Individual differences and changes in lifestyle behaviours predict decreased subjective well-being during COVID-19 restrictions in an Australian sample.

BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, social distancing practices were introduced to curb infection rates in many countries. The purpose of this study was to assess the effects of these restrictions on behaviours and well-being and whether individual differences predict changes in well-being. METHODS: Australian adults participated in a cross-sectional, online survey during May 2020. The survey captured demographic information; health behaviours; personality traits; life satisfaction and COVID-19-related attitudes, financial concerns, perceived risks and impacts. RESULTS: In total, 3745 (86.8% of 4313) participants completed all items. Participants were mostly female (85.7%) and 56.4 years (standard deviation [SD] = 12.6) on average. Over 95.0% of the sample indicated they had been social distancing or isolating. Health behaviours and well-being had generally worsened, with social connections being the most negatively affected. Life satisfaction was significantly lower since restrictions. For changes in life satisfaction, extroversion was a risk factor and openness to experience was a protective factor. CONCLUSIONS: Overall, well-being was negatively impacted by the COVID-19 pandemic and associated social distancing particularly in this sample containing mainly older women. In future, it will be crucial to understand why and who may be differentially affected, to encourage behaviours that are protective of well-being.

Managing symptoms and health through self-prescribed restrictive diets: What can general practitioners learn from the phenomenon of wheat avoidance?

BACKGROUND: Seven per cent of Australian adults report avoiding wheat products for the relief of symptoms. The objective of this study was to explore the experiences, symptoms, influences and beliefs that may explain the tendency for this behaviour to occur pre-dominantly in the absence of a reported medical diagnosis or expert dietary supervision. METHODS: Data were collected through preliminary questionnaires and semi-structured interviews with 35 self-identified symptomatic individuals who avoid consumption of wheat-based products without a diagnosis of coeliac disease or wheat allergy. RESULTS: Like other contested health phenomena, symptomatic wheat avoidance is characterised by broad symptomatology, perceived benefits, absence of clear biological markers, dissatisfaction with conventional medicine following previous negative test results, and the fact that presumed treatment - elimination of a dietary factor - requires no medical intervention. DISCUSSION: Self-prescribed food avoidance represents a diagnostic and therapeutic challenge for practitioners, central to which is a tension between patient expectations and biomedical standards of evidence in the diagnostic relationship.

Food avoidance in an Australian adult population sample: the case of dairy products.

OBJECTIVE: To assess the prevalence of and explanations for the avoidance of dairy foods, including symptoms attributed to their consumption, diagnoses and psychological predictors of avoidance. Also considered were comparisons with symptom-related avoidance of wheat in the same sample. DESIGN: Cross-sectional population survey. SETTING: The study was conducted in Australia using a national postal omnibus survey. SUBJECTS: Adults aged 18 years and over (n 1184; 52·9 % female) selected at random from the Australian Electoral Roll. RESULTS: Despite few claims of formally diagnosed allergy or intolerance, 11·8 % of the sample reported avoiding dairy products because of adverse physiological effects, which commonly included gastrointestinal symptoms. Unlike wheat (3·5 %) or wheat-and-dairy (3·6 %) avoidance, dairy avoidance (8·2 %) was predicted by age (negatively) and worry about illness (positively). CONCLUSIONS: The findings are further evidence of a widespread tendency for consumers to exercise control over their health by eliminating dietary factors considered suspect without medical evidence or oversight. Unanswered questions include the decision processes underlying dairy avoidance, whether symptoms are attributed correctly, the agents and physiological mechanism(s) involved, the relative contributions of symptom severity and vigilance to the association with illness worry, and the nutritional adequacy of dairy avoiders' diets. Irrespective of the accuracy of self-diagnoses, if the elimination of suspect foods is an end in itself the paradoxical possibility for nutritional imbalances may have significant public health implications.

Motivations for avoiding wheat consumption in Australia: results from a population survey.

OBJECTIVE: To assess the prevalence of and explanations for wheat avoidance, including reported symptoms, diagnoses and information sources influencing the decision to avoid wheat, and to investigate potential psychological predictors of this behaviour. DESIGN: Cross-sectional population survey. SETTING: The study was conducted in Australia, using a nationwide postal omnibus survey. SUBJECTS: Adults aged 18 years and over (n 1184; 52·9% female) selected at random from the Australian Electoral Roll. RESULTS: With cases of stated and suspected coeliac disease (1·2%) excluded, 7·3% of the sample reported adverse physiological effects, predominantly gastrointestinal, that they associated with wheat consumption. Few among this group (5·7%) claimed a formally diagnosed intolerance or allergy requiring avoidance of wheat-based foods. Symptomatic wheat avoidance was highly correlated with dairy avoidance and predicted by gender (female), lesser receptiveness to conventional medicine and greater receptiveness to complementary medicine, but not by neuroticism, reasoning style or tendency to worry about illness. CONCLUSIONS: The data indicate that many adult Australians are consciously avoiding consumption of wheat foods, predominantly without any formal diagnosis. Reported symptoms suggest a physiological but not allergenic basis to this behaviour. Questions to be answered concern whether symptoms are attributed correctly to wheat, the agents (wheat components, dietary factors or additives) and physiological mechanism(s) involved, the nutritional adequacy of avoiders' diets, and the clinical and psychosocial processes that lead a substantial number of adults to avoid consuming wheat (or any other dietary factor) apparently independently of a medical diagnosis.

