La actividad física en la gestión de la obesidad en adultos: una ponencia de Exercise and Sport Science Australia / Physical activity in the management of obesity in adults: A position statement from Exercise and Sport Science Australia / Atividade física no controle da obesidade em adultos: um documento da Exercise and Sport Science Australia

Resumen Esta ponencia examina las evidencias para la actividad física en la pérdida de peso y de adiposidad, la prevención del aumento de peso y la adiposidad, así como la recuperación de peso en adultos, y provee orientación sobre las implicaciones para los profesionales del ejercicio. La evidencia de la investigación indica que se requieren > 150 minutos, pero preferiblemente 300 minutos por semana de actividad aeróbica de intensidad al menos moderada para prevenir el aumento de peso y adiposidad, y al menos el extremo superior de esta gama de actividad para prevenir la recuperación de peso después de la pérdida de peso. Para que la pérdida de peso y adiposidad total sea significativa, se requiere un mínimo de 300 a 400 minutos por semana de actividad aeróbica de intensidad, al menos, moderada. La evidencia en torno al volumen de actividad física aeróbica requerida para reducir la adiposidad central está surgiendo, y las investigaciones apuntan a que puede ser sustancialmente menor que la que se requiere para la pérdida de peso. El impacto de la actividad física de alta intensidad y el ejercicio de resistencia para la gestión del peso es incierto. Durante las consultas para la gestión del peso, los profesionales en ejercicio deben aconsejar que se pueden lograr beneficios para la salud metabólica y cardiovascular por medio de la actividad física a cualquier peso, e independientemente del cambio de peso.

Abstract This Position Statement examines the evidence for physical activity in weight and adiposity loss, prevention of weight and adiposity gain, and in weight regain in adults, and provides guidance on implications for exercise practitioners. Research evidence indicates that >150 min but preferably 300 min per week of aerobic activity of at least moderate intensity is required to prevent weight and adiposity gain, and at least the upper end of this range of activity to prevent weight regain after weight loss. For meaningful weight and total adiposity loss, a minimum of 300-420 min per week of aerobic activity of at least moderate intensity is required. The evidence around the volume of aerobic physical activity required to reduce central adiposity is emerging, and research suggests that it may be substantially less than that required for weight loss. The impact of high-intensity physical activity and resistance exercise for weight management is uncertain. During consultations for weight management, exercise practitioners should advise that metabolic and cardiovascular health benefits can be achieved with physical activity at any weight, and irrespective of weight change.

Resumo Este documento examina as evidências da atividade física na perda de peso e adiposidade, na prevenção do ganho de peso e adiposidade e na recuperação de peso em adultos, e fornece orientações sobre as implicações para os profissionais do exercício físico. As evidências da pesquisa indicam que são necessários mais de 150 minutos, mas preferencialmente 300 minutos por semana de atividade aeróbica de intensidade moderada para evitar o ganho de peso e adiposidade, e pelo menos o extremo superior dessa gama de atividade para evitar o ganho de peso após a perda de peso. É necessário um mínimo de 300 a 400 minutos por semana de atividade aeróbica de intensidade moderada para uma perda significativa de peso e adiposidade total. Estão surgindo evidências sobre a quantidade de atividade física aeróbica necessária para reduzir a adiposidade central, e pesquisas sugerem que ela pode ser substancialmente menor do que a necessária para a perda de peso. O impacto da atividade física de alta intensidade e dos exercícios de resistência no controle de peso é incerto. Durante as consultas de controle de peso, os profissionais do exercício físico devem informar que os benefícios metabólicos e cardiovasculares à saúde podem ser obtidos por meio da atividade física em qualquer peso, independentemente da mudança de peso.

Motivations for participation in weight loss clinical trials.

Males are under-represented in weight loss clinical trials, usually comprising fewer than one-quarter of participants. Our study aimed to investigate people's motivations for participating in weight loss trials and determine any relationship with gender. Eighty individuals from an existing registry for weight loss trials were contacted, of whom 24 (9 males, 15 females) agreed to participate in a 20-min semi-structured interview around their expectations and motivations for volunteering. Interviews were audio-recorded and transcribed in Zoom. A transcript of each interview was uploaded into NVivo for preliminary thematic analysis. Improved health was a common motivation for pursuing weight loss in all subjects regardless of gender. Male recruitment to weight loss trials was often influenced by advice from a healthcare professional to lose weight for the prevention of obesity-related comorbidities, whereas family and aesthetic expectations (e.g., clothes and fashion) were key elements of female participation. Identification of gender differences in motivations for volunteering in weight loss trials will help improve tailoring of recruitment strategies and interventions to enhance male participation in the future.

