Risk of Social Isolation as a Contributing Factor to Diet Quality in Community-Dwelling Older Persons Living in the Australian Capital Territory-A Pilot Study.

OBJECTIVES: Social isolation is recognised as a risk factor in the inflammatory process. This study explored the association between social isolation and the Dietary Inflammatory Index (DII) in community-dwelling older persons. METHODS: This cross-sectional pilot study recruited 107 community-dwelling people aged over 55 years living in the Australian Capital Territory. Participants completed an extensive food frequency questionnaire and provided anthropometric and sociodemographic data. Social isolation was evaluated using the Lubben Social Network Scale (LSNS). Diet quality was assessed using DII. RESULTS: Average age was 70.1 (±8.61) years and 62.8% were female. The average DII score was -1.10 (±1.21), indicating an anti-inflammatory diet. Higher LSNS was associated with lower DII (b (95% CI) = -0.041 (-0.066, -0.17); p < 0.01) and was positively influenced by the number of people in household (b (95% CI) = 5.731 (2.336, 9.127); p = 0.001). CONCLUSION: Increased risk of social isolation was associated with an increased tendency towards a more inflammatory diet. Reducing social isolation may decrease the inflammatory component of dietary intake for older persons living independently in the community.

An Exploratory Study of Nutrition Knowledge and Challenges Faced by Informal Carers of Community-Dwelling People with Dementia: Online Survey and Thematic Analysis.

Nutrition knowledge is a primary factor influencing food choices and the ability to identify nutritional risk for carers of people with dementia. Acquiring nutrition knowledge helps carers monitor changes in food intake and micronutrient intake, and whether a healthy and balanced diet is being consumed. This study aimed to assess the nutrition knowledge of carers in the Australian community and their experiences with nutrition education. Using a mixed-methods approach, the nutrition knowledge of informal carers was assessed using the revised General Nutrition Knowledge Questionnaire (AUS-R-NKQ), and interviews of informal carers were used to explore the perspectives in a sub-sample. A total of 57 carers (44 females; mean age of 63.0 ± 13.1) completed the survey, and 11 carers participated in follow-up interviews. The total sample scored 22.9 (±4.57) out of 38 on the AUS-R-NKQ, suggesting basic nutrition knowledge. The interviewed carers acknowledged the importance of healthy nutrition but viewed the provision of a healthy diet for a person with dementia as challenging. In both the survey and interviews, carers reported limited use and availability of dementia-specific nutrition resources. Carers were unsatisfied with the advice and number of referrals provided to improve the nutrition of the person with dementia and desired less confusing nutrition education materials adapted to their level of knowledge. The present study highlights the need for informal carers to be supported to acquire adequate nutrition knowledge.

Healthy eating blog readership: A cross-sectional survey in Australian adults.

AIMS: To investigate whether members of the public read blogs for the purpose of accessing healthy eating information; examine demographic predictors of healthy eating blog readership, specifically education, gender, age, body mass index, and residential location; and explore the reasons for reading, and not reading, healthy eating blogs. METHODS: This study used a cross-sectional online self-reported survey design collected over three time points (round 1: December 2017-March 2018, round 2: August 2018-December 2018, round 3: December 2021-March 2022). The total sample of participants comprised of 238 respondents with a mean age of 46 years old, who mostly reported gender as female (82%), being educated with a university degree (69%), and predominantly resided in urban and city areas (84%). RESULTS: Fifty-one percent of respondents reported reading healthy eating blogs, suggesting that consumers were proactively seeking healthy eating information through this avenue. Participants who identified as female were 3.2 times more likely to read healthy eating blogs. Commonly, healthy eating blogs were read to receive practical information that aligned with current food choices. The main reason participants reported not reading healthy eating blogs was not thinking about using them (29%). CONCLUSIONS: Understanding who is seeking healthy eating information through blogs, and their reasons doing so, is important to continue research into the potential effectiveness of blogs as a platform to communicate healthy eating and nutrition messages. This study provides direction for further investigation into how dietetics professionals could effectively use blogs to disseminate healthy eating information and positively influence consumer food choices and dietary intake.

