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1.
Nutrients ; 13(9)2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34578885

RESUMO

The obesity epidemic in adolescents from Middle Eastern (ME) backgrounds necessitates co-designed and culturally-responsive interventions. This study's objective was to gather the opinions, attitudes, capabilities, opportunities and motivations of ME adolescents residing in Australia on healthy eating and physical activity (PA) behaviours to inform a future prevention program. Five focus groups were conducted, with 32 ME participants, aged 13-18 years, recruited via purposive and snowball sampling. More participants were female (n = 19) and from lower socioeconomic areas (n = 25). A reflexive thematic analysis was performed using the Capability, Opportunity, Motivation-Behaviour (COM-B) model as the coding framework. Limited nutritional knowledge and cooking skills accompanied by a desire to make dietary changes were reported. Local and school facilities provided adolescents with PA opportunities, but participants declared safety concerns and limited opportunities for females and older grade students. Social support from family and friends were enablers for both healthy eating and PA. Cravings and desire for cultural foods influenced food choices. Individual and/or group approaches using social media and face-to-face format were recommended for future programs. To enable PA and dietary behaviour changes, interventions should be specifically tailored for ME adolescents to improve their nutrition literacy and skills, along with providing safe environments for sport in conjunction with social support.

2.
J Acad Nutr Diet ; 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34352437

RESUMO

BACKGROUND: University students may experience a high prevalence of food insecurity. The impacts of food insecurity on dietary intake and meal patterns of students have not been fully researched. OBJECTIVE: This systematic review aimed to examine the association between food insecurity and dietary outcomes among university students. METHODS: Nine electronic databases and gray literature were searched from their inception to July 2020. Studies that reported dietary outcomes in both food-secure and -insecure students or the association between food insecurity and dietary outcomes among current students in tertiary education settings in any country were included. All study designs were eligible for inclusion, except qualitative studies. Two reviewers completed the screening, data extraction, and quality assessment independently. Study quality was assessed using the Joanna Briggs Institute appraisal tools. RESULTS: Sixteen studies were included in the final qualitative synthesis of this review. Most studies were cross-sectional designs and of fair quality. The prevalence of food insecurity among university students ranged from 21% to 82% across studies. Lower intakes of healthy foods (eg, fruits, vegetables, and whole grains) and higher intakes of unhealthy foods (eg, fast foods, added sugars, and sugar-sweetened beverages) were observed in food-insecure students, and studies with the most representative samples of the student body found these trends. Some food-insecure students consumed breakfast and evening meals less frequently than food-secure students but the evidence was limited. Validated food security and dietary assessment tools were inconsistently used to assess diet quality among students with differing food security status. The heterogeneity of student sampling and data collection may contribute to inconsistent findings. CONCLUSION: Poorer dietary outcomes were found in university students with food insecurity compared with food-secure students, but statistical significance was only observed in a small number of studies. Future longitudinal studies using food security and dietary assessment tools validated in this population are recommended to confirm the observed associations between food insecurity and diet quality among university students.