Multi-Nutrient Analysis of Dietary Macronutrients with All-Cause, Cardiovascular, and Cancer Mortality: Data from NHANES 1999-2014.

Macronutrients are a major component of the human diet. However, few studies have assessed their collective association with mortality. We sought to evaluate the associations of macronutrient intake with all-cause, cardiovascular, and cancer mortality in US adults using a multi-nutrient approach. This prospective cohort analysis used data from the National Health and Nutrition Examination Survey from the years 1999 to 2014. The participants included 33,681 US adults aged 20−85 years (52.5% female). The maximum follow-up time was 16.8 years, with a total of 4398 total deaths, including 772 cardiovascular deaths and 952 cancer deaths. The associations between mortality and dietary macronutrients were explored using three-dimensional generalized additive models, allowing for visual and statistical inference of complex nonlinear associations. Absolute macronutrient intake demonstrated a three-way interactive association with all-cause mortality (p < 0.001), cardiovascular mortality (p = 0.02), and cancer mortality (p = 0.05), adjusted for age, sex, ethnicity, socioeconomic status, dietary quality, and lifestyle. Compositionally, a high caloric diet composed of moderately high protein (20%), moderate fat (30%), and moderate carbohydrate (50%) levels was associated with the highest mortality risk. Across the total energy intake levels, lower mortality risk was observed in two separate regions consisting of higher protein (30%), higher carbohydrate (60%), and lower fat levels (10%) or lower protein (10%), moderate carbohydrate (45%), and higher fat levels (45%). These findings highlight a complex nonlinear and interactive association between macronutrients and all-cause mortality such that several distinct dietary compositions are associated with similarly high or low risk. Future research is needed to explore the drivers of these associations and whether they differ across varying dietary patterns and populations.

Gambling, fast food and alcohol sponsorship in elite sport - perspectives from Australian sporting fans.

BACKGROUND: Public health bodies in Australia remain concerned about marketing of unhealthy commodities; namely unhealthy food, alcohol and gambling products. Children are particularly susceptible to the influence of unhealthy commodity marketing. This study explored adults' perceptions of unhealthy commodities sponsorship in elite sport and policies to restrict them. METHODS: Four focus groups of 7-8 frequent sport spectators were recruited, including parents and non-parents, and located in inner and outer suburbs of Sydney, Australia. Results were analysed thematically. RESULTS: Participants identified the contradictions of healthy messages of sport and unhealthy commodities, while highlighting the commercial value of sport sponsorship to sporting clubs. There is concern around children's exposure to effective and integrated marketing techniques when viewing sport, which encouraged unhealthy habits. Support for restricting sponsorship related to perceived product harm, with gambling viewed as having the greatest health impact. Participants were supportive of policies that reduced exposure of unhealthy commodities to children, but were concerned about the financial risk to sporting clubs. Governments and sports associations were identified as holding responsibility for enacting changes. CONCLUSION: A number of options were identified for advocates to gain public and political traction to reduce unhealthy commodity sponsorship. There is potential for shifts away from unhealthy sponsorship by both governments and sports associations.

Differences in weight loss outcomes for males and females on a low-carbohydrate diet: A systematic review.

It has been widely demonstrated that there are a broad range of individual responses to all weight management regimens, often masked by reports of the mean. Identifying features of responders and non-responders to weight loss regimens enables a more tailored approach to the provision of weight management advice. Low-carbohydrate diets are currently popular, and anecdote suggests that males are more successful at losing weight using this approach. This is feasible given the physiological and socio-psychological differences between the genders. We analysed the extent and variation in weight change for males and females separately through a systematic search for all low-carbohydrate diet trials published since 1985. Very few studies compared weight loss outcomes by gender and, of those that did, most lacked supporting data. The majority of studies reported no gender difference but when a gender difference was found, males were more frequently reported as losing more weight than females on a low-carbohydrate diet. The lack of gender stratification in weight loss trials is concerning, as there are a range of gender-based factors that affect weight loss outcomes. This study highlights the importance of examining weight change for males and females separately, since as failure to do so may mask any potential differences, which, if detected, could assist with better weight loss outcomes.

A Comparison of the Australian Dietary Guidelines to the NOVA Classification System in Classifying Foods to Predict Energy Intakes and Body Mass Index.

