Nutrition & Dietetics最新文献

Aims: This study aims to evaluate the existing definitions of double burden of malnutrition and to synthesise and propose operational definitions at different levels, with the goal of improving consistency in measurement and policy development.

Methods: We conducted a narrative review that used structured search and narrative synthesis to review and summarise how double burden of malnutrition has been defined at different levels. We performed a structured search across PubMed, Web of Science and Scopus, focusing on peer-reviewed articles published between January 2010 and December 2024. We screened articles for relevance to double burden of malnutrition and categorised them based on the level of the definition, such as households, individuals and populations.

Results: Of the 60 selected studies, the majority originated from Latin America (n = 19, 32%), followed by South Asia (n = 10, 17%) and Southeast Asia (n = 8, 13%). At the household level, the most common definition of double burden of malnutrition was the coexistence of an overweight/obese mother and a stunted child. Individual-level definitions commonly included the coexistence of overweight/obesity with anaemia or stunting. However, definitions at the population level varied considerably and lacked consistency across studies.

Conclusions: Our findings highlight the need for consistent operational definitions of double burden of malnutrition across different levels of analysis. Drawing on existing literature, we synthesise practical definitions at different levels to more accurately reflect the coexistence of different forms of malnutrition. Clarifying these definitions can improve the comparability of prevalence estimates across contexts and support the development of more effective, evidence-based strategies to address the growing burden of double burden of malnutrition.

Aims: Demand for infant and child foods in squeeze pouches is increasing, yet limited evidence exists to inform public health strategies on who uses them and why. The aim of this scoping review was to explore the frequency and types of squeeze pouches consumed by children, the sociodemographic characteristics of users and insights from parental experiences regarding their use.

Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. Between January and April 2024, three databases were searched (MEDLINE, Scopus and CINAHL) in addition to grey literature. Two independent reviewers screened 125 articles, of which 16 underwent full-text review. Results were summarised narratively.

Results: Eleven studies across five countries were included. Eight studies reported on the prevalence of squeeze pouch consumption, ranging from 23.5% to 82.8% for infants and children. Frequency of intake ranged from daily (n = 4; 8.7%-29.2%), weekly (n = 7; 20.9%-75.2%), to monthly consumption (n = 7 16.7%-70.4%), depending on the study. Predominantly fruit- and dairy-based pouches were consumed. Frequent use was linked to higher deprivation, childcare use, larger families, early breastfeeding cessation and early solid food introduction. Studies on parental perceptions (n = 6) reported their perceived convenience, healthiness and low cost and concerns related to waste.

Conclusions: This review identified widespread use of squeeze pouches among infants and children, particularly fruit and dairy-based pouches. More research is needed on their nutritional impact to guide public health strategies promoting healthy early feeding practices.

Aims: The views of parents/caregivers about food programs in schools internationally is not well understood. This review aimed to synthesise what parents/caregivers identify as the key features of school food programs and their perspectives of these programs globally.

Methods: A mixed papers review was undertaken with a systematic search (January 2024) and screening of three databases (Scopus, Web of Science, PubMed). Eligible studies captured parent/caregiver perspectives across all school food models. Study findings were extracted using Bayesian methods to translate quantitative findings into qualitative data. Data was deductively categorised to identify features of school food models, and separately themed to identify parent perspectives.

Results: Twenty-six eligible studies were identified from 11 countries. Fifteen features were identified, including cost, time, effort and convenience, child preferences, nutrition, policy and messaging, eating environment and food education. Parent perspective themes were: child is the priority, lunchbox procurement, preparation and provision is challenging, school-provided meals have strengths and limitations, and parents acknowledge they are central to feeding. An overarching theme was that compromises must be made to meet the needs of family members, when parents make decisions on school food.

Conclusions: This review found that globally parents perceive benefits and challenges to school food programs, regardless of provision model, with a range of features that influence parent acceptability. Considering parent/caregiver perspectives when developing or changing school food provision models is likely to increase caregiver acceptability, supporting children to engage with health promotion efforts.

Aims: This review aimed to describe the current evidence on fluid requirements for adults with medically compromised eating disorders, with objectives to: (1) review study designs and aims, (2) describe participant characteristics, (3) identify modes of fluid delivery, and (4) examine fluid reporting methods and adverse events relating to fluid intake.

Methods: This scoping review was conducted following the Joanna Briggs Institute's methodology. Three research databases (PubMed, CINAHL, Embase) were searched until 25 November 2024 for relevant studies. Research articles examining adult (aged ≥18 years), acutely unwell, hospitalised patients with eating disorders and that included information on fluid (requirements, provision, intake, output and/or restrictions) and any fluid-related outcomes were included. Screening of search results was conducted independently in duplicate. Results were synthesised narratively.

