A scoping review of Australian nutrition resources for feeding children under 5 years of age.

INTRODUCTION: This review identified and appraised Australian open-access online resources relating to feeding and nutrition during the first 5 years of life. METHODS: Eligible resources were identified by hand searching plus a targeted search of pertinent source websites (government, hospitals and health services, peak bodies, and nutrition organisations) published in English with/without translations to other languages between 2012 and 2022. Search terms relating to the population (children) AND topic (nutrition OR feeding) were entered into Google and Bing. Critical appraisal of each resource was conducted using a modified version of the Centres for Disease Control and Prevention Clear Communication Index. RESULTS: The search identified 1327 nutrition resources, of which 1067 were appraised. Forty-five percent were paper-based resources, 47% were online content only, and 8% audio-visual resources. Almost half of the resources (45%) broadly addressed the 0-5 years age range, and 24% provided information on breast or formula feeding. Limited resources were found specifically addressing growth and development (5%) and introducing solids (8%). Only 10% of resources were culturally tailored and only 3% were translated into a language other than English. Appraisal showed the majority included visual cues and appropriate language, but less included images to support the main message of the resource. DISCUSSION: Although there were a large volume of evidence-based nutrition resources available in Australia for feeding children under 5 years, they were highly dispersed and of varying quality. Collating and presenting these resources in an open-access resource hub would empower families and education and health professionals in the nutritional care of young children.

Fostering collaborative practice through interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students.

Literature regarding simulation for learning interprofessional collaborative practice (IPCP) indicates a need to include a range of health professions and to focus on students' development of team communication and conflict resolution skills in day-to-day healthcare delivery. This study evaluated the impact of interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students on interprofessional collaboration competencies, specifically collaborative communication and conflict resolution during day-to-day interactions, and their intention for IPCP during placement. A series of simulations featuring the potential for interprofessional conflict and involving explicit coaching on communication and conflict resolution were conducted. A single cohort pre-test post-test design included the Students' Perceptions of Interprofessional Clinical Education Revised (SPICE-R), the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), and an open response survey question on future intended practice. A total of 237 students participated in the simulation experience. Overall scores and scores on all IPCP competencies in the ICASS (n = 193) and SPICE-R (n = 226) improved for all professions post-simulation. The mean score of the ICCAS increased for 98% of the respondents and similarly the mean score of the SPICE-R increased for 71% of the respondents. Open-ended responses indicated students' intentions to pursue self-leadership in IPCP. Students who participated in an interprofessional simulation reported perceived improvements in IPCP competencies and were encouraged to initiate IPCP when on placement in the practice setting.

Applying the Integrated Sustainability Framework to explore the long-term sustainability of nutrition education programmes in schools: a systematic review.

OBJECTIVE: This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥ 2 years) sustainment of school-based nutrition programmes. DESIGN: Four databases (PubMed, Cochrane Library, Embase and Scopus) were searched to identify studies reporting on the international literature relating to food and nutrition programmes aimed at school-age (5-14 years) children that had been running for ≥ 2 years (combined intervention and follow-up period). Eligible studies were analysed using the Integrated Sustainability Framework (ISF), which involved deductive coding of programme enablers and barriers. A quality assessment was completed, using the Mixed-Methods Appraisal Tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. SETTING: International school-based nutrition programmes. SUBJECTS: Individuals involved with the implementation of school-based nutrition programmes. RESULTS: From the 7366 articles identified, thirteen studies (seven qualitative, five mixed methods and one quantitative descriptive) were included, from which the enablers and barriers of eleven different nutrition-related programmes were analysed. Thirty-four factors across the five domains of the ISF were identified that influenced the sustained implementation of programmes. The most common barrier was a lack of organisational readiness and resources, whereas the most common enabler was having adequate external partnerships and a supportive environment. CONCLUSIONS: These findings have application during the initiation and implementation phases of school-based nutrition programmes. Paying attention to the 'outer contextual factors' of the ISF including the establishment and maintenance of robust relationships across whole of government systems, local institutions and funding bodies are crucial for programme sustainment.

