insecure respondents were more likely to prepare food using only frozen, pre‐packaged products (P < .001). No significant differences were found between food security status and the enjoyment and social bonding derived from cooking. Conclusions Food insecure respondents appeared to be accessing a poorer quality of food through greater consumption of takeaway and fast food. These dietary compromises are most likely related to perceived financial, time or cooking facility constraints and to a lesser extent food literacy skills. So what? This study highlights some of the health and social inequities apparent within food insecure populations. Food insecure households should be supported to access healthy fresh food and in‐home cooking practices. While a multi strategy approach is required, healthy food environment policy, particularly in disadvantaged areas, should be considered to guarantee that all Australians have dignified access to nutritious food.
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Affiliation(s)
- Lucy M Butcher
- Edith Cowan University, Joondalup, WA, Australia.,Foodbank WA, Perth Airport, WA, Australia
| | | | - Maria M Ryan
- Edith Cowan University, Joondalup, WA, Australia
| | - Johnny Lo
- Edith Cowan University, Joondalup, WA, Australia
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12
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O'Sullivan TA, Schmidt KA, Kratz M. Whole-Fat or Reduced-Fat Dairy Product Intake, Adiposity, and Cardiometabolic Health in Children: A Systematic Review. Adv Nutr 2020; 11:928-950. [PMID: 32119732 PMCID: PMC7360438 DOI: 10.1093/advances/nmaa011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 10/15/2019] [Revised: 12/16/2019] [Accepted: 01/24/2020] [Indexed: 12/29/2022] Open
Abstract
Dietary guidelines commonly recommend that children aged >2 y consume reduced-fat dairy products rather than regular- or whole-fat dairy. In adults, most studies have not found the consumption of whole-fat dairy products to be associated with increased cardiometabolic or adiposity risk. Associations in children could differ due to growth and development. We systematically reviewed the literature in indexed, peer-reviewed journals to summarize pediatric studies (children aged from 2 to 18 y) assessing associations between whole- and reduced-fat dairy intake and measures of adiposity as well as biomarkers of cardiometabolic disease risk, including the serum lipid profile, blood pressure, low-grade chronic inflammation, oxidative stress, and measures of glucose homeostasis. For the purposes of this review, a "whole-fat" dairy product was defined as a product with the natural fat content, whereas a "reduced-fat" dairy product was defined as a product with some or all of the fat removed (including "low-fat" and "skim" versions). A total of 29 journal articles met our criteria for inclusion. The majority were conducted in the United States and were prospective or cross-sectional observational studies, with only 1 randomized controlled trial. Studies were consistent in reporting that whole-fat dairy products were not associated with increased measures of weight gain or adiposity. Most evidence indicated that consumption of whole-fat dairy was not associated with increased cardiometabolic risk, although a change from whole-fat to reduced-fat dairy improved outcomes for some risk factors in 1 study. Taken as a whole, the limited literature in this field is not consistent with dietary guidelines recommending that children consume preferably reduced-fat dairy products. High-quality randomized controlled trials in children that directly compare the effects of whole-fat compared with reduced-fat dairy intake on measures of adiposity or biomarkers of cardiometabolic disease risk are needed to provide better quality evidence in this area.
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Affiliation(s)
| | - Kelsey A Schmidt
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Research Centre, Seattle, WA, USA
| | - Mario Kratz
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Research Centre, Seattle, WA, USA,Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington, Seattle, WA, USA,Department of Epidemiology, University of Washington, Seattle, WA, USA
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13
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Adams LA, Wang Z, Liddle C, Melton PE, Ariff A, Chandraratna H, Tan J, Ching H, Coulter S, de Boer B, Christophersen CT, O'Sullivan TA, Morrison M, Jeffrey GP. Bile acids associate with specific gut microbiota, low-level alcohol consumption and liver fibrosis in patients with non-alcoholic fatty liver disease. Liver Int 2020; 40:1356-1365. [PMID: 32243703 DOI: 10.1111/liv.14453] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Bile acids (BAs) are synthesized by the liver and modified by gut bacteria, and may play an intermediary role between the gut microbiome and liver in promoting fibrosis in non-alcoholic fatty liver disease (NAFLD). We investigated the associations between serum and faecal BAs, gut microbiome and fibrosis in patients with and without NAFLD and examined the impact of diet and alcohol consumption on these relationships. METHODS Adult patients (n = 122) underwent liver biopsy and BAs characterization by high-performance liquid chromatography/mass spectrometry. Gut microbiome composition was analysed using next-generation 16S rRNA sequencing. Diet and alcohol intake were determined by 3-day food diary. RESULTS Serum and faecal BA concentrations increased progressively among non-NAFLD controls (n = 55), NAFLD patients with no/mild fibrosis (F0-2, n = 58) and NAFLD with advanced fibrosis (F3/4, n = 9). Progressive increases in serum BAs were driven by primary conjugated BAs including glycocholic acid [GCA] and secondary conjugated BAs. In contrast, faecal BA increase was driven by secondary unconjugated BAs (predominately deoxycholic acid [DCA]). Serum GCA levels and faecal DCA levels correlated with the abundance of Bacteroidaceae and Lachnospiraceae, and stool secondary BAs with an unclassifiable family of the order Bacteroidales (Bacteroidales;other). These bacterial taxa were also associated with advanced fibrosis. Modest alcohol consumption was positively correlated with faecal DCA levels and relative abundance of Lachnospiracaea and Bacteroidales;other. CONCLUSIONS Higher serum and faecal BA levels are associated with advanced fibrosis in NAFLD. Specific gut bacteria link alterations in BA profiles and advanced fibrosis, and may be influenced by low-level alcohol consumption.
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Affiliation(s)
- Leon A Adams
- Medical School, Faculty of Medical and Health Sciences, The University of Western Australia, Perth, WA, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Zhengyi Wang
- Medical School, Faculty of Medical and Health Sciences, The University of Western Australia, Perth, WA, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Chris Liddle
- Storr Liver Centre, The Westmead Institute, University of Sydney, Westmead, NSW, Australia
| | - Phillip E Melton
- Curtin/UWA Centre for Genetic Origins of Health and Disease, Curtin University and University of Western Australia, Perth, WA, Australia.,School of Pharmacy and Biomedical Sciences, Curtin University, Bentley, WA, Australia
| | - Amir Ariff
- Curtin/UWA Centre for Genetic Origins of Health and Disease, Curtin University and University of Western Australia, Perth, WA, Australia
| | | | - Jeremy Tan
- Department of Upper GI and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore
| | - Helena Ching
- Medical School, Faculty of Medical and Health Sciences, The University of Western Australia, Perth, WA, Australia
| | - Sally Coulter
- Storr Liver Centre, The Westmead Institute, University of Sydney, Westmead, NSW, Australia
| | - Bastiaan de Boer
- Department of Anatomy, PathWest Laboratory Medical WA, Pathwest, WA, Australia
| | - Claus T Christophersen
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,WA Human Microbiome Collaboration Centre, School of Molecular and Life Sciences, Curtin University, Bentley, WA, Australia
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Mark Morrison
- Faculty of Medicine, The University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, QLD, Australia
| | - Gary P Jeffrey
- Medical School, Faculty of Medical and Health Sciences, The University of Western Australia, Perth, WA, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
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14
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Ng FJ, Mackey DA, O'Sullivan TA, Oddy WH, Yazar S. Is Dietary Vitamin A Associated with Myopia from Adolescence to Young Adulthood? Transl Vis Sci Technol 2020; 9:29. [PMID: 32821526 PMCID: PMC7408804 DOI: 10.1167/tvst.9.6.29] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 04/01/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose Potential links may exist between vitamin A intake and myopia via various pathways. In this study, we examined the association between dietary vitamin A intake during adolescence and myopia in early adulthood. Methods We performed a prospective analysis utilizing data collected from participants of the Raine Study Gen2. Dietary vitamin A intake, determined via food frequency questionnaires completed at ages 14, 17, and 20 years, was compared with ophthalmic measurements collected at year 20. Low vitamin A levels were defined as <600 µg/day. Regression models were used to adjust for ocular sun exposure level, educational level, and parental myopia as potential confounders. Results A total of 642 subjects were analyzed. Although those with adequate vitamin A intakes were less likely to be myopic (P = 0.03), this association became insignificant when adjusted for potential confounding factors in logistic regression modeling (odds ratio, 0.59; 95% confidence interval, 0.98–2.52; P = 0.06). Conclusions There were no significant associations between total vitamin A intakes during adolescence and year 20 refractive errors after adjustment for confounders. Replication of this finding and further investigations are essential to rule out the suggestion that sufficient vitamin A intake during adolescence is associated with lower risk of myopia in early adulthood. Translational Relevance Our findings are not definitive that ingesting foods high in vitamin A during childhood and adolescence does not have a role for preventing myopia in early adulthood.
