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BACKGROUND: Emerging observational evidence supports a role for higher fruit and vegetable intake in protecting against the development of depression. However, there is a scarcity of research in older adults or in low- to middle-income countries (LMICs). METHODS: Participants were 7801 community-based adults (mean age 68.6 ± 8.0 years, 55.8 % female) without depression, from 10 diverse cohorts, including four cohorts from LMICs. Fruit and vegetable intake was self-reported via comprehensive food frequency questionnaire, short food questionnaire or diet history. Depressive symptoms were assessed using validated measures, and depression defined applying validated cut-offs. The associations between baseline fruit and vegetable intakes and incident depression over a follow-up period of three to nine years were examined using Cox regression. Analyses were performed by cohort with results meta-analysed. RESULTS: There were 1630 cases of incident depression (21 % of participants) over 40,258 person-years of follow-up. Higher intake of fruit was associated with a lower risk of incident depression (HR 0.87, 95%CI [0.77, 0.99], I2 = 4 %). No association was found between vegetable intake and incident depression (HR 0.93, 95%CI [0.84, 1.04], I2 = 0 %). LIMITATIONS: Diverse measures used across the different cohorts and the modest sample size of our study compared with prior studies may have prevented an association being detected for vegetable intake. CONCLUSIONS: Our study supports a role for fruit, but not vegetable intake in protecting against depression. Research investigating different types of fruits and vegetables using standardised measures in larger cohorts of older adults from low- and middle-income countries is warranted.
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Depresión , Dieta , Frutas , Verduras , Humanos , Femenino , Masculino , Anciano , Persona de Mediana Edad , Depresión/epidemiología , Estudios Longitudinales , Dieta/estadística & datos numéricos , IncidenciaRESUMEN
BACKGROUND: The global population is ageing rapidly and there is a need for strategies to promote health and wellbeing among older adults. Nutrition knowledge is a key predictor of dietary intake; therefore, effective educational programmes are urgently required to rectify poor dietary patterns. Digital health technologies provide a viable option for delivering nutrition education that is cost-effective and widely accessible. However, few technologies have been developed to meet the unique needs and preferences of older adults. OBJECTIVE: The aim of this study was to explore technology use among older adults and qualitatively determine the content needs and design preferences for an online nutrition education resource tailored to older adult consumers in Australia. METHODS: Twenty adult participants aged 55 years and older (95% female) participated in one of four 2-h participatory design workshops. In each workshop, prompted discussion questions were used to explore participants' technology use and preferences and to explore content needs and design preferences for an online nutrition education resource specific to older adults. RESULTS: All participants were regularly using a range of different devices (e.g., smartphones, tablets and computers) and reported being comfortable doing so. Participants wanted a website that provided general nutrition information, practical advice and recipes. To enhance engagement, they sought a personalised resource that could be adjusted to suit their needs, included up-to-date information and allowed for easy sharing with others by exporting information as a PDF. CONCLUSIONS: Participatory design methods generate new knowledge for designing and tailoring digital health technologies to be appropriate and useful for the target audience. Specifically, older adults seek an online resource that has large and simple fonts with clear categories, providing them with practical advice and general nutrition information that can be personalised to suit their own needs and health concerns, with the option to export and print information into a paper-based format. PATIENT OR PUBLIC CONTRIBUTION: Older adults actively participated in the development and evaluation process to generate ideas about potential features, functionalities, uses and practicalities of an online nutrition education resource.
