Stepwise tailoring and test-retest of reproducibility of an ethnic-specific FFQ to estimate nutrient intakes for South Asians in New Zealand.

OBJECTIVE: To develop and test-retest the reproducibility of an ethnic-specific FFQ to estimate nutrient intakes for South Asians (SA) in New Zealand (NZ). DESIGN: Using culturally appropriate methods, the NZFFQ, a validated dietary assessment tool for NZ adults, was modified to include SA food items by analysing foods consumed by SA participants of the Adult Nutrition Survey, in-person audit of ethnic food stores and a web scan of ethnic food store websites in NZ. This was further refined via three focus group discussions, and the resulting New Zealand South Asian Food Frequency Questionnaire (NZSAFFQ) was tested for reproducibility. SETTING: Auckland and Dunedin, NZ. PARTICIPANTS: Twenty-nine and 110 males and females aged 25-59 years of SA ethnicity participated in the focus group discussions and the test-retest, respectively. RESULTS: The development phase resulted in a SA-specific FFQ comprising of 11 food groups and 180 food items. Test-retest of the NZSAFFQ showed good reproducibility between the two FFQ administrations, 6 months apart. Most reproducibility coefficients were within or higher than the acceptable range of 0·5-0·7. The lowest intraclass correlation coefficients (ICC) were observed for ß-carotene (0·47), vitamin B12 (0·50), fructose (0·55), vitamin C (0·57) and selenium (0·58), and the highest ICC were observed for alcohol (0·81), iodine (0·79) and folate (0·77). The ICC for fat ranged from 0·70 for saturated fats to 0·77 for polyunsaturated fats. The ICC for protein and energy were 0·68 and 0·72, respectively. CONCLUSIONS: The developed FFQ showed good reproducibility to estimate nutrient intakes and warrants the need for validation of the instrument.

Fitness and Fatness Are Both Associated with Cardiometabolic Risk in Preadolescents.

OBJECTIVE: To determine the associations between cardiorespiratory fitness (CRF) and fatness (overweight-obesity) with cardiometabolic disease risk among preadolescent children. STUDY DESIGN: This cross-sectional study recruited 392 children (50% female, 8-10 years of age). Overweight-obesity was classified according to 2007 World Health Organization criteria for body mass index. High CRF was categorized as a maximum oxygen uptake, determined using a shuttle run test, exceeding 35 mL·kg-1·minute-1 in girls and 42 mL·kg-1·minute-1 in boys. Eleven traditional and novel cardiometabolic risk factors were measured including lipids, glucose, glycated hemoglobin, peripheral and central blood pressure, and arterial wave reflection. Factor analysis identified underlying cardiometabolic disease risk factors and a cardiometabolic disease risk summary score. Two-way analysis of covariance determined the associations between CRF and fatness with cardiometabolic disease risk factors. RESULTS: Factor analysis revealed four underlying factors: blood pressure, cholesterol, vascular health, and carbohydrate-metabolism. Only CRF was significantly (P = .001) associated with the blood pressure factor. Only fatness associated with vascular health (P = .010) and carbohydrate metabolism (P = .005) factors. For the cardiometabolic disease risk summary score, there was an interaction effect. High CRF was associated with decreased cardiometabolic disease risk in overweight-obese but not normal weight children (P = .006). Conversely, high fatness was associated with increased cardiometabolic disease risk in low fit but not high fit children (P < .001). CONCLUSIONS: In preadolescent children, CRF and fatness explain different components of cardiometabolic disease risk. However, high CRF may moderate the relationship between fatness and cardiometabolic disease risk. TRIAL REGISTRATION: ACTRN 12614000433606.

Short-term high-intensity interval training exercise does not affect gut bacterial community diversity or composition of lean and overweight men.

