Exploring the role of social support and social media for lifestyle interventions to prevent weight gain with young adults: Focus group findings.

BACKGROUND: Young adults gain more weight annually than other adults and may be destined for future obesity. Effective interventions are needed, and social support may be a key element for success. The present study explores how best to leverage social media to support young adults with their health goals in a healthy lifestyle programme. METHOD: Young adults aged 18-25 years were recruited from the community to a series of four focus groups led by an experienced facilitator who used a discussion guide developed a priori. The discussion explored their opinions regarding which social media platforms were appropriate for providing social support, the types of support that were relevant (family and friends versus strangers) and factors that would encourage peer-to-peer communication in a healthy lifestyle intervention. Sessions were audio-taped, transcribed and analysed using the qualitative software, nvivo, version 11 (QSR International Pty Ltd., Melbourne, VIC, Australia). Themes were generated using an inductive approach informed by the Theory of Social Identity and Social Influence Model of Consumer Participation. RESULTS: Thirty-three people (12 male) participated. Facebook was the most popular platform for facilitating social support as a result of its private group capabilities and already being embedded into their daily routines. The preference was to be grouped with strangers who shared similar goals in smaller groups of participants. The discussions highlighted the integral role of a credible and relatable health coach to serve as a mentor, mediator and role model. CONCLUSIONS: The learnings from this research will be applied to optimise engagement within social media support groups in lifestyle interventions.

Cost effectiveness of dietitian-led nutrition therapy for people with type 2 diabetes mellitus: a scoping review.

BACKGROUND: The management of diabetes costs in excess of $1.3 trillion per annum worldwide. Diet is central to the management of type 2 diabetes. It is not known whether dietetic intervention is cost effective. This scoping review aimed to map the existing literature concerning the cost effectiveness of medical nutrition therapy provided by dietitians for people with type 2 diabetes. METHODS: Thirteen scientific databases, including MEDLINE, EMBASE and CINAHL, as well as multiple official websites, were searched to source peer-reviewed articles, reports, guidelines, dissertations and other grey literature published from 2008 to present. Eligible articles had to have assessed and reported the cost effectiveness of dietetic intervention for adults with type 2 diabetes in developed countries. Experimental, quasi-experimental, observational and qualitative studies were considered. RESULTS: Of 2387 abstracts assessed for eligibility, four studies combining 22 765 adults with type 2 diabetes were included. Dietetic intervention was shown to be cost-effective in terms of diabetes-related healthcare costs and hospital charges, at the same time as also reducing the risk of cumulative days at work lost to less than half and the risk of disability 'sick' days at work to less than one-seventh. CONCLUSIONS: The findings highlight the importance of advocacy for medical nutrition therapy for people with type 2 diabetes, with respect to alleviating the great global economic burden from this condition. Further studies are warranted to elucidate the factors that mediate and moderate cost effectiveness and to allow for the generalisation of the findings.

The barriers and enablers to achieving adequate calcium intake in young adults: a qualitative study using focus groups.

BACKGROUND: Despite the established benefits of calcium consumption, many young Australians are not meeting the recommendations for calcium intake. This is concerning because an adequate calcium consumption is important throughout young adulthood to reach peak bone mass and for the prevention of osteoporosis. Therefore, the present study aimed to explore the barriers and enablers to consuming calcium-rich foods with young adults. METHODS: Using a semi-structured question guide, five focus group discussions were conducted with 39 participants [mean (SD) age 22.5 (1.8) years]. Participants were mostly females (n = 29) and enrolled in tertiary education (n = 31). A deductive approach was used to group common ideas into themes. The findings from the focus groups were analysed using the COM-B framework, which examines the interactions between three key components (i.e. capability, opportunity and motivation). RESULTS: On examining the young adults' capability to consume a diet adequate in calcium, it was found that young adults had limited knowledge of sources, prevention of disease and recommended amounts. Some participants voiced physical barriers to consumption (lactose intolerance). Opportunity was reported as a physical (availability of calcium-rich foods), financial and social opportunity. Some participants reported motivation to include dairy as a result of the habit becoming engrained during their childhood under parental influence (automatic motivation), whereas others reflected on a lack of awareness relating to inadequacy and health consequences (reflective motivation). CONCLUSIONS: Although social media was seen to be an acceptable mode of intervention, concerns were raised about the source and credibility of the information. The findings may inform the development of future interventions targeting eating habits of young adults.