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AIMS: To describe patient-reported physical activity and step count trajectory and explore perceived barriers and enablers to physical activity amongst people with obesity participating in a chronic care programme whilst awaiting arthroplasty. DESIGN: Convergent parallel mixed-method study. METHOD: A patient cohort derived from a longitudinal sample of adults with end-stage osteoarthritis and obesity from a chronic care programme whilst awaiting primary total knee or hip arthroplasty (n = 97) was studied. Physical activity was measured at baseline (entry to the wait list) and before surgery (9-12 months waiting time) using the Lower Extremity Activity Scale (LEAS) and activity monitors (activPAL™). A subset of participants completed in-depth semi-structured interviews 6 months after being waitlisted to explore perceived barriers and enablers to physical activity. Themes were inductively derived and then interpreted through the COM-B model. RESULTS: Baseline LEAS and activPAL™ data were available from 97 and 63 participants, respectively. The proportion of community ambulant individuals reduced from 43% (95% CI 33%-53%) at baseline to 17% (95% CI 9%-28%) pre-surgery. Paired activPAL™ data (n = 31) for step count, upright time, and stepping time remained unchanged. Twenty-five participants were interviewed. Five themes underpinning physical activity were mapped to the COM-B model components of capability (physical capability), opportunity (accessibility and social norms), and motivation (self-efficacy and beliefs and physical activity). CONCLUSIONS: Participation in a chronic care programme did not improve physical activity levels for people with obesity awaiting arthroplasty. Programs cognisant of the COM-B model components may be required to address the natural trajectory of declining physical activity levels while awaiting arthroplasty.
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Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Cadera , Osteoartritis de la Rodilla , Adulto , Humanos , Osteoartritis de la Rodilla/cirugía , Ejercicio Físico , Extremidad Inferior , Obesidad/cirugía , Osteoartritis de la Cadera/cirugíaRESUMEN
AIM: To explore perceived barriers and enablers to weight management among people with obesity awaiting total knee or hip arthroplasty. DESIGN: A nested qualitative study within a multi-centre, quasi-experimental pilot study comparing usual care weight management to a dietitian-led weight-loss diet. METHODS: Semi-structured individual interviews were conducted with adults with end-stage osteoarthritis and a body mass index ≥30 kg/m2 waitlisted for primary total knee or hip arthroplasty. Participants with diverse sociodemographic characteristics and varied success with weight management in the pilot study were purposively sampled. Interviews were analysed using inductive thematic analysis, underpinned by constructivist-interpretivist epistemology. The Patient Activation Measure and Health Literacy Questionnaire were used for context when interpreting the findings. RESULTS: Twenty-five participant interviews were conducted with a sociodemographically varied sample (aged 44-80 years, 9 born in Australia, 6 in paid employment and 11 lost ≥5% of their baseline weight). Four identified themes underpinned successful weight management: beliefs, adaptability, navigating healthcare and sociocultural context. Beliefs about whether weight was perceived as a problem, the expectation of weight loss and treatment-related beliefs influenced participants' perspectives towards weight loss. Adaptability, the ability to overcome barriers to weight loss, comprised three subthemes; readiness to act, degree of independence and problem-solving skills. Approaches towards navigating healthcare influenced uptake and adherence to weight management recommendations. Importantly, these themes were dependent on social and environmental circumstances, which influenced the type of barriers experienced and resources available to the individual. CONCLUSION: Differences in a person's beliefs, their ability to adapt and navigate healthcare and sociocultural context appear to explain successful weight management among people with end-stage arthritis. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Clinicians should allow for individualisation cognisant of the identified themes when providing advice and treatment to promote adherence to weight management interventions. IMPACT: This study explored perceived barriers and enablers to weight management among people with obesity awaiting total knee or hip arthroplasty. Four identified themes underpinned successful weight management: beliefs, adaptability, navigating healthcare and sociocultural context. Beliefs about whether weight was perceived as a problem, the expectation of weight loss and treatment-related beliefs influenced participants' perspectives towards weight loss. Understanding and assessing the contribution of each factor may guide weight management from clinicians treating patients with obesity and osteoarthritis. REPORTING METHOD: The data are reported using the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: Patients contributed to the data collected.
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Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Rodilla , Adulto , Humanos , Osteoartritis de la Rodilla/cirugía , Proyectos Piloto , Obesidad/cirugía , Pérdida de Peso , Investigación CualitativaRESUMEN
Nutrition scientists are currently facing a substantial challenge: to feed the world population sustainably and ethically while supporting the health of all individuals, animals and the environment. The Nutrition Society of Australia's 2022 Annual Scientific meeting theme 'Sustainable nutrition for a healthy life' was a timely conference focusing on the environmental impact of global, national and local food systems, how nutrition science can promote sustainable eating practices while respecting cultural and culinary diversity and how to ensure optimal nutrition throughout life to prevent and manage chronic diseases. Comprehensive, diverse, collaborative and forward-thinking research was presented in a 3 d programme of keynote presentations, oral and poster sessions, breakfast and lunch symposiums, ending with a panel discussion to answer the question of how we can best achieve a nutritious food supply that supports human and planetary health. We concluded that this complex issue necessitates coordinated efforts and multi-faceted responses at local, national and global levels. Collaboration among consumers, scientists, industry and government using a systems approach is vital for finding solutions to this challenge.
