Using Wearable Cameras to Assess Foods and Beverages Omitted in 24 Hour Dietary Recalls and a Text Entry Food Record App.

Technology-enhanced methods of dietary assessment may still face common limitations of self-report. This study aimed to assess foods and beverages omitted when both a 24 h recall and a smartphone app were used to assess dietary intake compared with camera images. For three consecutive days, young adults (18-30 years) wore an Autographer camera that took point-of-view images every 30 seconds. Over the same period, participants reported their diet in the app and completed daily 24 h recalls. Camera images were reviewed for food and beverages, then matched to the items reported in the 24 h recall and app. ANOVA (with post hoc analysis using Tukey Honest Significant Difference) and paired t-test were conducted. Discretionary snacks were frequently omitted by both methods (p < 0.001). Water was omitted more frequently in the app than in the camera images (p < 0.001) and 24 h recall (p < 0.001). Dairy and alternatives (p = 0.001), sugar-based products (p = 0.007), savoury sauces and condiments (p < 0.001), fats and oils (p < 0.001) and alcohol (p = 0.002) were more frequently omitted in the app than in the 24 h recall. The use of traditional self-report methods of assessing diet remains problematic even with the addition of technology and finding new objective methods that are not intrusive and are of low burden to participants remains a challenge.

Ensuring the right to food for indigenous children: a case study of stakeholder perspectives on policy options to ensure the rights of tamariki Maori to healthy food.

BACKGROUND: The United Nations Convention on the Rights of the Child confirms a child's right to adequate food, and to the highest attainable standard of health. For indigenous children, these rights are also recognised in the UN Declaration on the Rights of Indigenous Peoples. However, Indigenous children endure higher rates of obesity and related health conditions than non-indigenous children, including in Aotearoa New Zealand (NZ). For indigenous tamariki (Maori children) in NZ, high levels of obesity are interconnected with high rates of food insecurity. Therefore there is a need for action. This study aimed to investigate policy options that would safeguard the rights of indigenous children to healthy food. We explored with key stakeholder's policy options to ensure the rights of indigenous children to healthy food, through a case study of the rights of tamariki. METHODS: Interviews were conducted with 15 key stakeholders, with experience in research, development or delivery of policies to safeguard the rights of tamariki to healthy food. Iterative thematic analysis of the transcripts identified both deductive themes informed by Kaupapa Maori theory and literature on rights-based approaches and inductive themes from the interviews. RESULTS: The analysis suggests that to ensure the right to adequate food and to healthy food availability for tamariki, there needs to be: a comprehensive policy response that supports children's rights; an end to child poverty; food provision and food policy in schools; local government policy to promote healthy food availability; and stronger Maori voices and values in decision-making. CONCLUSIONS: The right to food for indigenous children, is linked to political and economic systems that are an outcome of colonisation. A decolonising approach where Maori voices and values are central within NZ policies and policy-making processes is needed. Given the importance of food to health, a broad policy approach from the NZ government to ensure the right to adequate food is urgent. This includes economic policies to end child poverty and specific strategies such as food provision and food policy in schools. The role of Iwi (tribes) and local governments needs to be further explored if we are to improve the right to adequate food within regions of NZ.

Enhancing Maori food security using traditional kai.

ISSUE: Lack of food security is one of the major nutrition issues facing Maori today. Loss of traditional kai (food) gathering places and practices following colonisation and urbanisation has impacted negatively on food security for Maori. This paper explores the role of Maori in enhancing Maori food security through revitalising traditional kai. METHODS: A narrative literature review of peer reviewed and grey literature on revitalising traditional kai for Maori was conducted. The focus was on two areas: increasing the availability of traditional kai to Maori households (such as through replenishing fish stocks, and gardening projects) and increasing the financial means available to Maori households to purchase food (by economic development of traditional kai industries and employment creation). RESULTS: A range of activities to improve food security for Maori by revitalising traditional kai was identified in the literature. Maori are now significant players in New Zealand's fishing industry, and are developing their horticultural resources. Gardening initiatives have also grown considerably in Maori communities. Enabling factors included: the return of traditional kai resources by the Crown, and successful pursuit by Maori of the legal rights to develop them; development of Maori models of governance; government policy around Maori economic development and healthy eating; and Maori leadership on the issue. Barriers to revitalising traditional kai that remain to be addressed include: tensions between Government and Maori goals and models of resource management; economic pressures resulting in severely depleted fishing stocks; and pollution of marine and freshwater fish. CONCLUSION: Revitalising traditional kai has considerable potential to improve food security for Maori, both directly in terms of food supply and by providing income, and warrants policy and practical support. These findings have implications for other indigenous cultures who are struggling to be food secure.

The road we travel: Maori experience of cancer.

AIM: This research explores Maori experiences of cancer. It does so to shed light on the causes of cancer inequalities for Maori. METHODS: The views of 44 Maori affected by cancer--including patients, survivors, and their whanau (extended families)--were gathered in five hui (focus groups) and eight interviews in the Horowhenua, Manawatu, and Tairawhiti districts of New Zealand. After initial analysis, a feedback hui was held to validate the findings. RESULTS: Maori identified effective providers of cancer services such as Maori health providers. They also identified positive and negative experiences with health professionals. The involvement of whanau in the cancer journey was viewed as highly significant as was a holistic approach to care. Participants had many suggestions for improvements to cancer services such as better resourcing of Maori providers, cultural competence training for all health workers, the use of systems 'navigators', and the inclusion of whanau in the cancer control continuum. CONCLUSION: The research identifies a range of health system, healthcare process, and patient level factors that contribute to inequalities in cancer for Maori. It also explores the role of racism as a root cause of these inequalities and calls for urgent action.

Perceptions of New Zealand nutrition labels by Maori, Pacific and low-income shoppers.

BACKGROUND: In New Zealand the burden of nutrition-related disease is greatest among Maori, Pacific and low-income peoples. Nutrition labels have the potential to promote healthy food choices and eating behaviours. To date, there has been a noticeable lack of research among indigenous peoples, ethnic minorities and low-income populations regarding their perceptions, use and understanding of nutrition labels. Our aim was to evaluate perceptions of New Zealand nutrition labels by Maori, Pacific and low-income peoples and to explore improvements or alternatives to current labelling systems. METHODS: Maori, Samoan and Tongan researchers recruited participants who were regular food shoppers. Six focus groups were conducted which involved 158 people in total: one Maori group, one Samoan, one Tongan, and three low-income groups. RESULTS: Maori, Pacific and low-income New Zealanders rarely use nutrition labels to assist them with their food purchases for a number of reasons, including lack of time to read labels, lack of understanding, shopping habits and relative absence of simple nutrition labels on the low-cost foods they purchase. CONCLUSIONS: Current New Zealand nutrition labels are not meeting the needs of those who need them most. Possible improvements include targeted social marketing and education campaigns, increasing the number of low-cost foods with voluntary nutrition labels, a reduction in the price of 'healthy' food, and consideration of an alternative mandatory nutrition labelling system that uses simple imagery like traffic lights.