A Systematic Review Investigating Maternal Nutrition During Pregnancy After Bariatric Surgery.

The aim of this review was to report on maternal diet, micronutrient supplementation, and gestational weight gain (GWG) during pregnancy following bariatric surgery and explore the impact on maternal micronutrient deficiency, offspring growth, and perinatal outcomes. A search in PubMed, CINAHL, EMBASE, and ProQuest in July 2022 returned 23 eligible studies (n = 30-20, 213). Diet was reported in two studies, supplementation in six and GWG in 19 studies. Although many women did not achieve healthy GWG, no consistent link with adverse outcomes was reported. Studies were grades II and III on the National Health and Medical Research Council evidence hierarchy and received a neutral or negative score on the Academy of Nutrition and Dietetics Quality Criteria Checklist, suggesting that methodological limitations impact the reliability of reported findings.

What Do Health Professionals and Parents Want as Part of an Online Childhood Obesity Prevention Program?

Background: There are limited evidence-based programs for children living in Queensland, Australia, who are at risk of overweight or obesity. Despite the known importance of prevention initiatives, an online, locally relevant program supporting sustainable health behaviors does not exist. This study aimed to understand the perspectives of parents/guardians and health professionals regarding important aspects of an online childhood obesity prevention program. Methods: This pragmatic, mixed-methods study was conducted from March to December 2020. Recruitment included participants from two groups involved with children aged 2-17 years, health professionals, and parents/guardians. Phase 1 involved dissemination of an online survey. Questions addressed program structure, content delivery (including nutrition, physical activity, and parenting practices), program evaluation, and information dissemination. Descriptive statistics were used to describe survey data to inform the delivery of Phase 2, where two focus groups further explored the topics. Thematic analysis was used to investigate the qualitative data. Results: Twenty-eight health professionals and 11 parents/guardians completed the survey, and 14 health professionals and 6 parents/guardians participated in the focus groups. Participants believed that the most beneficial approach would target younger children with family-based interventions, via a nontraditional structure. There was a strong preference for interactive content, gamification, and practical resources to translate knowledge into practice. Parents emphasized that there should be no assumption of basic knowledge, and that decision fatigue is a barrier to engagement. Conclusion: Participants provided clear direction regarding key aspects for future development of an online prevention program, highlighting the importance of codesign to tailor the program to identified needs.

Communicating Health to Young Adults Using Social Media: How, Where, and When?

Communication with young adults about healthy lifestyle behaviours needs to result in improvements in dietary choices to impact the prevalence of diet-related diseases. This paper presents the health beliefs, behaviours, and communication practices in young Australian adults (n = 2019) by their pre-defined psycho-behavioural characteristics: Lifestyle Mavens, Health-Conscious, Aspirational Healthy Eaters, Balanced-All Rounders, Contemplating Another Day, or Blissfully Unconcerned. The Lifestyle Mavens and Health-Conscious groups were more likely to actively seek out health information on social media (p < 0.05). Lifestyle Mavens were the most likely to engage with health and food content on social media, whereas the Blissfully Unconcerned were the least likely to engage (p < 0.05). Lifestyle Mavens are more likely to report creating food and health-related content for social media, whereas Aspirational Healthy Eaters are more likely to report searching for food and health-related content online, but are less likely to share or create content. Contemplating Another Day are more likely to report interactions with commercial content. This paper defines how psycho-behavioural segments communicate about health, where they look for information, how they may prefer to receive health messages, and when they are most receptive to messages. By applying existing robust market segmentation techniques, this paper provides nuanced information that challenges the assumption that online social media health information is preferred by all young adults.

Nutrition Meets Social Marketing: Targeting Health Promotion Campaigns to Young Adults Using the Living and Eating for Health Segments.