The relationship between process use and stage of change for sugary drinks.

BACKGROUND: Decreasing sugar-sweetened beverage consumption may reduce obesity and obesity-related diseases. To better understand what processes could facilitate a reduction in sugary beverage intake, we examined the relationship between stage-of-change and use of 10 processes of change. Secondarily, reliability of the measure was assessed. METHODS: A cross-sectional study was conducted, using a newly developed stage-of-change and process of change questionnaire. Participants (n = 105; male, n = 28) were aged between 18 and 60 years. A one-way analysis of variance, with Tukey's and Benjamini-Hochberg post hoc tests, was used to compare process use by stages. Paired t-tests were used to compare total cognitive and total behavioural process use within each stage. Cronbach's α coefficient and mean inter-item correlation was used to assess internal consistency. Reliability of repeated items was examined using kappa. RESULTS: Cognitive and behavioural processes were used more in the contemplation/preparation and maintenance stages than in precontemplation (all P < 0.05). Compared to precontemplation, process use was significantly higher in contemplation/preparation for five individual processes, action for four processes and maintenance for five processes. The use of dramatic relief and self liberation was lower in maintenance than contemplation/preparation. Across the stages, the use of eight of the 10 processes differed. The use of consciousness raising, self re-evaluation and self liberation differed between stages more frequently than other processes. CONCLUSIONS: The use of many processes differed by stage and could be incorporated into programmes aiming to assist adults in reducing their consumption of sugary drinks.

Effectiveness of lifestyle interventions for preventing harmful weight gain among young adults from lower socioeconomic status and ethnically diverse backgrounds: a systematic review.

The incidence of overweight and obesity are increasing with each successive generation of young adults. Associated co-morbidities will emerge at an earlier age unless weight gain is prevented. Evidence has demonstrated young adults (aged 18-35 years) from low socioeconomic and ethnically diverse backgrounds are at greater risk of overweight or obesity, yet it is unclear how to effectively intervene in this population. This systematic review aimed to assess the effectiveness of lifestyle interventions conducted in this population. Thirty studies reporting on lifestyle interventions for prevention of weight gain were identified from eight electronic databases searched. Six interventions included subgroup analyses to determine if ethnicity moderated weight change, and two included subgroup analyses to determine if socioeconomic status had an effect on change in weight. Five of these six studies were effective in preventing weight gain, and subgroup analyses showed no differences in effect by ethnicity. Of these five studies, two included a subgroup analysis that showed socioeconomic status to have no effect on weight outcome. Despite the promising results from these five lifestyle interventions utilizing online and mobile components to effectively reach and prevent weight gain in this priority population, the evidence base of high quality trials is limited.

The use of smartphone health apps and other mobile health (mHealth) technologies in dietetic practice: a three country study.

BACKGROUND: Smartphone health applications (apps) and other mobile health (mHealth) technologies may assist dietitians in improving the efficiency of patient care. The present study investigated the use of health apps and text messaging in dietetic practice and formulated intervention recommendations for supporting app uptake by dietitians based on the behavioural 'COM-B' system, where interactions between capability, opportunity and motivation influence behaviour. METHODS: A 52-item online survey tool, taking 20 min to complete, was developed and piloted, with questions exploring the use of health apps and text messaging in dietetic practice, types of apps dietitians recommended and that patients used, and barriers and enablers to app use in dietetic practice. The Australian, New Zealand and British dietetic associations distributed the survey to their members. RESULTS: A 5% response rate was achieved internationally, with 570 completed responses included for further analysis. Health apps, namely nutrition apps, were used by 62% of dietitians in their practice, primarily as an information resource (74%) and for patient self-monitoring (60%). The top two nutrition apps recommended were MyFitnessPal® (62%) and the Monash University Low FODMAP Diet® (44%). Text messaging was used by 51% of respondents, mainly for appointment-related purposes (84%). CONCLUSIONS: Although the reported use of smartphone health apps in dietetic practice is high, health apps and other mHealth technologies are not currently being used for behaviour change, nor are they an integral part of the nutrition care process. Dietetic associations should provide training, education and advocacy to enable the profession to more effectively engage with and implement apps into their practice.

