The relationship between diet and sleep in 2-y-old children: Results from Growing Up in New Zealand.

OBJECTIVES: This study aimed to examine the relationship between dietary practices and sleep in young children. METHODS: In this study, 2-y-old children (n = 6327) and their mothers were enrolled at birth and during pregnancy, respectively. The study obtained maternal demographic, health, and lifestyle data during late pregnancy. Parents reported the 2-y-old child's dietary practices on a food frequency questionnaire, as well as sleep duration and night-waking frequency. Measures of dietary intake quantified servings per day for each food group (grouped as low/moderate/high intake). Sleep measures were as inadequate sleep when <11 h sleep in a 24-h period and increased night waking when waking ≥2 times per night. Multivariable logistic regression analyses examined associations between toddler diet and sleep, which were described using adjusted odds ratios (ORs) and 95% confidence intervals. RESULTS: In this study, 2-y-old children (n = 6288) slept for a mean of 12.3 hours (standard deviation: ±1.5 hours) over a 24-h period, with 734 children (12%) getting <11 h of sleep in 24 h. Increased night waking occurred in 1063 children (17%). Compared with low intake, high soft drink/snack/fast food intake was associated with inadequate sleep (OR: 1.37) and increased night waking (OR: 1.34). High milk/cheese/yoghurt intake (OR: 1.55) was associated with increased odds of night waking, but moderate (OR: 0.81) or high (OR: 0.78) vegetable intake was associated with decreased odds of night waking. Exposure to screens (OR: 1.28) and heavy maternal cigarette smoking (OR: 2.20) were also associated with inadequate sleep and increased night waking, respectively. CONCLUSIONS: At age 2 y, higher consumption of soft drinks/snacks/fast foods is associated with shorter, more disrupted sleep. Conversely, higher vegetable consumption is associated with less disrupted sleep. Dietary modifications may improve toddlers' sleep.

Ethnic disparities in infectious disease hospitalisations in the first year of life in New Zealand.

AIM: Infectious disease (ID) hospitalisation rates are increasing in New Zealand (NZ), especially in pre-school children, and Maori and Pacific people. We aimed to identify risk factors for ID hospitalisation in infancy within a birth cohort of NZ children, and to identify differences in risk factors between ethnic groups. METHODS: We investigated an established cohort of 6846 NZ children, born in 2009-2010, with linkage to a national data set of hospitalisations. We used multivariable logistic regression to obtain odds ratios (OR) for factors associated with ID hospitalisation in the first year of life, firstly for all children, and then separately for Maori or Pacific children. RESULTS: In the whole cohort, factors associated with ID hospitalisation were Maori (OR: 1.49, 95% CI: 1.17-1.89) or Pacific (2.51; 2.00-3.15) versus European maternal ethnicity, male gender (1.32; 1.13-1.55), low birthweight (1.94, 1.39-2.66), exclusive breastfeeding for <4 months (1.22, 1.04-1.43), maternal experience of health-care racism (1.60, 1.19-2.12), household deprivation (most vs. least deprived quintile of households (1.50, 1.12-2.02)), day-care attendance (1.43, 1.12-1.81) and maternal smoking (1.55, 1.26-1.91). Factors associated with ID hospitalisation for Maori infants were high household deprivation (2.16, 1.06-5.02) and maternal smoking (1.48, 1.02-2.14); and for Pacific infants were delayed immunisation (1.72, 1.23-2.38), maternal experience of health-care racism (2.20, 1.29-3.70) and maternal smoking (1.59, 1.10-2.29). CONCLUSIONS: Maori and Pacific children in NZ experience a high burden of ID hospitalisation. Some risk factors, for example maternal smoking, are shared, while others are ethnic-specific. Interventions aimed at preventing ID hospitalisations should address both shared and ethnic-specific factors.

Knowledge and beliefs about nutrition and physical activity during pregnancy in women from South Auckland region, New Zealand.