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Ambiente , Estado Nutricional , Animales , Humanos , Abastecimiento de Alimentos , Estado de Salud , Conducta AlimentariaRESUMEN
Despite the growing body of evidence demonstrating the positive health effects of the Mediterranean diet, it is not routinely recommended in practice and adherence is low in the general population in Australia. The knowledge-attitude-behaviour model explains how health behaviours are supported through a process of acquiring knowledge, developing attitudes, and forming behaviours. Evidence has suggested that having a high level of nutrition-related knowledge is associated with more positive attitudes, which is directly linked to positive dietary behaviours. However, reports of knowledge and attitudes towards the Mediterranean diet, and how these directly relate to behaviours in older adults, are lacking. This study explored Mediterranean diet-related knowledge, attitudes, and behaviours among community-dwelling older adults in Australia. Participants were adults aged 55 years and older who completed an online survey that contained three parts: (a) knowledge - Mediterranean Diet Nutrition Knowledge Questionnaire (Med-NKQ); (b) nutrition-related attitudes and behaviours, and barriers and enablers to dietary change; (c) demographics. The sample included 61 adults who ranged in age from 55 to 89 years. The overall knowledge score was 30.5 out of a possible 40 points, with 60.7% classified as having a high level of knowledge. Knowledge was lowest for nutrient content and label reading. Attitudes and behaviours were generally positive and were not associated with level of knowledge. The most common barriers to dietary change were perceived cost and lack of knowledge, and motivational factors. There are a number of key gaps in knowledge that should be addressed through targeted educational programs. Strategies and tools to overcome perceived barriers and improve self-efficacy are needed to facilitate positive dietary behaviours.
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Dieta Mediterránea , Humanos , Anciano , Conocimientos, Actitudes y Práctica en Salud , Dieta , Australia , Encuestas y CuestionariosRESUMEN
Mediterranean diet interventions have demonstrated positive effects in the prevention and management of several chronic conditions in older adults. Understanding the effective components of behavioural interventions is essential for long-term health behaviour change and translating evidence-based interventions into practice. The aim of this scoping review is to provide an overview of the current Mediterranean diet interventions for older adults (≥55 years) and describe the behaviour change techniques used as part of the interventions. A scoping review systematically searched Medline, Embase, CINAHL, Web of Science, Scopus, and PsycINFO from inception until August 2022. Eligible studies were randomized and non-randomized experimental studies involving a Mediterranean or anti-inflammatory diet intervention in older adults (average age > 55 years). Screening was conducted independently by two authors, with discrepancies being resolved by the senior author. Behaviour change techniques were assessed using the Behaviour Change Technique Taxonomy (version 1), which details 93 hierarchical techniques grouped into 16 categories. From 2385 articles, 31 studies were included in the final synthesis. Ten behaviour change taxonomy groupings and 19 techniques were reported across the 31 interventions. The mean number of techniques used was 5, with a range from 2 to 9. Common techniques included instruction on how to perform the behaviour (n = 31), social support (n = 24), providing information from a credible source (n = 16), information about health consequences (n = 15), and adding objects to the environment (n = 12). Although behaviour change techniques are commonly reported across interventions, the use of the Behaviour Change Technique Taxonomy for intervention development is rare, and more than 80% of the available techniques are not being utilised. Integrating behaviour change techniques in the development and reporting of nutrition interventions for older adults is essential for effectively targeting behaviours in both research and practice.