NOVA classification distinguishes foods by level of processing, with evidence suggesting that a high intake of ultra-processed foods (UPFs, NOVA category 4) leads to obesity. The Australian Dietary Guidelines, in contrast, discourage excess consumption of "discretionary foods" (DFs), defined according to their composition. Here, we (i) compare the classification of Australian foods under the two systems, (ii) evaluate their performance in predicting energy intakes and body mass index (BMI) in free-living Australians, and (iii) relate these outcomes to the protein leverage hypothesis of obesity. Secondary analysis of the Australian National Nutrition and Physical Activity Survey was conducted. Non-protein energy intake increased by 2.1 MJ (p < 0.001) between lowest and highest tertiles of DF intake, which was significantly higher than UPF (0.6 MJ, p < 0.001). This demonstrates that, for Australia, the DF classification better distinguishes foods associated with high energy intakes than does the NOVA system. BMI was positively associated with both DFs (−1. 0, p = 0.0001) and UPFs (−1.1, p = 0.0001) consumption, with no difference in strength of association. For both classifications, macronutrient and energy intakes conformed closely to the predictions of protein leverage. We account for the similarities and differences in performance of the two systems in an analysis of Australian foods.

Physical activity in the management of obesity in adults: A position statement from Exercise and Sport Science Australia.

This Position Statement examines the evidence for physical activity in weight and adiposity loss, prevention of weight and adiposity gain, and in weight regain in adults, and provides guidance on implications for exercise practitioners. Research evidence indicates that >150 min but preferably 300 min per week of aerobic activity of at least moderate intensity is required to prevent weight and adiposity gain, and at least the upper end of this range of activity to prevent weight regain after weight loss. For meaningful weight and total adiposity loss, a minimum of 300-420 min per week of aerobic activity of at least moderate intensity is required. The evidence around the volume of aerobic physical activity required to reduce central adiposity is emerging, and research suggests that it may be substantially less than that required for weight loss. The impact of high-intensity physical activity and resistance exercise for weight management is uncertain. During consultations for weight management, exercise practitioners should advise that metabolic and cardiovascular health benefits can be achieved with physical activity at any weight, and irrespective of weight change.

Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study.

OBJECTIVE: This study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs). DESIGN: Cross-sectional study. SETTING: National Nutrition and Physical Activity Survey (2011-2012). PARTICIPANTS: 12,153 participants aged 2+ years. MAIN OUTCOME MEASURES: Average dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs. DATA ANALYSIS: Food items were classified according to the NOVA system, a classification based on the nature, extent and purpose of industrial food processing. The contribution of each NOVA food group and their subgroups to total energy intake was calculated. Mean nutrient content of ultra-processed food and non-ultra-processed food fractions of the diet were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of nutrients linked to NCDs as well as in the prevalence of intakes outside levels recommended for the prevention of NCDs were examined. RESULTS: Ultra-processed foods had the highest dietary contribution (42.0% of energy intake), followed by unprocessed or minimally processed foods (35.4%), processed foods (15.8%) and processed culinary ingredients (6.8%). A positive and statistically significant linear trend was found between quintiles of ultra-processed food consumption and intake levels of free sugars (standardised ß 0.43, p<0.001); total (ß 0.08, p<0.001), saturated (ß 0.18, p<0.001) and trans fats (ß 0.10, p<0.001); sodium (ß 0.21, p<0.001) and diet energy density (ß 0.41, p<0.001), while an inverse relationship was observed for dietary fibre (ß -0.21, p<0.001) and potassium (ß -0.27, p<0.001). The prevalence of non-recommended intake levels of all studied nutrients increased linearly across quintiles of ultra-processed food intake, notably from 22% to 82% for free sugars, from 6% to 11% for trans fat and from 2% to 25% for dietary energy density, from the lowest to the highest ultra-processed food quintile. CONCLUSION: The high energy contribution of ultra-processed foods impacted negatively on the intake of non-ultra-processed foods and on all nutrients linked to NCDs in Australia. Decreasing the dietary share of ultra-processed foods would substantially improve the diet quality in the country and help the population achieve recommendations on critical nutrients linked to NCDs.

National policies to prevent obesity in early childhood: Using policy mapping to compare policy lessons for Australia with six developed countries.