BACKGROUND: Approximately 60% of women in South Auckland, a culturally diverse region in New Zealand, become pregnant with a high body mass index. However, little is known about these women's knowledge of nutrition and physical activity during pregnancy. AIMS: To assess knowledge of nutrition and physical activity during pregnancy, factors influencing eating habits and the willingness to participate in a nutritional intervention. MATERIALS AND METHODS: A total of 422 women completed the survey in late pregnancy between September and December 2013. Multivariable logistic regression investigated factors associated with infrequent healthy eating, adjusting for ethnicity and gestation at questionnaire completion. RESULTS: Ethnicity of participants was Maori (24.2%), Pacific (40.5%), Asian (12.8%) and European/Others (21.8%). Most (95.0%) reported receiving information about healthy eating while pregnant and 61% reported eating healthy frequently or very frequently. Forty-four point three per cent reported eating more in pregnancy; the commonest reasons were cravings and 'eating for two'. The adjusted odd ratios (aORs) indicated that the self-reported factors associated with infrequent healthy eating in this sample were Maori (aOR 17.66; 95% CI 8.49-36.77) and Pacific ethnicity (aOR 14.54; 95% CI 7.32-28.88); parity ≥3 (aOR 2.09; 95%CI 1.26-3.48); obesity (aOR 2.84; 95% CI 1.35-5.97); unplanned pregnancy (aOR 1.95; 95%CI 1.18-3.22); and eating takeaways ≥3 times/week (aOR 4.46; 95%CI 1.88-10.56). Of women sampled, 83.4% would likely/very likely participate in a nutritional intervention. CONCLUSION: Self-reported factors associated with infrequent healthy eating in pregnancy were identified in this sample. Our findings will assist development of a nutritional intervention for pregnant women in South Auckland.

Sociodemographic differences in the incidence of oropharyngeal and oral cavity squamous cell cancers in New Zealand.

OBJECTIVE: To determine whether the incidence of oropharyngeal and oral cavity squamous cell cancers differs by subsite, age, gender, ethnicity and social deprivation. METHODS: Using data from the New Zealand cancer registry, a retrospective review was undertaken of incident cases with a histological diagnosis of invasive squamous cell carcinoma (SCC) in the oral cavity or oropharynx. RESULTS: During the period 1981-2010, rates of oropharyngeal cancers (OPC) and oral cavity cancers (OCC) were higher among males and increased with age. The rapid rise in male OPCs was observed in those aged 40-49, 50-59, 60-69 and ≥70 years old. Overall and by gender, Maori had higher OPC rates but lower OCC rates than European/other ethnicities, whereas the inverse was apparent among Pacific Peoples. An upward trend in OPC and OCC rates with increasing deprivation was observed both overall and by gender. CONCLUSIONS: The recent rapid rise in male oropharyngeal SCCs occurred primarily among those aged ≥40 years old. IMPLICATIONS: Given oropharyngeal SCCs are more strongly associated with human papillomaviruses (HPV) than OCCs, OPC prevention may be enhanced through HPV vaccination and public health awareness. Clinically, as HPV-related OPCs have a better prognosis and response to radiotherapy, an improvement in survival rates can be predicted.

Comparison of oropharyngeal and oral cavity squamous cell cancer incidence and trends in New Zealand and Queensland, Australia.

BACKGROUND: Increases in the incidence of squamous cell oropharyngeal cancer (OPC) have been reported from some countries, but have not been assessed in Australia or New Zealand. This study examines trends for squamous cell OPC and squamous cell oral cavity cancer (OCC) in two similarly sized populations, New Zealand and Queensland, Australia. METHODS: Incidence data for 1982-2010 were obtained from the respective population-based cancer registries for squamous cell OPC and OCC, by subsite, sex, and age. Time trends and annual percentage changes (APCs) were assessed by joinpoint regression. RESULTS: The incidence rates of squamous cell OPC in males in New Zealand since 2005 and Queensland since 2006 have increased rapidly, with APCs of 11.9% and 10.6% respectively. The trends were greatest at ages 50-69 and followed more gradual increases previously. In females, rates increased by 2.1% per year in New Zealand from 1982, but by only 0.9% (not significant) in Queensland. In contrast, incidence rates for OCC decreased by 1.2% per year in males in Queensland since 1982, but remained stable for females in Queensland and for both sexes in New Zealand. Overall, incidence rates for both OCC and OPC were substantially higher in Queensland than in New Zealand. In males in both areas, OPC incidence is now higher than that of OCC. CONCLUSIONS: Incidence rates of squamous cell OPC have increased rapidly in men, while rates of OCC have been stable or reducing, showing distinct etiologies. This has both clinical and public health importance, including implications for the extension of human papilloma virus (HPV) vaccination to males.

Parent versus child reporting of tobacco smoke exposure at home and in the car.