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Dieta Mediterránea , Humanos , Anciano , Persona de Mediana Edad , Conductas Relacionadas con la Salud , Terapia Conductista/métodos , Enfermedad Crónica , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Sound general and sports nutrition knowledge in athletes is essential for making appropriate dietary choices. Assessment of nutrition knowledge enables evaluation and tailoring of nutrition education. However, few well-validated tools are available to assess nutrition knowledge in athletes. The objective of the present study was to establish the validity of the Platform to Evaluate Athlete Knowledge Sports - Nutrition Questionnaire (PEAKS-NQ) for use in the United Kingdom and Irish (UK-I) athletes. To confirm content validity, twenty-three sports nutritionists (SNs) from elite, UK-I sports institutes provided feedback on the PEAKS-NQ via a modified Delphi method. After minor changes, the UK-I version of the PEAKS-NQ was administered to UK-I SN from the British Dietetic Association Sport and Exercise Nutrition Register, and elite athletes (EA) training at elite sports institutes in the UK and Ireland. Independent samples t-test and independent samples median tests were used to compare PEAKS-NQ total and subsection scores between EA and SN (to assess construct validity). Cronbach's alpha (good ≥ 0â 7) was used to establish internal consistency. The SN achieved greater overall [SN (n 23) 92â 3 (9â 3) v. EA (n 154): 71â 4 (10â 0)%; P < 0â 001] and individual section scores (P < 0â 001) except Section B, Identification of Food Groups (P = 0â 07). Largest knowledge differences between SN and EA were in Section D, Applied Sports Nutrition [SN: 88â 5 (8â 9) v. EA: 56â 7 (14â 5)%; P < 0â 00]. Overall ES was large (2â 1), with subsections ranging from 0â 6 to 2â 3. Cronbach's alpha was good (0â 83). The PEAKS-NQ had good content and construct validity, supporting its use to assess nutrition knowledge of UK-I athletes.
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Atletas , Educación en Salud , Humanos , Irlanda , Alimentos , Reino UnidoRESUMEN
BACKGROUND: Prior work suggests that higher fruit and vegetable consumption may protect against depression in older adults. Better understanding of the influence of genetic and environmental factors on fruit and vegetable intakes may lead to the design of more effective dietary strategies to increase intakes. In turn this may reduce the occurrence of depression in older adults. OBJECTIVES: The primary aim of this study is to estimate the genetic and environmental influences on the consumption of fruit and vegetables in older adults. The secondary aim is an exploratory analysis into possible shared genetic influences on fruit and vegetable intakes and depression. METHODS: Analysis of observational data from 374 twins (67.1% female; 208 monozygotic (MZ); 166 dizygotic (DZ)) aged ≥ 65 years drawn from the Older Australian Twins Study. Dietary data were obtained using a validated food frequency questionnaire and depressive symptoms were measured using the 15-item short form Geriatric Depression Scale. The contribution of genetic and environmental influences on fruit and vegetable intake were estimated by comparing MZ and DZ twin intakes using structural equation modelling. A tri-variate twin model was used to estimate the genetic and environmental correlation between total fruit and vegetable intakes and depression. RESULTS: In this study, vegetable intake was moderately influenced by genetics (0.39 95%CI 0.22, 0.54). Heritability was highest for brassica vegetables (0.40 95%CI 0.24, 0.54). Overall fruit intake was not significantly heritable. No significant genetic correlations were detected between fruit and vegetable intake and depressive symptoms. CONCLUSIONS: Vegetable consumption, particularly bitter tasting brassica vegetables, was significantly influenced by genetics, although environmental influences were also apparent. Consumption of fruit was only influenced by the environment, with no genetic influence detected, suggesting strategies targeting the food environment may be particularly effective for encouraging fruit consumption.