Physicochemical, antioxidant and sensory properties of Mango Sorbet containing L-theanine as a potential functional food product.

The non-proteinous amino acid L-theanine (L-THE) is associated with a range of health benefits including improvements in immune function, cardiovascular outcomes and cognition. The aims of this study were to develop a food product (mango sorbet; ms-L-THE) containing physiologically relevant doses of L-THE (0.2/100 g w/w) and determine its antioxidant, physicochemical and sensory properties in comparison to a mango sorbet without L-THE (ms). Total phenolic and flavanol content, and antioxidant analysis (DPPH, FRAP and ABTS) were determined spectrophotometrically. Both products were also evaluated for acceptability and likeability in healthy participants using the 9-point hedonic scale. Any differences that could be caused by the addition of L-THE were examined using the triangle test. Results indicated no significant differences between ms-L-THE and ms in taste of the products (p > 0.05), and the ms-L-THE was well received and accepted as a potential commercial product. Findings of the DPPH assay indicated significant difference between the two products (p < 0.05). In conclusion, we have successfully created a mango sorbet that contains a potentially physiologically relevant concentration of L-THE with antioxidant properties that could be used as a novel method of L-THE delivery to clinical and healthy populations.

Are dietary patterns becoming more processed? The effects of different dietary patterns on cognition: A review.

Background: Identifying dietary patterns that promote healthy aging has become increasingly important due to changes in food processing and consumption of processed foods. Recently, the effects of these foods and unhealthy dietary patterns on cognitive function have become more widely recognized. Aim: The aim of this review is to discuss the association between various dietary patterns and cognition in older age, while also highlighting growing evidence that ultra processed food (UPF) may negatively impact healthy aging. Methods: We have performed a non-systematic literature review searches in Google Scholar electronic database with pre-defined terms relating to UPF, diet, dietary patterns, cognition and ageing. Results: The most prevalent diets in the literature include the Western, Mediterranean, Dietary Approach to Stop Hypertension (DASH), Mediterranean-DASH Intervention for Neurogenerative Delay (MIND), Japanese, Nordic, and plant-based diets. Based on the findings, higher intakes of fresh fruit and vegetables, wholegrains and oily fish are common components of dietary patterns that are positively associated with better cognitive function. In contrast, the characteristics of a Western style dietary pattern, consisting of high amounts of UPF's, are increasing in many countries even where the staple dietary pattern was identified as healthy (i.e. Japan). Conclusion: The consumption of UPF, classified by the NOVA food classification system as industrially manufactured foods containing high levels of starches, vegetable oils, sugar, emulsifiers, and foods additives, has a negative impact on the overall nutritional quality of individual diets.

The Benefits, Challenges and Impacts of Telehealth Student Clinical Placements for Accredited Health Programs During the COVID-19 Pandemic.

Introduction: Despite the advantages of telehealth, there has been a reluctance in its widespread adoption. During the COVID-19 pandemic, telehealth services and related placements increased internationally. Yet, there is currently limited research on the use of telehealth for student clinical placements. Aim: To explore the perceived benefits, challenges, and impacts of telehealth placements for key stakeholders (clients, students, clinical educators, and placement co-ordinators) in allied health courses. Methods: Stakeholder experiences with telehealth placements, undertaken within an Australian Allied Health University Clinic, were explored in virtual focus groups held between November 2020 and March 2021. These discussions used semi-structured interview questions, were audiotaped and transcribed verbatim. They were then thematically analyzed independently by two researchers, then cross-checked for consistency, using a qualitative descriptive approach, with reflexivity applied. Results: Twenty-six stakeholders from six allied health disciplines participated in seven homogeneous focus groups. Three themes were identified: (1) telehealth placements support competency development and graduate employability; (2) telehealth placements enable students to provide person centered-care; and (3) telehealth placements enabled innovation. Conclusion: Telehealth placements can make a valuable contribution as part of an overall placement program within accredited health courses and offer distinct advantages to student learning outcomes.