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Affiliation(s)
- Fletcher J Ng
- Department of Genetics and Epidemiology, Lions Eye Institute, Perth, Western Australia, Australia
| | - David A Mackey
- Department of Genetics and Epidemiology, Lions Eye Institute, Perth, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
| | - Therese A O'Sullivan
- School of Medical and Health Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Seyhan Yazar
- Department of Genetics and Epidemiology, Lions Eye Institute, Perth, Western Australia, Australia.,Garvan Institute of Medical Research, Sydney, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
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15
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Lövestam E, Vivanti A, Steiber A, Boström AM, Devine A, Haughey O, Kiss CM, Lang NR, Lieffers J, Lloyd L, O'Sullivan TA, Papoutsakis C, Peersen C, Thoresen L, Orrevall Y. Barriers and enablers in the implementation of a standardised process for nutrition care: findings from a multinational survey of dietetic professionals in 10 countries. J Hum Nutr Diet 2020; 33:252-262. [PMID: 31912581 DOI: 10.1111/jhn.12700] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 01/22/2023]
Abstract
BACKGROUND To explore the barriers and enablers experienced by nutrition and dietetic professionals in the implementation of the standardised Nutrition Care Process (NCP) across 10 different countries. NCP related beliefs, motivations and values were investigated and compared. METHODS A validated online survey was disseminated to nutrition and dietetics professionals in 10 countries in the local language during 2017. Cross-sectional associations and differences between countries were explored for level of implementation, barriers/enablers and attitudes/motivation among the respondents. RESULTS Higher NCP implementation was associated with greater occurrence of enabling aspects, as well as fewer occurrences of barriers. The most common enabler was 'recommendation by the national dietetic association' (69%) and the most common barrier was 'lack of time' (39%). A longer experience of NCP use was associated with a more positive attitude towards all NCP aspects. Differences between countries were identified, regarding both the occurrence of barriers/enablers and attitudes/motivations. CONCLUSIONS Implementation efforts need to be tailored to country-specific contexts when implementing a new standard of care framework among nutrition and dietetic professionals. Additional research is needed to further assess the management and workplace strategies to support the development of nutrition and dietetics professionals in multidisciplinary healthcare organisations.
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Affiliation(s)
- E Lövestam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - A Vivanti
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, QLD, Australia
- School of Human Movement and Nutrition Studies, University of Queensland, QLD, Australia
| | - A Steiber
- Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - A-M Boström
- Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institute, Huddinge, Sweden
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
- Research& Development unit, Stockholms Sjukhem, Stockholm, Sweden
- Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway
| | - A Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - O Haughey
- Irish Nutrition and Dietetic Institute, Dun Laoghaire, Co., Dublin, Ireland
- Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - C M Kiss
- Clinical Nutrition, Research and Development, University Department of Geriatric Medicine FELIX PLATTER, Basel, Swiftzerland
| | - N R Lang
- Department of Nutrition and Health, VIA University College, Aarhus N, Denmark
| | - J Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - L Lloyd
- Nutrition and Dietetics, Auckland City Hospital, Auckland, New Zealand
| | - T A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - C Papoutsakis
- Academy of Nutrition and Dietetics, Chicago, IL, USA
| | - C Peersen
- The municipality of Trondheim, Trondheim, Norway
| | - L Thoresen
- Cancer Clinic, Trondheim University Hospital, Trondheim, Norway
- National Advisory Unit on Disease-Related Malnutrition, Oslo University Hospital, Oslo, Norway
| | - Y Orrevall
- Function Area Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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16
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Ayonrinde OT, Sanfilippo FM, O'Sullivan TA, Adams LA, Ayonrinde OA, Robinson M, Oddy WH, Olynyk JK. Bowel patterns, gastrointestinal symptoms, and emotional well-being in adolescents: A cohort study. J Gastroenterol Hepatol 2019; 34:1946-1954. [PMID: 31059144 DOI: 10.1111/jgh.14699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/12/2019] [Accepted: 04/28/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM Bowel patterns are varied in the general population. Gastrointestinal symptoms are common reasons for clinical visits. We aimed to examine the usual bowel pattern and the prevalence and significance of gastrointestinal symptoms in a population-based cohort of Australian adolescents. METHODS Seventeen-year-old adolescents (n = 1279) in the Western Australian Pregnancy Cohort (Raine) Study participated in a cross-sectional assessment, involving health questionnaires. Questions included medical history, diet, bowel patterns, and gastrointestinal symptoms. Data were analyzed to identify patterns of bowel motions, gastrointestinal symptoms, and factors associated with these in adolescents. Multivariate logistic regression analysis was used to determine predictors of poorer self-rated health status. RESULTS The dominant pattern of bowel motions was passage of stool that was "not too hard and not too soft" (Bristol stool types 3 and 4) in 90% and occurring between three and seven times per week in 74%. The most prevalent gastrointestinal symptoms included abdominal bloating (72%), abdominal pain (36%), nausea (25%), and constipation (20%). A "Western" dietary pattern was associated with abdominal bloating, constipation, and nausea (P < 0.05). Apart from diarrhea, gastrointestinal symptoms were more prevalent in female adolescents than male adolescents (P < 0.05 for all). Female sex (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.16-3.02, P = 0.01), nausea (OR 3.18, 95% CI 2.03-4.98, P < 0.001), and depression (OR 6.68, 95% CI 3.65-12.22, P = 0.03) were independently associated with poorer self-rated health status, after adjusting for other gastrointestinal symptoms. CONCLUSIONS In adolescents, bowel patterns and gastrointestinal symptoms are diverse and show sex differences. Nausea, depression, and female sex are significant factors for poorer self-rated health.
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Affiliation(s)
- Oyekoya T Ayonrinde
- Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Perth, Western Australia, Australia.,Medical School, The University of Western Australia, Perth, Western Australia, Australia.,Faculty of Health Sciences, Curtin University, Bentley, Western Australia
| | - Frank M Sanfilippo
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Leon A Adams
- Medical School, The University of Western Australia, Perth, Western Australia, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Oyedeji A Ayonrinde
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada.,Kingston Health Sciences Centre, Hotel Dieu Hospital, Kingston, Ontario, Canada
| | - Monique Robinson
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - John K Olynyk
- Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Perth, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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17
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O'Sullivan TA, Cooke J, McCafferty C, Giglia R. Online Video Instruction on Hand Expression of Colostrum in Pregnancy is an Effective Educational Tool. Nutrients 2019; 11:nu11040883. [PMID: 31010174 PMCID: PMC6521170 DOI: 10.3390/nu11040883] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 03/22/2019] [Revised: 04/12/2019] [Accepted: 04/14/2019] [Indexed: 12/13/2022] Open
Abstract
The use of antenatal colostrum expression in the weeks prior to birth may help improve long-term breastfeeding, but few large-scale studies exist. Typically, antenatal colostrum expression instruction relies on face-to-face education, making large interventions costly. We aimed to determine whether an expert online instructional video can improve knowledge and confidence around antenatal colostrum expressing. Pregnant women were asked to complete a questionnaire pre- and post-watching the instructional video online. Ninety five pregnant women completed both pre- and post-questionnaires. Total antenatal colostrum expression knowledge scores improved after watching the video, from a mean of 3.05 ± 1.70 correct out of a maximum of 7, to 6.32 ± 0.76 (p < 0.001). Self-reported confidence around hand expressing in pregnancy also improved from an average ranking of not confident (2.56 ± 1.17, out of a possible 5) to confident (4.32 ± 0.80, p < 0.001). Almost all women (98%) reported that they would recommend the video to a friend or family member if antenatal colostrum expression was suggested by their healthcare provider. Findings suggest that the use of an online expert video is an acceptable and effective way to educate pregnant women in antenatal colostrum expression.
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Affiliation(s)
- Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.
| | - Joy Cooke
- Maternity Unit, Glengarry Private Hospital, Duncraig, WA 6023, Australia.
| | - Chris McCafferty
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Roslyn Giglia
- Telethon Kids Institute, University of Western Australia, Subiaco, WA 6008, Australia.
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18
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Butcher LM, Ryan MM, O'Sullivan TA, Lo J, Devine A. Food-Insecure Household's Self-Reported Perceptions of Food Labels, Product Attributes and Consumption Behaviours. Nutrients 2019; 11:nu11040828. [PMID: 31013699 PMCID: PMC6521285 DOI: 10.3390/nu11040828] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 11/20/2022] Open
Abstract
Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households in Australia. An online survey containing 19 food choice and 28 purchasing behaviours questions was completed by 1056 adults responsible for household grocery shopping. The short form of the US Household Food Security Survey Module was used as the food security indicator. Multinomial logistic regression modelling was employed to analyse the survey data. Respondents were classified as having either high-marginal (63.4%, n = 670), low (19.8%, n = 209) or very low (16.8%, n = 177) food security. Respondents with low or very low food security status were less likely to self-report understanding the information on the back of packaging (p < 0.001), find information on food labels useful (p = 0.002) or be influenced by product nutrition information (p = 0.002). Convenience (p < 0.001), organic (p = 0.027) and supermarket-branded products (p < 0.001) were more likely to be rated as important by food-insecure respondents when compared to their food-secure counterparts. When asked to rate “how healthy” their diet was, high–marginal FS respondents were twice as likely describe their diet as healthy than very low FS respondents (p = 0.001).