3.
Nutrients ; 13(7)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34371932

RESUMO

BACKGROUND: There are numerous guidelines developed for bone health. Yet, it is unclear whether the differences in guideline development methods explain the variability in the recommendations for vitamin D and calcium intake. The objective of this systematic review was to collate and compare recommendations for vitamin D and calcium across bone health guidelines, assess the methods used to form the recommendations, and explore which methodological factors were associated with these guideline recommendations. METHODS: We searched MEDLINE, EMBASE, CINAHL, and other databases indexing guidelines to identify records in English between 2009 and 2019. Guidelines or policy statements on bone health or osteoporosis prevention for generally healthy adults aged ≥40 years were eligible for inclusion. Two reviewers independently extracted recommendations on daily vitamin D and calcium intake, supplement use, serum 25 hydroxyvitamin D [25(OH)D] level, and sunlight exposure; assessed guideline development methods against 25 recommended criteria in the World Health Organization (WHO) handbook for guideline development; and, identified types identified types of evidence underpinning the recommendations. RESULTS: we included 47 eligible guidelines from 733 records: 74% of the guidelines provided vitamin D (200~600-4000 IU/day) and 70% provided calcium (600-1200 mg/day) recommendations, 96% and 88% recommended vitamin D and calcium supplements, respectively, and 70% recommended a specific 25(OH)D concentration. On average, each guideline met 10 (95% CI: 9-12) of the total of 25 methodological criteria for guideline development recommended by the WHO Handbook. There was uncertainty in the association between the methodological criteria and the proportion of guidelines that provided recommendations on daily vitamin D or calcium. Various types of evidence, including previous bone guidelines, nutrient reference reports, systematic reviews, observational studies, and perspectives/editorials were used to underpin the recommendations. CONCLUSIONS: There is considerable variability in vitamin D and calcium recommendations and in guideline development methods in bone health guidelines. Effort is required to strengthen the methodological rigor of guideline development and utilize the best available evidence to underpin nutrition recommendations in evidence-based guidelines on bone health.


Assuntos
Remodelação Óssea/efeitos dos fármacos , Osso e Ossos/efeitos dos fármacos , Cálcio/administração & dosagem , Suplementos Nutricionais , Guias de Prática Clínica como Assunto/normas , Recomendações Nutricionais , Vitamina D/administração & dosagem , Adulto , Osso e Ossos/fisiopatologia , Cálcio/efeitos adversos , Suplementos Nutricionais/efeitos adversos , Medicina Baseada em Evidências/normas , Feminino , Nível de Saúde , Disparidades em Assistência à Saúde/normas , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Osteoporose/fisiopatologia , Osteoporose/prevenção & controle , Vitamina D/efeitos adversos
4.
Nutrients ; 13(6)2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34073378

RESUMO

Technology-enhanced methods of dietary assessment may still face common limitations of self-report. This study aimed to assess foods and beverages omitted when both a 24 h recall and a smartphone app were used to assess dietary intake compared with camera images. For three consecutive days, young adults (18-30 years) wore an Autographer camera that took point-of-view images every 30 seconds. Over the same period, participants reported their diet in the app and completed daily 24 h recalls. Camera images were reviewed for food and beverages, then matched to the items reported in the 24 h recall and app. ANOVA (with post hoc analysis using Tukey Honest Significant Difference) and paired t-test were conducted. Discretionary snacks were frequently omitted by both methods (p < 0.001). Water was omitted more frequently in the app than in the camera images (p < 0.001) and 24 h recall (p < 0.001). Dairy and alternatives (p = 0.001), sugar-based products (p = 0.007), savoury sauces and condiments (p < 0.001), fats and oils (p < 0.001) and alcohol (p = 0.002) were more frequently omitted in the app than in the 24 h recall. The use of traditional self-report methods of assessing diet remains problematic even with the addition of technology and finding new objective methods that are not intrusive and are of low burden to participants remains a challenge.


Assuntos
Bebidas , Dieta , Ingestão de Alimentos , Alimentos , Envio de Mensagens de Texto , Dispositivos Eletrônicos Vestíveis , Adolescente , Adulto , Condimentos , Etanol , Feminino , Humanos , Masculino , Óleos Vegetais , Autorrelato , Lanches , Açúcares , Água , Adulto Jovem
5.
Nutrients ; 13(5)2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34069005

RESUMO

The food environment in New Caledonia is undergoing a transition, with movement away from traditional diets towards processed and discretionary foods and beverages. This study aimed to develop an up-to-date food composition database that could be used to analyze food and nutritional intake data of New Caledonian children and adults. Development of this database occurred in three phases: Phase 1, updating and expanding the number of food items to represent current food supply; Phase 2, refining the database items and naming and assigning portion size images for food items; Phase 3, ensuring comprehensive nutrient values for all foods, including saturated fat and total sugar. The final New Caledonian database comprised a total of 972 food items, with 40 associated food categories and 25 nutrient values and 615 items with portion size images. To improve the searchability of the database, the names of 593 food items were shortened and synonyms or alternate spelling were included for 462 foods. Once integrated into a mobile app-based multiple-pass 24-h recall tool, named iRecall.24, this country-specific food composition database would support the assessment of food and nutritional intakes of families in New Caledonia, in a cross-sectional and longitudinal manner, and with translational opportunities for use across the wider Pacific region.


