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1.
Appetite ; 167: 105661, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34437924

RESUMO

The Child Eating Behaviour Questionnaire (CEBQ) is designed to measure 'usual' eating behaviour, with no time period attached, thus may not be suitable for assessing the effectiveness of short-term experimental studies. The aim of this study was to validate i) the CEBQ adapted to measure 'past week' rather than 'usual' eating behaviour, and ii) a computerized questionnaire assessing desire to eat core and non-core foods, against an objective measure of eating behaviour and food intake (eating in the absence of hunger (EAH) experiment). Children (n = 103) aged 8-12 years completed the desire to eat questionnaire followed by the EAH experiment while primary caregivers completed the adapted CEBQ. Results from the CEBQ showed that children with greater 'satiety responsiveness' (1-point higher) consumed less energy (-342 kJ; 95% CI -574, -110) whereas those with greater 'enjoyment of food' scale consumed more energy (380 kJ; 95% CI 124, 636) during the ad-libitum phase of the EAH experiment. Higher scores for slowness in eating (-705 kJ; 95% CI -1157, -254), emotional undereating (-590 kJ; 95% CI -1074, -106) and food fussiness (-629 kJ; 95% CI -1103, -155) were associated with lower total energy intake. Children who expressed greater desire to eat non-core foods consumed more energy in total (275 kJ; 95% CI 87, 463). Overall, this adapted CEBQ appears valid for measuring several short-term eating behaviours in children. The desire to eat questionnaire may be useful for identifying short-term susceptibility to overeating, however further investigation into how ratings of desire relate to the intake of highly palatable, energy dense foods is warranted.


Assuntos
Comportamento Infantil , Comportamento Alimentar , Criança , Ingestão de Alimentos , Humanos , Fome , Saciação , Inquéritos e Questionários
2.
Am J Clin Nutr ; 114(4): 1428-1437, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34192297

RESUMO

BACKGROUND: While insufficient sleep duration has emerged as a strong, independent risk factor for obesity, the mechanisms remain unclear. One possibility is greater "eating in the absence of hunger" (EAH) or energy intake beyond the point of satiety, when tired. OBJECTIVE: The aim was to determine whether mild sleep loss increases EAH in children. METHODS: A crossover study was undertaken in 105 healthy children (8-12 y) with normal sleep (∼8-11 h/night). After randomization, children went to bed 1 h earlier (sleep extension) or 1 h later (sleep restriction) than their usual bedtime, over 2 intervention weeks separated by a 1-wk washout. At the end of each intervention week, children underwent an EAH feeding experiment involving a preloading meal until satiation, followed by an ad libitum buffet (of highly palatable snacks) to measure EAH, with each food item weighed before and after consumption. RESULTS: Ninety-three children completed the EAH experiment. There was no evidence of a difference in energy intake from EAH between sleep restriction and extension conditions when analyzed as a crossover design. However, a learning effect was found, with children eating significantly less (-239 kJ; 95% CI: -437, -41 kJ; P = 0.018) during the preload phase and significantly more (181 kJ; 95% CI: 38, 322 kJ; P = 0.013) in the ad libitum phase in the second week. No significant differences were seen using an underpowered parallel analysis for energy intake during the ad libitum phase when sleep deprived (106 kJ; 95% CI: -217, 431 kJ; P = 0.514). CONCLUSIONS: Our findings suggest that measuring a difference in eating behavior in relation to sleep proved unsuitable using the EAH experiment in a crossover design in children, due to a learning effect. This trial was registered at the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=367587&isReview=true) as ACTRN12618001671257 .