NEW FINDINGS: What is the central question of this study? Does short-term high-intensity interval training alter the composition of the microbiome and is this associated with exercise-induced improvements in cardiorespiratory fitness and insulin sensitivity? What is the main finding and its importance? Although high-intensity interval training increased insulin sensitivity and cardiovascular fitness, it did not alter the composition of the microbiome. This suggests that changes in the composition of the microbiome that occur with prolonged exercise training might be in response to changes in metabolic health rather than driving exercise training-induced adaptations. ABSTRACT: Regular exercise reduces the risk of metabolic diseases, and the composition of the gut microbiome has been associated with metabolic function. We investigated whether short-term high-intensity interval training (HIIT) altered the diversity and composition of the bacterial community and whether there were associations with markers of insulin sensitivity or aerobic fitness. Cardiorespiratory fitness ( V̇O2peak ) and body composition (dual energy X-ray absorptiometry scan) were assessed and faecal and fasted blood samples collected from 14 lean (fat mass 21 ± 2%, aged 29 ± 2 years) and 15 overweight (fat mass 33 ± 2%, aged 31 ± 2 years) men before and after 3 weeks of HIIT training (8-12 × 60 s cycle ergometer bouts at V̇O2peak power output interspersed by 75 s rest, three times per week). Gut microbiome composition was analysed by 16S rRNA gene amplicon sequencing. The HIIT significantly increased the aerobic fitness of both groups (P < 0.001) and improved markers of insulin sensitivity (lowered fasted insulin and HOMA-IR; P < 0.001) in the overweight group. Despite differences in the abundance of several bacterial taxa being evident between the lean and overweight group, HIIT did not affect the overall bacterial diversity or community structure (α-diversity or ß-diversity). No associations were found between the top 50 most abundant bacterial genera and cardiorespiratory fitness markers; however, significant associations (P < 0.05) were observed between the abundance of the bacterial species Coprococcus_3, Blautia, Lachnospiraceae_ge and Dorea and insulin sensitivity markers in the overweight group. Our results suggest that short-term HIIT does not greatly impact the overall composition of the gut microbiome, but that certain microbiome genera are associated with insulin sensitivity markers that were improved by HIIT in overweight participants.

Diet quality, nutrient intakes and biochemical status of New Zealand women of childbearing age according to alcohol consumption patterns.

OBJECTIVE: To investigate associations between alcohol consumption patterns and diet quality, nutrient intakes and biochemical profile of women of childbearing age. DESIGN: Nutrient intake data from 24 h diet recalls, alcohol consumption data and diet quality from the Dietary Habits Questionnaire, and biochemical analyses from the cross-sectional 2008/09 Adult Nutrition Survey in New Zealand. SETTING: New Zealand households. PARTICIPANTS: New Zealand women aged 18-45 years (n 1124). RESULTS: All analyses were completed using Stata and survey weights were used to allow for the complex survey design to produce population estimates. Multinomial logistic regression models were used to examine the associations between drinking patterns and the variables of interest, with 'infrequent moderate/light' drinkers being the reference category. The findings indicate that alcohol-consuming women of childbearing age tend to replace food energy with alcohol energy (P = 0·022). 'More frequent heavy' and 'more frequent moderate/light' drinkers had higher intakes of total, mono- and polyunsaturated fats with the latter group also consuming higher levels of saturated fats (P < 0·05). Women who were 'infrequent moderate/light' drinkers had relatively better diet quality, nutrient intakes and adequate biochemical status in comparison to other drinkers and abstainers. 'Infrequent heavy' drinkers, who were predominantly younger in age, had lower serum vitamin B12 levels (P = 0·01) with a higher proportion of women in this category having below-recommended levels of serum folate (P < 0·05). CONCLUSIONS: Alcohol consumption, especially heavy drinking patterns, may compromise nutritional status of women of childbearing age.

Associations of accelerometer-measured sedentary time, sedentary bouts, and physical activity with adiposity and fitness in children.

Sedentary time (ST) has been inconsistently associated with adiposity and cardiorespiratory fitness in children in previous studies. We studied cross-sectional associations of ST, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with fat mass index (FMI) and cardiorespiratory fitness (estimated VO2max). Associations were evaluated with and without considering pattern of ST by bout length. We measured ST and activity by a wrist-worn accelerometer, FMI by bioelectrical impedance, and VO2max by Pacer test in 443 children (51.2% girls, 10.2 ± 0.6 years). Isotemporal substitution regression models estimated the effects of substituting ST, LPA, and MVPA on FMI and VO2max. Further models repeated analyses separating ST into short (<10 min) and long (≥10 min) bouts. Only replacing ST or LPA with MVPA was consistently associated with lower FMI and greater VO2max. When separated by bout length, only one unique association was found where replacing long ST bouts with short ST bouts was associated with lower FMI in girls only. In conclusion, activity pattern is associated with adiposity in girls and fitness in boys and girls. Separating ST into long and short ST bouts may be of minimal importance when assessing associations with adiposity and fitness using wrist-worn accelerometry in children.