Sensory and Compositional Properties Affecting the Likeability of Commercially Available Australian Honeys.

Honey's composition and appearance is largely influenced by floral and geographic origins. Australian honeys are frequently sourced from supermarkets; however, properties associated with consumer preference and likeability remain relatively unknown. The aim of this study was to complete sensory and compositional analyses on a selection of commercially available Australian honeys. Samples (n = 32) were analysed for visual, olfactory and taste characteristics, with overall likeability assessed by the trained sensory panel (n = 24; M = 12). Compositional analysis included colour intensity (mAU); phenolic content; antioxidant characteristics (DPPH, CUPRAC); and physicochemical properties (pH, viscosity, total soluble solids). There were 23 honey samples that were significantly less liked when compared to the most liked honey (p < 0.05). The likeability of honey was positively associated with perceived sweetness (p < 0.01), and it was negatively associated with crystallisation; odour intensity; waxy, chemical, and fermented smell; mouthfeel; aftertaste; sourness; bitterness and pH (All p's < 0.05). The price (AUD/100 g) was not associated with likeability (p = 0.143), suggesting price value potentially does not influence consumer preferences. Conclusively, differences in likeability between the honey samples demonstrate that consumer perception of sampled honeys is diverse. Honey preference is primarily driven by the organoleptic properties, particularly perceived negative tastes, rather than their antioxidant capacity or phenolic content.

The P.O.S.T Guidelines for Nutrition Blogs: A Modified e-Delphi Study.

BACKGROUND: Blogs are being used increasingly to disseminate nutrition information to consumers, including by registered dietitians (RDs). Guidelines in authoring blogs are important for dietetics professionals so that they effectively communicate evidence-based nutrition information in this format. OBJECTIVE: The aim of this study was to obtain consensus from experts comprising RDs with active blog-writing experience on a set of guidelines for use by RDs when authoring a healthy eating or nutrition information blog. DESIGN: A modified e-Delphi technique with a consensus-based approach was used in this study undertaken between June and October 2019. The purpose-built, pilot-tested e-Delphi survey was informed by a literature review and included statements from 3 domains comprising blog readers and communication; purpose and healthy eating messages; and structure, voice, and tone. Expert participants were identified purposively and via snowballing. In each survey round, statements that achieved 80% consensus were accepted. PARTICIPANTS/SETTING: A total of 19 experts consented to participate. Experts resided in the United States, Australia, and United Kingdom. Experts were mainly women aged between 30 and 49 years and working in private practice and/or research or teaching areas of nutrition and dietetics. RESULTS: Across 3 domains, a total of 33 statements were accepted, comprising a final set of guidelines named the P.O.S.T (purpose, community, structure, and tone) Guidelines for Nutrition Blogs. CONCLUSIONS: Consensus from a panel of dietetics experts resulted in the P.O.S.T Guidelines for Nutrition Blogs, which can support RDs in authoring healthy eating blogs. This will ensure that evidence-based nutrition messages provided to consumers are engaging and effective.

Effects of a virtual group cycling experience on people living with dementia: A mixed method pilot study.