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Frutas , Verduras , Humanos , Femenino , Anciano , Masculino , Frutas/genética , Depresión/epidemiología , Depresión/genética , Australia/epidemiología , Dieta , Conducta AlimentariaRESUMEN
The present study aimed to assess the longitudinal associations of coffee and tea consumption with metabolic syndrome and its component conditions in a group of Australian older adults who participated in the Blue Mountains Eye Study (n 2554, mean age: 64 years, 43 % female). Participants' coffee and tea intake were measured using a validated food frequency questionnaire. Hazard ratios (HRs) over a 10-year period were estimated using Cox hazard regression models adjusting for lifestyle factors. Results showed that coffee consumption was not associated with the incidence of metabolic syndrome, high fasting glucose, high triglycerides, central obesity, high blood pressure and low HDL-cholesterol (HDL-C). Tea consumption was not associated with incidence of metabolic syndrome and the component conditions except for the risk of having low HDL-C, in which a nominally inverse association was observed (multivariate-adjusted HR at 2-3 cups/d: 0â 48, 95 % CI 0â 26, 0â 87, P = 0â 016; 4 cups/d or more: 0â 50, 95 % CI 0â 27, 0â 93, P = 0â 029). After stratifying for fruit consumption (P interaction between tea and fruit = 0â 007), consuming four cups of tea per day was nominally associated with lower incidence of metabolic syndrome among those with high fruit consumption (multivariable-adjusted HR: 0â 44, 95 % CI 0â 20, 0â 93, P = 0â 033). Our results did not support a significant association between tea and coffee consumption and metabolic syndrome. Tea consumption may be associated with a lower risk of having low HDL-C, while high tea and fruit consumption together may be associated with a lower risk of developing metabolic syndrome.
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Café , Síndrome Metabólico , Femenino , Humanos , Anciano , Persona de Mediana Edad , Masculino , Síndrome Metabólico/epidemiología , Té , Australia/epidemiología , Estilo de VidaRESUMEN
Vitamin C is an essential nutrient for humans and animals which are unable to synthesise it themselves. Vitamin C is important for tissue regeneration due to the role it plays in collagen formation, and its antioxidant properties. We reviewed the literature to evaluate potential associations between vitamin C supplementation and healing of an acute or chronic condition. Embase, Medline, PubMed, and the Cochrane Library were searched for studies published prior to April 2022. Studies were eligible if they reported at least one association between vitamin C supplementation and healing outcomes. Eighteen studies met the inclusion criteria and were included in this review. Overall, vitamin C supplementation improved healing outcomes in certain pathologies, predominantly pressure ulcers. However, many of the studies had small sample sizes, combined nutritional treatments, and did not test baseline vitamin C. Future studies should be of larger scale, exclusively using vitamin C to determine its role in tissue healing in other wounds. We recommend consideration of vitamin C supplementation for people with pressure ulcers.
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The Maintain Your Brain (MYB) trial is one of the largest internet-delivered multidomain randomised controlled trial designed to target modifiable risk factors for dementia. It comprises four intervention modules: physical activity, nutrition, mental health and cognitive training. This paper explains the MYB Nutrition Module, which is a fully online intervention promoting the adoption of the 'traditional' Mediterranean Diet (MedDiet) pattern for those participants reporting dietary intake that does not indicate adherence to a Mediterranean-type cuisine or those who have chronic diseases/risk factors for dementia known to benefit from this type of diet. Participants who were eligible for the Nutrition Module were assigned to one of the three diet streams: Main, Malnutrition and Alcohol group, according to their medical history and adherence to the MedDiet at baseline. A short dietary questionnaire was administered weekly during the first 10 weeks and then monthly during the 3-year follow-up to monitor whether participants adopted or maintained the MedDiet pattern during the intervention. As the Nutrition Module is a fully online intervention, resources that promoted self-efficacy, self-management and process of change were important elements to be included in the module development. The Nutrition Module is unique in that it is able to individualise the dietary advice according to both the medical and dietary history of each participant; the results from this unique intervention will contribute substantively to the evidence that links the Mediterranean-type diet with cognitive function and the prevention of dementia and will increase our understanding of the benefits of a MedDiet in a Western country.