Sleep timing is associated with diet and physical activity levels in 9-11-year-old children from Dunedin, New Zealand: the PEDALS study.

It is well documented that short sleep duration is associated with excess body weight and poor food intake in children. It has been suggested that sleep timing behaviour may also be an important predictor of weight and other related behaviours, independent of sleep duration; however, there is a lack of research investigating these relationships. The present study investigated sleep timing in association with diet and physical activity levels in 439 children aged 9-11 years old from New Zealand. Sleep and physical activity data were collected using accelerometry, and food choice using a short food-frequency questionnaire. Participants were classified into one of four sleep timing behaviour categories using the median split for sleep-onset and -offset times. Differences between sleep timing groups for weekly consumption frequency of selected food groups, dietary pattern scores and minutes of moderate-to-vigorous physical activity were examined. Children in the late sleep/late wake category had a lower 'Fruit & Vegetables' pattern score [mean difference (95% CI): -0.3 (-0.5, -0.1)], a lower consumption frequency of fruit and vegetables [mean weekly difference (95% CI): -2.9 (-4.9, -0.9)] and a higher consumption frequency of sweetened beverages [mean weekly difference (95% CI): 1.8 (0.2, 3.3)] compared with those in the early sleep/early wake category. Additionally, children in the late sleep/late wake category accumulated fewer minutes of moderate-to-vigorous physical activity per day compared with those in the early sleep/early wake category [mean difference (95% CI): -9.4 (-15.3, -3.5)]. These findings indicate that sleep timing, even after controlling for sleep duration, was associated with both food consumption and physical activity.

Cardiorespiratory fitness is positively associated with a healthy dietary pattern in New Zealand adolescents.

OBJECTIVE: To examine the association between cardiorespiratory fitness and dietary patterns in adolescents. DESIGN: Food choice was assessed using the validated New Zealand Adolescent FFQ. Principal components analysis was used to determine dietary patterns. Trained research assistants measured participants' height and body mass. Cardiorespiratory fitness was assessed in a subset of participants using the multistage 20 m shuttle run. The level and stage were recorded, and the corresponding VO2max was calculated. Differences in mean VO2max according to sex and BMI were assessed using t tests, while associations between cardiorespiratory fitness and dietary patterns were examined using linear regression analyses adjusted for age, sex, school attended, socio-economic deprivation and BMI. SETTING: Secondary schools in Otago, New Zealand. SUBJECTS: Students (n 279) aged 14-18 years who completed an online lifestyle survey during a class period. RESULTS: Principal components analysis produced three dietary patterns: 'Treat Foods', 'Fruits and Vegetables' and 'Basic Foods'. The 279 participants who provided questionnaire data and completed cardiorespiratory fitness testing had a mean age of 15·7 (sd 0·9) years. Mean VO2max was 45·8 (sd 6·9) ml/kg per min. The 'Fruits and Vegetables' pattern was positively associated with VO2max in the total sample (ß=0·04; 95%CI 0·02, 0·07), girls (ß=0·06; 95% CI 0·03, 0·10) and boys (ß=0·03; 95% CI 0·01, 0·05). CONCLUSIONS: These results indicate that increase in cardiorespiratory fitness was associated with a healthier dietary pattern, suggesting both should be targeted as part of a global lifestyle approach. Longitudinal studies are needed to confirm this association in relation to health outcomes in New Zealand adolescents.

Associations between parental feeding practices, problem food behaviours and dietary intake in New Zealand overweight children aged 4-8 years.