Validity of short food questionnaire items to measure intake in children and adolescents: a systematic review.

BACKGROUND: Short food questions are appealing to measure dietary intakes. METHODS: A review of studies published between 2004 and 2016 was undertaken and these were included in the present study if they reported on a question or short item questionnaire (≤50 items, data presented as ≤30 food groups) measuring food intake or food-related habits, in children (aged 6 months to 18 years), and reported question validity or reliability. Thirty studies met the inclusion criteria. RESULTS: Most questions assessed foods or food groups (n = 29), with the most commonly assessed being fruit (n = 22) or vegetable intake (n = 23), dairy foods and discretionary foods (n = 20 studies each). Four studies assessed food habits, with the most common being breakfast and meal frequency (n = 4 studies). Twenty studies assessed reliability, and 25 studies determined accuracy and were most commonly compared against food records. Evaluation of question performance relied on statistical tests such as correlation. CONCLUSIONS: The present study has identified valid and reliable questions for the range of key food groups of interest to public health nutrition. Questions were more likely to be reliable than accurate, and relatively few questions were both reliable and accurate. Gaps in repeatable and valid short food questions have been identified that will provide direction for future tool development.

The barriers and enablers of healthy eating among young adults: a missing piece of the obesity puzzle: A scoping review.

Young adults in Western countries are gaining weight faster than their parents and are more likely to gain weight than any other age cohort. Despite this, investigation into the complex young adults' food choice motives, which enable and prevent healthy eating, has not been widely investigated. A scoping review was conducted involving an extensive literature search of four major electronic databases: Medline, Embase, PsychInfo and CINAHL. Data were collected from 34 articles: study descriptions numerically analysed and key findings thematically analysed. The key barriers found included: male apathy towards diet; unhealthy diet of friends and family; expected consumption of unhealthy foods in certain situations; relative low cost of unhealthy foods; lack of time to plan, shop, prepare and cook healthy foods; lack of facilities to prepare, cook and store healthy foods; widespread presence of unhealthy foods; lack of knowledge and skills to plan, shop, prepare and cook healthy foods; lack of motivation to eat healthily (including risk-taking behaviour). The key enablers found included: female interest in a healthy diet; healthy diet of friends and family; support/encouragement of friends and family to eat healthy; desire for improved health; desire for weight management; desire for improved self-esteem; desire for attractiveness to potential partners and others; possessing autonomous motivation to eat healthy and existence and use of self-regulatory skills. This research provides evidence that can be used to tailor interventions for healthy eating and overweight and obesity in this population. However, government intervention in addressing food access, affordability, marketing and taxation remains essential to any significant change.

Description, measurement and evaluation of tertiary-education food environments.

Obesity in young adults is an increasing health problem in Australia and many other countries. Evidence-based information is needed to guide interventions that reduce the obesity-promoting elements in tertiary-education environments. In a food environmental audit survey, 252 outlets were audited across seven institutions: three universities and four technical and further education institutions campuses. A scoring instrument called the food environment-quality index was developed and used to assess all food outlets on these campuses. Information was collated on the availability, accessibility and promotion of foods and beverages and a composite score (maximum score=148; higher score indicates healthier outlets) was calculated. Each outlet and the overall campus were ranked into tertiles based on their 'healthiness'. Differences in median scores for each outcome measure were compared between institutions and outlet types using one-way ANOVA with post hoc Scheffe's testing, χ 2 tests, Kruskal-Wallis H test and the Mann-Whitney U test. Binomial logistic regressions were used to compare the proportion of healthy v. unhealthy food categories across different types of outlets. Overall, the most frequently available items were sugar-sweetened beverages (20 % of all food/drink items) followed by chocolates (12 %), high-energy (>600 kJ/serve) foods (10 %), chips (10 %) and confectionery (10 %). Healthy food and beverages were observed to be less available, accessible and promoted than unhealthy options. The median score across all outlets was 72 (interquartile range=7). Tertiary-education food environments are dominated by high-energy, nutrient-poor foods and beverages. Interventions to decrease availability, accessibility and promotion of unhealthy foods are needed.