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Affiliation(s)
- Lucy M Butcher
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
- Foodbank Western Australia, Perth Airport, WA 6105, Australia.
| | - Maria M Ryan
- School of Business and Law, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
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19
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Lövestam E, Steiber A, Vivanti A, Boström AM, Devine A, Haughey O, Kiss CM, Lang NR, Lieffers J, Lloyd L, O'Sullivan TA, Papoutsakis C, Peersen C, Thoresen L, Orrevall Y. Use of the Nutrition Care Process and Nutrition Care Process Terminology in an International Cohort Reported by an Online Survey Tool. J Acad Nutr Diet 2018; 119:225-241. [PMID: 30553587 DOI: 10.1016/j.jand.2018.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 09/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Dietitians in countries across the world have been implementing the Nutrition Care Process (NCP) and Terminology (NCPT) during the past decade. The implementation process has been evaluated in specific countries and in smaller international studies; however, no large international study comparing implementation between countries has been completed. OBJECTIVE The aim of this study was to describe and compare the level of NCP/NCPT implementation across 10 countries. METHODS A previously tested web-based survey was completed in 2017 by 6,719 dietitians across 10 countries. Participants were recruited through e-mail lists, e-newsletters, and social media groups for dietitians. Nondietitians were excluded through screening questions and targeted dissemination channels. MAIN OUTCOME MEASURES AND STATISTICAL ANALYSIS The main outcome of interest was the level of implementation of each of the four NCP steps. Differences in implementation between the NCP (process) and NCPT (terminology) were also measured. Differences between groups were assessed using Kruskal-Wallis test and Mann-Whitney U test. Multiple linear regression was used to assess relationships between the main outcomes and respondent demographic information. RESULTS Australia, New Zealand, and the United States had higher implementation rates compared with other countries surveyed. Awareness of the NCP was high in most countries (>90%) but lower in Greece (50%). All countries had a higher implementation level of the NCP (process) compared with the NCPT (terminology). Dietitians working with inpatients reported the highest implementation levels while those working in public health reported the lowest. CONCLUSIONS Dietitians in countries with more experience in NCP/NCPT implementation and a clear implementation strategy had higher levels of implementation. To achieve a successful NCP/NCPT implementation among dietitians, there is a need to promote the value of a standardized dietetic language together with the more easily implemented process. There is also a need to promote NCP/NCPT for all areas of practice, and develop strategic plans for implementation of the NCP and NCPT.
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Lövestam E, Vivanti A, Steiber A, Boström AM, Devine A, Haughey O, Kiss CM, Lang NR, Lieffers J, Lloyd L, O'Sullivan TA, Papoutsakis C, Thoresen L, Orrevall Y. The International Nutrition Care Process and Terminology Implementation Survey: Towards a Global Evaluation Tool to Assess Individual Practitioner Implementation in Multiple Countries and Languages. J Acad Nutr Diet 2018; 119:242-260. [PMID: 30552017 DOI: 10.1016/j.jand.2018.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 09/04/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The Nutrition Care Process (NCP) and NCP Terminology (NCPT) is a systematic framework for critical thinking, decision making, and communication for dietetics practitioners worldwide, aiming to improve quality and patient safety in nutrition care. Although dietetics practitioners in several countries have implemented the NCP/NCPT during recent years, to date there is no globally validated instrument for the evaluation of NCP/NCPT implementation that is available in different languages and applicable across cultures and countries. OBJECTIVE The aim of this study was to develop and test a survey instrument in several languages to capture information at different stages of NCP/NCPT implementation across countries and cultures. SETTING In this collaboration between dietetics practitioners and researchers from 10 countries, an International NCP/NCPT Implementation Survey tool was developed and tested in a multistep process, building on the experiences from previous surveys. The tool was translated from English into six other languages. It includes four modules and describes demographic information, NCP/NCPT implementation, and related attitudes and knowledge. METHODS The survey was reviewed by 42 experts across 10 countries to assess content validity and clarity. After this, 30 dietetics practitioners participated in cognitive interviews while completing the survey. A pilot study was performed with 210 participants, of whom 40 completed the survey twice within a 2- to 3-week interval. RESULTS Scale content validity index average was 0.98 and question clarity index was 0.8 to 1.0. Cognitive interviews and comments from experts led to further clarifications of the survey. The repeated pilot test resulted in Krippendorff's α=.75. Subsequently, refinements of the survey were made based on comments submitted by the pilot survey participants. CONCLUSIONS The International NCP/NCPT Implementation Survey tool demonstrated excellent content validity and high test-retest reliability in seven different languages and across an international context. This tool will be valuable in future research and evaluation of implementation strategies.
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Properzi C, O'Sullivan TA, Sherriff JL, Ching HL, Jeffrey GP, Buckley RF, Tibballs J, MacQuillan GC, Garas G, Adams LA. Ad Libitum Mediterranean and Low-Fat Diets Both Significantly Reduce Hepatic Steatosis: A Randomized Controlled Trial. Hepatology 2018; 68:1741-1754. [PMID: 29729189 DOI: 10.1002/hep.30076] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/18/2018] [Accepted: 04/30/2018] [Indexed: 12/12/2022]
Abstract
Although diet-induced weight loss is first-line treatment for patients with nonalcoholic fatty liver disease (NAFLD), long-term maintenance is difficult. The optimal diet for improvement in either NAFLD or associated cardiometabolic risk factors, regardless of weight loss, is unknown. We examined the effect of two ad libitum isocaloric diets (Mediterranean [MD] or low fat [LF]) on hepatic steatosis (HS) and cardiometabolic risk factors. Subjects with NAFLD were randomized to a 12-week blinded dietary intervention (MD vs. LF). HS was determined by magnetic resonance spectroscopy (MRS). From a total of 56 subjects enrolled, 49 completed the intervention and 48 were included for analysis. During the intervention, subjects on the MD had significantly higher total and monounsaturated fat, but lower carbohydrate and sodium, intakes compared to LF subjects (P < 0.01). At week 12, HS had reduced significantly in both groups (P < 0.01), and there was no difference in liver fat reduction between groups (P = 0.32), with mean (SD) relative reductions of 25.0% (±25.3%) in LF and 32.4% (±25.5%) in MD. Liver enzymes also improved significantly in both groups. Weight loss was minimal and not different between groups (-1.6 [±2.1] kg in LF vs -2.1 [±2.5] kg in MD; P = 0.52). Within-group improvements in Framingham Risk Score (FRS), total cholesterol, serum triglyceride (TG), and glycated hemoglobin (HbA1c) were observed in the MD (all P < 0.05), but not with the LF diet. Adherence was higher for the MD compared to LF (88% vs. 64%; P = 0.048). Conclusion: Ad libitum low-fat and Mediterranean diets both improve HS to a similar degree.
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Affiliation(s)
- Catherine Properzi
- School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Therese A O'Sullivan
- School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Jill L Sherriff
- School of Public Health, Curtin Health Innovation Research Institute, Curtin University, Bentley, Australia
| | - Helena L Ching
- Medical School, The University of Western Australia, Nedlands, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Garry P Jeffrey
- Medical School, The University of Western Australia, Nedlands, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Jonathan Tibballs
- Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Gerry C MacQuillan
- Medical School, The University of Western Australia, Nedlands, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - George Garas
- Medical School, The University of Western Australia, Nedlands, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Leon A Adams
- Medical School, The University of Western Australia, Nedlands, Australia.,Department of Hepatology, Sir Charles Gairdner Hospital, Nedlands, Australia
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O'Sullivan TA, Lo J, Vivanti A. Predictors of nutrition care process and terminology use, applicability and importance within Asia-Pacific dietitians. Nutr Diet 2018; 76:455-461. [PMID: 30182523 DOI: 10.1111/1747-0080.12467] [Citation(s) in RCA: 6] [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: 05/29/2018] [Revised: 07/13/2018] [Accepted: 07/25/2018] [Indexed: 11/27/2022]
Abstract
AIM Many dietitians are yet to incorporate the Nutrition Care Process and Terminology (NCPT) into practice. The present study investigated factors predicting (i) NCPT use, (ii) perceived importance of NCPT implementation and (iii) perceived NCPT applicability to personal dietetic practice among dietitians in the Asia-Pacific region. METHODS Dietetic association members from Australia, New Zealand and Singapore were invited to participate in an online survey assessing NCPT implementation, knowledge, and self-rated familiarity, attitudes, benefits, concerns, barriers, and enablers. Forward stepwise logistic regression used all factors to identify predictive dietetic characteristics for current NCPT use, importance or applicability to practice. RESULTS A total of 377 dietitians (5%-55% of national dietetic memberships surveyed) completed at least one survey question. In logistic regression models, independent positive predictors of current NCPT users were knowledge (P = 0.003), confidence to implement (P = 0.036), confidence to write nutrition diagnoses (P = 0.002) and experiencing managerial support (P = 0.004). Not seeing a reason to change was a significant negative predictor of NCPT use (P = 0.003). An independent positive predictor of dietitians viewing NCPT implementation as important was feeling that it will improve patient care (P < 0.001), while negative predictors were seeing minimal benefit in changing (P < 0.001) and a preference to continue with current routine (P = 0.015). Independent positive predictors of dietitians viewing NCPT as applicable to their practice were NCPT knowledge (P = 0.009), seeing the value of NCPT (P < 0.001) and attendance at workshops or conferences (P = 0.014). CONCLUSIONS NCPT implementation may be enhanced thorough activities building confidence, gaining managerial corroboration and demonstration of NCPT benefits, including improved patient care.