OBJECTIVE: Parents report that children's eating behaviours are a major barrier to providing them with a healthy diet. Links between problem eating behaviours and parental feeding practices are not well established and have not previously been examined in overweight children. The aim of the present study was to assess associations between problem food behaviours, dietary intake and parental feeding practices of overweight children aged 4-8 years. DESIGN: Participants were recruited for a lifestyle intervention (n 203). At baseline, children's BMI was measured and parents completed comprehensive questionnaires about the feeding practices they used, the problem food behaviours their children exhibited and the foods their child consumed. A fussy eating scale was developed and associations were determined using correlations and regression analysis, including interactions. SETTING: Dunedin, New Zealand. SUBJECTS: Overweight children aged 4-8 years. RESULTS: Healthy eating guidance and monitoring by parents were related to the consumption of fewer unhealthy foods (B=-0·4, P=0·001 and B=-0·4, P<0·001). Conversely, a lack of parental control (child control) was related to a higher intake of unhealthy foods (B = 0·5, P<0·001). Parents of children who were fussy eaters monitored their child's food intake less (P<0·001) and allowed the child more freedom over what he/she ate (P<0·001). These children consumed fewer fruit and vegetables than those who were not fussy eaters (P<0·001). However, fussy eaters with food-restrictive parents ate more fruit and vegetables (B=2·9, P<0·001). CONCLUSIONS: These results suggest that a more structured food environment might be beneficial for the diet and food behaviours of young overweight children.

Diet quality is associated with measures of body fat in adolescents from Otago, New Zealand.

OBJECTIVE: To examine the potential associations between diet quality and multiple measures of body composition in a sample of New Zealand adolescents aged 14-18 years. DESIGN: Cross-sectional survey of eleven high schools in Otago, New Zealand. Each participant completed an online FFQ and a New Zealand Diet Quality Index for Adolescents (NZDQI-A) score was calculated based on variety and adequacy of intake for five major food groups. Besides height and waist circumference measurements, body composition was assessed using segmental bio-impedance analysis. Generalized estimating equations were used to examine associations between diet quality and body composition in models adjusted for sex, age, ethnicity and socio-economic status. SETTING: High schools in Otago, New Zealand. SUBJECTS: High-school students (n 681, 56 % male, mean age 16·1 (sd 1·5) years) participating in the Otago School Students Lifestyle Survey Two. RESULTS: Higher NZDQI-A scores were significantly associated with lower body fat percentage (ß=-0·19; 95 % CI -0·35, -0·04; P=0·014), fat-to-lean mass ratio (ß=-0·26; 95 % CI -0·46, -0·05; P=0·016) and lower fat mass index (ß=-0·23; 95 % CI -0·45, -0·004; P=0·046) after multivariate adjustment. No association was found between NZDQI-A and BMI, waist circumference or waist-to-height ratio. CONCLUSIONS: Diet quality, as measured by NZDQI-A, was associated only with measures of body fat, not measures of overall body size. Measures specific to body fat should be used for more accurate ascertainment of body composition in examining the diet-body composition associations in this age group.

Relative validity and reproducibility of an FFQ to determine nutrient intakes of New Zealand toddlers aged 12-24 months.

OBJECTIVE: The study objective was to determine the relative validity and reproducibility of a modified FFQ for ranking the nutrient intakes of New Zealand toddlers aged 12-24 months. DESIGN: Cross-sectional study. SETTING: Dunedin, New Zealand. SUBJECTS: One hundred and fifty-two participants completed a ninety-five-item FFQ twice, and five days of weighed diet recording (WDR), over one month. Validity and reproducibility were assessed for crude data and for data that were weighted for total fruit and vegetable intake (FV-adjusted). RESULTS: De-attenuated correlations between FV-adjusted FFQ data and WDR data ranged from 0.45 (Zn) to 0.77 (Ca). The percentage classified to the correct WDR quartile by the FV-adjusted FFQ data ranged from 34.6% (total fat, Zn) to 50.3% (Fe). Average gross misclassification was 3%. Bland-Altman statistics showed crude data had a range of 128-178% agreement with the WDR and mean FV-adjusted intakes had 112-160% agreement. FV-adjusted intra-class correlations, assessing reproducibility, ranged from 0.65 (vitamin C) to 0.75 (Ca). CONCLUSIONS: The Eating Assessment in Toddlers (EAT) FFQ showed acceptable to good relative validity, and good reproducibility, for ranking participants' nutrient intake and is able to identify toddlers at extremes of the nutrient intake distribution. It will be a useful tool for investigating toddlers' nutrient intakes in studies that require a method of dietary assessment with low respondent burden.

Healthy dietary habits score as an indicator of diet quality in New Zealand adolescents.