Assuntos
Gerenciamento de Dados , Bases de Dados Factuais , Ingestão de Alimentos , Aplicativos Móveis , Avaliação Nutricional , Adulto , Bebidas , Criança , Estudos Transversais , Dieta , Carboidratos da Dieta , Eletrônica , Ingestão de Energia , Abastecimento de Alimentos , Humanos , Melanesia , Nova Caledônia , Nutrientes , Polinésia , Tamanho da Porção
6.
Artigo em Inglês | MEDLINE | ID: mdl-34073299

RESUMO

New technologies may improve the validity of dietary and physical activity assessment and thereby associated findings for lifestyle-related bone health research. This scoping review mapped the evidence for the validity of new technologies that measure bone-related dietary and physical activity risk factors in adolescents and young adults. A systematic literature search was conducted using seven electronic databases for peer-reviewed studies published from January 2008 to 2021. Four studies from four countries were deemed eligible and included in the qualitative synthesis for this review. Two studies assessed diet, reporting the validity or usability of apps. Apps were shown to be a valid tool to measure the dietary intake of vitamin D (r = 0.84) and calcium (r = 0.63). Two studies assessed physical activity and reported the validity of wearable devices to measure impact loading. Hip-worn raw acceleration output correlated positively with ground reaction forces (GRF) for both studies (r range = 0.50-0.87), but wrist-worn accelerations and loading outcomes differed between studies, reporting poor to strong correlations (r range = 0.17-0.87). More research to provide robust evidence concerning validity, reliability, usability and engagement for the use of newer technologies is needed for future diet and physical activity bone research.


Assuntos
Dieta , Exercício Físico , Adolescente , Ingestão de Alimentos , Humanos , Reprodutibilidade dos Testes , Fatores de Risco , Adulto Jovem
7.
Nutrients ; 13(6)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34064220

RESUMO

Young adults are the highest consumers of food prepared outside home (FOH) and gain most weight among Australian adults. One strategy to address the obesogenic food environment is menu labelling legislation whereby outlets with >20 stores in one state and >50 Australia-wide must display energy content in kJ. The aim of this study was to assess the contribution of FOH to the energy and macronutrients, saturated fat, total sugars and sodium intakes of young Australians. One thousand and one 18 to 30-year-olds (57% female) residing in Australia's most populous state recorded all foods and beverages consumed and the location of preparation for three consecutive days using a purpose-designed smartphone application. Group means for the daily consumption of energy, percentage energy (%E) for protein, carbohydrate, total sugars, total and saturated fats, and sodium density (mg/1000 kJ) and proportions of nutrients from FOH from menu labelling and independent outlets were compared. Overall, participants consumed 42.4% of their energy intake from FOH with other nutrients ranging from 39.8% (sugars) to 47.3% (sodium). Independent outlets not required to label menus, contributed a greater percentage of energy (23.6%) than menu labelling outlets (18.7%, p < 0.001). Public health policy responses such as public education campaigns, extended menu labelling, more detailed nutrition information and reformulation targets are suggested to facilitate healthier choices.