Effectiveness and Feasibility of a Self-guided Mobile App Targeting Emotional Well-being in Healthy Adults: 4-Week Randomized Controlled Trial.

BACKGROUND: Commercial smartphone apps designed to promote emotional well-being are becoming increasingly popular, but few apps have been empirically validated. OBJECTIVE: This study examined the feasibility and effectiveness of a self-guided app designed to reduce daily stress via positive messaging and tailored short inspirational talks (ie, peps). METHODS: A total of 166 participants (n=112, 67.5% female; mean age 38.48, SD 6.73 years) were recruited through social media advertising and randomized into an intervention (Hey Lemonade app plus twice daily mood monitoring using the Multidimensional Mood Questionnaire [MDMQ]) or active control (twice daily mood monitoring [MDMQ]) group. Primary (coping self-efficacy [CSE]; 3 subscales) and secondary outcomes (vitality, satisfaction with life, perceived stress, positive and negative affect, and hassles and uplifts) were measured at the baseline (week 1) and end point (week 4). The app evaluation questions were assessed at week 2. All interactions and measurements were collected on the internet and through the apps. RESULTS: In total, of 166 participants, 125 (75.3%) completed the trial. There were no differences in dropout rates between the groups (62/81, 76% intervention; 63/85, 74% control). There were significant group-by-time interactions for vitality and hassles but no significant effect for CSE total (P=.05). For the intervention group, the change from baseline to week 4 was significant for vitality (P=.002) and hassles (P=.004), CSE total (P=.008), and CSE Emotional subscale (P=.02). For the control group, any changes over 4 weeks were not significant for any outcome. There was a significant group-by-time interaction for MDMQ calmness (P=.04). By week 4, calmness was significantly higher in the intervention group (P=.046). Of those in the intervention group at week 2 (n=68), 39 (57%) participants recommended the app and 41 (60%) participants wanted to continue using it. Pep talks and customizable voice options were the most popular features. CONCLUSIONS: Participants who had access to the smartphone app on an as-needed basis over the 4-week trial showed significant improvements in emotional well-being indicators. More broadly, this suggests that simple accessible solutions may generate meaningful well-being outcomes. Whether these changes are sustained and can be generalized to other population groups is yet to be determined. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ANZCTR) 12622001005741; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384304&isReview=true.

Thinking about going wheat-free? Evidence of nutritional inadequacies in the dietary practices of wheat avoiders.

AIM: To assess dietary intake and nutritional adequacy amongst self-identified symptomatic wheat-avoiders. METHODS: Thirty-four self-identified symptomatic avoiders of wheat-based products without a diagnosis of coeliac disease or wheat allergy were recruited to participate in a dietary assessment study. Dietary intake was assessed via a three-day weighed food record. Participants were aged 33 to 83 years, were predominantly women (n = 30) and had been avoiding wheat for a mean of six years. Nutrient intakes were compared with Nutrient Reference Values. Food group intakes were assessed and consumption of wheat-containing and wheat-free cereal-based foods described. RESULTS: Inadequate intakes of key protective nutrients such as fibre and calcium were common; many participants reported avoiding dairy as well as wheat. Intakes of total and saturated fat exceeded recommendations. Although 85% of the sample reported avoiding all wheat products, at least one third of cereal products and dishes consumed in this group, comprising mostly discretionary-type foods, were wheat based. CONCLUSIONS: Dietary intake patterns and resulting nutrient imbalances in individuals restricting or eliminating wheat to manage symptoms are cause for concern. The situation is likely exacerbated by the tendency for many wheat avoiders to report also avoiding other foods, especially dairy products. A bi-disciplinary approach from medical practitioners and dietitians to individuals experiencing unexplained gastro-intestinal symptoms and strategies to support informed food choice is needed to combat longer-term health consequences of a diet with this nutritional profile.

Responses to GM food content in context with food integrity issues: results from Australian population surveys.

This study examined community responses to use of genetically modified (GM) content in food in the context of responses to familiar food additives by testing an empirically and theoretically derived model of the predictors of responses to both GM content and food integrity issues generally. A nationwide sample of 849 adults, selected at random from the Australian Electoral Roll, responded to a postal Food and Health Survey. Structural equation modelling analyses confirmed that ratings of general concern about food integrity (related to the presence of preservatives and other additives) strongly predicted negativity towards GM content. Concern about food integrity was, in turn, predicted by environmental concern and health engagement. In addition, both concern about food integrity generally and responses to GM content specifically were weakly predicted by attitudes to benefits of science and an intuitive (i.e., emotionally-based) reasoning style. Data from a follow-up survey conducted under the same conditions (N=1184) revealed that ratings of concern were significantly lower for use of genetic engineering in food than for four other common food integrity issues examined. Whereas the question of community responses to GM is often treated as a special issue, these findings support the conclusion that responses to the concept of GM content in food in Australia are substantially a specific instance of a general sensitivity towards the integrity of the food supply. They indicate that the origins of responses to GM content may be largely indistinguishable from those of general responses to preservatives and other common food additives.