Social isolation and sedentary behaviour are common in residential aged care facilities (also known as nursing homes or long-term care). Use of new technologies such as virtual and augmented reality are currently under investigation for their potential to provide exciting and engaging activities for older people in residential aged care facilities. However, there is limited evidence on whether these technologies can promote physical activity in a small group setting for people with cognitive impairment. Using mixed methods, we examined the use of a virtual cycling experience in a sample of 10 participants with cognitive impairment living in residential aged care facilities. In a randomised crossover design, participants engaged in a 25-minute, self-paced, facilitated seated virtual cycling experience and a time-matched seated physical activity session in groups of five. All participants completed a brief pre- and post-intervention mood questionnaire. Video analysis was used for both conditions to compare levels of environmental stimulation, apathy and engagement using both the Person-Environment Apathy Rating Scale and the Engagement of a Person with Dementia Scale. A thematic analysis of semi-structured interviews following the virtual cycling experience was also performed. No differences were observed between conditions for all outcomes except for environmental stimulation, where there was a lower response in the intervention than the control condition (p = 0.032). This was primarily driven by lower scores for the virtual cycling experience than control in physical accessibility (p = 0.012). Participants reported the virtual cycling experience to be immersive and challenging and reminisced about cycling earlier in life. The activity manager observed that the virtual cycling experience was an overall positive experience and emphasised benefits of safety screening and preparation prior to the activities. The findings of this study support the use of the virtual cycling experience as an immersive and engaging alternative to usual activities, which might encourage higher levels of physical activity in residential aged care facilities.

Activities outside of the care setting for people with dementia: a systematic review.

OBJECTIVES: To summarise the evidence from interventions investigating the effects of out of care setting activities on people with dementia living in residential aged care. DESIGN: A systematic review. METHODS: A systematic search of electronic databases (PubMed, PsycINFO, Scopus, Web of Science and the Cochrane Library) was performed to identify intervention trials published from journal inception to January 2020. Controlled trials, or quasi-experimental trials, which measured pre-intervention, post-intervention or during-intervention outcomes, where the participants were required to leave the care setting to participate in an intervention, were eligible for inclusion. Quality appraisal of the studies was performed following the Cochrane Collaboration's Risk of Bias or Newcastle-Ottawa Scale tools. RESULTS: Of the 4155 articles screened, 11 articles met the inclusion criteria from 9 different studies. The number of participants in the studies ranged from 6 to 70 people living with dementia and lasted for 3 weeks up to 5 months. The interventions were aquatic exercise, wheelchair cycling, art gallery discussion groups, an intergenerational mentorship programme, horse riding, walking and outdoor gardening. Overall, the studies indicated preliminary evidence of psychological (n=7), physical (n=4) and physiological (n=1) benefits, and all interventions were feasible to conduct away from the aged care facilities. However, the low number of participants in the included studies (n=177), the absence of a control group in all but three studies, and potential for selection bias, limits the generalisability of the findings. CONCLUSIONS: Activities outside of the residential aged care setting have the potential to be effective at providing a range of benefits for people living with dementia. Higher quality studies are required to encourage care providers to implement these type of activities in dementia care settings. PROSPERO REGISTRATION NUMBER: CRD42020166518.

Food Habits of Older Australians Living Alone in the Australian Capital Territory.

The link between adequate nutrition and quality of life for older persons is well established. With the proportion of older adults increasing, policy regarding support and care for the ageing has shifted emphasis to keeping older adults in their homes for as long as possible. Risk of malnutrition is an issue of importance for this population and, while this risk is well researched within the hospital setting, it is still relatively under-researched within the community-dwelling elderly, particularly with respect to the lived experience. This qualitative study (underpinned by interpretative phenomenology philosophy) explores how the lived experiences of community-dwelling older people living in one-person households in the Australian Capital Territory (ACT) influences dietary patterns, food choices and perceptions about food availability. Using purposeful and snowballing sampling, older people (65 years and over) living alone in the community participated in focus group discussions triangulated with their family/carers. Data were thematically analysed using a previously established approach. Participants (n = 22) were interviewed in three focus groups. Three themes were identified: active and meaningful community connectedness; eating well and behaviours to promote dietary resilience. Of these, community connectedness was pivotal in driving food patterns and choices and was a central component influencing behaviours to eating well and maintaining dietary resilience.

The Effect of L-Theanine Incorporated in a Functional Food Product (Mango Sorbet) on Physiological Responses in Healthy Males: A Pilot Randomised Controlled Trial.