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Affiliation(s)
- Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Angela Vivanti
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Human Movement and Nutrition Studies, University of Queensland, Brisbane, Queensland, Australia
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Nicholl A, O'Sullivan TA. Keep Calm and Carry on: Parental Opinions on Improving Clinical Dietary Trials for Young Children. Nutrients 2018; 10:nu10091166. [PMID: 30149614 PMCID: PMC6163458 DOI: 10.3390/nu10091166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 07/31/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 12/03/2022] Open
Abstract
Recruitment can be an issue for paediatric research. We aimed to investigate parental opinions of paediatric clinical assessments, and to combine findings with recent literature to inform the design of a clinical dietary trial. We used convenience sampling to recruit 17 parents of children aged 2–6 years from two community playgroups in Perth, Western Australia. Three focus groups considered proposed child assessments, study design, and potential study enrolment. Qualitative thematic analysis of focus group transcripts used NVivo 11 (QSR, Melbourne, VIC, Australia). Four main parental concerns emerged, presented here with solutions combining parent responses and relevant literature. (1) Parent and child needle fear: a good experience and a good phlebotomist help keep participants calm, and offering additional analysis (e.g., iron status) makes blood tests more worthwhile. (2) Concerns about children’s age, stage, understanding and ability to cope: create a themed adventure to help explain concepts and make procedures fun. (3) Persistent misunderstandings involving study purpose, design, randomization and equipoise: provide clear information via multiple platforms, and check understanding before enrolment. (4) Parental decisions to enrol children focused on time commitment, respectful treatment of their child, confronting tests and altruism: child-centred methodologies can help address concerns and keep participants engaged throughout procedures. Addressing the concerns identified could improve participation in a range of paediatric health interventions.
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Affiliation(s)
- Analise Nicholl
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup WA 6027, Australia.
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup WA 6027, Australia.
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Barber RL, Ekin AE, Sivakumar P, Howard K, O'Sullivan TA. Glucose Gel as a Potential Alternative Treatment to Infant Formula for Neonatal Hypoglycaemia in Australia. Int J Environ Res Public Health 2018; 15:E876. [PMID: 29702618 PMCID: PMC5981915 DOI: 10.3390/ijerph15050876] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/14/2018] [Revised: 04/05/2018] [Accepted: 04/17/2018] [Indexed: 11/17/2022]
Abstract
Infant formula is often used as a treatment for neonatal hypoglycaemia in Australia; however, there are concerns that this may jeopardise mother-baby bonding and breastfeeding. Successful use of glucose gel as an alternative treatment for hypoglycaemia has been reported. We wanted to investigate in a pilot study whether the use of glucose gel has the potential to quickly and safely restore normoglycaemia in the infants of diabetic mothers in an Australian setting. Infants with asymptomatic hypoglycaemia were treated with glucose gel (n = 36) and compared to a historical group of infants which had been treated with infant formula (n = 24). Within 15 min of the first treatment, the gel group had a mean blood glucose level (BGL) of 2.6 mmol/L, and 2.7 mmol/L 30 min after the second treatment. This was lower than the BGL after the first treatment for the formula group, which rose to a mean of 2.8 then to 3.2 mmol/L after the second treatment (p = 0.003). In successfully treated infants, administration of the gel resulted in normoglycaemia within 30 min. The likelihood of special care nursery admission was not significantly different between the groups, although we had a small sample size, and our findings should be interpreted with caution. These pilot results provide support for further investigations into the use of glucose gel as an alternative treatment to infant formula.
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Affiliation(s)
- Raenee L Barber
- School of Medical and Health Science, Edith Cowan University, Joondalup 6027, Australia.
| | - Amy E Ekin
- School of Medical and Health Science, Edith Cowan University, Joondalup 6027, Australia.
| | - Pushparani Sivakumar
- Nutrition and Dietetics Department, King Edward Memorial Hospital, Subiaco 6008, Australia.
| | - Kay Howard
- Murdoch University, School of Veterinary and Life Sciences, Murdoch 6150, Australia.
| | - Therese A O'Sullivan
- School of Medical and Health Science, Edith Cowan University, Joondalup 6027, Australia.
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Abstract
Issue addressed Currently, two food sufficiency questions are utilised as a proxy measure of national food security status in Australia. These questions do not capture all dimensions of food security and have been attributed to underreporting of the problem. The purpose of this study was to investigate food security using the short form of the US Household Food Security Survey Module (HFSSM) within an Australian context; and explore the relationship between food security status and multiple socio‐demographic variables. Methods Two online surveys were completed by 2334 Australian participants from November 2014 to February 2015. Surveys contained the short form of the HFSSM and twelve socio‐demographic questions. Cross‐tabulations chi‐square tests and a multinomial logistic regression model were employed to analyse the survey data. Results Food security status of the respondents was classified accordingly: High or Marginal (64%, n = 1495), Low (20%, n = 460) or Very Low (16%, n = 379). Significant independent predictors of food security were age (P < 0.001), marital status (P = 0.005), household income (P < 0.001) and education (P < 0.001). Conclusion Findings suggest food insecurity is an important issue across Australia and that certain groups, regardless of income, are particularly vulnerable. So what? Government policy and health promotion interventions that specifically target “at risk” groups may assist to more effectively address the problem. Additionally, the use of a multi‐item measure is worth considering as a national indicator of food security in Australia.
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Affiliation(s)
- Lucy M Butcher
- Edith Cowan University, Joondalup, WA, Australia.,Foodbank WA, Perth Airport, WA, Australia
| | | | - Maria M Ryan
- Edith Cowan University, Joondalup, WA, Australia
| | - Johnny Lo
- Edith Cowan University, Joondalup, WA, Australia
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26
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Vivanti A, O'Sullivan TA, Porter J, Hogg M. Successful long-term maintenance following Nutrition Care Process Terminology implementation across a state-wide health-care system. Nutr Diet 2017; 74:372-380. [DOI: 10.1111/1747-0080.12346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 11/18/2016] [Accepted: 01/15/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Angela Vivanti
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Brisbane Queensland Australia
- School of Human Movement and Nutrition Studies; University of Queensland; Brisbane Queensland Australia
| | - Therese A. O'Sullivan
- School of Medical and Health Science; Edith Cowan University; Joondalup Western Australia Australia
| | - Jane Porter
- School of Medical and Health Science; Edith Cowan University; Joondalup Western Australia Australia
| | - Marion Hogg
- Department of Nutrition and Dietetics; Ipswich Hospital; Brisbane Queensland Australia
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27
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Vivanti A, Lewis J, O'Sullivan TA. The Nutrition Care Process Terminology: Changes in perceptions, attitudes, knowledge and implementation amongst Australian dietitians after three years. Nutr Diet 2017; 75:87-97. [DOI: 10.1111/1747-0080.12347] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/22/2016] [Accepted: 01/22/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Angela Vivanti
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Woolloongabba Queensland Australia
- School of Human Movement and Nutrition Studies; University of Queensland; St. Lucia Queensland Australia
| | - Jessica Lewis
- School of Human Movement and Nutrition Studies; University of Queensland; St. Lucia Queensland Australia
| | - Therese A. O'Sullivan
- School of Medical and Health Sciences; Edith Cowan University; Joondalup Queensland Australia
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28
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Nyaradi A, Li J, Foster JK, Hickling S, Jacques A, O'Sullivan TA, Oddy WH. Good-quality diet in the early years may have a positive effect on academic achievement. Acta Paediatr 2016; 105:e209-18. [PMID: 26719022 DOI: 10.1111/apa.13324] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 12/06/2015] [Accepted: 12/28/2015] [Indexed: 12/16/2022]
Abstract
AIM The aim of this study was to investigate the associations between early diet and academic performance during childhood. METHODS Participants were from the Western Australian Pregnancy Cohort (Raine) Study (n = 2287). Frequency of consumption of food and beverages was collected at the one-, two- and three-year follow-ups, using a 24-hour food recall. Diet scores were developed from the number of eating occasions. The Western Australian Literacy and Numeracy Assessment (WALNA) data from grades five (age 10) and seven (age 12) were linked to the Raine study using The Western Australian Data Linkage System. The association between diet scores and WALNA scores was assessed using multivariate linear regression models. RESULTS A higher (i.e. better quality) diet score at one year of age was associated with significantly higher scores in mathematics, reading, writing and spelling at both grades five and seven. Associations were observed between a higher diet score at two years and academic scores for mathematics, writing and spelling at grade seven. Higher dairy consumption at ages one, two and three, and higher fruit consumption at age one were associated with higher academic scores at all ages. CONCLUSION Quality of early diet may be a predictor for later academic achievement.