AIMS: To compare self-reported exposure to tobacco smoke in the home or in cars between parents and their pre-adolescent children. METHODS: We analysed data on self-reported exposure to secondhand smoke from 3,645 matched pairs of children at baseline (aged between 10 and 13 years) and their parents whether smokers or not, who were participants in Keeping Kids Smokefree (KKS), a community-based study in South Auckland, New Zealand from 2007-2009. The study aimed to reduce children's smoking initiation through parental behaviour change. The responses of the parent-child pairs were analysed using proportions, Kappa scores, and McNemar's Chi-squared test. Additionally, 679 children were biochemically tested for smoking exposure using exhaled carbon monoxide. RESULTS: There was approximately a 30% discordance between the self-reports of children and their parents, with parents reporting less smoking in homes or cars than their children. Kappa scores for parent-child agreement by ethnicity ranged from 0.15 to 0.41 for smoking at home and 0.17 to 0.54 for smoking in cars. Biochemical testing suggested that around 30% of children had been exposed to secondhand smoke, corroborating their self-reported proportion of 37% (baseline in the home) whereas few parents (11%) reported smoking in home or cars. CONCLUSION: Parents were significantly less likely than children to report smoking inside the home or car. Biochemical testing indicated that children's reporting is more accurate. This has implications for future studies relying on self-reporting by children and/or their caregivers.

Risk factors for and prevention of human papillomaviruses (HPV), genital warts and cervical cancer.

Genital HPV infection is associated with development of cervical cancer, cervical neoplasia, anogenital warts, and other anogenital cancers. A number of reviews have primarily addressed the role of HPV infection in cervical carcinogenesis, and differences in human papillomavirus (HPV) subtypes found in cervical cancer cases by histology and geographical region. This review provides an informative summary of the broad body of literature on the burden of HPV, the risk factors for HPV infection, genital warts and cervical cancer, and preventive measures against these conditions in females. Studies have identified the main risk factors for genital HPV infection in females as follows: acquisition of new male partners; an increasing number of lifetime sexual partners both in females and their male partners; and having non-monogamous male partners. Cervical cancer screening and HPV vaccination are the primary measures currently recommended to prevent cervical cancer. There is also an ongoing debate and conflicting findings on whether male circumcision and condom use protect against HPV infection and subsequent development of HPV-related illnesses in females.

Human papillomavirus (HPV) vaccine acceptance and perceived effectiveness, and HPV infection concern among young New Zealand university students.

Two-hundred undergraduate students completed an anonymous questionnaire after viewing a human papillomavirus (HPV) vaccine television commercial. Eight-four percent of participants would accept a free HPV vaccine, whereas 47% were unconcerned about future personal HPV infection risk. Males were less likely to accept a free HPV vaccine and to be concerned about future personal HPV infection risk. Perceived HPV vaccine effectiveness was significantly greater among participants who had previously heard of the vaccine and who knew that HPV is sexually transmitted. More education on the role of sexual behavioural characteristics of both males and females in HPV transmission is necessary to promote awareness and concern of personal HPV infection risk and acceptance of HPV vaccination.

Human papillomavirus knowledge and awareness among undergraduates in healthcare training in New Zealand.

AIMS: To describe knowledge of HPV and its transmission, knowledge of the HPV vaccine, and awareness of free HPV vaccine for 12-18 year old New Zealand females; and to assess whether there are significant age and gender differences in HPV-related knowledge. METHODS: Undergraduate university students were invited to complete an anonymous questionnaire, after viewing a brief HPV vaccine TV commercial. RESULTS: Compared to 19 year olds, 18 years olds were more likely to have heard of HPV (OR=3.78; 95%CI=1.66-8.65) and the HPV vaccine (OR=3.94; 95%CI=1.85-8.39), know about sexual transmission of HPV (OR=2.79; 95%CI=1.34-5.77), and be aware of the free HPV vaccine (OR=4.00; 95%CI=1.81-8.84). Participants who knew someone ever diagnosed with cervical cancer were more likely to have heard of the HPV vaccine (OR=2.98; 95%CI=1.09-8.13). Male participants were less likely to be aware of the free vaccine (OR=0.16; 95%CI=0.07-0.40). CONCLUSION: Average levels of basic knowledge of HPV and HPV vaccine most likely represent minimal awareness as more specific knowledge on sexual transmission of HPV is low. HPV vaccination should be complimented with public education on the link between sexual behaviour, HPV infection and cervical cancer.