Consumption of L-Theanine (L-THE) has been associated with a sensation of relaxation, as well as a reduction of stress. However, these physiological responses have yet to be elucidated in humans where L-THE is compared alongside food or as a functional ingredient within the food matrix. The aim of this study was to determine the physiological responses of a single intake of a potential functional food product (mango sorbet) containing L-THE (ms-L-THE; 200 mgw/w) in comparison to a flavour and colour-matched placebo (ms). Eighteen healthy male participants were recruited in this randomised, double-blind, placebo-controlled trial. The participants were required to consume ms-L-THE or placebo and their blood pressure (BP) (systolic and diastolic), heart rate (HR), and heart rate variability (HRV) were monitored continuously over 90 minutes. Eleven males (age 27.7 ± 10.8 years) completed the study. Changes in area under the curve for systolic and diastolic blood pressure and HRV over the 90 minute observation period indicated no differences between the three conditions (all p > 0.05) or within individual groups (all p > 0.05). The values for heart rate were also not different in the placebo group (p = 0.996) and treatment group (p = 0.066), while there was a difference seen at the baseline (p = 0.003). Based on the findings of this study, L-THE incorporated in a food matrix (mango sorbet) demonstrated no reduction in BP or HR and showed no significant parasympathetic interaction as determined by HRV high-frequency band and low-frequency/high-frequency ratio. Further studies should be focussed towards the comparison of pure L-THE and incorporation within the food matrix to warrant recommendations of L-THE alongside food consumption.

Assessing the diet quality of individuals with rheumatic conditions: a cross-sectional study.

Arthritis is a significant cause of chronic pain and disability, affecting around 3.5 million Australians. However, little is known regarding the overall diet quality of those living with arthritis. This study aimed to assess the dietary quality of Australians living in the Australian Capital Territory region with arthritis. This cross-sectional study analysed dietary intake data of individuals living with arthritis using a validated food frequency questionnaire. Dietary quality was assessed using the Healthy Eating Index-2015 (HEI-2015) to examine associations between diet composition, age, income and arthritis impact using the short form of the Arthritis Impact Measurement Scales 2 (AIMS2-SF). Participants, predominantly female (82.6%), were grouped by age: 18-50 years (n = 32), 50-64 years (n = 31), and 65 + years (n = 23). Significant correlations were observed between age and HEI-2015 (rs = 0.337, p = 0.002) and income and AIMS2-SF (rs = - 0.353, p < 0.001). The mean HEI-2015 score for the 18-49 years group was fair (72.1 ± 12.3), lower than both the 50-64 years group score of good (81.5 ± 9.72) (p = 0.004), and the 65 + years group score of good (81.8 ± 12.1) (p = 0.007). Dietary fibre, seafood and plant protein, fatty acids, and refined grains were identified as dietary components of concern for the 18-49 years group, and total fruit and added sugar were components of concern for people in the worst tertile for the AIMS2-SF. People aged between 18 and 49 years are consuming a lower quality diet compared to people aged 50 years and over. Further research is needed to understand why this association is occurring in this high socioeconomic region of Australia (a high-income country).

Toxicities Caused by Head and Neck Cancer Treatments and Their Influence on the Development of Malnutrition: Review of the Literature.

Malnutrition poses a significant problem for oncology patients, resulting in fatalities within this population. Patients with head and neck cancer (HNC) are at high risk, with up to 90% developing malnutrition. Common treatments used for HNC can often lead to adverse side effects, including oral health conditions, gastrointestinal upsets, and several metabolic changes. Consequently, treatments can cause inadequate nutritional intake, resulting in a reduction in energy consumption, and alterations in energy utilization, contributing to the development of malnutrition. Furthermore, the presence of these treatment toxicities, and the related malnutrition can lead to reduced quality of life, weight loss, and psychological distress. There are interventions available (nutritional, medicinal, and physical therapies) that have demonstrated potential effectiveness in reducing the severity of symptomatic toxicities, reducing the risk of malnutrition, and improving survival outcomes of patients with HNC. Based on the findings of this review, there is an urgent need for the implementation or continuation of multi-disciplinary strategies, as well as updated and improved guidelines to assist in the prevention and treatment of malnutrition caused by treatment-related toxicities in patients with HNC.