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Affiliation(s)
- Anett Nyaradi
- School of Population Health; The University of Western Australia; Perth WA Australia
- Telethon Kids Institute; The University of Western Australia; Perth WA Australia
| | - Jianghong Li
- Telethon Kids Institute; The University of Western Australia; Perth WA Australia
- WZB Berlin Social Science Center; Berlin Germany
- Centre for Population Health Research; The Faculty of Health Sciences; Curtin University; Perth WA Australia
| | - Jonathan K. Foster
- Telethon Kids Institute; The University of Western Australia; Perth WA Australia
- School of Psychology & Speech Pathology; Curtin University; Perth WA Australia
- Neurosciences Unit; Health Department of Western Australia; Perth WA Australia
- School of Paediatrics & Child Health; The University of Western Australia; Perth WA Australia
| | - Siobhan Hickling
- School of Population Health; The University of Western Australia; Perth WA Australia
| | - Angela Jacques
- School of Population Health; The University of Western Australia; Perth WA Australia
| | - Therese A. O'Sullivan
- School of Exercise and Health Science; Edith Cowan University; Joondalup WA Australia
| | - Wendy H. Oddy
- Telethon Kids Institute; The University of Western Australia; Perth WA Australia
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O'Sullivan TA, Bremner AP, Mori TA, Beilin LJ, Wilson C, Hafekost K, Ambrosini GL, Huang RC, Oddy WH. Regular Fat and Reduced Fat Dairy Products Show Similar Associations with Markers of Adolescent Cardiometabolic Health. Nutrients 2016; 8:nu8010022. [PMID: 26729163 PMCID: PMC4728636 DOI: 10.3390/nu8010022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/20/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 02/07/2023] Open
Abstract
Reduced fat dairy products are generally recommended for adults and children over the age of two years. However, emerging evidence suggests that dairy fat may not have detrimental health effects. We aimed to investigate prospective associations between consumption of regular versus reduced fat dairy products and cardiometabolic risk factors from early to late adolescence. In the West Australian Raine Study, dairy intake was assessed using semi-quantitative food frequency questionnaires in 860 adolescents at 14 and 17-year follow-ups; 582 of these also had blood biochemistry at both points. Using generalized estimating equations, we examined associations with cardiometabolic risk factors. Models incorporated reduced fat and regular fat dairy together (in serves/day) and were adjusted for a range of factors including overall dietary pattern. In boys, there was a mean reduction in diastolic blood pressure of 0.66 mmHg (95% CI 0.23–1.09) per serve of reduced fat dairy and an independent, additional reduction of 0.47 mmHg (95% CI 0.04–0.90) per serve of regular fat dairy. Each additional serve of reduced fat dairy was associated with a 2% reduction in HDL-cholesterol (95% CI 0.97–0.995) and a 2% increase in total: HDL-cholesterol ratio (95% CI 1.002–1.03); these associations were not observed with regular fat products. In girls, there were no significant independent associations observed in fully adjusted models. Although regular fat dairy was associated with a slightly better cholesterol profile in boys, overall, intakes of both regular fat and reduced fat dairy products were associated with similar cardiometabolic associations in adolescents.
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Affiliation(s)
- Therese A O'Sullivan
- School of Exercise and Health Science, Edith Cowan University, 270 Joondalup Dr, Joondalup WA 6027, Australia.
| | - Alexandra P Bremner
- School of Population Health, The University of Western Australia, Crawley WA 6009, Australia.
| | - Trevor A Mori
- School of Medicine and Pharmacology, The University of Western Australia, Crawley WA 6009, Australia.
| | - Lawrence J Beilin
- School of Medicine and Pharmacology, The University of Western Australia, Crawley WA 6009, Australia.
| | - Charlotte Wilson
- School of Exercise and Health Science, Edith Cowan University, 270 Joondalup Dr, Joondalup WA 6027, Australia.
| | - Katherine Hafekost
- Telethon Kids Institute, The University of Western Australia, West Perth WA 6008, Australia.
| | - Gina L Ambrosini
- School of Population Health, The University of Western Australia, Crawley WA 6009, Australia.
| | - Rae Chi Huang
- School of Medicine and Pharmacology, The University of Western Australia, Crawley WA 6009, Australia.
| | - Wendy H Oddy
- Telethon Kids Institute, The University of Western Australia, West Perth WA 6008, Australia.
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Sherriff JL, O'Sullivan TA, Properzi C, Oddo JL, Adams LA. Choline, Its Potential Role in Nonalcoholic Fatty Liver Disease, and the Case for Human and Bacterial Genes. Adv Nutr 2016; 7:5-13. [PMID: 26773011 DOI: 10.3945/an.114.007955] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Our understanding of the impact of poor hepatic choline/phosphatidylcholine availability in promoting the steatosis characteristic of human nonalcoholic fatty liver disease (NAFLD) has recently advanced and possibly relates to phosphatidylcholine/phosphatidylethanolamine concentrations in various, membranes as well as cholesterol dysregulation. A role for choline/phosphatidylcholine availability in the progression of NAFLD to liver injury and serious hepatic consequences in some individuals requires further elucidation. There are many reasons for poor choline/phosphatidylcholine availability in the liver, including low intake, estrogen status, and genetic polymorphisms affecting, in particular, the pathway for hepatic de novo phosphatidylcholine synthesis. In addition to free choline, phosphatidylcholine has been identified as a substrate for trimethylamine production by certain intestinal bacteria, thereby reducing host choline bioavailability and providing an additional link to the increased risk of cardiovascular disease faced by those with NAFLD. Thus human choline requirements are highly individualized and biomarkers of choline status derived from metabolomics studies are required to predict those at risk of NAFLD induced by choline deficiency and to provide a basis for human intervention trials.
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Affiliation(s)
- Jill L Sherriff
- School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Curtin University, Bentley, Australia;
| | - Therese A O'Sullivan
- School of Exercise and Health Science, Edith Cowan University, Joondalup, Australia
| | - Catherine Properzi
- School of Exercise and Health Science, Edith Cowan University, Joondalup, Australia
| | - Josephine-Lee Oddo
- School of Exercise and Health Science, Edith Cowan University, Joondalup, Australia
| | - Leon A Adams
- School of Medicine and Pharmacology, The University of Western Australia, Nedlands, Australia; and Liver Transplant Unit, Sir Charles Gairdner Hospital, Nedlands, Australia
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Porter JM, Devine A, Vivanti A, Ferguson M, O'Sullivan TA. Development of a Nutrition Care Process implementation package for hospital dietetic departments. Nutr Diet 2015. [DOI: 10.1111/1747-0080.12169] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jane M. Porter
- Faculty of Health; Engineering and Health Science; School of Exercise and Health Science; Edith Cowan University; Joondalup Western Australia Australia
| | - Amanda Devine
- Faculty of Health; Engineering and Health Science; School of Exercise and Health Science; Edith Cowan University; Joondalup Western Australia Australia
| | - Angela Vivanti
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Brisbane Australia
| | - Maree Ferguson
- Department of Nutrition and Dietetics; Princess Alexandra Hospital; Brisbane Australia
| | - Therese A. O'Sullivan
- Faculty of Health; Engineering and Health Science; School of Exercise and Health Science; Edith Cowan University; Joondalup Western Australia Australia
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Affiliation(s)
- Jane M. Porter
- Faculty of Health, Engineering and Health Science; School of Exercise and Health Science; Edith Cowan University; Joondalup Western Australia Australia
| | - Amanda Devine
- Faculty of Health, Engineering and Health Science; School of Exercise and Health Science; Edith Cowan University; Joondalup Western Australia Australia
| | - Therese A. O'Sullivan
- Faculty of Health, Engineering and Health Science; School of Exercise and Health Science; Edith Cowan University; Joondalup Western Australia Australia
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O'Sullivan TA, Bremner AP, Bremer HK, Seares ME, Beilin LJ, Mori TA, Lyons-Wall P, Devine A, Oddy WH. Dairy product consumption, dietary nutrient and energy density and associations with obesity in Australian adolescents. J Hum Nutr Diet 2014; 28:452-64. [PMID: 25157608 DOI: 10.1111/jhn.12264] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 01/25/2023]
Abstract
BACKGROUND Dairy intake is likely to influence dietary energy density (ED) and nutrient density (ND), which are factors representing aspects of dietary quality. Although evidence suggests dairy intake is unlikely to contribute to obesity, intake tends to decrease over adolescence, potentially as a result of concerns around weight gain. We examined associations between dairy intake, ED and ND, and investigated relationships with obesity in adolescents. METHODS The present study comprised a cross-sectional study of 1613 14-year-olds in the Western Australian Pregnancy Cohort (Raine) Study. Adolescents completed a 212-item food frequency questionnaire. Nutrient Rich Food index 9.3 (NRF9.3) was used to estimate ND. Age-specific body mass index (BMI) and waist-height cut-offs were used to categorise obesity risk. RESULTS Mean (SD) dairy intake was: 2.62 (1.51) servings daily; ED was 4.53 (0.83) (food and beverage) and 6.28 (1.33) (food only); ND was 373 (109). Dairy intake was inversely associated with ED and positively associated with ND. The odds of being overweight (as assessed by BMI) increased by 1.24 (95% confidence interval = 1.09-1.42) with each 100-point increase in ND, after adjustment for potential confounders and energy intake. ED measures and dairy intake were inversely associated with obesity after adjustment for confounders; associations became nonsignificant after energy adjustment. CONCLUSIONS The NRF9.3 was originally designed to assess foods, not diets. Further research in other cohorts to determine whether similar findings exist, or investigations into alternate measures of dietary ND, may prove useful. Our findings may be the result of factors such as an excess consumption of refined but fortified foods. Although higher dairy intakes were associated with higher ND, intakes were not associated with higher obesity risk.