Assuntos
Dieta/psicologia , Fast Foods/estatística & dados numéricos , Comportamento Alimentar/psicologia , Rotulagem de Alimentos/métodos , Serviços de Alimentação/estatística & dados numéricos , Adolescente , Adulto , Austrália , Estudos Transversais , Dieta/estatística & dados numéricos , Inquéritos sobre Dietas , Ingestão de Energia , Feminino , Rotulagem de Alimentos/legislação & jurisprudência , Serviços de Alimentação/legislação & jurisprudência , Humanos , Masculino , New South Wales , Política Nutricional , Valor Nutritivo , Restaurantes , Adulto Jovem
8.
Nutrients ; 13(3)2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-33809656

RESUMO

Airline passengers experience a range of symptoms when travelling on long flights. This review evaluated the efficacy of functional foods, beverages, and supplements claiming to address the effects of air travel for healthy adults. Products were identified in a scoping review of electronic databases, search engines, and grey literature (March to August 2019). A systematic review of the efficacy of product ingredients was conducted using five electronic databases from inception to February 2021. Articles were screened, data extracted, and assessed for risk of bias by two researchers independently. Meta-analysis was performed. Of the 3842 studies identified, 23 met selection criteria: melatonin (n = 10), Pycnogenol (n = 4), various macronutrients (n = 2), caffeine (n = 2), Centella asiatica (n = 1), elderberry (n = 1), Echinacea (n = 1), fluid (n = 1), and Pinokinase (n = 1). Meta-analysis (random effects model) indicated melatonin reduced self-reported jetlag following eastbound (n = 5) and westbound (n = 4) flights: standard mean difference -0.76 (95% CI = -1.06 to -0.45, I2 0%, p < 0.00001) and -0.66 (95% CI = -1.07 to -0.26, I2 45%, p = 0.001), respectively. Pycnogenol also reduced edema scores (n = 3), standard mean -4.09 (95% CI = -6.44 to -1.74), I2 98%, p = 0.0006). Overall, 12 of 183 ingredients contained in 199 products had evidence to support claims.


Assuntos
Viagem Aérea , Bebidas , Suplementos Nutricionais , Alimento Funcional , Síndrome do Jet Lag/prevenção & controle , Humanos , Síndrome do Jet Lag/dietoterapia , Síndrome do Jet Lag/tratamento farmacológico , Resultado do Tratamento
9.
Nutrients ; 13(3)2021 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-33799532

RESUMO

Online food delivery (OFD) platforms have changed how consumers purchase food prepared outside of home by capitalising on convenience and smartphone technology. Independent food outlets encompass a substantial proportion of partnering outlets, but their offerings' nutritional quality is understudied. Little is also known as to how OFD platforms influence consumer choice. This study evaluated the nutritional quality and marketing attributes of offerings from independent takeaway outlets available on Sydney's market-leading OFD platform (UberEats®). Complete menus and marketing attributes from 202 popular outlets were collected using web scraping. All 13841 menu items were classified into 38 food and beverage categories based on the Australian Dietary Guidelines. Of complete menus, 80.5% (11,139/13,841) were discretionary and 42.3% (5849/13,841) were discretionary cereal-based mixed meals, the largest of the 38 categories. Discretionary menu items were more likely to be categorised as most popular (OR: 2.5, 95% CI 1.9-3.2), accompanied by an image (OR: 1.3, 95% CI 1.2-1.5) and offered as a value bundle (OR: 6.5, 95% CI 4.8-8.9). Two of the three discretionary food categories were more expensive than their healthier Five Food Group counterparts (p < 0.02). The ubiquity of discretionary choices offered by independent takeaways and the marketing attributes employed by OFD platforms has implications for public health policy. Further research on the contribution of discretionary choices and marketing attributes to nutritional intakes is warranted.


Assuntos
Comportamento do Consumidor , Fast Foods , Alimentos , Refeições , Valor Nutritivo , Restaurantes , Austrália , Custos e Análise de Custo , Estudos Transversais , Fast Foods/economia , Alimentos/economia , Rotulagem de Alimentos , Humanos
10.
Nutrition ; 85: 111100, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33545541