Adoption of optimal dietary habits during adolescence is associated with better health outcomes later in life. However, the associations between a pattern of healthy dietary habits encapsulated in an index and sociodemographic and nutrient intake have not been examined among adolescents. This study aimed to develop a behavior-based diet index and examine its validity in relation to sociodemographic factors, nutrient intakes, and biomarkers in a representative sample of New Zealand (NZ) adolescents aged 15-18 y (n = 694). A 17-item Healthy Dietary Habits Score for Adolescents (HDHS-A) was developed based on dietary habits information from the 2008/2009 NZ Adult Nutrition Survey. Post hoc trend analyses were used to identify the associations between HDHS-A score and nutrient intakes estimated by single 24-h diet recalls and selected nutritional biomarkers. Being female, not of Maori or Pacific ethnicity, and living in the least-deprived socioeconomic quintile were associated with a higher HDHS-A score (all P < 0.001). HDHS-A tertile was associated positively with intake of protein, dietary fiber, polyunsaturated fatty acid, and lactose and negatively with sucrose. Associations in the expected directions were also found with most micronutrients (P < 0.05), urinary sodium (P < 0.001), whole blood (P < 0.05), serum (P < 0.01), and RBC folate (P < 0.05) concentrations. This suggests that the HDHS-A is a valid indicator of diet quality among NZ adolescents.

A comprehensive FFQ developed for use in New Zealand adults: reliability and validity for nutrient intakes.

OBJECTIVE: To evaluate the reliability and relative validity of a semi-quantitative FFQ for assessing the habitual intake of multiple nutrients in New Zealand (NZ) adults over the past 12 months. DESIGN: A 154-item FFQ was developed. After initial pre-testing, reliability was assessed using intra-class correlations. Relative validity was assessed by comparing nutrient intakes derived from the FFQ v. those from an 8 d diet record (8dWDR) collected over 12 months and selected blood biomarkers, using Spearman correlations. Supplementary cross-classification and Bland-Altman analyses were performed to assess validity of the FFQ v. the 8dWDR. SETTING: Dunedin, NZ. SUBJECTS: One hundred and thirty-two males and females aged 30-59 years who completed all FFQ and 8dWDR and provided a blood sample. RESULTS: Reliability coefficients ranged from 0·47 for Ca to 0·83 for alcohol, with most values falling between 0·60 and 0·80. The highest validity coefficients for energy-adjusted data were observed for alcohol (0·74), cholesterol (0·65) and ß-carotene (0·58), and the lowest for Zn (0·24) and Ca (0·28). For all energy-adjusted nutrients mean percentage correct classification was 77·9% and gross misclassification was 4·5%. Results of Bland-Altman analyses showed wide limits of agreement for all micronutrients but high agreement was observed for most macronutrients (99% for protein, 103% for total fat). When compared with biomarkers, energy-adjusted coefficients were 0·34 for ß-carotene and 0·33 for vitamin C. CONCLUSIONS: The FFQ provides highly repeatable measurements and good validity in ranking individuals' intake, suggesting that it will be a useful tool to assess nutrient intake of NZ adults in future research.

Utility of waist-to-height ratio, waist circumference and body mass index in predicting clustered cardiometabolic risk factors and subclinical vascular phenotypes in children and adolescents: A pooled analysis of individual data from 14 countries.

AIMS: The clinical utility of waist-to-height ratio (WHtR) in predicting cardiometabolic risk factors (CMRFs) and subclinical markers of cardiovascular disease remains controversial. We aimed to compare the utility of WHtR with waist circumference (WC) and body mass index (BMI) in identifying children and adolescents (youths) at risk for cardiometabolic outcomes, including clustered CMRFs, high carotid intima-media thickness (cIMT), and arterial stiffness (assessed as high pulse wave velocity, PWV). METHODS: We analyzed data from 34,224 youths (51.0 % boys, aged 6-18 years) with CMRFs, 5004 (49.5 % boys, aged 6-18 years) with cIMT measurement, and 3100 (56.4 % boys, aged 6-17 years) with PWV measurement from 20 pediatric samples across 14 countries. RESULTS: WHtR, WC, and BMI z-scores had similar performance in discriminating youths with ≥3 CMRFs, with the area under the curve (AUC) (95 % confidence interval, CI)) ranging from 0.77 (0.75-0.78) to 0.78 (0.76-0.80) using the modified National Cholesterol Education Program (NCEP) definition, and from 0.77 (0.74-0.79) to 0.77 (0.74-0.80) using the International Diabetes Federation (IDF) definition. Similarly, all three measures showed similar performance in discriminating youths with subclinical vascular outcomes, with AUC (95 % CI) ranging from 0.67 (0.64-0.71) to 0.70 (0.66-0.73) for high cIMT (≥P95 values) and from 0.60 (0.58-0.66) to 0.62 (0.58-0.66) for high PWV (≥P95 values). CONCLUSIONS: Our findings suggest that WHtR, WC, and BMI are equally effective in identifying at-risk youths across diverse pediatric populations worldwide. Given its simplicity and ease of use, WHtR could be a preferable option for quickly screening youths with increased cardiometabolic risk in clinical settings.