Assuntos
Ingestão de Alimentos , Fome , Privação do Sono , Criança , Estudos Cross-Over , Feminino , Humanos , Aprendizagem , Masculino
3.
Nutr Rev ; 79(10): 1079-1099, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-33440009

RESUMO

CONTEXT: Although dietary advice has long been a cornerstone of a healthy lifestyle, how sleep quality and quantity may interact with dietary intake or eating behaviors remains unclear. OBJECTIVE: To consider a bidirectional relationship between sleep and diet in children aged 6-12 years via a systematic review following PRISMA guidelines. DATA SOURCES: Relevant trials and observational studies were identified by searching the PubMed, Medline, Embase, and CENTRAL databases up to June 1, 2019, without language or date restrictions and supplemented with hand searching. Recognized procedures and reporting standards were applied. DATA EXTRACTION: Data on participant characteristics, study parameters, diet measures, sleep measures, and findings of study quality assessment criteria were collected. DATA ANALYSIS: Forty-five articles involving 308 332 participants on a diverse range of topics were included. Meta-analyses were planned but were impossible to perform due to high study heterogeneity. Most studies (82%) were cross-sectional, which prevented examining directionality of the observed associations. Risk of bias was assessed for trial, cohort studies, and cross-sectional studies, using the Cochrane Risk of Bias Tool or Newcastle Ottawa Scale. RESULTS: Of 16 studies in which the effect of sleep on dietary intake was investigated, 81% (n = 13) reported a significant association. All studies (n = 8) of sugar-sweetened or caffeinated beverages reported a negative association with sleep, and in 6 of 7 studies in which eating behaviors were investigated, associations with sleep were reported. The use of objective measures of sleep and diet were scarce, with most trials and studies relying on subjective measures of sleep (68%) or diet (93%). CONCLUSION: Because most studies investigating the relationship between sleep and diet in this age group are cross-sectional, temporality could not be determined. Additional randomized controlled trials and long-term cohort studies in middle childhood, particularly those using objective rather than questionnaire measures of sleep, are required to better understand interactions between diet and sleep. SYSTEMATIC REVIEW REGISTRATION: Prospectively registered with PROSPERO International Prospective Register of Systematic Reviews (CRD42018091647).


Assuntos
Dieta , Ingestão de Alimentos , Comportamento Alimentar , Sono , Criança , Estudos Transversais , Humanos , Sono/fisiologia
4.
J Prim Health Care ; 12(1): 79-87, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32223854

RESUMO

INTRODUCTION Practice nurses in general practice are ideally placed to deliver weight management treatments. Teaching people to eat according to their appetite, based on measurements of blood glucose ('hunger training'), is known to lead to weight loss and improved eating behaviour. To effectively translate this research to primary care requires understanding of key stakeholder perspectives. AIM The aim of this study was to explore the perspectives of practice nurses on the suitability of using hunger training as a weight management intervention in general practice. METHODS Ten nurses trialled hunger training for 1 week, followed by a semi-structured interview where they were asked about their experience; perceived patient interest; enablers and barriers; and suggested changes to hunger training. RESULTS All nurses were positive about hunger training and wanted to use it with their patients. They thought it was a useful method for teaching patients about eating according to their appetite, and the impact of food choices on glucose. Motivation was seen to be both an important potential barrier and enabler for patients. Other anticipated patient enablers included the educational value of hunger training and ease of the programme. Other barriers included lack of time and cost of equipment and appointments. For most nurses, 1 week of following hunger training was sufficient training to deliver the intervention. Suggested refinements included adding nutrition advice to the booklet, incorporating other health goals and enabling social support. DISCUSSION These findings suggest that hunger training could be translated to primary care with minor modifications.


