Cohort profile: the Diet and Healthy Aging (DaHA) study in Singapore.

How diet is related with cognition and health has not been systematically examined in Asians whose eating habits are very different from their counterparts in the West and the biological mechanisms underlying such links are not well known yet. The diet and healthy aging (DaHA) study is a community-based longitudinal study conducted to examine the role of diet and nutrition in promoting cognitive, emotional, and physical health among community-living elderly Singaporeans. The first wave of DaHA, conducted from 2011 to 2017, provided detailed information on diet and baseline cognitive function and health from 1010 community-living elderly in Singapore. Biomarkers of oxidative stress, systemic inflammation, and genetic information were collected. The ongoing second wave of DaHA is conducted from 2017 to 2020, which provides follow- up assessments using established cognitive tests and clinical tools. This well-characterized cohort, with its archived biological samples and high-quality data on diet and lifestyle factors will allow researchers to explore the relationships among diet, nutrition, genes, cognition, mental and physical health in an extremely cost-effective manner. Translations of the research findings into clinical and public health practices will potentially help to promote cognitive health at the population level and reduce healthcare costs related to cognitive impairment.

Personal values, marketing attitudes and nutrition trust are associated with patronage of convenience food outlets in the Asia-Pacific region: a cross-sectional study.

BACKGROUND: An online cross-sectional survey examined the relationships between the demographic characteristics, personal values, trust in sources of nutrition information and the use of convenience food outlets among middle-class household food providers in the Asia-Pacific region. METHODS: The survey was administered to 3945 household food providers in Melbourne, Singapore, Shanghai, Vietnam and Indonesia in late 2013. Information about demographics, personal values, trust in sources of nutrition information and use of convenience food outlets was elicited. Exploratory factor analysis, two-step clustering and logistic regression were employed. RESULTS: The analyses found that the use of convenience food outlets was positively related to hedonist values and trust in food industry sources of nutrition information. However, lesser use of convenience food outlets and trust in health sources of nutrition information was associated with traditional (community-oriented) values. CONCLUSIONS: Further replication and extension of these findings would be useful. However, they suggest that improvements in the quality of foods sold in convenience food outlets combined with stronger regulation of food marketing and long-term food education are required.

Family Food Providers' Perceptions of the Causes of Obesity and Effectiveness of Weight Control Strategies in Five Countries in the Asia Pacific Region: A Cross-Sectional Survey.

The rise of the middle classes in developing countries and the associated epidemiological transition raises the importance of assessing this population group's awareness of the causes of obesity and effective weight control strategies in order to develop effective health promotion strategies. The study aimed to examine the perceptions of the causes of obesity and weight control strategies held by middle class household food providers in Melbourne, Singapore, Shanghai, Indonesia and Vietnam. An online survey was conducted in late 2013, early 2014 among 3945 respondents. Information about body weight concerns, perceived causes of obesity, effectiveness of weight control methods, demographics, self-reported height and weight, and personal values was elicited. Confirmatory factor analyses (CFA) derived nine reliable factors which were used in structural equation modelling (SEM). Two thirds of respondents were trying to change their body weight, of them, 71% were trying to lose weight. The CFA and SEM showed that demographics, region of residence, personal values and perceptions of the causes of obesity (Unhealthy food behaviours, influences Beyond personal control and Environmental influences) had direct and indirect associations with three weight control methods factors, named: Healthy habits, Eat less, sit less, and Dieting. Middle class food providers in the study regions share public health views of obesity causation and personal weight control. These findings could inform public health and food policies, and the design of public health interventions and communications. Further research is required among lower socio economic status (SES) populations.

Dietary Behaviours, Impulsivity and Food Involvement: Identification of Three Consumer Segments.

This study aims to (1) identify consumer segments based on consumers' impulsivity and level of food involvement, and (2) examine the dietary behaviours of each consumer segment. An Internet-based cross-sectional survey was conducted among 530 respondents. The mean age of the participants was 49.2 ± 16.6 years, and 27% were tertiary educated. Two-stage cluster analysis revealed three distinct segments; "impulsive, involved" (33.4%), "rational, health conscious" (39.2%), and "uninvolved" (27.4%). The "impulsive, involved" segment was characterised by higher levels of impulsivity and food involvement (importance of food) compared to the other two segments. This segment also reported significantly more frequent consumption of fast foods, takeaways, convenience meals, salted snacks and use of ready-made sauces and mixes in cooking compared to the "rational, health conscious" consumers. They also reported higher frequency of preparing meals at home, cooking from scratch, using ready-made sauces and mixes in cooking and higher vegetable consumption compared to the "uninvolved" consumers. The findings show the need for customised approaches to the communication and promotion of healthy eating habits.

Current levels of salt knowledge: a review of the literature.

