The effect of cereal Β-glucan on body weight and adiposity: A review of efficacy and mechanism of action.

The current review examines the totality of the evidence to determine if there exists a relationship between ß-glucan and body weight and adiposity and whether such a relationship is a consistent, causal and plausible one. Observational studies suggest an association between oat (i.e., ß-glucan) intake and reduced body weight, waist circumference and adiposity. High and moderate quality randomized controlled trials that were specifically designed to evaluate the efficacy of ß-glucan on anthropometric outcomes were given the highest weight. Several of these studies indicated a causal relationship between ß-glucan consumption and reduction in body weight, BMI, and at least one measure of body fat within diets that were not calorie-restricted. A review of additional animal and human evidence suggests multiple plausible mechanisms by which ß-glucan may impact satiety perception, gastric emptying, gut hormones, gut microbiota and short chain fatty acids in the complex interplay of appetite and energy regulation.Supplemental data for this article is available online at http://dx.doi.org/10.1080/10408398.2021.1994523.

Nutrient Intake Adequacy from Food and Beverage Intake of US Children Aged 1-6 Years from NHANES 2001-2016.

The early years, between the ages of one and six, are a period of rapid physical, social and cognitive growth and a nutritionally adequate diet is an important factor for optimum development. We investigated the micronutrient adequacy and status of young US children aged 1-6 years (n = 9848) using 24-h dietary recall interviews completed by parents and caregivers participating in the National Health and Nutrition Examination Survey (NHANES) 2001-2016. data. The proportion of the sample not meeting the Dietary Reference Intakes (DRI) increased with increasing age and was most pronounced for calcium. Despite adequate iron intake, 7.4% and 2.5% had signs of iron deficiency and anemia based on serum ferritin and hemoglobin levels, with younger children and WIC participants at most risk and Non-Hispanic Black children the least. Vitamin B6 intake was adequate, but 6.4% had serum pyridoxal-5-phosphate deficiency. For vitamin E, 69% had intakes below the estimated average requirement (EAR), yet serum deficiency was only detected in 0.9%. Vitamin D intake was inadequate for 87%, but true deficiency may be overestimated. Mean DHA intake was 24 mg/d, well below expert recommendations of 70-100 mg/day. Iron and vitamin B6 deficiency and inadequate calcium, fiber, choline, potassium and DHA intakes are a concern for a significant percentage of young children. The discrepancy between nutrient intakes and serum deficiency levels needs to be further investigated.

Global review of whole grain definitions and health claims.

Recommendations to increase whole grain consumption are part of dietary guidelines around the world. To assist consumers in meeting this recommendation, some countries, and health-promoting organizations, have defined qualifying criteria for a whole grain food for product labeling or health claims. Other countries have not yet developed similar guidelines. Existing whole grain definitions and health claims are reviewed here. While there appears to be increasing consensus for defining a whole grain, significant disparity exists in defining a whole grain food when a product is not 100% whole grain. Moreover, while whole grain health claims have been approved in a few countries, other countries have concluded there is insufficient evidence to substantiate such claims.

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Global review of heart health claims for oat beta-glucan products.

Coronary heart disease (CHD) is the leading cause of death globally. Consumption of whole grains and cereal fiber, as part of a healthy diet, can lower the risk of CHD. Health claims on food products are effective in helping consumers select healthful diets. The US Food and Drug Administration was the first to approve a health claim, in 1997, between beta-glucan soluble fiber from whole oats, oat bran, and whole oat flour and reduced risk of CHD. Only a few countries have approved similar claims. Since 1997, a significant amount of additional evidence has been published on the relationship between oat beta-glucan and CHD. To assist other jurisdictions in potentially utilizing this claim, the full extent of data that supports this claim (ie, the evidence utilized by the US Food and Drug Administration to substantiate the claim, as well as the results of 49 clinical trials published since 1997) are reviewed here. The complexities involved in authoring evidence-based health claims, including the impact of processing on beta-glucan cholesterol-lowering efficacy in approving eligible beta-glucan products, are also discussed.

Diabetes, Care Homes, and the Influence of Technology on Practice and Care Delivery in Care Homes: Systematic Review and Qualitative Synthesis.