Prevalence and period trends of overweight and obesity in Australian young adults.

This analysis examines period trends in body weight of Australian 18-24 year olds. Secondary analysis of National Health Surveys was performed, including examination of socio-demographic determinants of obesity. The prevalence of overweight and obesity has increased from 24.0 and 5.1% in males and 13.2 and 5.8% in females, respectively, in 1995 to 29.3 and 13.8% in males and 20.6 and 20.6% in females in 2012. Mean body mass index (BMI) increased over time from 23.7 (s.d. 3.5) for males and 22.4 (s.d. 4.0) for females in 1995 to 25.2 (s.d. 4.8) and 25.5 (s.d. 5.9) in 2011/2. Lower educational attainment increased the odds of having BMI⩾25.00 kg/m(2) for both sexes (P=0.03 males and P<0.001 females). Overweight and obesity were higher in rural females (P<0.05) and those socio-economically disadvantaged (P<0.0001). The obesity epidemic has worsened for Australian young adults and in particular young females.

Strategies for successful recruitment of young adults to healthy lifestyle programmes for the prevention of weight gain: a systematic review.

Recruiting healthy young adults, aged 18-35, to lifestyle programmes for prevention of weight gain is challenging but important given their increasing rates of obesity. This review aimed to examine the success of different recruitment strategies. A systematic literature search identified 26 separate studies using 10 electronic databases. Participant characteristics and efficacy of interventions were well reported in all studies, but reporting of recruitment procedures, costs, times and effectiveness was minimal. Of those reporting recruitment, both active (e.g. face-to-face) and passive (e.g. print-media and mass-mailings) approaches were identified with the latter most frequently employed. Novel strategies such as social media and marketing approaches were identified. Television and radio have potentially high reach but low efficiency with high cost compared with mass-mailings which yield high numbers of participants. Marketing campaigns appeared to be a promising approach. Incentives demonstrated enhanced recruitment. The use of formative research to guide recruitment strategies for interventions is recommended. Reporting of success, cost and timelines for recruitment should be included in reporting of future trials. This first synthesis of recruitment information can be used to inform recruitment frameworks for lifestyle programmes seeking to attract young adults.

A systematic literature review of nutrition interventions in vending machines that encourage consumers to make healthier choices.

UNLABELLED: Internationally, vending machines are scrutinized for selling energy-dense nutrient-poor foods and beverages, and the contribution to overconsumption and subsequent risk of obesity. The aim of this review is to determine the efficacy of nutrition interventions in vending machine in eliciting behaviour change to improve diet quality or weight status of consumers. Electronic databases Cochrane, EMBASE, CINAHL, Science Direct and PubMed were searched from inception. INCLUSION CRITERIA: (i) populations that have access to vending machines; (ii) nutrition interventions; (iii) measured outcomes of behaviour change (e.g. sales data, dietary intake or weight change); and (iv) experimental trials where controls were not exposed to the intervention. Risk of bias was assessed independently by two researchers, and higher quality research formed the basis of this qualitative review. Twelve articles from 136 searched were included for synthesis. Intervention settings included schools, universities and workplaces. Reducing price or increasing the availability increased sales of healthier choices. The results of point-of-purchase nutrition information interventions were heterogeneous and when measured changes to purchases were small. This review offers evidence that pricing and availability strategies are effective at improving the nutritional quality foods and beverages purchased from vending machines. Evidence on how these interventions alter consumer's overall diet or body mass index is needed.