Interventions for obesity prevention in early childhood (first 5 years of life) are likely to have a significant preventive health impact. This mapping review identified recommended policy options for the Australian Federal Government (AFG) by comparing countries with similar population, income, and language to Australia. Policies were mapped in six countries using two matrices. The first matrix examined policy context, describing obesity prevention governance. The second matrix examined policy content, compared with global recommendations. Policies were grouped into downstream (healthcare), midstream (lifestyle and settings), and upstream (determinants of health, including food and built environments). Results identified variance in obesity governance across the six countries including policy coherence, leadership, institutional drivers, and overlapping responsibility across different levels of government. While countries tended to have more downstream or midstream policies, upstream policies were more likely when countries had invested in system-wide approaches to obesity such as developing a national obesity strategy, having separate food/nutrition and physical activity plans, and a dedicated preventive health agency. This study recommends a range of initiatives for the AFG to strengthen policies for the prevention of obesity in early childhood, including prioritising the development of a national food/nutrition strategy.

A Systematic Review of Research into the Impact of Loose Parts Play on Children's Cognitive, Social and Emotional Development.

Loose parts play (LPP) interventions introduce moveable materials and equipment to children's play spaces to facilitate unstructured, child-led play. Meta-analysis of previous school-based research has shown significant benefits of LPP for physical activity. In the current paper, we review the scope and quality of the quantitative evidence relating to cognitive, social and emotional outcomes. We conducted a systematic search of the literature on LPP interventions for primary school-aged children which used quantitative outcome indicators for cognitive, social and/or emotional development. Studies were screened for inclusion by two independent researchers and reviewed for content, relevant outcomes and quality indicators. Five studies met the review inclusion criteria. Two studies used a randomised controlled trial design, two studies used quasi-experimental design, and one used an observational design. Outcomes measured focused mainly on social development. With the exception of enjoyment, school satisfaction and self-esteem, emotional outcomes were almost entirely absent. No measures of cognitive or academic outcomes were found. For the studies using control groups, few differences between groups were reported, although one study found increased happiness at school and increased odds of reporting being pushed/shoved at playtime associated with intervention. Null results were found for peer acceptance, relational bullying, social competence, social skills, peer group size and psychosocial quality of life. In the non-controlled study, there were observed increases in co-operative play. There is insufficient high-quality, quantitative, empirical evidence available to determine whether or not LPP interventions have an impact on children's cognitive, social and emotional development. We conclude our review with some recommendations which we hope will assist future research in this promising field.

The normative power of food promotions: Australian children's attachments to unhealthy food brands.

OBJECTIVE: The formation of food brand associations and attachment is fundamental to brand preferences, which influence purchases and consumption. Food promotions operate through a cascade of links, from brand recognition, to affect, and on to consumption. Frequent exposures to product promotions may establish social norms for products, reinforcing brand affect. These pathways signify potential mechanisms for how children's exposure to unhealthy food promotions can contribute to poor diets. The present study explored children's brand associations and attachments for major food brands. DESIGN: A cross-sectional online survey was conducted. Fourteen study brands were used, with each child viewing a set of seven logos. The questionnaire assessed perceptions of food brands and perceptions of users of brands, using semantic differential scales, and perceived brand 'personalities', using Likert scales. SETTING: New South Wales, Australia, October-November 2014. SUBJECTS: Children aged 10-16 years (n 417). RESULTS: Children demonstrated strong positive affect to certain brands, perceiving some unhealthy food brands to have positive attributes, desirable user traits and alignment to their own personality. Brand personality traits of 'smart' and 'sporty' were viewed as indicators of healthiness. Brands with these traits were ranked lower for popularity. CONCLUSIONS: Children's brand associations and attachments indicate the potential normative social influences of promotions. While children are aware of brand healthiness as an attribute, this competes with other brand associations, highlighting the challenge of health/nutrition messaging to counter unhealthy food marketing. Restricting children's exposure to unhealthy food marketing and the persuasive nature of marketing is an important part of efforts to improve children's diet-related health.

Typical food portion sizes consumed by Australian adults: results from the 2011-12 Australian National Nutrition and Physical Activity Survey.

Considerable evidence has associated increasing portion sizes with elevated obesity prevalence. This study examines typical portion sizes of commonly consumed core and discretionary foods in Australian adults, and compares these data with the Australian Dietary Guidelines standard serves. Typical portion sizes are defined as the median amount of foods consumed per eating occasion. Sex- and age-specific median portion sizes of adults aged 19 years and over (n = 9341) were analysed using one day 24 hour recall data from the 2011-12 National Nutrition and Physical Activity Survey. A total of 152 food categories were examined. There were significant sex and age differences in typical portion sizes among a large proportion of food categories studied. Typical portion sizes of breads and cereals, meat and chicken cuts, and starchy vegetables were 30-160% larger than the standard serves, whereas, the portion sizes of dairy products, some fruits, and non-starchy vegetables were 30-90% smaller. Typical portion sizes for discretionary foods such as cakes, ice-cream, sausages, hamburgers, pizza, and alcoholic drinks exceeded the standard serves by 40-400%. The findings of the present study are particularly relevant for establishing Australian-specific reference portions for dietary assessment tools, refinement of nutrition labelling and public health policies.