BACKGROUND: Diabetes is increasing in prevalence and complexity in the care home setting, affecting up to a quarter of care home residents. Health outcomes for these residents are impacted by management of the disease, health care professionals (HCPs)' decision-making skills within the care home setting, and access to specialist services. The use of technology has the potential to recognize opportunities for early intervention that enables efficient responsive care, taking a fundamental role in linking the care home community to wider multidisciplinary teams for support. OBJECTIVE: The aim of this paper was to identify evidence that explores factors relevant to the use of technology in and around the care home setting to aid in the management of diabetes. METHODS: Databases searched using a structured prespecified approach included: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), OVID Nursing database, Scopus, MEDLINE, the Cochrane Library, and the King's Fund from 2012 to 2017: handsearching was undertaken additionally for any gray literature. Preferred Reporting Items for Systematic review and Meta-Analysis Protocol was used as protocol with Risk of Bias in Systematic reviews a tool to assess the risk of bias across studies. Studies had to include interventions that combined technology to or from the care home setting to support residents living with diabetes. RESULTS: The combined search strategy identified a total of 493 electronic records. Of these, 171 papers were screened for eligibility, 66 full papers were accessed, and 13 have been included in this study. Qualitative synthesis has identified different strands of research evidence in what and how technology is currently being used in and around care homes to enhance diabetes management. New initiatives and implementations of technology and emerging models of care that included the use of technology have also been included. CONCLUSIONS: By triangulating the perspectives of HCPs, practitioners, specialists, and members of the care home community, the authors anticipate that this review will represent an up-to-date, evidence-based overview of the potential for using technology within the care home setting for diabetes management as well as stimulate research in this area.

Stevia Leaf to Stevia Sweetener: Exploring Its Science, Benefits, and Future Potential.

Steviol glycoside sweeteners are extracted and purified from the Stevia rebaudiana Bertoni plant, a member of the Asteraceae (Compositae) family that is native to South America, where it has been used for its sweet properties for hundreds of years. With continued increasing rates of obesity, diabetes, and other related comorbidities, in conjunction with global public policies calling for reductions in sugar intake as a means to help curb these issues, low- and no-calorie sweeteners (LNCSs, also known as high-potency sweeteners) such as stevia are gaining interest among consumers and food manufacturers. This appeal is related to stevia being plant-based, zero calorie and with a sweet taste that is 50-350 times sweeter than sugar, making it an excellent choice for use in sugar- and calorie-reduced food and beverage products. Despite the fact that the safety of stevia has been affirmed by several food regulatory and safety authorities around the world, insufficient education about stevia's safety and benefits, including continuing concern with regard to the safety of LNCSs in general, deters health professionals and consumers from recommending or using stevia. Therefore, the aim of this review and the stevia symposium that preceded this review at the ASN's annual conference in 2017 was to examine, in a comprehensive manner, the state of the science for stevia, its safety and potential health benefits, and future research and application. Topics covered included metabolism, safety and acceptable intake, dietary exposure, impact on blood glucose and insulin concentrations, energy intake and weight management, blood pressure, dental caries, naturality and processing, taste and sensory properties, regulatory status, consumer insights, and market trends. Data for stevia are limited in the case of energy intake and weight management as well as for the gut microbiome; therefore, the broader literature on LNCSs was reviewed at the symposium and therefore is also included in this review.

Vested interests in addiction research and policy. Is the alcohol industry delaying government action on alcohol health warning labels in Australia?

AIMS: This paper examines the strategies and arguments used by segments of the alcohol industry to delay the introduction of mandatory health warning labels on alcohol containers in Australia. These strategies are compared with those used by the tobacco industry to delay the introduction of warning labels for cigarettes. METHODS: Submissions made by members of the alcohol industry to the Australian Government's review of labelling and Parliamentary Inquiry into Fetal Alcohol Spectrum Disorders were analysed. RESULTS: Segments of the alcohol industry have delayed the introduction of mandatory alcohol health warning labels in Australia by questioning the rationale and evidence base for labels; arguing that they will cause damage to public health and the economy; lobbying and seeking to influence government and political representatives including through monetary donations; and introducing its own voluntary labelling scheme. The arguments made by these organizations against the introduction of mandatory health warning labels for alcohol are flawed and their empirical basis is limited. CONCLUSION: The Australian Government has delayed the introduction of mandatory alcohol health warning labels in Australia by 2 years, until at least December 2013. The campaigning of some parts of the alcohol industry appears to have been instrumental in this decision.

Analysis of national data shows mixed evidence of hardening among Australian smokers.