Relative Validity of a Diet History Questionnaire Against a Four-Day Weighed Food Record among Older Men in Australia: The Concord Health and Ageing in Men Project (CHAMP).

OBJECTIVES: To evaluate the relative validity of the diet history questionnaire (DHQ) used in the Concord Health and Ageing in Men Project (CHAMP) against a four-day weighed food record (4dWFR) as the reference method. DESIGN AND MEASUREMENTS: Detailed DHQ followed by a 4dWFR were completed between July 2012 and October of 2013. SETTING: Burwood, Canada Bay and Strathfield in Sydney, Australia. PARTICIPANTS: Fifty six community- dwelling men aged 75 years and over (mean=79 years). RESULTS: DHQ estimates of intakes were generally higher than estimates from 4dWFR. Differences between the two methods were generally less than 20% with the exception of ß-carotene (37%). Fixed and proportional biases were only present for retinol, ß-carotene, magnesium, phosphorus and percentage of energy from protein; however, 95% limits of agreement were in some cases wide. Pearson correlation coefficient of log-transformed unadjusted values ranged from 0.15 (zinc) to 0.70 (alcohol), and from 0.06 (iron) to 0.63 (thiamin) after energy-adjustment. Spearman's correlation coefficients ranged from 0.16 (zinc) to 0.80 (alcohol) before energy adjustment, and from 0.15(zinc) to 0.81(alcohol) after energy adjustment. CONCLUSION: Our findings suggest that the DHQ used in CHAMP to measure the nutritional intake of its participants is appropriate to this age group and provides reasonably similar results to the 4dWFR for the majority of nutrients analysed.

You are what you choose to eat: factors influencing young adults' food selection behaviour.

BACKGROUND: Young or 'emerging' adulthood (ages 18-24 years) is a life-stage characterised by rapid weight gain, particularly among those born in recent decades, when environments have become saturated with cheap, highly palatable, processed foods. Although intervening in the immediate food environments of emerging adults is indicated, little is known about the factors influencing their food selection. The present study aimed to: (i) measure the relative importance of different influences on foods selected by emerging adults for consumption from a tertiary education setting and (ii) examine whether these influences differ according to gender, adiposity status, perceived stress and dieting or physical activity behaviours. METHODS: An online survey was administered with 112 emerging adults aged 19-24 years assessing demographics, perceived stress, dieting, physical activity and influences on food selection. Adiposity indicators (body mass index and waist circumference) were measured. Analyses compared the importance of influences on food selection by gender, adiposity, perceived stress, dieting and physical activity. RESULTS: Taste was the most important influence on food selection, followed by convenience (availability), cost, nutrition/health value, smell and stimulatory properties (alertness). Participants with an elevated waist circumference selected foods to help them cope with stress and control their weight. Those reporting a higher level of physical activity placed greater importance on nutritional/health value of foods but less importance on taste. Female dieters also placed less importance on taste and value for money. CONCLUSIONS: Health promotion strategies addressing tertiary education food environments of emerging adults should ensure the ready availability of tasty and nutritious foods at a low cost.

Poor quality of external validity reporting limits generalizability of overweight and/or obesity lifestyle prevention interventions in young adults: a systematic review.

Young adulthood is a high-risk life stage for weight gain. Evidence is needed to translate behavioural approaches into community practice to prevent weight gain in young adults. This systematic review assessed the effectiveness and reporting of external validity components in prevention interventions. The search was limited to randomized controlled trial (RCT) lifestyle interventions for the prevention of weight gain in young adults (18-35 years). Mean body weight and/or body mass index (BMI) change were the primary outcomes. External validity, quality assessment and risk of bias tools were applied to all studies. Twenty-one RCTs were identified through 14 major electronic databases. Over half of the studies were effective in the short term for significantly reducing body weight and/or BMI; however, few showed long-term maintenance. All studies lacked full reporting on external validity components. Description of the intervention components and participant attrition rates were reported by most studies. However, few studies reported the representativeness of participants, effectiveness of recruitment methods, process evaluation detail or costs. It is unclear from the information reported how to implement the interventions into community practice. Integrated reporting of intervention effectiveness and enhanced reporting of external validity components are needed for the translation and potential upscale of prevention strategies.