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Affiliation(s)
- T A O'Sullivan
- School of Exercise and Health Science, Edith Cowan University, Joondalup, WA, Australia
| | - A P Bremner
- School of Population Health, The University of Western Australia, Perth, WA, Australia
| | - H K Bremer
- School of Exercise and Health Science, Edith Cowan University, Joondalup, WA, Australia
| | - M E Seares
- School of Exercise and Health Science, Edith Cowan University, Joondalup, WA, Australia
| | - L J Beilin
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia
| | - T A Mori
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA, Australia
| | - P Lyons-Wall
- School of Exercise and Health Science, Edith Cowan University, Joondalup, WA, Australia
| | - A Devine
- School of Exercise and Health Science, Edith Cowan University, Joondalup, WA, Australia
| | - W H Oddy
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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Trapp GSA, Allen K, O'Sullivan TA, Robinson M, Jacoby P, Oddy WH. Energy drink consumption is associated with anxiety in Australian young adult males. Depress Anxiety 2014; 31:420-8. [PMID: 24019267 DOI: 10.1002/da.22175] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 08/01/2013] [Accepted: 08/02/2013] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Energy drinks are predominantly targeted to young adult consumers; however, there has been limited research into their effects on psychological functioning in this demographic group. This study examined cross-sectional associations between energy drink consumption and mental health in a population-based sample of young adults participating in the Western Australian Pregnancy Cohort (Raine) Study. METHODS We used self-report questionnaires to assess energy drink consumption and mental health (Depression Anxiety Stress Scale-21; DASS-21) at the 20-year cohort follow-up. In the regression analyses, we considered associations between energy drink consumption (mL/day) and continuous DASS-21 scores, adjusting for sociodemographic variables, alcohol and drug use, physical activity, body mass index (BMI), and dietary intake. Our sample included 502 males and 567 females (mean age 20 ± 3 years). RESULTS After adjusting for potential confounding factors and controlling for coexisting mental health problems, energy drink consumption (per 100 mL/day) was significantly associated with anxiety (but not depression or stress), and this relationship was found only in males (β = 0.32; 95% CI = 0.05, 0.58). CONCLUSIONS Our study found that energy drink consumption was associated with increased anxiety in young adult males. Further research into the possible contribution of energy drink use to the development of mental health problems in young adults is needed.
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Affiliation(s)
- Georgina S A Trapp
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia
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Abstract
We summarized the data related to foods high in saturated fat and risk of mortality. We searched Cochrane Library, MEDLINE, EMBASE, and ProQuest for studies from January 1952 to May 2012. We identified 26 publications with individual dietary data and all-cause, total cancer, or cardiovascular mortality as endpoints. Pooled relative risk estimates demonstrated that high intakes of milk, cheese, yogurt, and butter were not associated with a significantly increased risk of mortality compared with low intakes. High intakes of meat and processed meat were significantly associated with an increased risk of mortality but were associated with a decreased risk in a subanalysis of Asian studies. The overall quality of studies was variable. Associations varied by food group and population. This may be because of factors outside saturated fat content of individual foods. There is an ongoing need for improvement in assessment tools and methods that investigate food sources of saturated fat and mortality to inform dietary guidelines.
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Affiliation(s)
- Therese A O'Sullivan
- School of Exercise and Health Science, Edith Cowan University, Joondalup, Western Australia
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Oddy WH, Herbison CE, Jacoby P, Ambrosini GL, O'Sullivan TA, Ayonrinde OT, Olynyk JK, Black LJ, Beilin LJ, Mori TA, Hands BP, Adams LA. The Western dietary pattern is prospectively associated with nonalcoholic fatty liver disease in adolescence. Am J Gastroenterol 2013; 108:778-85. [PMID: 23545714 DOI: 10.1038/ajg.2013.95] [Citation(s) in RCA: 193] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Poor dietary habits have been implicated in the development of nonalcoholic fatty liver disease (NAFLD); however, little is known about the role of specific dietary patterns in the development of NAFLD. We examined prospective associations between dietary patterns and NAFLD in a population-based cohort of adolescents. METHODS Participants in the Western Australian Pregnancy Cohort (Raine) Study completed a food frequency questionnaire at 14 years and had liver ultrasound at 17 years (n=995). Healthy and Western dietary patterns were identified using factor analysis and all participants received a z-score for these patterns. Prospective associations between the dietary pattern scores and risk of NAFLD were analyzed using multiple logistic regression. RESULTS NAFLD was present in 15.2% of adolescents. A higher Western dietary pattern score at 14 years was associated with a greater risk of NAFLD at 17 years (odds ratio (OR) 1.59; 95% confidence interval (CI) 1.17-2.14; P<0.005), although these associations were no longer significant after adjusting for body mass index at 14 years. However, a healthy dietary pattern at 14 years appeared protective against NAFLD at 17 years in centrally obese adolescents (OR 0.63; 95% CI 0.41-0.96; P=0.033), whereas a Western dietary pattern was associated with an increased risk of NAFLD. CONCLUSIONS A Western dietary pattern at 14 years in a general population sample was associated with an increased risk of NAFLD at 17 years, particularly in obese adolescents. In centrally obese adolescents with NAFLD, a healthy dietary pattern may be protective, whereas a Western dietary pattern may increase the risk.
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Affiliation(s)
- Wendy H Oddy
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia.
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Hafekost K, Lawrence D, Mitrou F, O'Sullivan TA, Zubrick SR. Tackling overweight and obesity: does the public health message match the science? BMC Med 2013; 11:41. [PMID: 23414295 PMCID: PMC3626646 DOI: 10.1186/1741-7015-11-41] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 02/18/2013] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Despite the increasing understanding of the mechanisms relating to weight loss and maintenance, there are currently no validated public health interventions that are able to achieve sustained long-term weight loss or to stem the increasing prevalence of obesity in the population. We aimed to examine the models of energy balance underpinning current research about weight-loss intervention from the field of public health, and to determine whether they are consistent with the model provided by basic science. EMBASE was searched for papers published in 2011 on weight-loss interventions. We extracted details of the population, nature of the intervention, and key findings for 27 articles. DISCUSSION Most public health interventions identified were based on a simple model of energy balance, and thus attempted to reduce caloric consumption and/or increase physical activity in order to create a negative energy balance. There appeared to be little consideration of homeostatic feedback mechanisms and their effect on weight-loss success. It seems that there has been a lack of translation between recent advances in understanding of the basic science behind weight loss, and the concepts underpinning the increasingly urgent efforts to reduce excess weight in the population. SUMMARY Public health weight-loss interventions seem to be based on an outdated understanding of the science. Their continued failure to achieve any meaningful, long-term results reflects the need to develop intervention science that is integrated with knowledge from basic science. Instead of asking why people persist in eating too much and exercising too little, the key questions of obesity research should address those factors (environmental, behavioral or otherwise) that lead to dysregulation of the homeostatic mechanism of energy regulation. There is a need for a multidisciplinary approach in the design of future weight-loss interventions in order to improve long-term weight-loss success.
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Affiliation(s)
- Katherine Hafekost
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, West Perth WA6872 Australia.