Young adults are a key target age group for lifestyle behaviour change as adoption of healthier behaviours has the potential to impact long term health. This paper arises from a multi-disciplinary research project, Communicating Health, which aims to bridge the gap between nutritionists, media, and social marketing professionals to produce the tools that may be used to improve engagement with young adults and reduce the prevalence of obesity. The aim of this paper is to provide nuanced details of the psycho-behavioral characteristics of each of these Living and Eating for Health Segments (LEHS). The design and validation of the LEHS employed a four-stage mixed methods design underpinned by the Integrated Model of Behaviour Change and incorporating sequential formative, qualitative, and quantitative phases. This paper defines the psycho-behavioural characteristics of six distinct market segments: Lifestyle Mavens, Aspirational Healthy Eaters, Balanced-all Rounders, the Health Conscious, those Contemplating Another Day, and the Blissfully Unconcerned. These psycho-behavioural characteristics are important to understand to help build our capability in designing campaigns that are specifically and purposefully targeting these different market segments of young adults. Social marketing practices can enhance the utility of nutrition and health messages to young adults in order to engage them in adopting positive lifestyle change. Tailoring health promotions to the perceived needs of sub-groups or segments of young adults should lead to increased engagement and uptake of messages and cost-efficient use of health promotion budgets.

Association of carbonated soft drink and fast food intake with stress-related sleep disturbance among adolescents: A global perspective from 64 countries.

BACKGROUND: Poor quality sleep adversely impacts on adolescent wellbeing. More multinational research is needed to understand modifiable risk factors, such as dietary behaviours. This study aimed to examine the association of carbonated soft drink and fast food intake with stress-related sleep disturbance among adolescents across 64 countries. METHODS: We analysed the Global School-based Student Health Survey data from 175,261 adolescents (mean age 13.8 [0.98]; 48.5% females). Adolescents reported frequency of stress-related sleep disturbance and consumption of carbonated soft drinks and fast foods. Country-level estimates were obtained by using multivariable logistic regression and meta-analysis to obtain pooled estimates. FINDINGS: Overall, 7.5% of adolescents reported sleep disturbance during the past 12 months (males: 6.6%; females: 8.4%). Meta-analysis showed that adolescents having carbonated soft drinks ≥3 times/day had over 50% higher odds of reporting sleep disturbance than

Bioavailability of a Novel Form of Microencapsulated Bovine Lactoferrin and Its Effect on Inflammatory Markers and the Gut Microbiome: A Pilot Study.

Bovine lactoferrin, extracted from milk or whey, is used in a range of products to enhance immunity and support digestive health, iron absorption, and homeostasis. This study examined the absorption and effect of Progel (Brisbane, Queensland, Australia) microencapsulated bovine lactoferrin (InferrinTM, Bega Bionutrients, Victoria, Australia) on immune markers and the microbiome. A double-blind randomised, cross-over trial was conducted with 12 healthy males randomised to one of two doses, equivalent to 200 mg or 600 mg lactoferrin, for two four-week supplementation arms, with a two-week washout period. Subjects received either standard bovine lactoferrin or InferrinTM for each arm. Baseline and post each trial arm, CD69+ activation on CD4+ and CD8+ cells was analysed, bovine and human lactoferrin contents of faecal and serum samples were reported, and the gut microbiome was analysed using 16S sequencing and metagenomic sequencing. The mean level of CD69+ activation on the CD4+ cells was lower after supplementation regardless of the form or dose of lactoferrin. This was statistically significant for the 200 mg dose. A higher level of bovine lactoferrin was found post-supplementation in those taking InferrinTM, although this was not statistically significant. Changes in phylum-level microbial community profiling were detected post-supplementation in the second trial arm, particularly in those receiving InferrinTM. Metagenomic sequencing showed changes in the volumes of the top 100 species of bacteria present before and after all treatment arms. Results suggest that lactoferrin supplementation may have beneficial effects on the microbiome and immune system, and that the use of InferrinTM improves absorption. Larger detailed studies are needed to ascertain the potential positive effects of bovine lactoferrin supplementation.

The role of vitamin D in adipogenesis.