Reframing healthy food choices: a content analysis of Australian healthy eating blogs.

BACKGROUND: Blogs are widely being used by health professionals and consumers to communicate and access nutrition information. There are numerous benefits for dietitians to establish and contribute to healthy eating blogs. In particular, to disseminate evidence-based nutrition information to promote healthier dietary practices. The aim of this study was to explore characteristics of popular healthy eating blogs and inform the provision of healthy eating information in the Australian context. METHODS: A content analysis approach was used to identify characteristics of popular Australian healthy eating blogs. A purposive and snowball sampling approach was used to identify healthy eating blogs from search engines including Google, Bing and Yahoo. Blogs were deemed eligible if: (1) the author self-identified as a health professional; (2) the blog was written by a single author; (3) the blog was written by an Australian author; (4) the blog had a minimum of one post per month, and (5) the blog focused on communicating healthy eating information to the general adult population. RESULTS: Five popular blogs were followed over a three-month period (December 2017-March 2018), with 76 blog posts included for analysis. Characteristics of these popular blogs were examined and four main features were identified: (i) clearly conveying the purpose of each post; (ii) developing a strong understanding of the reader base and their preferences; (iii) employing a consistent writing style; use of vocabulary and layout; and (iv) communicating healthy eating information in a practical manner. These findings reveal important insight into the features that promote effective nutrition communication within this context. CONCLUSION: Findings from this study highlight common characteristics of popular healthy eating blogs. Future research into the development of blog guidelines which incorporate the characteristics identified in this study can support dietitians in establishing or contributing to the successful provision of evidence-based nutritional information through blogs.

Psychophysiological Responses in People Living with Dementia after an Art Gallery Intervention: An Exploratory Study.

The use of existing public spaces by people living with dementia, such as museums and art galleries, are becoming popular due to their ability to facilitate programs which promote social engagement and inclusion. However, few studies have investigated physiological outcomes of art gallery-based programs. Using a quasi-experimental design, the present study aimed to investigate the levels of salivary biomarkers of cortisol and interleukin-6, quality of life (QoL), depressive symptoms, cognition, and wellbeing, after attending the National Gallery of Australia (NGA) Art and Dementia program. Twenty-eight people living with dementia, each supported by a carer or family member, were recruited for a six-week program and were followed up at twelve weeks. In total, 25 participants (17 female; mean age 84.6±7.27 years) completed the study, and 22 provided viable saliva samples. The waking to evening salivary cortisol ratio was higher post-intervention (p = 0.033), and returned to baseline levels at follow-up (p = 1.00), indicating a more dynamic salivary cortisol rhythm in response to the six-week program. Interleukin-6 levels remained unchanged (p = 0.664). No improvements in QoL (DEMQOL-Carer) were observed between baseline and post-intervention (p = 0.076). However, self-reported depressive symptoms decreased post-intervention compared with baseline (p = 0.015), and memory (immediate recall) (p = 0.009) and verbal fluency (p = 0.027) improved between the same timepoints. The NGA Art and Dementia program appears to have quantifiable benefits, including improved hypothalamic-pituitary-adrenal axis function, justifying a need for longer controlled trial inclusive of physiological outcomes.

A Mini-Review of Virtual Reality-Based Interventions to Promote Well-Being for People Living with Dementia and Mild Cognitive Impairment.