Assuntos
Atitude do Pessoal de Saúde , Automonitorização da Glicemia/métodos , Comportamento Alimentar/fisiologia , Enfermeiras e Enfermeiros/psicologia , Programas de Redução de Peso/métodos , Adulto , Glicemia/fisiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Fome , Entrevistas como Assunto , Pessoa de Meia-Idade , Motivação , Pesquisa Qualitativa
5.
Sleep Med Rev ; 49: 101231, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31783229

RESUMO

We have undertaken a systematic review examining the role of diet on sleep, and sleep on diet, in children aged 0-5 y. Controlled trials and cohort or cross-sectional studies were identified with online searches of PubMed, Medline, Embase, Scopus, and CENTRAL up to 1 June 2019, and hand searching of relevant publications. Searches, extraction, and risk of bias assessments were undertaken independently by at least two researchers. Fifty articles involving 72,491 children on a diverse range of topics were eligible. All five studies that investigated the effect of sleep on diet indicated that poorer sleep (measured by a variety of indices) was associated with greater dietary energy intake or poorer diet quality. Conversely, the findings regarding how diet might influence sleep were less consistent when considering feeding practises, energy and macronutrient intake, or micronutrient and small metabolite intake. Studies were typically of short duration and relied on subjective measures of sleep (66%) or diet (88%). While we identified a clear relationship between reduced sleep and poorer diets, future studies require improved methodological reporting and support from transdisciplinary collaborations to better understand the possible role of diet on sleep. Prospectively registered with PROSPERO International Prospective Register of Systematic Reviews (CRD42018091647).


Assuntos
Dieta , Ingestão de Energia/fisiologia , Sono/fisiologia , Pré-Escolar , Humanos , Lactente , Recém-Nascido
6.
BMC Public Health ; 19(1): 1347, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640636

RESUMO

BACKGROUND: Although insufficient sleep has emerged as a strong, independent risk factor for obesity in children, the mechanisms by which insufficient sleep leads to weight gain are uncertain. Observational research suggests that being tired influences what children eat more than how active they are, but only experimental research can determine causality. Few experimental studies have been undertaken to determine how reductions in sleep duration might affect indices of energy balance in children including food choice, appetite regulation, and sedentary time. The primary aim of this study is to objectively determine whether mild sleep deprivation increases energy intake in the absence of hunger. METHODS: The Daily, Rest, Eating, and Activity Monitoring (DREAM) study is a randomized controlled trial investigating how mild sleep deprivation influences eating behaviour and activity patterns in children using a counterbalanced, cross-over design. One hundred and ten children aged 8-12 years, with normal reported sleep duration of 8-11 h per night will undergo 2 weeks of sleep manipulation; seven nights of sleep restriction by going to bed 1 hr later than usual, and seven nights of sleep extension going to bed 1 hr earlier than usual, separated by a washout week. During each experimental week, 24-h movement behaviours (sleep, physical activity, sedentary behaviour) will be measured via actigraphy; dietary intake and context of eating by multiple 24-h recalls and wearable camera images; and eating behaviours via objective and subjective methods. At the end of each experimental week a feeding experiment will determine energy intake from eating in the absence of hunger. Differences between sleep conditions will be determined to estimate the effects of reducing sleep duration by 1-2 h per night. DISCUSSION: Determining how insufficient sleep predisposes children to weight gain should provide much-needed information for improving interventions for the effective prevention of obesity, thereby decreasing long-term morbidity and healthcare burden. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12618001671257 . Registered 10 October 2018.


Assuntos
Comportamento Infantil/psicologia , Dieta/psicologia , Comportamento Alimentar/psicologia , Privação do Sono/psicologia , Austrália/epidemiologia , Criança , Estudos Cross-Over , Feminino , Humanos , Masculino , Obesidade Pediátrica/epidemiologia , Projetos de Pesquisa , Privação do Sono/epidemiologia
7.
BMC Musculoskelet Disord ; 20(1): 324, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299929