Liquid versus solid energy intake in relation to body composition among Australian children.

BACKGROUND: The debate about whether energy consumed in liquid form is more obesogenic than energy consumed in solid form remains equivocal. We aimed to evaluate the effects of liquid versus solid energy intake and different beverage types on changes in childhood adiposity. METHODS: Our analyses included 8-year-old Australian children (n = 158) participating in the Childhood Asthma Prevention Study. Dietary information was collected using three 24-h recalls at age 9 years. Multivariate linear regression was used to evaluate the effects of liquid versus solid energy intake and different beverage types on changes in body mass index (BMI) Z-score from ages 8 to 11.5 years (△BMIz(8-11.5y)) and percentage body fat (%BF) at age 11.5 years (%BF(11.5y)). Substitution models were used to evaluate the effects of substituting other beverage types for sugar-sweetened beverages (SSB). RESULTS: Liquid energy intake (1 MJ day(-1)) was more closely associated with both △BMIz(8-11.5y) (ß = 0.23, P = 0.02) and %BF(11.5y) (ß = 2.31%, P = 0.01) than solid energy intake (△BMIz(8-11.5y): ß = 0.12, P = 0.01 and %BF(11.5y): ß = 0.80%, P = 0.07). SSB consumption (100 g day(-1)) was directly associated with △BMIz(8-11.5y) (ß = 0.08, P = 0.02) and %BF(11.5y) (ß = 0.92%, P = 0.004),whereas diet drinks (100 g day(-1) ) were inversely associated with △BMIz(8-11.5y) (ß = 0.18, P = 0.02). Substitution of 100 g of SSB by 100 g of water or diet drink, but not other beverages, was inversely associated with both △BMIz(8-11.5y) and %BF(11.5y) (P < 0.01). CONCLUSIONS: Our findings indicate that liquid energy is more obesogenic than solid energy. In particular, SSB, but not other beverage types, are a significant predictor of childhood adiposity and replacing SSB with water can have long-term beneficial effects on childhood adiposity.

A systematic review and meta-analysis of interventions for weight management using text messaging.

BACKGROUND: Obesity prevalence continues to increase worldwide, with significant associated chronic disease and health cost implications. Among more recent innovations in health service provision is the use of text messaging for health behaviour change interventions including weight management. This review investigates the efficacy of weight management programmes incorporating text messaging. METHODS: Medical and scientific databases were searched from January 1993 to October 2013. Eligibility criteria included randomised controlled trials (RCTs), pseudoRCTs and before and after studies of weight management, among healthy children and adults, that used text messaging and included a nutrition component. Data extraction and quality assessment followed guidelines from PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and the Evidence Analysis Manual of the American Academy of Nutrition and Dietetics. RESULTS: From 512 manuscripts retrieved, 14 met the inclusion criteria (five manuscripts in children and nine in adults). Duration of interventions ranged from 1 to 24 months. Frequency of text messaging was from daily to fortnightly. Six studies in adults were included in a meta-analysis with mean body weight change as the primary outcome. The weighted mean change in body weight in intervention participants was -2.56 kg (95% confidence interval = -3.46 to -1.65) and in controls -0.37 kg (95% confidence interval = -1.22 to 0.48). CONCLUSIONS: The small body of evidence indicates that text messaging interventions can promote weight loss. However, lack of long-term results indicate that further efficacy studies are required. Future investigations should elucidate the determinants, such as intervention duration, text message frequency and level of interactivity that maximise the success and cost effectiveness of the delivery medium.

Systematic review: the treatment of muscle cramps in patients with cirrhosis.