Dieting status influences associations between dietary patterns and body composition in adolescents: a cross-sectional study.

BACKGROUND: Associations between food choice and body composition in previous studies of adolescents have been inconsistent. This may be due to the body composition measures used, or these associations may be affected by the dieting status of adolescents. The objective of this study was to investigate the association between dietary patterns and body composition in adolescents, and determine if these associations are moderated by dieting status. METHODS: Information on food consumption and current dieting status was collected, using a web-based survey, in 681 adolescents (mean age 15.8 (SD 0.9) years) from schools in Otago, New Zealand. Non-dieters were defined as those reporting not being on a diet as they were "happy with their weight". Principal components analysis (PCA) was used to determine dietary patterns. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), fat mass index (FMI), and fat-free mass index (FFMI) were examined as outcomes. Generalized estimating equations were used to examine associations between dietary patterns and body composition. RESULTS: PCA produced three dietary patterns: 'Treat Foods', 'Fruits and Vegetables', and 'Basic Foods'. A standard deviation increase in 'Basic Foods' was associated with a 3.58% decrease in FMI (95%CI -6.14, -0.94) in the total sample. When separate sex analysis was undertaken significant negative associations were found in boys only, between the 'Basic Food' score and WC, WHtR, FMI, and FFMI, while the 'Fruits and Vegetables' pattern was negatively associated with FMI. Associations between 'Treat Foods' and BMI, WC, and WHtR in non-dieters were positive, while these associations were negative for all other participants. CONCLUSIONS: Significant associations were found between dietary patterns and indices of both central and total adiposity, but not BMI. Therefore using only BMI measures may not be useful in this age group. Since our results were significant for boys and not girls, nutrition messages designed to prevent obesity may be particularly important for adolescent boys. As an interaction between dieting status and 'Treat Foods' existed, future studies should also explore the role of dieting when investigating food choice and body composition.

Sleep duration and adiposity in older adolescents from Otago, New Zealand: relationships differ between boys and girls and are independent of food choice.

BACKGROUND: While relationships between sleep and BMI have been extensively studied in younger children the effect of sleep duration on adiposity in adolescents, who are undergoing rapid growth periods, is less well known. There is also a lack of consistent evidence on the role of sleep on other measures of adolescent body composition which may be more reflective of health than BMI in this age group. Previous research investigating whether these relationships differ between sexes is also inconsistent. Therefore the objective of this study was to investigate relationships between sleep duration and multiple body composition measures in older adolescents and to investigate if these relationships differ between boys and girls. METHODS: A web-based cross-sectional survey and anthropometric measurement of 685 adolescents (mean age 15.8 years) from 11 schools in Otago, New Zealand. Height and weight were measured by trained researchers and fat mass and fat-free mass were estimated using bio-impedance. Generalised estimating equations were used to examine associations between sleep duration and the following body composition measures: BMI, waist circumference (WC), waist-to-height ratio (WHtR), fat mass index (FMI), and fat-free mass index (FFMI). Analyses were adjusted for ethnicity, deprivation, the number of screens in the bedroom and fruit and vegetable consumption. RESULTS: When data from all participants were analysed together, no significant relationships were seen between sleep duration and any body composition measure but significant sex interactions were seen. An hour increase in average nightly sleep duration in boys only was associated with decreases of 1.2% for WC, 0.9% for WHtR, 4.5% for FMI and 1.4% for FFMI in multivariate models. Similar results were seen for weekday and weekend night sleep duration. CONCLUSIONS: Sex specific factors may play a role in relationships between sleep and body composition in older adolescents. The results in boys were most pronounced for FMI, a measure of total adiposity, which suggests that insufficient sleep in adolescent boys may affect fat mass more than lean mass and that the use of measures such as BMI may result in an under-estimation of relationships.