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O'Sullivan TA. Evaluation of an electronic record prototype incorporating the Nutrition Care Process and International Dietetics and Nutrition Terminology. Nutr Diet 2013. [DOI: 10.1111/1747-0080.12012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Therese A. O'Sullivan
- School of Exercise and Health Science; Edith Cowan University; Joondalup; Western Australia; Australia
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Herbison CE, Hickling S, Allen KL, O'Sullivan TA, Robinson M, Bremner AP, Huang RC, Beilin LJ, Mori TA, Oddy WH. Low intake of B-vitamins is associated with poor adolescent mental health and behaviour. Prev Med 2012; 55:634-8. [PMID: 23010437 DOI: 10.1016/j.ypmed.2012.09.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 08/23/2012] [Accepted: 09/15/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The current prevalence of mental health problems in Western populations is approximately 20% and half of all adult mental health disorders are estimated to originate in adolescence. Diet plays an important role in modulating psychological wellbeing and B-vitamins are vital for the synthesis of neurotransmitters such as serotonin. We aimed to examine the relationship between B-group vitamins and adolescent mental health and behaviour. METHODS This is a cross-sectional analysis of the West Australian Pregnancy Cohort (Raine) Study. The 17-year follow-up included collection of a food frequency questionnaire allowing B-vitamin intake calculation. Mental health was assessed using the Youth Self Report (YSR) which measures total, internalising (withdrawn/depressed) and externalising (aggressive/delinquent) behaviour scores. Multiple linear regression was used to analyse associations between B-vitamins and mental health with adjustment for relevant confounders (n=709). RESULTS Lower intake of vitamins B1, B2, B3, B5, B6, and folate was associated with higher externalising behaviour scores (p ≤ 0.05). Reduced intake of vitamin B6 and folate was associated with higher internalising behaviour scores (p ≤ 0.05). CONCLUSIONS Poor nutrition may contribute to the pathogenesis of mental health problems in adolescence. The role of B-vitamins requires further investigation in randomised controlled trials.
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Affiliation(s)
- Carly E Herbison
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Australia
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Bobridge KS, Haines GL, Mori TA, Beilin LJ, Oddy WH, Sherriff J, O'Sullivan TA. Dietary fructose in relation to blood pressure and serum uric acid in adolescent boys and girls. J Hum Hypertens 2012; 27:217-24. [DOI: 10.1038/jhh.2012.36] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Oddy WH, Hickling S, Smith MA, O'Sullivan TA, Robinson M, de Klerk NH, Beilin LJ, Mori TA, Syrette J, Zubrick SR, Silburn SR. Dietary intake of omega-3 fatty acids and risk of depressive symptoms in adolescents. Depress Anxiety 2011; 28:582-8. [PMID: 21538725 DOI: 10.1002/da.20822] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 03/21/2011] [Accepted: 03/29/2011] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Previous randomized controlled trials have demonstrated that omega-3 polyunsaturated fatty acids (n-3 PUFA) are beneficial in reducing symptoms of depression. However, there is limited evidence regarding the influence of dietary n-3 PUFA intake on mood in adolescents drawn from population studies. OBJECTIVE In the present investigation, we examined the relationship between dietary n-3 PUFA intake on depression symptomatology in a large prospective pregnancy cohort followed for 17 years. METHODS Adolescents enrolled in the Western Australian Pregnancy Cohort (Raine) Study completed a Food Frequency Questionnaire to assess dietary fatty acid intake, as well as other dietary factors at age 14 and a fasting blood sample was taken. Participants also completed the Beck Depression Inventory for Youth (BDI-Y) at age 14 (N = 1,407) and at age 17 (N = 995). RESULTS An inverse relationship was observed between intake of both saturated fat and of n-3 PUFA at age 14 and BDI-Y scores at both 14 and 17 years of age. However, after adjusting for energy (kJ) intake and other lifestyle confounders, the relationships were no longer significant. CONCLUSIONS Associations previously reported between n3 PUFA and depressive symptoms may be due to collinearity with other dietary and lifestyle factors.
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Affiliation(s)
- Wendy H Oddy
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia.
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O'Sullivan TA, Bremner AP, Beilin LJ, Ambrosini GL, Mori TA, Huang RC, Oddy WH. Polyunsaturated fatty acid intake and blood pressure in adolescents. J Hum Hypertens 2011; 26:178-87. [PMID: 21307885 DOI: 10.1038/jhh.2011.7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Evidence that intake of polyunsaturated fatty acids (PUFAs) may modify blood pressure (BP) is generally limited to middle-aged or hypertensive populations. This study examined cross-sectional associations between BP and dietary intake of PUFAs in 814 adolescents aged 13-15 years participating in the Western Australian Pregnancy Cohort (Raine) Study. Fatty acid intakes were assessed using 3-day diet records and resting BP was determined using multiple oscillometric readings. In multivariate regression models, systolic BP was inversely associated with intakes of polyunsaturated (b=-0.436, P<0.01), omega-3 (b=-2.47, P=0.02), omega-6 (b=-0.362, P=0.04) and long chain omega-3 fatty acids (b=-4.37, P=0.04) in boys. Diastolic BP and mean arterial pressure were inversely associated with intakes of long chain omega-3 fatty acids in boys (b=-3.93, P=0.01, b=-4.05, P=0.01, respectively). For specific long-chain omega-3s, significant inverse associations were observed between eicosapentaenoic acid (EPA) and docosahexaenoic acid, such as systolic BP decreasing by 4.7 mm Hg (95% CI -9.3 to -0.1) for a quarter gram increase in EPA, but no significant associations were observed with docosapentaenoic acid. No significant associations were observed in girls, or with the omega-6 to omega-3 ratio. Our results suggest that gender may moderate relationships between fatty acid intake and BP in adolescence.
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Affiliation(s)
- T A O'Sullivan
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, West Perth, Western Australia, Australia.
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Ambrosini GL, O'Sullivan TA, de Klerk NH, Mori TA, Beilin LJ, Oddy WH. Relative validity of adolescent dietary patterns: a comparison of a FFQ and 3 d food record. Br J Nutr 2011; 105:625-33. [PMID: 21269548 PMCID: PMC3308192 DOI: 10.1017/s0007114510004137] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Interest in empirically derived dietary patterns has increased over the past decade. However, relatively few studies have evaluated dietary patterns using different dietary methods, or in young populations. We quantitatively compared dietary patterns from a FFQ with those from a 3 d food record (FR) in a cohort of adolescents. Subjects from the Western Australian Pregnancy Cohort (Raine) Study completed a semi-quantitative FFQ and a 3 d FR at 14 years of age (n 783). Major dietary patterns were identified using exploratory factor analysis on thirty-eight food groups. Dietary pattern z-scores were compared using 95 % limits of agreement (LOA) and Spearman's r. Two major dietary patterns were identified in the FFQ and FR: a 'Healthy' pattern, which was high in fresh fruit, vegetables, whole grains and grilled or canned fish, and a 'Western' pattern, which was high in take-away foods, confectionery, soft drinks, crisps and fried potato. The nutrient profiles of these dietary patterns were similar when estimated by the FFQ and FR. The LOA between dietary pattern scores from the FFQ and FR were - 1·69 to 1·75 ('Healthy') and - 1·89 to 1·82 ('Western'). Minor differences in agreement were observed when boys and girls were analysed separately. Spearman's correlation coefficients between the FFQ and the FR were r 0·45 ('Healthy') and r 0·36 ('Western'). Comparable dietary patterns may be obtained from the FFQ and FR using exploratory factor analysis. This supports the use of major dietary patterns identified using the FFQ in this adolescent cohort.
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Affiliation(s)
- Gina L Ambrosini
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, WA, Australia.
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O'Sullivan TA, Ambrosini G, Beilin LJ, Mori TA, Oddy WH. Dietary intake and food sources of fatty acids in Australian adolescents. Nutrition 2011; 27:153-9. [DOI: 10.1016/j.nut.2009.11.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2009] [Revised: 10/16/2009] [Accepted: 11/14/2009] [Indexed: 11/24/2022]
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O'Sullivan TA, Lyons-Wall P, Bremner AP, Ambrosini GL, Huang RC, Beilin LJ, Mori TA, Blair E, Oddy WH. Dietary glycaemic carbohydrate in relation to the metabolic syndrome in adolescents: comparison of different metabolic syndrome definitions. Diabet Med 2010; 27:770-8. [PMID: 20636957 DOI: 10.1111/j.1464-5491.2010.03021.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [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] [Indexed: 11/27/2022]
Abstract
AIMS High dietary glycaemic carbohydrate, as measured by the dietary glycaemic index and glycaemic load has been associated with increased risk of the metabolic syndrome in adults, but limited research exists for younger populations. We aimed to evaluate associations between dietary glycaemic carbohydrate and insulin resistance or the prevalence of the metabolic syndrome defined by three different criteria in a population-based adolescent cohort. METHODS Diet was assessed using 3 day food records in 769 adolescents aged 13-15 years participating in the Western Australian Pregnancy Cohort (Raine) Study. The metabolic syndrome was identified using age-specific adolescent definitions from the International Diabetes Federation, the National Cholesterol Education Program Adult Treatment Panel III and a population-derived 'high-risk' metabolic cluster algorithm. Presence of a high waist circumference was mandatory only in the International Diabetes Federation definition. Insulin resistance was measured using homeostasis model assessment (HOMA-IR). RESULTS The prevalence of the metabolic syndrome as defined by the International Diabetes Federation and the Adult Treatment Panel III was 3.6 and 4.0%, respectively; 25.9% of subjects were classified into the high-risk cluster. Significantly increased odds of International Diabetes Federation-defined metabolic syndrome were independently associated with a 20 unit glycaemic load increase (odds ratio 2.18; 95% confidence interval 1.26-3.78) and a 30 g carbohydrate increase (odds ratio 3.86; 95% confidence interval 1.80-8.28). No significant associations were observed when using the Adult Treatment Panel III, or the cluster-defined metabolic syndrome, or with HOMA-IR. CONCLUSIONS This study supports the concept that high dietary glycaemic carbohydrate is associated with a higher prevalence of the metabolic syndrome in adolescents. However, relationships vary according to the definition of the metabolic syndrome used, with waist circumference a potentially relevant factor.