RESUMO

The number of international students within tertiary education facilities continues to increase globally, but the challenges for this population in achieving a healthy diet in an unfamiliar environment receives insufficient attention. This scoping review aimed to synthesize current literature that investigated dietary changes and food security status of this student population. We followed a five-stage methodological framework developed by Arksey and O'Malley. Six electronic databases were searched. All types of research methods, including qualitative, quantitative, and mixed methods, were considered for inclusion. This review included 30 articles reporting dietary changes and 12 articles reporting food insecurity in international students. The students were able to explore novel foods in their host country without totally abandoning their original diet, thus developing a hybrid diet. Dietary habits oscillated between the new and traditional dietary cultures with many students consuming foods from their new food environment but less so in the long term. Changes in diet may contribute to weight change and some negative health impacts, but none of the included studies investigated the effects on academic performance. Additionally, international students appeared to be more vulnerable to food insecurity, but the contributing factors and impacts of this issue were insufficiently researched. International students often experienced dietary acculturation and faced more challenges in food security than their domestic peers. More specific support should be provided by tertiary institutions and governments to international students including regular culturally appropriate nutrition education programs.


Assuntos
Aculturação , Abastecimento de Alimentos , Dieta , Insegurança Alimentar , Humanos , Estudantes
11.
Crit Rev Food Sci Nutr ; : 1-12, 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33596740

RESUMO

A 2011 review associated eating out with increased energy intake. Popular outlets, nutrient composition, and menus may have changed since 2011. This study aimed to investigate relative contributions of foods prepared outside of home to total energy, total and saturated fat, sugars, and sodium intakes. Studies were included if they were observational cohort or cross-sectional, investigated the contributions that foods prepared out of home made to energy, nutrient intakes and/or nutrient densities of adults aged 18-64 years, published between 2009 and 2019. Socio-demographic differences were explored. Data were extracted guided by the STROBE Statement for cohort and cross-sectional studies. A descriptive, qualitative synthesis was conducted. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklists for Analytical Cross-sectional and Cohort Studies. Evidence strength was assessed using GRADE. Twenty-six studies were included. Higher consumption of foods purchased outside home increased intakes of energy and nutrients of public health concern, particularly in males and younger adults. Heterogeneity of definitions of foods prepared outside of home made comparison difficult. Studies frequently used self-reported consumption data, prone to misreporting. Foods prepared outside of home are associated with poorer diets. Policy and practice initiatives are required to address this.

12.
Artigo em Inglês | MEDLINE | ID: mdl-33477603

RESUMO

Higher consumption of fruit and vegetables has been associated with a lower risk of various chronic diseases including coronary heart disease, obesity, and certain cancers. Recently, fruit and vegetable intake has also been linked with mental health, including depression; however, this area is largely unexplored studies in young people and adults. This systematic review aimed to evaluate the association between fruit and vegetable intake and depressive symptoms in young people and adults aged 15-45. The review used a predefined protocol registered with International Prospective Register of Systematic Reviews (PROSPERO) database (ID no: CRD42018091642). The systematic review focused on peer-reviewed cohort studies published from 1 January 2000 to 31 August 2020 using searches of six electronic databases. The exposure was fruit and vegetable consumption analysed both separately and/or together, and the outcome was depression or depressive symptoms. Data from eligible studies were extracted according to predefined criteria and the studies were appraised using the Newcastle-Ottawa Scale (NOS) for cohort studies to evaluate for study quality and risk of bias. A total of 12 studies from seven countries were deemed eligible and included in the qualitative synthesis, one study was categorised as "very good" quality, nine studies were "good" quality, and two studies were "moderate" quality by the quality assessment based on the total score for the NOS. The majority of cohort studies support the evidence that fruit consumption is associated with decreased risk of developing depression. However, the inconsistent results were observed when the effects of vegetable consumption were analysed independently, and the effects of fruit and vegetables combined were analysed. Despite this, the evidence seems to be building that a possible association exists, and this may have implications for addressing the burden of mental illness in young people and adults aged 15-45 years. More well-designed prospective cohort studies are needed to provide more robust evidence on the relationship between fruit and vegetable intake and depression.