RESUMO

BACKGROUND: Osteoarthritis is the most common form of arthritis, principally affecting the older population. Highly prevalent, disabling diseases such as osteoarthritis strain the capacity of health systems, and can result in unmet need for services. The Joint Clinic was initiated to provide secondary care consultations and access to outpatient services for people with advanced hip or knee osteoarthritis, who were referred by their general practitioner for orthopaedic consultation but not offered an orthopaedic specialist appointment. METHODS: This longitudinal programme evaluation comprised four components: a proof-of-concept evaluation; an implementation evaluation; a process evaluation; and an outcomes evaluation. Interviews and surveys of general practitioners, staff, and patients were conducted pre- and post-implementation. Interviews were transcribed, and thematic analysis was completed. In addition, Joint Clinic patient visits and outcomes were reviewed. RESULTS: One hundred and eleven primary care physicians (GPs) and 66 patients were surveyed, and 28 semi-structured interviews of hospital staff and GPs were conducted. Proof of concept was satisfied. Interim and final implementation evaluations indicated adherence to the concept model, high levels of acceptance of and confidence in the programme and its staff, and timely completion within budget. Process evaluation revealed positive impacts of the programme and positive stakeholder perceptions, with some weaknesses in communication to the outer context of primary care. The Joint Clinic saw a total of 637 patient visits during 2 years of operation. Unmet need was reduced by 90%. Patient and referring physician satisfaction was high. Hospital management confirmed that the programme will continue. CONCLUSIONS: This evaluation indicates that the Joint Clinic concept model is fit for purpose, functioned well within the organisation, and achieved its primary objective of reducing unmet need of secondary care consultation for those suffering advanced hip or knee osteoarthritis.


Assuntos
Instituições de Assistência Ambulatorial/organização & administração , Assistência Ambulatorial/organização & administração , Osteoartrite do Quadril/diagnóstico , Osteoartrite do Joelho/diagnóstico , Encaminhamento e Consulta/organização & administração , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial/estatística & dados numéricos , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Estudos Longitudinais , Masculino , Osteoartrite do Quadril/terapia , Osteoartrite do Joelho/terapia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida
8.
BMJ Open ; 9(12): e032248, 2019 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-31892654

RESUMO

OBJECTIVES: Hunger training (HT) is an intervention designed to teach people to eat according to their hunger by connecting physical symptoms of appetite with glucose levels. HT is most effective for weight loss, and improving eating behaviours when adherence is high. However, adherence is a challenge that should be explored prior to wider dissemination. The aim of this study was to explore participants' experience and self-reported adherence and behaviour change related to HT. DESIGN: A qualitative study, nested within a randomised controlled pilot study of two different methods of monitoring glucose during HT. Semistructured interviews were audio-recorded, transcribed verbatim and analysed thematically using a phenomenological approach. SETTING: Single-centre study with participants recruited from the local area. PARTICIPANTS: 40 participants began the pilot study and 38 participants (52.6% women) remained at 1 month and completed interviews. RESULTS: Most participants felt they were able to match their hunger to their glucose levels by the end of the intervention. The main adherence barriers were the social pressure to eat, lack of time and lack of flexibility in participants' meal schedules. Common adherence enablers were having a set routine, social support and accountability. Participants described increased awareness of hungry versus non-hungry eating and better cognition of feelings of hunger and satiety as a result of the intervention, which in turn led to changes of food choice, portion size and adjusted meal timing and frequency. CONCLUSIONS: Findings show that HT is acceptable from a patient perspective, and results can be used to inform the translation of HT programme to healthcare settings. TRIAL REGISTRATION NUMBER: ACTRN12618001257257.


Assuntos
Glicemia/análise , Comportamento Alimentar/fisiologia , Fome , Perda de Peso , Adulto , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pesquisa Qualitativa , Saciação
9.
Aust N Z J Public Health ; 42(4): 340-346, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29972258