BACKGROUND: Up to 88% of patients with hepatic cirrhosis experience painful muscle cramps resulting in sleep deprivation and impaired quality of life. Management is often based on poor evidence with varying degrees of success in controlling the frequency and severity of muscle cramps in this group. AIM: To review systematically the treatment options for muscle cramps in cirrhosis. METHODS: A systematic review of the relevant databases to identify treatments for muscle cramps in patients with hepatic cirrhosis was performed. Studies meeting the selection criteria were reviewed and quality of the papers was rated using a validated quality rating scale. The results for each treatment are reported. RESULTS: Eighteen publications were identified as eligible for inclusion in this systematic review. The majority (n = 15) of these were treatment/intervention reports. Only three randomised-control studies were identified. A wide range of treatments were identified including zinc, 1-α-hydroxy vitamin D, vitamin E, branched chain amino acids, taurine, l-carnitine, nuiche-shen-qi-wen, eperisone hydrochloride, intravenous albumin and quinidine. There were some reported improvements in muscle cramps with most interventions with the exception of vitamin E but the evidence predominantly relies on case study reports. There is a lack of randomised-controlled clinical studies to support using these interventions. CONCLUSIONS: There appear to be a number of promising treatments for muscle cramps in cirrhosis. However, there remains a need for further double-blinded, randomised, controlled clinical investigations to support routine use of these interventions to treat muscle cramps in patients with hepatic cirrhosis.

Misreporting of energy intake in the 2007 Australian Children's Survey: differences in the reporting of food types between plausible, under- and over-reporters of energy intake.

BACKGROUND: Misreporting is common when collecting dietary intake data, although relatively little is known about the types of foods misreported among children. The present study aimed to identify differences in the reporting of food types between plausible and misreporters of energy intake in a national nutrition survey of Australian children. METHODS: Dietary data were collected using a 24-h recall from 4826 children aged 2-16 years who were participating in the 2007 Australian National Children's Nutrition and Physical Activity Survey. Misreporters of energy intake were classified using the Goldberg criteria. Differences in the reporting of a range of food types were examined between plausible, under- and over-reporters. RESULTS: Compared with plausible reporters, under-reporters reported less frequent consumption and smaller quantities of consumption of both core and noncore foods. Older children (self-report) under-reported a larger selection of noncore foods than younger children (parental report). Over-reporters reported similar percentages of consumption of many core and noncore foods, with some exceptions. The quantities consumed by over-reporters were generally much larger and this was evident in younger and older children. Compared with plausible reporters, under-reporters had significantly higher intakes of protein and starch but lower intakes of sugar and fat, as percentage energy, than plausible reporters, whereas over-reporters had higher fat and lower carbohydrate intakes. CONCLUSIONS: Differences in the reporting of food types were common between plausible, under- and over-reporters of energy intake by children (or their parents) and were not restricted to noncore foods.

Sugar-sweetened beverages consumption in relation to changes in body fatness over 6 and 12 years among 9-year-old children: the European Youth Heart Study.

BACKGROUND/OBJECTIVES: In parallel with the obesity epidemic, consumption of sugar-sweetened beverages (SSB) has risen over the same period. Our aim was to investigate associations between the consumption of SSB in childhood and adolescence with subsequent changes in body fatness in early adulthood. SUBJECTS/METHODS: A longitudinal study of 9-year-old children (n=283) enrolled in the Danish part of the European Youth Heart Study with a 6-year and 12-year follow-up. Data were collected at ages 9, 15 and 21 years. Multivariate regression analyses with adjustment for potential confounders were used to evaluate the effect of SSB consumption at 9 and 15 years and change in SSB consumption from 9-15 years on subsequent change in body fatness until 21 years. RESULTS: Subjects who consumed more than one serve of SSB daily at age 15 years had larger increases in body mass index (BMI) (ß=0.92, P=0.046) and waist circumference (WC) (ß=2.69, P=0.04) compared to non-consumers over the subsequent 6 years. In addition, subjects who increased their SSB consumption from age 9-15 years also had larger increases in BMI (ß=0.91, P=0.09) and WC (ß=2.72, P=0.04) from 15-21 years, compared to those who reported no change in consumption. No significant association was observed from 9-21 years. CONCLUSION: This study provides new evidence that SSB consumption in adolescence and changes in SSB consumption from childhood to adolescence are both significant predictors of change in body fatness later in early adulthood.