OBJECTIVE: According to the 'hardening hypothesis', the proportion of smokers that are 'low-probability quitters' will increase as societal disapproval of smoking increases. This paper examines whether there has been increased hardening in Australian smokers over the past decade as reflected in an increased prevalence of psychological distress and social disadvantage among current smokers. METHODS: The relationship between psychological distress, living in a disadvantaged area and level of education was determined using logistic regression at two time points 7 to 10 years apart in three cross-sectional household survey series: National Drug Strategy Household Survey (NDSHS), National Health Survey (NHS) and National Survey of Mental Health and Well-being (NSMHW). RESULTS: The relationships between smoking and living in the most disadvantaged areas and having completed less than 12 years of schooling strengthened between 2001 and 2010 in the NDSHS, but there were no significant changes between survey years in the NHS and NSMHW. There was no significant change in the relationship between smoking and psychological distress between survey years in any of the survey series. CONCLUSION: Social disadvantage may be increasing among current smokers, but the results were inconsistent between survey series, presenting weak evidence that the population of Australian smokers hardened as smoking prevalence declined by approximately 4% over the last decade. IMPLICATIONS: A greater focus on intensive individual-level tobacco cessation interventions does not appear warranted at this time.

Direct-to-consumer genetic testing for addiction susceptibility: a premature commercialisation of doubtful validity and value.

Genetic research on addiction liability and pharmacogenetic research on treatments for addiction have identified some genetic variants associated with disease risk and treatment. Genetic testing for addiction liability and treatment response has not been used widely in clinical practice because most of the genes identified only modestly predict addiction risk or treatment response. However, many of these genetic tests have been commercialized prematurely and are available direct to the consumer (DTC). The easy availability of DTC tests for addiction liability and lack of regulation over their use raises a number of ethical concerns. Of paramount concern is the limited predictive power and clinical utility of these tests. Many DTC testing companies do not provide the consumer with the necessary genetic counselling to assist them in interpreting and acting on their test results. They may also engage in misleading marketing to entice consumers to purchase their products. Consumers' genetic information may be vulnerable to misuse by third parties, as there are limited standards to protect the privacy of the genetic information. Non-consensual testing and inappropriate testing of minors may also occur. The United States Food and Drug Administration plans to regulate DTC genetic tests. Based on the ethical concerns we discuss below, we believe there is a strong case for regulation of DTC genetic tests for addiction liability and treatment response. We argue that until this occurs, these tests have more potential to cause harm than to contribute to improved prevention and treatment of addiction.

Depression and psychological distress in tobacco smokers and people with cannabis dependence in the National Survey of Mental Health and Wellbeing.

OBJECTIVE: To examine changes in the prevalence of affective disorders and psychological distress among smokers and people with cannabis dependence between 1997 and 2007. DESIGN, PARTICIPANTS AND SETTING: Cross-sectional analysis of the 1997 and 2007 National Survey of Mental Health and Wellbeing. MAIN OUTCOME MEASURES: The Composite International Diagnostic Interview generated diagnoses of cannabis dependence and affective disorders based on criteria of the Diagnostic and statistical manual of mental disorders, fourth edition. Psychological distress was measured using the Kessler Psychological Distress Scale. Logistic regressions examined the relationship between affective disorders, psychological distress and (i) smoking status (current, former and never-smoker) and (ii) cannabis dependence. RESULTS: Affective disorders and psychological distress were more common among smokers than non-smokers and among cannabis-dependent participants in both years. The prevalence of affective disorders and psychological distress among smokers, ex-smokers and non-smokers did not change between 1997 and 2007. Psychological distress and affective disorders were more common in cannabis-dependent participants in 2007 than in 1997. CONCLUSION: Affective disorders were more common in current than never-smokers and in people with cannabis dependence than without. We did not find strong evidence that the prevalence of these disorders changed in smokers between 1997 and 2007, but we did find such evidence in cannabis-dependent people.

What are the major drivers of prevalent disability burden in young Australians?