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Disfunción Cognitiva , Demencia , Dieta Mediterránea , Encéfalo , Disfunción Cognitiva/prevención & control , Demencia/prevención & control , Humanos , InternetRESUMEN
BACKGROUND: We piloted an educational intervention that aimed to enhance awareness about nutrition-age-related macular degeneration (AMD) links among practising and student dietitians then expanded the scope of this intervention to include general eye health, which was delivered to pharmacy students. METHODS: A pilot intervention was conducted in 2019 at the Dietitians Australia Conference (Gold Coast, Australia) where practising and student dietitians underwent a 2-hour small group educational workshop on nutrition and AMD links. Pre-post questionnaires were administered to participants, with voluntary completion of both questionnaires an indicator of consent to participate in the intervention. The primary intervention outcome was a change in AMD-related nutrition knowledge pre-post intervention. A larger intervention was then conducted at the University of Sydney (Sydney, Australia) where pharmacy students underwent a 4-hour educational module to improve general eye health knowledge, as well as student perceptions and attitudes towards a pharmacists' role in low vision care. Similarly, pre-post questionnaires were administered, with voluntary completion of both questionnaires an indicator of consent to participate in the intervention. The primary intervention outcomes were changes in total knowledge, total perception and total attitude scores pre-post intervention. RESULTS: (1) Among 10 accredited and 5 student dietitians, there was significant overall knowledge improvement (mean pre-post score: 7.07 ± 1.94 vs. 10.8 ± 1.01, p = 0.001) specifically around appropriate dietary advice, food sources of key AMD-related nutrients, and awareness of supplements. (2) Among 179 second-year pharmacy students enrolled in the 'Pharmacy Practice' Unit of Study (Bachelor of Pharmacy, University of Sydney), total eye health knowledge (6.25 ± 1.93 vs. 6.64 ± 2.0; p = 0.011) significantly improved, along with total perception scores (41.54 ± 5.26 vs. 42.45 ± 4.95; p = 0.004). Total attitude scores were not significantly different. CONCLUSIONS: The pilot intervention improved relevant nutrition-AMD knowledge among practising/student dietitians. The modified intervention for pharmacy students also significantly improved general eye health knowledge as well as students' perception of a pharmacists' role in low vision care.
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Dietética , Educación en Farmacia , Servicios Farmacéuticos , Farmacia , Estudiantes de Farmacia , Humanos , Encuestas y CuestionariosRESUMEN
The Mediterranean diet (MD) has significant benefits for cardiovascular disease (CVD), yet clinicians lack reliable tools to measure patient knowledge. This study aimed to develop a short tool to test knowledge of MD related to cardiac health. Themes included foods to reduce CVD risk factors, quantification of servings, and common MD dietary patterns; a maximum score of 42 was determined for correct responses. Content validity was assessed through expert consensus in a Delphi survey. A 70% level of agreement was set for each domain tested. Repeatability was assessed via a test-retest protocol in a sample with self-reported CVD, advertised through social media and administered online. Ten and six of twenty-five invited experts responded to round one and two of the Delphi survey respectively. All items achieved greater than 70% consensus. Twenty people completed the repeatability study. A paired t-test found no significant difference in mean scores between the two test periods (Test one, 28 (standard deviation (SD) 5.4). Test two 29.5, (SD 5.5), p = 0.174) and a Bland-Altman Plot indicated no bias between the two surveys. The Med-NKQ demonstrated good content validity and reliability in people with CVD, and is short and easy to administer, making it practical in clinical and research settings.
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Enfermedades Cardiovasculares/prevención & control , Dieta Mediterránea , Conocimientos, Actitudes y Práctica en Salud , Encuestas y Cuestionarios/normas , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
This systematic review investigated the effects of weight-loss diets before elective surgery on preoperative weight loss and postoperative outcomes in people with obesity. Electronic databases were searched from inception to May 2021. Inclusion criteria were prospective cohort or randomised controlled studies that compared effects of weight-loss diets to standard care on postoperative outcomes in adults with obesity awaiting surgery. Participants with cancer or undergoing bariatric surgery were excluded. Data on preoperative weight change, length of stay, postoperative complications and patient-reported outcome measures were extracted and synthesised in meta-analyses. One randomised controlled trial involving total knee arthroplasty and two that investigated general surgery were eligible that included 173 participants overall. Each study compared low-calorie diets using meal replacement formulas to usual care. There is very-low-quality evidence of a statistically significant difference favouring the intervention for preoperative weight loss (mean difference [MD] -6.67 kg, 95% confidence interval [CI] -12.09 to -1.26 kg; p = 0.02) and low-quality evidence that preoperative weight-loss diets do not reduce postoperative complications to 30 days (odds ratio [OR] 0.34, 95% CI 0.08-1.42; p = 0.14) or length of stay (MD -3.72 h, 95% CI -10.76 to 3.32; p = 0.30). From the limited data that is of low quality, weight loss diets before elective surgery do not reduce postoperative complications.