Assuntos
Frutas , Verduras , Adolescente , Adulto , Estudos de Coortes , Depressão/epidemiologia , Dieta , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
13.
J Hum Nutr Diet ; 34(3): 511-523, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33406314

RESUMO

Associations between diet and cardiometabolic outcomes are often based on a single measurement of diet in adulthood. Dietary exposures in childhood are thought to influence cardiometabolic disease development and individuals' diets can change over time, therefore dietary exposure in childhood and over long periods are both important to consider. This scoping review aimed to identify and characterise the literature on associations between diet measured in both childhood and adulthood and cardiometabolic outcomes. Seven databases were searched; eligible evidence sources were original analyses published as a journal article in English. Exposures included measures of dietary intake, diet quality and eating behaviours measured in both childhood and adulthood with at least five years between first and last measurements. Cardiometabolic outcomes included measures of anthropometry, biochemistry, vascular structure/function and disease states/scores. We identified 37 eligible articles from nine cohort studies. Dietary exposures were measured between two and eight times and most often assessed by food frequency questionnaire or diet history. The dietary exposures most frequently examined were protein, fat, carbohydrate, fruit, vegetables, sugar-sweetened beverages and breakfast. Cardiometabolic outcomes were predominantly based on risk markers. Authors utilised a variety of analytical approaches to transform and analyse repeated measures of diet, providing insights relevant to different lifespan nutrition concepts. The literature on associations between diet in childhood and adulthood and cardiometabolic outcomes is limited, but such studies have great potential to extend our knowledge in ways only possible with repeated measures of diet over time. Further research is needed to develop the evidence base for diet-disease relationships from a life course perspective, accounting for diet in both childhood and adulthood.

14.
Clin Nutr ; 40(5): 3114-3122, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33413914

RESUMO

BACKGROUND: Diet is central to treatment of type 2 diabetes. This review aimed to compare the effectiveness of nutrition therapy delivered by dietitians to nutrition advice delivered by other healthcare professionals in adults with type 2 diabetes on metabolic parameters. METHODS: Cochrane CENTRAL, CINAHL, EMBASE, MEDLINE and PsychINFO were searched for randomised controlled trials of three months duration or longer, published from 1st January 2008 to 18th June 2019. Relevant data were extracted from studies with additional author information. Random-effects meta-analysis assessed mean changes in HbA1c and other clinical parameters. PROSPERO registration number: CRD42019130528. RESULTS: Of 2477 records identified, fourteen studies, involving 3338 participants, were eligible for qualitative synthesis and meta-analysis. The mean changes [95% CI] at follow-up in HbA1c, BMI, weight, LDL cholesterol, systolic and diastolic blood pressure were -0·47 [-0·92, -0·02] %, -0·38 [-0·63, -0·13] kg/m2, -1·49 [-2·14, -0·84] kg, -0·15 [-0·33, 0·04] mmol/L, -0·75 [-2·45, 0·96] mm Hg and -1·17 [-4·52, 2·17] mm Hg respectively in favour of the intervention group. The quality of evidence was limited due to heterogeneity, risk of bias, publication bias and indirectness. CONCLUSIONS: Nutrition therapy provided by dietitians was associated with better clinical parameters of type 2 diabetes, including clinically significant improved glycaemic control, across diverse multiethnic patient groups from all six inhabited continents. This conclusion should be reflected in clinical guidelines.


Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Dieta/métodos , Dietética/métodos , Humanos , Resultado do Tratamento
15.
Obes Rev ; 22(2): e13109, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32725749

RESUMO

Obesity in adolescence is associated with stigma during school years, early emergence of co-morbidities in adulthood and premature mortality. Adolescence presents a key window of opportunity to intervene for building healthy eating and physical activity routines and prevent weight gain. This review of reviews assesses the evidence on the effectiveness of prevention interventions conducted with adolescents. Nine reviews assessing the effects of lifestyle interventions in adolescents (defined as age 10 to 19 years old) on weight gain were identified from the 10 health databases searched. Only four reviews conducted meta-analyses, of which, three (two exercise-focused) demonstrated positive changes in primary outcomes of body mass index (BMI) and/or BMI z-score (range of decrease in BMI from 0.06 to 0.47 kg/m2) ). Most were conducted in school settings, and all but two reviews were of low quality. Few reviews reported external validity components that would enable clearer directions for policy makers to implement in real-world settings. More than 140 distinct interventions were included in the reviews, but there remains a serious gap in evidence for effective interventions in adolescents.