Vitamin D, a secosteroid predominately obtained by endogenous production, has in recent years been linked to obesity and its comorbidities. The purpose of this review is to draw conclusions from animal and human studies on the effects of vitamin D on adipogenesis to identify the molecular links between vitamin D and obesity. The information presented herein was obtained from 4 databases (PubMed, CINAHL, Cochrane Library, Scopus) using predefined search terms, as well as research literature and other reviews. The effects of vitamin D on adipogenesis have been researched in several animal models, and the majority of these studies suggest vitamin D plays an inhibitory role in adipogenesis. Studies into vitamin D status and obesity in humans are limited, with the majority being observational epidemiological studies that provide no conclusions on cause and effect or clear links on the molecular mechanisms. The few cell culture and supplementation studies that have investigated adipogenesis in human cells indicate that, in contrast to findings from rodent studies, vitamin D is proadipogenic. There is insufficient evidence to determine whether 1) vitamin D deficiency is associated with a lean or obese phenotype, 2) vitamin D deficiency is a consequence of obesity, or (3) the effects of vitamin D on fat tissue are due to interactions with calcium.

Association of Sun Exposure, Skin Colour and Body Mass Index with Vitamin D Status in Individuals Who Are Morbidly Obese.

Vitamin D deficiency is a common issue, particularly in obese populations, and is tested by assessing serum 25(OH)D concentrations. This study aimed to identify factors that contribute to the vitamin D status in fifty morbidly obese individuals recruited prior to bariatric surgery. Data collected included serum 25(OH)D concentrations, dietary and supplement intake of vitamin D, sun exposure measures, skin colour via spectrophotometry, and genotype analysis of several single nucleotide polymorphisms in the vitamin D metabolism pathway. Results showed a significant correlation between serum 25(OH)D concentrations and age, and serum 25(OH)D and ITAC score (natural skin colour). Natural skin colour accounted for 13.5% of variation in serum 25(OH)D, with every 10° increase in ITAC score (i.e., lighter skin) leading to a 9 nmol/L decrease in serum 25(OH)D. Multiple linear regression using age, ITAC score, and average UV index in the three months prior to testing, significantly predicted serum 25(OH)D concentrations (R² = 29.7%). Single nucleotide polymorphisms for all vitamin D genes tested, showed lower serum 25(OH)D for those with the rare genotype compared to the common genotype; this was most pronounced for fok1 and rs4588, where those with the rare genotype were insufficient (<50 nmol/L), and those with the common genotype were sufficient (≥50 nmol/L). Assessing vitamin D status in individuals with morbid obesity requires testing of 25(OH)D, but potential risk factors for this population include natural skin colour and age.

Vitamin D: Australian dietitian's knowledge and practices.

AIM: To survey dietitians on their knowledge and practices regarding vitamin D (VitD) intake, sources, supplementation and effect on disease state. METHODS: An online survey was disseminated to members of the Dietitian Association Australia via the weekly online state newsletter during April 2015. Response rate was 3%, with 134 respondents completing the survey. The survey included questions about knowledge and current practices. Descriptive statistics were used to analyse the results. RESULTS: Dietitians have good knowledge regarding dietary sources of VitD and roles in the body, but there is confusion around supplement doses for treatment and prevention of deficiency and sun exposure guidelines. CONCLUSIONS: Dietitians are well positioned to provide patients with advice on VitD supplementation and sun exposure practices, but not all are confident to provide this care. There is a need for clear and well-disseminated guidelines for VitD management by dietitians.

A Systematic Review: Vitamin D Status and Sleeve Gastrectomy.

BACKGROUND: Bariatric patients regularly present with insufficient vitamin D status before and after surgery, which requires substantial supplementation to treat. This review aims to assess the effect of sleeve gastrectomy on vitamin D status and the effectiveness of vitamin D supplementation. METHODS: This review was conducted in accordance with the Guidelines for Meta-Analyses and Systematic Reviews of Observational Studies. RESULTS: The current guidelines recommend initial vitamin D supplementation of at least 3000 IU/day post-operatively, with no need for follow-up testing after sleeve gastrectomy. Only one study has trialled a dose in line with the recommendations for this patient group. They found that it was effective in improving VitD status. CONCLUSIONS: On-going monitoring of vitamin D status is necessary, as the recommended level is not often reached.