A snapshot of the scope of obesity prevention practice in Australia.

Community-based initiatives (CBIs) that build capacity and promote healthy environments hold promise for preventing obesity and non-communicable disease, however their characteristics remain poorly understood and lessons are learned in isolation. This limits understanding of likely effectiveness of CBIs; the potential for actively supporting practice; and the translation of community-based knowledge into policy. Building on an initial survey (2010), an online survey was launched (2013) with the aim to describe the reach and characteristics of Australian CBIs and identify and evaluate elements known to contribute to best practice, effectiveness and sustainability. Responses from 104 CBIs were received in 2013. Geographic location generally reflected population density in Australia. Duration of CBIs was short-term (median 3 years; range 0.2-21.0 years), delivered mostly by health departments and local governments. Median annual funding had more than doubled since the 2010 survey, but average staffing had not increased. CBIs used at least two strategy types, with a preference for individual behaviour change strategies. Targeting children was less common (31%) compared with the 2010 survey (57%). Logic models and theory were used in planning, but there was low use of research evidence and existing prevention frameworks. Nearly, all CBIs had an evaluation component (12% of budget), but dissemination was limited. This survey provides information on the scope and varied quality of the current obesity prevention investment in Australia. To boost the quality and effectiveness of CBIs, further support systems may be required to ensure that organizations adopt upstream, evidence-informed approaches; and integrate CBIs into systems, policies and environments.

A map of community-based obesity prevention initiatives in Australia following obesity funding 2009-2013.

OBJECTIVE: Obesity is the single biggest public health threat to developed and developing economies. In concert with healthy public policy, multi-strategy, multi-level community-based initiatives appear promising in preventing obesity, with several countries trialling this approach. In Australia, multiple levels of government have funded and facilitated a range of community-based obesity prevention initiatives (CBI), heterogeneous in their funding, timing, target audience and structure. This paper aims to present a central repository of CBI operating in Australia during 2013, to facilitate knowledge exchange and shared opportunities for learning, and to guide professional development towards best practice for CBI practitioners. METHODS: A comprehensive search of government, non-government and community websites was undertaken to identify CBI in Australia in 2013. This was supplemented with data drawn from available reports, personal communication and key informant interviews. The data was translated into an interactive map for use by preventive health practitioners and other parties. RESULTS: We identified 259 CBI; with the majority (84%) having a dual focus on physical activity and healthy eating. Few initiatives, (n=37) adopted a four-pronged multi-strategy approach implementing policy, built environment, social marketing and/or partnership building. CONCLUSION: This comprehensive overview of Australian CBI has the potential to facilitate engagement and collaboration through knowledge exchange and information sharing amongst CBI practitioners, funders, communities and researchers. IMPLICATIONS: An enhanced understanding of current practice highlights areas of strengths and opportunities for improvement to maximise the impact of obesity prevention initiatives.

Digital junk: food and beverage marketing on Facebook.

OBJECTIVES: We assessed the amount, reach, and nature of energy-dense, nutrient-poor (EDNP) food and beverage marketing on Facebook. METHODS: We conducted a content analysis of the marketing techniques used by the 27 most popular food and beverage brand Facebook pages in Australia. We coded content across 19 marketing categories; data were collected from the day each page launched (mean = 3.65 years of activity per page). RESULTS: We analyzed 13 international pages and 14 Australian-based brand pages; 4 brands (Subway, Coca-Cola, Slurpee, Maltesers) had both national and international pages. Pages widely used marketing features unique to social media that increase consumer interaction and engagement. Common techniques were competitions based on user-generated content, interactive games, and apps. Four pages included apps that allowed followers to place an order directly through Facebook. Adolescent and young adult Facebook users appeared most receptive to engaging with this content. CONCLUSIONS: By using the interactive and social aspects of Facebook to market products, EDNP food brands capitalize on users' social networks and magnify the reach and personal relevance of their marketing messages.

Shiftworking, nutrition and obesity: implications for workforce health- a systematic review.