Assistive technology including virtual reality and augmented reality has gained interest as a novel intervention in a range of clinical settings. This technology has the potential to provide mental stimulation, a connection to autobiographical memory through reminiscence, and enhanced quality of life (QoL) to people living with dementia (PLWD) and mild cognitive impairment (MCI). In this mini-review, we examine the available evidence from studies reporting on the potential benefits of virtual and augmented reality to provide enjoyable, leisurely activities that may promote QoL and psychological well-being and facilitate social interaction. In total, 10 studies of varying study designs and durations (5 min to 6 months) using virtual (n = 9) and augmented reality (n = 1) were examined in PLWD (n = 6) and MCI (n= 3), in addition to 1 study that included participants with both conditions. Overall, the virtual experiences were enjoyed by the participants, improved their mood and apathy, and were preferred when compared with nonvirtual experiences. However, small sample sizes and variations in study design limit the generalizability of the results. Nevertheless, the use of virtual and augmented reality technology for PLWD and MCI is a novel and emerging method which may provide cognitive stimulation and improve well-being. Future research should explore the potential application of this technology to promote social interaction in both the community and aged care settings. We suggest future studies in PLWD and MCI assess the effects of more sustained use of virtual and augmented reality technology on psychological outcomes including QoL, apathy, and depressive symptoms, with the incorporation of physiological biomarker outcomes.

What is healthy eating? A qualitative exploration.

OBJECTIVE: The present study aimed to explore how healthy food choices are translated into everyday life by exploring definitions of healthy food choices, perceptions of own food choice, and healthy food choice drivers (facilitators) and barriers. DESIGN: An exploratory qualitative study design was employed using semi-structured face-to-face interviews. Convenience sampling was used to recruit participants. Interviews were audio-recorded, transcribed verbatim and cross-checked for consistency. Thematic analysis was used to identify patterns emerging from the data. SETTING: Canberra, Australia, October 2015-March 2016. PARTICIPANTS: A total of twenty-three participants aged 25-60 years were interviewed. The mean age was 38 years and the mean BMI was 29·1 kg/m2. All male participants (n 4) were within the healthy weight range compared with 58 % of female participants, with 26 % being overweight and 16 % being obese. RESULTS: (i) Healthy food choices are important but are not a daily priority; (ii) healthy eating information is known but can be difficult to apply into everyday life; (iii) popular diets are used in attempts to improve healthy eating; and (iv) social media inspires and connects people with healthy eating. CONCLUSIONS: Social media facilitates healthy food choices by providing access to healthy eating information. In addition to Facebook and Instagram, healthy eating blogs were highlighted as a source of nutrition information. Research should consider exploring the use of healthy eating blogs and whether these blogs can be used as a tool by dietitians to communicate procedural healthy eating information more effectively in the future.

The effects of grape and red wine polyphenols on gut microbiota - A systematic review.

There is a growing body of evidence implicating the gut 'microbiome' role in overall human health. Bacterial species belonging to the genera Lactobacillus and Bifidobacterium are generally considered to be beneficial and are commonly used in probiotic applications, whereas increases in some genera including Clostridum, Eubacterium and Bacteroides are implicated in negative health outcomes. Dietary polyphenols are bioactive compounds that have been found to increase the numbers of beneficial bacteria and antimicrobial actions against pathogenic bacteria, however most studies have been conducted in animal models or in-vitro colonic models. The aim of this systematic review was to provide an overview of recent trials on the effect of dietary grape and red wine polyphenols on the gut microbiota in humans. Following PRISMA guidelines, a systematic review was conducted of electronic databases (PubMed, CINAHL, Cochrane Library, Wed of Science and Scopus) to identify human intervention trials examining the effect of grape or wine polyphenols on gut microbiota. Seven trials met the inclusion criteria. One study looked at changes in gut microbiota following the ingestion of de-alcoholised red wine or red wine, and six studies referred to gut microbiota as intermediates in formation of phenolic metabolites. All studies confirmed that ingested polyphenols from grape and red wine, were modulated by gut microbiota, increasing numbers of polyphenolic metabolites which were found in blood, urine, ileal fluid and faeces. Intake of polyphenols derived from grape and red wine can modulate gut microbiota and contribute to beneficial microbial ecology that can enhance human health benefits. Additionally, grape and red wine polyphenols were modulated by the gut microbiota and there is a potential for a two-way relationship between the gut microbiota and polyphenolic compounds. Nevertheless, additional research is required to fully understand the complex relationship between gut microbiota and dietary polyphenols before any health claims can be made in relation to human health.