Attitudes to food differ between adolescent dieters and non-dieters from Otago, New Zealand, but overall food intake does not.

OBJECTIVE: There is increasing pressure for adolescents to be thin and this may not always be acted upon in healthy ways; for example, certain foods or food groups may be restricted or meals skipped. As foods are not eaten in isolation it is useful to examine dietary patterns and associated psychosocial factors to better understand eating behaviour. The aim of the present study was to identify correlates of 'dieting' in adolescents from Otago, New Zealand. DESIGN: A web-based survey was conducted in 2009, collecting information on food consumption and factors potentially associated with food consumption. Principal components analysis was used to investigate dietary patterns. Correlates were examined in 1329 students using multiple logistic regression analysis. SETTING: Nineteen secondary schools in the province of Otago, New Zealand. SUBJECTS: Students from school years 9 and 10 (mean age 14.1 (SD 0.7) years). RESULTS: There was no relationship between dieting and dietary patterns. Those not dieting were 17 % (95 % CI 7, 26 %) more likely to eat lunch and 22 % (95 % CI 3, 37 %) more likely to eat an evening meal on one more weekday than those who were dieting. Those who reported dieting were more likely to report healthiness (OR = 2.18, 95 % CI 1.11, 4.26) as an important factor when choosing food and that eating fruit and vegetables makes you better looking. No sex by dieting interaction was found. CONCLUSIONS: In this cohort, while there was no difference in actual food consumption between dieters and non-dieters, there were significant differences in attitudes to food.

Development and validation of a food-based diet quality index for New Zealand adolescents.

BACKGROUND: As there is no population-specific, simple food-based diet index suitable for examination of diet quality in New Zealand (NZ) adolescents, there is a need to develop such a tool. Therefore, this study aimed to develop an adolescent-specific diet quality index based on dietary information sourced from a Food Questionnaire (FQ) and examine its validity relative to a four-day estimated food record (4DFR) obtained from a group of adolescents aged 14 to 18 years. METHODS: A diet quality index for NZ adolescents (NZDQI-A) was developed based on 'Adequacy' and 'Variety' of five food groups reflecting the New Zealand Food and Nutrition Guidelines for Healthy Adolescents. The NZDQI-A was scored from zero to 100, with a higher score reflecting a better diet quality. Forty-one adolescents (16 males, 25 females, aged 14-18 years) each completed the FQ and a 4DFR. The test-retest reliability of the FQ-derived NZDQI-A scores over a two-week period and the relative validity of the scores compared to the 4DFR were estimated using Pearson's correlations. Construct validity was examined by comparing NZDQI-A scores against nutrient intakes obtained from the 4DFR. RESULTS: The NZDQI-A derived from the FQ showed good reliability (r = 0.65) and reasonable agreement with 4DFR in ranking participants by scores (r = 0.39). More than half of the participants were classified into the same thirds of scores while 10% were misclassified into the opposite thirds by the two methods. Higher NZDQI-A scores were also associated with lower total fat and saturated fat intakes and higher iron intakes. CONCLUSIONS: Higher NZDQI-A scores were associated with more desirable fat and iron intakes. The scores derived from either FQ or 4DFR were comparable and reproducible when repeated within two weeks. The NZDQI-A is relatively valid and reliable in ranking diet quality in adolescents at a group level even in a small sample size. Further studies are required to test the predictive validity of this food-based diet index in larger samples.

Factor analysis of the Comprehensive Feeding Practices Questionnaire in a large sample of children.