BACKGROUND: Shiftworking has long been unrecognised as an occupational health hazard up until now. METHODS: Electronic databases were searched using OVID host as the main search engine for Medline, PUBMED and CINHAL during the years 1990-December 2010. Combinations of the keywords yielded 35 full papers and ab-stracts, of which 16 articles were relevant. One paper was not in English, leaving 15 included in this review after final reconsideration. Studies were categorised into two main titles: studies assessing the association between shift working and obesity and/or BMI (n=8) and studies assessing the association between shift working and nu-tritional/dietary patterns (n=7). Type of study was also considered as a part of the search strategy. RESULTS: In total, one interventional, nine cross-sectional and five cohort studies were retrieved. Seven cross-sectional studies and one cohort study showed a higher BMI/obesity prevalence in shiftworks. Interventional, one cross-sectional and three cohort studies showed higher frequency of meal intake or poor nutrition quality/habits in the shift workers compared with the day-shift workers. Another cross-sectional study showed no difference between workers. CONCLUSION: In terms of obesity or high BMI, majority of cross-sectional studies indicate that shiftwork increases weight gain and the prevalence of obesity. On the other hand, half of cohort studies show higher frequency of meal intake and/or poor nutrition quality in the shift workers. Generally, it is indicated that shift working negatively impacts on health and nutritional status of workforces.

Prevalence and sociodemographic factors of malnutrition among children in Malaysia.

BACKGROUND: For many developing countries undergoing rapid economic growth and urbanization, trends in nutritional status indicate a decrease in malnutrition with an associated rise in the prevalence of obesity. An understanding of the situation among children in Malaysia is lacking. OBJECTIVE: To examine the prevalence, trends and sociodemographic factors described for underweight and overweight children in Malaysia. METHODS: The literature from January 1996 to November 2010 on the prevalence of underweight and overweight among children in Malaysia was reviewed. RESULTS: Twelve studies were identified that reported on both underweight and overweight among children in Malaysia, of which only one was a nationally representative survey. Based on the National Health and Morbidity Survey in 2006, 13.2% (95% CI, 12.6 to 13.9) of children aged 0 to 18 years were underweight (weight-for-age < -2SD), and 8.0% (95% CI, 7.5 to 8.6) of those aged 0 to 13 years were overweight (weight-for-height > +2SD). Both underweight and overweight were more prevalent in males than females. Children in rural areas were more likely to be underweight and less likely to be overweight than urban children. Ethnic differences between Malays, Chinese, and Indians were inconsistent across studies and less clear. Aborigines were more likely to be underweight and less likely to be overweight than the general population. The available evidence, although limited and sparse, suggests that over the past decade the prevalence of both underweight and overweight among children in Malaysia has been stable or has shown an increasing trend. CONCLUSIONS: Long-term national monitoring and longitudinal cohort studies will be critical for understanding, preventing, and managing the double burden of malnutrition among children in Malaysia.

The development of a network for community-based obesity prevention: the CO-OPS Collaboration.

BACKGROUND: Community-based interventions are a promising approach and an important component of a comprehensive response to obesity. In this paper we describe the Collaboration of COmmunity-based Obesity Prevention Sites (CO-OPS Collaboration) in Australia as an example of a collaborative network to enhance the quality and quantity of obesity prevention action at the community level. The core aims of the CO-OPS Collaboration are to: identify and analyse the lessons learned from a range of community-based initiatives aimed at tackling obesity, and; to identify the elements that make community-based obesity prevention initiatives successful and share the knowledge gained with other communities. METHODS: Key activities of the collaboration to date have included the development of a set of Best Practice Principles and knowledge translation and exchange activities to promote the application (or use) of evidence, evaluation and analysis in practice. RESULTS: The establishment of the CO-OPS Collaboration is a significant step toward strengthening action in this area, by bringing together research, practice and policy expertise to promote best practice, high quality evaluation and knowledge translation and exchange. Future development of the network should include facilitation of further evidence generation and translation drawing from process, impact and outcome evaluation of existing community-based interventions. CONCLUSIONS: The lessons presented in this paper may help other networks like CO-OPS as they emerge around the globe. It is important that networks integrate with each other and share the experience of creating these networks.

A comparison of two nutrition signposting systems for use in Australia.

Consumers are interested in making healthier food choices but the mandatory nutrition information panel currently in use in Australia is not easily understood or interpreted by most consumers. A simple nutrition signpost would be valuable. This paper reviews two nutrition signposting systems currently being considered for adoption in Australia. The authors conclude that a system similar to the colour-coded Traffic Light System is likely to be most useful.