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Dieta Reductora , Procedimientos Quirúrgicos Electivos , Adulto , Humanos , Obesidad/cirugía , Complicaciones Posoperatorias , Estudios ProspectivosRESUMEN
AIM: To systematically examine the longitudinal observational evidence between diet and the incidence of depression in adults aged 45 years and older. METHOD: Three electronic databases were searched for cohort studies published up to December 2020 that investigated the association between baseline dietary intake and incidence of depression in community-dwelling adults aged 45+years. Combined odds ratios (OR) and 95% confidence intervals (95%CI) were calculated. Random-effects models were used. RESULTS: In total 33 articles were included, with 21 combined in meta-analyses. Both the Dietary Inflammatory Index and the Western diet were associated with an increased odds of incident depression (Dietary Inflammatory Index: OR 1.33; 95%CI 1.04, 1.70; P = 0.02; Western: OR 1.15 95%CI 1.04, 1.26; P = 0.005). Higher fruit and vegetable intakes were associated with a reduced risk of incident depression (vegetables: OR 0.91; 95%CI 0.87, 0.96; P < 0.001; fruit: OR 0.85; 95%CI 0.81, 0.90; P < 0.001). No association was observed between the Mediterranean diet, "healthy" diet, fish intake and incident depression. CONCLUSIONS: Results suggest an association between higher consumption of pro-inflammatory diets and Western diets and increased incidence of depression, while higher intake of fruit and vegetables was associated with decreased incidence of depression. These results are limited by the observational nature of the evidence (results may reflect residual confounding) and the limited number of studies. More high-quality intervention and cohort studies are needed to confirm these associations and to extend this work to other food groups and dietary patterns.
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Depresión , Dieta Mediterránea , Anciano , Depresión/epidemiología , Dieta , Frutas , Humanos , Incidencia , Persona de Mediana Edad , Estudios Observacionales como Asunto , VerdurasRESUMEN
AIMS: To evaluate the nutrition knowledge of elite Australian athletes, and to obtain feedback from sports dietitians on the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaires' (PEAKS-NQ) suitability. METHODS: Sports dietitians from the National Institute Network across Australia recruited athletes to complete the online, 50-item PEAKS-NQ which contained two sections (General Nutrition and Sports Nutrition). Sports dietitians provided feedback on the PEAKS-NQ using a 14-item questionnaire (with two open-ended items). The main outcome measures were nutrition knowledge score and tool suitability (usefulness, acceptability and feasibility) scores. For knowledge scores, independent t-tests, ANOVA and Chi-square tests were used to evaluate differences between groups. Suitability was evaluated using descriptive statistics. RESULTS: Twelve sports dietitians from the National Institute Network in Australia recruited a convenience sample of 240 athletes (21.3 ± 4.3 years, 63.5% female, 63.3% competed internationally). Athletes scored 70.7 ± 10.5%, with better general vs sports nutrition knowledge. Females had higher overall scores (P < .001) with no differences for age or sport played. University-educated athletes scored higher than non-tertiary educated athletes (P = .004). Knowledge gaps were identified in fats (role and food sources), recovery nutrition and managing body composition. Sports dietitians rated suitability of PEAKS-NQ positively with complete agreement on 8 of 12 items. CONCLUSIONS: Athletes have greater understanding of general nutrition compared to sports nutrition concepts and may benefit from education on applying nutrition in sports-specific contexts. Sports dietitians' responses showed PEAKS-NQ was a highly acceptable, feasible and useful measure.