OBJECTIVE: To examine age and sex differences in the leading causes of prevalent disability in young Australians. DESIGN, SETTING AND PARTICIPANTS: We analysed data from the 2003 Australian Burden of Disease and Injury Study, which estimated the prevalent disability burden attributable to 170 diseases and injuries, for younger adolescents (10-14 years), older adolescents (15-19 years) and young adults (20-24 years). MAIN OUTCOME MEASURES: The broad categories of disease and injury that are the main contributors to prevalent disability and the 10 leading disease and injury causes of prevalent disability, according to sex and age group. RESULTS: Total prevalent disability rates are lowest in younger adolescents and highest in young adults. Mental disorders are the largest "contributor" to disability in young Australians, and anxiety and depressive disorders are the leading single cause. In young males, autism and attention deficit hyperactivity disorder cause similar levels of disability as do anxiety and depression. In young females, eating disorders are the second leading cause of mental disorder disability. Alcohol use disorders and schizophrenia make important contributions to disability in young adult males. Asthma is the most prominent cause of physical disability in all three age groups. CONCLUSIONS: There are substantial changes in both the pattern and level of disability burden across the three age groups that we studied. The increase in total prevalent disability that occurs from early adolescence to young adulthood should focus attention on the delivery of accessible and youth friendly health care as well as the effectiveness of transitions from child health services to adult health services.

Development of the private practice management standards for psychology.

This paper describes the process of developing a set of private practice management standards to support Australian psychologists and promote high quality services to the public. A review of the literature was conducted to identify management standards relevant to psychology, which were further developed in consultation with a panel of experts in psychology or in the development of standards. Forty-three psychologists in independent private practice took part in either a survey (n=22) to provide feedback on the relevance of, and their compliance with, the identified standards, or a 6-month pilot study (n=21) in which a web-based self-assessment instrument evaluating the final set of standards and performance indicators was implemented in their practice to investigate self-reported change in management procedures. The pilot study demonstrated good outcomes for practitioners when evaluation of compliance to the standards was operationalized in a self-assessment format. Study results are based on a small sample size. Nevertheless, relevance and utility of the standards was found providing an initial version of management standards that have relevance to the practice of psychology in Australia, along with a system for evaluating psychological service provision to ensure best practice in service delivery.

Is there evidence of 'hardening' among Australian smokers between 1997 and 2007? Analyses of the Australian National Surveys of Mental Health and Well-Being.

OBJECTIVES: To use data from the 1997 and 2007 National Surveys of Mental Health and Well-Being (NSMHWB) to assess whether Australian smokers in 2007 have higher rates of mental distress and social disadvantage than smokers in 1997. METHOD: We compared symptoms of mental distress and social disadvantage in Australian smokers in the 1997 and 2007 National Surveys of Mental Health and Well-Being (N = 10 373 in 1997 and N = 8135 in 2007). Both surveys used multistage probability samples of Australians living in private dwellings. Participants were classified into smokers and non-smokers (which included former and never smokers). We used the Kessler 10 (K10) symptom score to classify smokers into three levels of psychological distress (low, medium or high) and socioeconomic disadvantage was measured using an area-based index of relative disadvantage converted into quintiles. We used logistic regressions to: (i) examine associations between smoking status (smoker/non-smoker) and psychological distress and socioeconomic disadvantage in 1997 and 2007 surveys; and (ii) to test whether the prevalence of psychological distress and social disadvantage among smokers increased between 1997 and 2007. RESULTS: Psychological distress and social disadvantage were more common among smokers than non-smokers in both surveys but there was no evidence that the prevalence of psychological distress or social disadvantage was more common among smokers in 2007 than in 1997. CONCLUSION: We find no evidence that the declining smoking prevalence in Australia (over the last decade) has been accompanied by a 'hardening' of continuing smokers in terms of rates of mental disorders and socioeconomic disadvantage.

Social support and fires in the workplace: a preliminary investigation.

Workers who experience fire in the workplace are faced with disruption to their work routine, as well as the emotional strain of the fire. In the broader occupational stress literature, researchers have suggested that social support will be most effective at reducing the negative effects of stressors on strain when the type of support matches the type of stressor being experienced (either instrumental or emotional). This study was a preliminary investigation into employee responses to less routine stressors, such as workplace fires, and the role of different sources of social support in predicting coping effectiveness. This study also was a first attempt at considering the influence of the social context (in terms of group identification) on the effectiveness of social support as a predictor of coping effectiveness. Specifically, it was predicted that social support would be more effective when it came from multiple sources within the organization, that it would be especially effective when provided from a group that workers identified more strongly with, and that simply feeling part of a group would improve adjustment. Both quantitative and qualitative data were collected from 33 employees who had recently experienced a significant fire in their workplace. Results suggested that the type of stressors experienced and the type of support were mismatched, but despite this, coping effectiveness was generally moderate to high. There was mixed support for predictions about the effects of social support-no moderating effect of group identification on coping effectiveness was observed for measures of workplace support, although it did moderate the effects of family support on this adjustment indicator.