16.
Eur J Nutr ; 60(4): 1875-1885, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32886147

RESUMO

PURPOSE: Young adults are vulnerable to weight gain and dietary behaviours such as 'eating on the run' are likely contributors. The objective of this study was to examine eating and drinking behaviours during transport journeys in a sample of young adults using wearable cameras that take continuous images every 30 s. METHODS: Seventy-eight 18-30 year olds wore an Autographer wearable camera for three consecutive days. Image coding schedules were designed to assess physical activity (included transportation) and diet. For the general description of data, frequency analysis was calculated as image number (percentage) and mean (± SD) or median (IQR) when appropriate. RESULTS: A total of 281,041 images were coded and 32,529 (14%) of images involved transport. The median (IQR) camera wear time was 8 h per day (7-9 h). The camera images identified 52 participants (67%) either eating or drinking during transport (excluding water). A total of 143 eating and drinking occasions were identified, averaging 3 occasions per person over the three study days. Fifty five (38%) eating episodes were identified by the camera images of which 27 (49%) were discretionary and 88 (62%) drinking episodes were identified of which (45%) were discretionary. CONCLUSION: This study confirms that transport is a potential setting for intervention. Young adults are consuming discretionary food and beverages during transport which may contribute to energy-dense diets and compromise diet quality. Substituting unhealthy with healthy food advertising and potentially prohibiting eating and drinking whilst on public transport is suggested.


Assuntos
Dieta , Dispositivos Eletrônicos Vestíveis , Comportamento de Ingestão de Líquido , Ingestão de Alimentos , Exercício Físico , Comportamento Alimentar , Alimentos , Humanos , Adulto Jovem
17.
J Nutr Educ Behav ; 53(1): 43-53, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33077370

RESUMO

OBJECTIVE: To describe the experiences and perspectives of people with type 2 diabetes mellitus (T2DM) regarding dietetic services and to suggest improvements for their access and delivery. DESIGN: Semistructured telephone interviews. SETTING: Urban and rural Australia. PARTICIPANTS: A total of 30 English-speaking adults with T2DM recruited by means of electronic advertisements and posters. PHENOMENON OF INTEREST: Engagement with services, adherence to diet, and perspectives regarding dietetic services. ANALYSIS: Capability, opportunity, and motivation model of behavior and theoretical domains framework informed the analysis. RESULTS: Participants were predominantly middle-aged, White, university-educated, and full-time professionals. Most had been diagnosed with T2DM for 2 years or more, were overweight or obese, were on glucose-lowering medication, and had visited the dietitian at least once. Two inter-related behaviors were identified: eating a healthy diet for T2DM and participating with dietetic services. Health literacy, as well as support by family, friends, and professionals, were reported as enablers for both these behaviors. Barriers stated included misconceptions about diets and the role of dietitians, unpleasant previous experiences with services, and lack of social support. CONCLUSIONS AND IMPLICATIONS: These data support that improving health literacy of people with T2DM, in conjunction with social support by family and friends and professional support by dietitians, is likely to facilitate dietary behavior change.