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Affiliation(s)
- T A O'Sullivan
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, West Perth, WA 6872, Australia.
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Ambrosini GL, Huang RC, Mori TA, Hands BP, O'Sullivan TA, de Klerk NH, Beilin LJ, Oddy WH. Dietary patterns and markers for the metabolic syndrome in Australian adolescents. Nutr Metab Cardiovasc Dis 2010; 20:274-283. [PMID: 19748245 DOI: 10.1016/j.numecd.2009.03.024] [Citation(s) in RCA: 119] [Impact Index Per Article: 8.5] [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: 02/05/2009] [Revised: 03/22/2009] [Accepted: 03/27/2009] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Overweight and other risk factors for cardiovascular disease (CVD) as well as their clustering, are increasingly prevalent among adolescents. We examined dietary patterns, CVD risk factors, and the clustering of these risk factors in 1139 14-year-olds living in Western Australia. METHODS AND RESULTS Usual dietary intake was assessed using a food frequency questionnaire. Two dietary patterns, 'Western' and 'Healthy', were identified using factor analysis. Associations between these dietary patterns and BMI, waist circumference, systolic blood pressure, fasting levels of serum glucose, insulin, total cholesterol, HDL-C, LDL-C, triglycerides and insulin resistance were assessed using ANOVA. Cluster analysis identified a high risk group (the 'high risk metabolic cluster') with features akin to adult metabolic syndrome. Belonging to the 'high risk metabolic cluster' was examined in relation to dietary patterns using logistic regression, adjusting for aerobic fitness and socio-demographic factors. Higher 'Western' dietary pattern scores were associated with greater odds for the 'high risk metabolic cluster' (p for trend=0.02) and greater mean values for total cholesterol (p for trend=0.03), waist circumference (p for trend=0.03) and BMI (p for trend=0.02) in girls, but not boys. Scores for the 'Healthy' dietary pattern were not related to the 'high risk metabolic cluster' but were inversely associated with serum glucose in boys and girls (p for trend=0.01 and 0.04, respectively) and were positively associated with HDL-C in boys (p for trend=0.02). CONCLUSIONS Dietary patterns are associated with CVD risk factors and the clustering of these risk factors in adolescence.
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Affiliation(s)
- G L Ambrosini
- School of Public Health, Curtin University of Technology, Western Australia, Australia
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O'Sullivan TA, Bremner AP, O'Neill S, Lyons-Wall P. Comparison of multiple and novel measures of dietary glycemic carbohydrate with insulin resistant status in older women. Nutr Metab (Lond) 2010; 7:25. [PMID: 20370933 PMCID: PMC2859357 DOI: 10.1186/1743-7075-7-25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 04/07/2010] [Indexed: 11/29/2022] Open
Abstract
Background Previous epidemiological investigations of associations between dietary glycemic intake and insulin resistance have used average daily measures of glycemic index (GI) and glycemic load (GL). We explored multiple and novel measures of dietary glycemic intake to determine which was most predictive of an association with insulin resistance. Methods Usual dietary intakes were assessed by diet history interview in women aged 42-81 years participating in the Longitudinal Assessment of Ageing in Women. Daily measures of dietary glycemic intake (n = 329) were carbohydrate, GI, GL, and GL per megacalorie (GL/Mcal), while meal based measures (n = 200) were breakfast, lunch and dinner GL; and a new measure, GL peak score, to represent meal peaks. Insulin resistant status was defined as a homeostasis model assessment (HOMA) value of >3.99; HOMA as a continuous variable was also investigated. Results GL, GL/Mcal, carbohydrate (all P < 0.01), GL peak score (P = 0.04) and lunch GL (P = 0.04) were positively and independently associated with insulin resistant status. Daily measures were more predictive than meal-based measures, with minimal difference between GL/Mcal, GL and carbohydrate. No significant associations were observed with HOMA as a continuous variable. Conclusion A dietary pattern with high peaks of GL above the individual's average intake was a significant independent predictor of insulin resistance in this population, however the contribution was less than daily GL and carbohydrate variables. Accounting for energy intake slightly increased the predictive ability of GL, which is potentially important when examining disease risk in more diverse populations with wider variations in energy requirements.
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Affiliation(s)
- Therese A O'Sullivan
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia.
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Oddy WH, Robinson M, Ambrosini GL, O'Sullivan TA, de Klerk NH, Beilin LJ, Silburn SR, Zubrick SR, Stanley FJ. The association between dietary patterns and mental health in early adolescence. Prev Med 2009; 49:39-44. [PMID: 19467256 DOI: 10.1016/j.ypmed.2009.05.009] [Citation(s) in RCA: 171] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2009] [Revised: 05/18/2009] [Accepted: 05/19/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the associations between dietary patterns and mental health in early adolescence. METHOD The Western Australian Pregnancy Cohort (Raine) Study is a prospective study of 2900 pregnancies recruited from 1989-1992. At 14 years of age (2003-2006; n=1324), the Child Behaviour Checklist (CBCL) was used to assess behaviour (characterising mental health status), with higher scores representing poorer behaviour. Two dietary patterns (Western and Healthy) were identified using factor analysis and food group intakes estimated by a 212-item food frequency questionnaire. Relationships between dietary patterns, food group intakes and behaviour were examined using general linear modelling following adjustment for potential confounding factors at age 14: total energy intake, body mass index, physical activity, screen use, family structure, income and functioning, gender and maternal education at pregnancy. RESULTS Higher total (b=2.20, 95% CI=1.06, 3.35), internalizing (withdrawn/depressed) (b=1.25, 95% CI=0.15, 2.35) and externalizing (delinquent/aggressive) (b=2.60, 95% CI=1.51, 3.68) CBCL scores were significantly associated with the Western dietary pattern, with increased intakes of takeaway foods, confectionary and red meat. Improved behavioural scores were significantly associated with higher intakes of leafy green vegetables and fresh fruit (components of the Healthy pattern). CONCLUSION These findings implicate a Western dietary pattern in poorer behavioural outcomes for adolescents. Better behavioural outcomes were associated with a higher intake of fresh fruit and leafy green vegetables.
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Affiliation(s)
- Wendy H Oddy
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA 6872, Australia.
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Wang JP, Unadkat JD, McNamara S, O'Sullivan TA, Smith AL, Trager WF, Ramsey B. Disposition of drugs in cystic fibrosis. VI. In vivo activity of cytochrome P450 isoforms involved in the metabolism of (R)-warfarin (including P450 3A4) is not enhanced in cystic fibrosis. Clin Pharmacol Ther 1994; 55:528-34. [PMID: 8181197 DOI: 10.1038/clpt.1994.66] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To determine whether the activity of cytochrome P450 isoforms involved in the metabolism of (R)-warfarin is enhanced in cystic fibrosis. DESIGN Six adult subjects with cystic fibrosis and six healthy control subjects, matched by age and sex, were administered (R)-warfarin as a single intravenous bolus dose (0.375 mg/kg), and urine and plasma samples were collected for 192 hours. The concentration of (R)-warfarin in plasma and the concentration of (R)-warfarin and its metabolites in urine were determined by HPLC and GC/MS, respectively. Plasma protein binding of (R)-warfarin was measured by ultrafiltration. RESULTS The unbound plasma clearance of (R)-warfarin was not significantly (p > 0.05) different between the cystic fibrosis and the control groups (cystic fibrosis, 997 +/- 483 ml/hr/kg; control, 788 +/- 219 ml/hr/kg). The unbound metabolic clearances of (R)-warfarin to its oxidative metabolites--6-hydroxywarfarin, 7-hydroxywarfarin, 8-hydroxywarfarin, and 10-hydroxywarfarin (mediated by P450 3A4)--were also similar (p > 0.05) in the two groups (6-hydroxywarfarin: cystic fibrosis: 124.2 +/- 72.8 ml/hr/kg, control: 99.4 +/- 37.3 ml/hr/kg; 7-hydroxywarfarin: cystic fibrosis: 43.8 +/- 32.2 ml/hr/kg, control: 34.5 +/- 10.6 ml/hr/kg; 8-hydroxywarfarin: cystic fibrosis: 80.4 +/- 85.4 ml/hr/kg, control: 69.5 +/- 39.5 ml/hr/kg; 10-hydroxywarfarin: cystic fibrosis: 4.38 +/- 2.72 ml/hr/kg, control: 16.28 +/- 13.71 ml/hr/kg). CONCLUSION The in vivo activity of cytochrome P450 isoforms involved in the metabolism of (R)-warfarin, including P450 3A4, is not enhanced in cystic fibrosis.
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Affiliation(s)
- J P Wang
- Department of Pharmaceutics, University of Washington, Seattle 98195
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