High salt intake increases the risk of hypertension and cardiovascular diseases. Given the role of knowledge as a determinant of food intake, this paper aims to review the current levels of salt knowledge and the association between salt knowledge and dietary salt intake and salt-related dietary practices in the general population. Twenty two studies were included in the review. In general, the studies showed consumers were able to identify the health risks associated with high salt intake. However, knowledge of recommended daily intakes, understanding of the relationships between salt and sodium and foods that contribute most salt to the diet were poor. Four of the five studies which examined the relationships between salt knowledge and salt-related dietary practices reported significant associations. Two important gaps in the current literature were identified. First, there is a need for a robustly validated tool to examine salt knowledge and its impact on salt intake. Second, a comprehensive salt knowledge assessment should include assessment of procedural, as well as declarative, knowledge.

Development and validation of a salt knowledge questionnaire.

OBJECTIVE: Initiatives promoting the reduction of high-salt food consumption by consumers need to be partly based on current levels of salt knowledge in the population. However, to date there is no validated salt knowledge questionnaire that could be used to assess population knowledge about dietary salt (i.e. salt knowledge). Therefore, the aim of the present study was to develop and validate a salt knowledge questionnaire. DESIGN: A cross-sectional study was conducted on an online web survey platform using convenience, snowball sampling. The survey questionnaire was evaluated for content and face validity before being administered to the respondents. SETTING: Online survey. SUBJECTS: A total of forty-one nutrition experts, thirty-two nutrition students and thirty-six lay people participated in the study. RESULTS: Item analyses were performed to evaluate the psychometric properties of the test items. Twenty-five items were retained to form the final set of questions. The total scores of the experts were higher than those of the students and lay people (P < 0·05). The total salt knowledge score showed significant correlations with use of salt at the table (ρ = -0·197, P < 0·05) and inspection of the salt content in food products when shopping (ρ = 0·400; P < 0·01). CONCLUSIONS: The questionnaire demonstrated sufficient evidence of construct validity and internal consistencies between the items. It is likely to be a useful tool for the evaluation and measurement of levels of salt knowledge in the general population.

A cluster-randomised, controlled trial to assess the impact of a workplace osteoporosis prevention intervention on the dietary and physical activity behaviours of working women: study protocol.

BACKGROUND: Osteoporosis is a debilitating disease and its risk can be reduced through adequate calcium consumption and physical activity. This protocol paper describes a workplace-based intervention targeting behaviour change in premenopausal women working in sedentary occupations. METHOD/DESIGN: A cluster-randomised design was used, comparing the efficacy of a tailored intervention to standard care. Workplaces were the clusters and units of randomisation and intervention. Sample size calculations incorporated the cluster design. Final number of clusters was determined to be 16, based on a cluster size of 20 and calcium intake parameters (effect size 250 mg, ICC 0.5 and standard deviation 290 mg) as it required the highest number of clusters.Sixteen workplaces were recruited from a pool of 97 workplaces and randomly assigned to intervention and control arms (eight in each). Women meeting specified inclusion criteria were then recruited to participate. Workplaces in the intervention arm received three participatory workshops and organisation wide educational activities. Workplaces in the control/standard care arm received print resources. Intervention workshops were guided by self-efficacy theory and included participatory activities such as goal setting, problem solving, local food sampling, exercise trials, group discussion and behaviour feedback.Outcomes measures were calcium intake (milligrams/day) and physical activity level (duration: minutes/week), measured at baseline, four weeks and six months post intervention. DISCUSSION: This study addresses the current lack of evidence for behaviour change interventions focussing on osteoporosis prevention. It addresses missed opportunities of using workplaces as a platform to target high-risk individuals with sedentary occupations. The intervention was designed to modify behaviour levels to bring about risk reduction. It is the first to address dietary and physical activity components each with unique intervention strategies in the context of osteoporosis prevention. The intervention used locally relevant behavioural strategies previously shown to support good outcomes in other countries. The combination of these elements have not been incorporated in similar studies in the past, supporting the study hypothesis that the intervention will be more efficacious than standard practice in osteoporosis prevention through improvements in calcium intake and physical activity.

An examination of the mediating role of salt knowledge and beliefs on the relationship between socio-demographic factors and discretionary salt use: a cross-sectional study.

BACKGROUND: Discretionary salt use varies according to socio-demographic factors. However, it is unknown whether salt knowledge and beliefs mediate this relationship. This study examined the direct and indirect effect of socio-demographic factors on salt knowledge and discretionary salt use in a sample of 530 Australian adults. METHODS: An internet based cross-sectional survey was used to collect data for this study. Participants completed an online questionnaire which assessed their salt knowledge, beliefs and salt use behaviour. Mplus was used to conduct structural equation modelling to estimate direct and indirect effects. RESULTS: The mean age of the participants was 49.2 years, and about a third had tertiary education. Discretionary salt use was inversely related to age (r=-0.11; p<0.05), and declarative salt knowledge (knowledge of factual information) scores (r = -0.17; p<0.01), but was positively correlated with misconceptions about salt (r = 0.09; p<0.05) and beliefs about the taste of salt (r = 0.51; p<0.001). Structural equation modelling showed age, education and gender were indirectly associated with the use of discretionary salt through three mediating pathways; declarative salt knowledge, misconceptions about salt and salt taste beliefs. CONCLUSIONS: Inequalities observed between socio-demographic groups in their use of discretionary salt use can potentially be reduced through targeted salt knowledge and awareness campaigns.