How parents feed their children may impact on their weight and eating behaviours, both now and in the future. The Comprehensive Feeding Practices Questionnaire (CFPQ) proposes to measure parental feeding practices and was originally developed using 12 factors in relatively small, homogenous samples. In contrast the present study used a large, diverse sample (n=1013) of children aged 4-8years. A confirmatory factor analysis showed that the original 12-factor model was not a good fit and that several factors were strongly inter-correlated. A subsequent exploratory factor analysis yielded five scales of interest: Healthy Eating Guidance, Monitoring, Parent Pressure, Restriction and Child Control. These scales were largely supported by further analyses in these data. Parents who were concerned about their child being overweight reported more Healthy Eating Guidance and Restriction and less Parent Pressure, whereas parents concerned about their child being underweight used more Parent Pressure and less Healthy Eating Guidance. Parents who rated a healthy diet for their child as very important undertook more Healthy Eating Guidance and Monitoring of food intake and less Child Control. These five factors from the CFPQ provide a well-supported and useful set of feeding practices that could be applicable to a wide variety of population groups.

A Cross-Sectional Investigation of Preadolescent Cardiometabolic Health: Associations with Fitness, Physical Activity, Sedentary Behavior, Nutrition, and Sleep.

BACKGROUND: Cardiometabolic disease (CMD) risk often begins early in life. Healthy lifestyle behaviors can mitigate risk, but the optimal combination of behaviors has not been determined. This cross-sectional study simultaneously examined the associations between lifestyle factors (fitness, activity behaviors, and dietary patterns) and CMD risk in preadolescent children. METHODS: 1480 New Zealand children aged 8-10 years were recruited. Participants included 316 preadolescents (50% female, age: 9.5 ± 1.1 years, BMI: 17.9 ± 3.3 kg/m2). Fitness (cardiorespiratory fitness [CRF], muscular fitness), activity behaviors (physical activity, sedentary, sleep), and dietary patterns were measured. Factor analysis was used to derive a CMD risk score from 13 variables (adiposity, peripheral and central hemodynamics, glycemic control, and blood lipids). RESULTS: Only CRF (ß = -0.45, p < 0.001) and sedentary time (ß = 0.12, p = 0.019) were associated with the CMD risk score in the adjusted multivariable analysis. CRF was found to be nonlinear (VO2 max ≤ ≈42 mL/kg/min associated with higher CMD risk score), and thus a CRF polynomial term was added, which was also associated (ß = 0.19, p < 0.001) with the CMD risk score. Significant associations were not found with sleep or dietary variables. CONCLUSION: The findings indicate that increasing CRF and decreasing sedentary behavior may be important public health targets in preadolescent children.

The relationship between fermentable carbohydrates and post-prandial bowel symptoms in patients with functional bowel disorders.

Background and aims: A low fermentable oligosaccharide, disaccharide, monosaccharide, and polyols (FODMAP) diet alleviates symptoms of irritable bowel syndrome (IBS). We aimed to investigate the relationship between habitual FODMAP intake and post-prandial bowel symptoms in adults with IBS, functional diarrhoea (FD), or constipation (FD) (functional bowel disorders), and in healthy adults (controls). Methods: 292 participants (173 with functional bowel disorders and 119 controls) completed a food and symptom times diary. Estimated meal portion sizes were entered into the Monash FODMAP Calculator to analyse FODMAP content. Wilcoxon and ANOVA tests were used to investigate the relationship between FODMAP intake and post-prandial bowel symptoms. Results: IBS participants experienced more post-prandial bowel symptoms compared to participants with other functional bowel disorders or controls. Meals associated with abdominal pain contained on average increased excess fructose (0.31 g vs. 0.18 g, p < 0.05), sorbitol (0.27 g vs. 0.10 g, p < 0.01), and total FODMAP (3.46 g vs. 2.96 g, p < 0.05) compared to meals not associated with pain. Abdominal swelling was associated with increased sorbitol (0.33 g vs. 0.11 g, p < 0.01), and total FODMAP (3.26 g vs. 3.02 g, p < 0.05) consumption. Abdominal bloating was associated with increased galacto oligosaccharide consumption (0.18 g vs. 0.14 g, p < 0.05). Conclusion: These findings support the role of FODMAP in post-prandial bowel symptom onset, however, the amount and type of FODMAP triggering symptoms vary between individuals. Future research should investigate the relationship between the effect of individual FODMAP consumption on post-prandial bowel symptoms for each subtype, the interaction of FODMAP with differing functional bowel disorders and whether longitudinally symptoms and dietary intake are stable.