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Conocimientos, Actitudes y Práctica en Salud , Ciencias de la Nutrición y del Deporte , Atletas , Australia , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
Objectives: There is limited information about the dietary habits of patients with Parkinson's Disease (PD), or associations of diet with clinical PD features. We report on nutritional intake in an Australian PD cohort. Methods: 103 PD patients and 81 healthy controls (HCs) completed a validated, semi-quantitative food frequency questionnaire. Food and nutrient intake was quantified, with consideration of micronutrients and macronutrients (energy, protein, carbohydrate, fat, fibre, and added sugar). Participants also completed PD-validated non-motor symptom questionnaires to determine any relationships between dietary intake and clinical disease features. Results: Mean daily energy intake did not differ considerably between PD patients and HCs (11,131 kJ/day vs. 10,188 kJ/day, p = 0.241). However, PD patients reported greater total carbohydrate intake (279 g/day vs. 232 g/day, p = 0.034). This was largely attributable to increased daily sugar intake (153 g/day vs. 119 g/day, p = 0.003) and in particular free sugars (61 g/day vs. 41 g/day, p = 0.001). PD patients who (1) experienced chronic pain, (2) were depressed, or (3) reported an impulse control disorder, consumed more total sugars than HCs (all p < 0.05). Increased sugar consumption was associated with an increase in non-motor symptoms, including poorer quality of life, increased constipation severity and greater daily levodopa dose requirement. Conclusions: We provide clinically important insights into the dietary habits of PD patients that may inform simple dietary modifications that could alleviate disease symptoms and severity. The results of this study support clinician led promotion of healthy eating and careful management of patient nutrition as part of routine care.
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Background: The evidence regarding the association between added sugar (AS) intake and obesity remains inconsistent. The aim of this study was to investigate the association between changes in the percentage of energy intake from AS (EAS%) and changes in body weight in a cohort study of older Australians during 15 years of follow-up. In addition, associations were assessed according to whether EAS% intake was provided from beverage or non-beverage sources. Methods: Data were analyzed from the participants of the Blue Mountains Eye Study Cohort. Dietary data were collected at baseline (1992-94) and three five-yearly intervals using a 145-item food frequency questionnaire. Participants' body weight was measured at each time point. Five-yearly changes in EAS% intake and body weight were calculated (n = 1,713 at baseline). A generalized estimating equation (GEE) model was used to examine the relationship between the overall five-yearly changes in EAS% intake and body weight, adjusted for dietary and lifestyle variables. Results: In each time interval, the EAS% intake decreased by ~5% in the lowest quartile (Q1) and increased by ~5% in the highest quartile (Q4). The mean (SD) body weight change in Q1 and Q4 were 1.24 (8.10) kg and 1.57 (7.50) kg (first time interval), 0.08 (6.86) kg and -0.19 (5.63) kg (second time interval), and -1.22 (5.16) kg and -0.37 (5.47) kg (third time interval), respectively. In GEE analyses, the overall five-yearly change in EAS% intake was not significantly associated with body weight change (P trend = 0.837). Furthermore, no significant associations were observed between changes in EAS% intake from either beverage or non-beverage sources and changes in body weight (P trend for beverage sources = 0.621 and P trend for non-beverage sources = 0.626). Conclusion: The findings of this older Australian cohort do not support the association between changes in EAS% intake and body weight, regardless of AS food sources (beverage or non-beverage).
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AIM: Nutrition-based applications ("apps") offer enormous research potential, however evidence of their use and acceptability among older adults is limited. We compared self-reported and dietitian-adjusted dietary intake records among adults aged 55 to 75 years using the Research Food Diary (RFD) app. METHODS: Participants were recruited from the 45 and Up Study and completed a 3-day food record using the RFD. A follow-up dietetic telephone interview was performed to confirm the electronic dietary data. Independent of these interviews, a set of adjustments based on dietetic skills, nutritional database knowledge, food composition and dietary assessment was established to resolve probable reporting errors. The "adjusted" and "dietitian-assisted" records were compared to self-reported records for nutrient intakes and serves of The Five Food Groups using one-way repeated measures analysis of variance. RESULTS: Sixty-two participants were recruited, with 48 using the RFD app which included eight records without any identified errors. Reporting errors contained in the raw self-reported records included: food items with missing/implausible quantities or insufficient descriptions to allow automatic coding. After removal of unusable records, 44 records were analysed. Differences were found between the self-reported and adjusted records for protein, calcium, vitamin B12 , zinc and dairy food serves (all P < .001; differences up to 8%). No significant differences were found between the adjusted and dietitian-assisted measures. CONCLUSIONS: Similarities between adjusted and dietitian-assisted records suggest carefully applied dietetic assumptions are likely to improve accuracy of self-reported intake data where dietitian interviews are not possible. We provide four key recommendations to guide this process.