RESUMO

OBJECTIVE: Transport impacts teenagers by affecting their autonomy and independent access to activities. This manuscript reports descriptive findings of transport behaviours among teenagers in Southland, New Zealand, and discusses the implications of these for public health and policy. METHODS: An online survey was implemented to investigate transport among respondents aged 16 years and older from twelve secondary schools. Two methods of survey distribution were used (in-class and at home). Descriptive results were analysed using Stata. RESULTS: Response rate was 71.5% (n=775). The most common forms of transport were as a passenger in a car and walking. Two-thirds of participants had some form of driving licence. Half the sample expressed frustration at being unable to access activities. Significant gender differences existed regarding transport and types of activities accessed. Licence status was associated with physical activity, screen time and transport frustration. CONCLUSIONS: The transport decisions made by teenagers, in aggregate, have implications for policy and infrastructure, and findings provide a foundation for discussions around potential changes to driver education programming, the school uniform policy in New Zealand and further research. Implications for public health: Inquiring about everyday transport habits, outside of the trip to school, and activities accessed provided data about an under-researched group, supporting the ecological approach to transport in the context of public health.


Assuntos
Comportamento do Adolescente , Condução de Veículo , Exercício Físico , Transportes/métodos , Caminhada , Adolescente , Feminino , Humanos , Licenciamento , Masculino , Nova Zelândia , População Rural , Inquéritos e Questionários
10.
Health Promot Int ; 31(2): 280-9, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25524473

RESUMO

Youth have the highest crash injury risk in New Zealand. Maori and Pacific youth have an even higher risk. Highlighting and promoting benefits of modal shift from cars to active and public transport may increase health and safety. We aimed to create a discussion surrounding transport issues to gain a better understanding of attitudes and behaviours of non-driving youth, to empower our participants and to promote health and social change by making participants' opinions and experiences known to the broader community through a public exhibition. We engaged nine non-drivers aged 16-24 years in photovoice. Through sharing their photos and stories, participants used the power of the visual image to communicate their experiences. This method is an internationally recognized tool that reduces inequalities by giving those who have minimal decision-making power an opportunity to share their voice. By the end of the project, it was clear that the participants were comfortable with their non-driving status, noting that public and active transport was more cost-effective, easy and convenient. This attitude reflects recent studies showing a marked decrease in licensure among young people in developed countries. This project uniquely prioritized young Maori, Pacific and Asian non-drivers.


Assuntos
Condução de Veículo/psicologia , Fotografação , Acidentes de Trânsito/prevenção & controle , Adolescente , Feminino , Humanos , Masculino , Nova Zelândia , Grupo com Ancestrais Oceânicos/psicologia , Transportes , Adulto Jovem
11.
Exp Gerontol ; 48(10): 1054-61, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23403042

RESUMO

Obesity in older adults is ubiquitous in many developed countries and is related to various negative health outcomes, making it an important public health target for intervention. However, treatment approaches for obesity in older adults remain controversial due to concerns surrounding the difficulty of behavior change with advancing age, exacerbating the age-related loss of skeletal muscle and bone, and the feasibility of long-term weight maintenance and related health consequences. This review serves to systematically examine the evidence regarding weight loss interventions with a focus on obese (body mass index 30kg/m(2) and above) older adults (aged 65years and older) and some proposed mechanisms associated with exercise and caloric restriction (lifestyle intervention). Our findings indicate that healthy weight loss in this age group can be achieved through lifestyle interventions of up to a one-year period. Most interventions reviewed reported a loss of lean body mass and bone mineral density with weight loss. Paradoxically muscle quality and physical function improved. Inflammatory molecules and metabolic markers also improved, although the independent and additive effects of exercise and weight loss on these pathways are poorly understood. Using our review inclusion criteria, only one small pilot study investigating long-term weight maintenance and associated health implications was found in the literature. Future research on lifestyle interventions for obese older adults should address the loss of bone and lean body mass, inflammatory mechanisms, and include sufficient follow-up to assess long-term weight maintenance and health outcomes.


Assuntos
Restrição Calórica/métodos , Obesidade/terapia , Perda de Peso/fisiologia , Idoso , Densidade Óssea/fisiologia , Remodelação Óssea/fisiologia , Doenças Cardiovasculares/prevenção & controle , Terapia por Exercício/métodos , Estudos de Viabilidade , Feminino , Idoso Fragilizado , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Comportamento Sedentário
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