18.
Patient Educ Couns ; 104(7): 1736-1744, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33334634

RESUMO

OBJECTIVE: Determine the effectiveness and acceptability of a text message intervention (DTEXT) on HbA1c and self-management behaviors for Australian adults with type 2 diabetes. METHODS: Using intention to treat analysis and generalized estimating equations, this randomized controlled trial of 395 adults determined change in HbA1c at 3 and 6 months between the intervention and control group. Secondary outcomes included change in nutrition, physical activity, blood lipid profile, body mass index, quality of life, self-efficacy, medication taking and program acceptability. RESULTS: No significant difference was observed between the intervention or control group for HbA1c at 3 months (P = 0.23) or 6 months (P = 0.22). Significant improvements were seen in consumption of vegetables at 3 months (P < 0.001) and 6 months (P = 0.04); fruit at 3 months (P = 0.046) and discretionary sweet foods at 3 months (P = 0.02). No other significant effects seen. The intervention demonstrated high rates of acceptability (94.0%) and minimal withdrawal (1.5%). CONCLUSIONS: DTEXT was an acceptable text message intervention that improved some nutritional behaviors in people with type 2 diabetes, but did not significantly improve HbA1c or other outcomes. Further research is required to optimize DTEXT. PRACTICE IMPLICATIONS: DTEXT provides an acceptable, feasible form of self-management support that may complement existing diabetes care.


Assuntos
Diabetes Mellitus Tipo 2 , Autogestão , Envio de Mensagens de Texto , Adulto , Austrália , Diabetes Mellitus Tipo 2/terapia , Hemoglobina A Glicada/análise , Humanos , Qualidade de Vida
19.
Aust J Prim Health ; 27(4): 312-318, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33352088

RESUMO

Diet is central to the management of type 2 diabetes (T2D) and better outcomes are achieved when the dietary intervention is delivered by a dietitian. Yet, many people with T2D never see a dietitian. It has been proposed that doctors prefer to provide the dietary advice themselves or rely on medication to treat their patients instead of referring them to a dietitian. This study aimed to collect the opinions and perspectives of doctors with regard to the dietary management of people with T2D in Australia. GPs and physicians treating people with T2D were recruited to participate in semistructured interviews conducted over the telephone. Inductive thematic analysis of content was conducted. Five GPs and seven physicians participated in the study. The qualitative analysis identified four main themes: the importance and role of diet in the management of T2D; the perceived value of dietetic care; access to dietetic services; and patients' motivation to consult a dietitian. All participants acknowledged the importance of diet in the treatment of T2D and all but one preferred to refer patients to a dietitian for nutritional management. Among the reported barriers to accessing dietetic services were: specialist physicians' lack of access to the national referral scheme for chronic conditions; patients' financial circumstances; and inadequacy of the number of subsidised sessions. It is important to facilitate and subsidise access to dietetic services through existing mechanisms by increasing the number of visits on the chronic disease management scheme and providing referral rights to specialist physicians.

20.
Artigo em Inglês | MEDLINE | ID: mdl-33322117

RESUMO

Device-based assessments are frequently used to measure physical activity (PA) but contextual measures are often lacking. There is a need for new methods, and one under-explored option is the use of wearable cameras. This study tested the use of wearable cameras in PA measurement by comparing intensity classifications from accelerometers with wearable camera data. Seventy-eight 18-30-year-olds wore an Actigraph GT9X link accelerometer and Autographer wearable camera for three consecutive days. An image coding schedule was designed to assess activity categories and activity sub-categories defined by the 2011 Compendium of Physical Activities (Compendium). Accelerometer hourly detailed files processed using the Montoye (2020) cut-points were linked to camera data using date and time stamps. Agreement was examined using equivalence testing, intraclass correlation coefficient (ICC) and Spearman's correlation coefficient (rho). Fifty-three participants contributing 636 person-hours were included. Reliability was moderate to good for sedentary behavior (rho = 0.77), light intensity activities (rho = 0.59) and moderate-to-vigorous physical activity (MVPA) (rho = 0.51). The estimates of sedentary behavior, light activity and MVPA from the two methods were similar, but not equivalent. Wearable cameras are a potential complementary tool for PA measurement, but practical challenges and limitations exist. While wearable cameras may not be feasible for use in large scale studies, they may be feasible in small scale studies where context is important.


Assuntos
Acelerometria/estatística & dados numéricos , Exercício Físico , Dispositivos Eletrônicos Vestíveis , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Saúde Pública , Reprodutibilidade dos Testes , Comportamento Sedentário , Adulto Jovem
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