Results: The search strategy yielded 1691 articles, and 13 studies (total n = 104 participants) were included. All studies were observational, including case report (n = 10 studies) and prospective study designs (n = 3 studies). No study specifically aimed to examine fluid requirements. Participants were predominantly female, and all had anorexia nervosa. Fluid was provided by multiple routes in most studies, and fluid reporting was inconsistent.

Conclusions: Limited evidence is available with no studies specifically addressing fluid requirements for adults with medically compromised eating disorders. The results identify major gaps in the evidence, including no justification for fluid provision or restrictions applied, minimal explanation as to how fluid may have impacted clinical presentations, and no fluid measurements conducted in totality from all fluid provision routes. Future research should prioritise larger, well-designed cohort studies with detailed fluid information to assist with building the evidence base and thereby enhancing nutritional support for this vulnerable group.

Aim: Identify and describe research that explores interest-holder perceptions and definitions of foodservice quality in residential aged care.

Methods: This review follows the Joanna Briggs Institute methodological framework for conducting scoping reviews and was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. PubMed, Embase, CINAHL, and Scopus were used to search for peer-reviewed literature. Grey literature was searched through Google and six Australian government sources. No restrictions were applied to methodology, year, or geographical location published. Findings were synthesised into distinct interest-holder and foodservice component groups using meta-synthesis.

Results: A total of 31 eligible texts, including peer-reviewed (n = 17) and grey literature (n = 14) were included in this review. Texts identifying perceptions (n = 23) were predominantly those of residents (n = 11) while definitions of quality (n = 13) were all described by researchers and experts. Despite some agreement that foodservice quality is associated with how acceptable food or meals are to residents, there is a lack of consensus on what defines quality, with none of the literature addressing quality across the whole foodservice system.

Conclusion: Published research and reports that examine the perspectives of interest-holders in residential aged care provided no consensus on definitions or clear sets of indicators defining foodservice quality. Further research is required to understand the perceptions of foodservice quality in order to guide the development and implementation of specific measures to support assessment and evaluation.

Aim: To explore the effect of blended tube feeding compared to conventional formulas on nutritional status, quality of life, anthropometry, diarrhoea and tube blockages in adults receiving tube feeding.

Methods: The protocol was registered (PROSPERO CRD42022372443). Five databases (MEDLINE, EMBASE, CINAHL, Scopus, CENTRAL) were searched from commencement of database to 14th June 2023 to identify studies comparing blended tube feeding to conventional formulas in adults receiving tube feeding. Certainty assessment was conducted using the Cochrane Risk of Bias Tools and the Grading of Recommendations, Assessment, Development and Evaluations framework, and a narrative synthesis of results is provided.

Results: From 4227 studies screened, eight were included (total n = 763 patients, 9-215 patients). Three studies were hospital-based and five were home-based with duration from 8 days-8 months. Blended tube feeding and conventional formulas were nutritionally equivalent in only three studies; energy and protein concentration of formulas ranged from 1.7-7.1 kJ/mL and 21-68.5 g/L for the blended tube feeding groups, and 4.2-6.7 kJ/mL and 39-100 g/L for the conventional groups. No studies assessed nutrition status or quality of life using validated measures. Blended tube feeding was associated with a clinically relevant reduction in diarrhoea with a low level of certainty. For remaining outcomes, there were inconclusive findings and an overall very low certainty of evidence for each.

Conclusion: The effect of blended tube feeding compared to conventional formulas on all outcomes remains uncertain. Blended tube feeding may reduce the incidence of diarrhoea. Future research using nutritionally equivalent comparisons and validated outcome measures is required.

Aims: The aim of this review was to explore the evidence available on food waste in residential aged care.

Methods: This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Peer-reviewed literature was retrieved from six databases (PubMed, SCOPUS, CINAHL, Academic Search Premier, ProQuest Consumer Health, ProQuest Public Health), and grey literature was retrieved through Google up to January 2025. Results were screened by two independent reviewers. Data were extracted from relevant sources using a data extraction tool developed by the reviewers and were reported in tables and narrative text.

Results: A total of 33 sources (20 peer-reviewed and 13 grey literature sources) were included in this review. The majority reported an amount of waste, typically as a weight or percentage. Key findings of the review were that plate waste was the most measured food waste in residential aged care (n = 14) and that most studies used weighed methods (n = 10) or visual estimation (n = 6) to measure waste. Ten strategies to reduce food waste in this setting were identified, and only three studies conducted interventions to reduce food waste.

Conclusion: This scoping review identified that plate waste was the most common type of food waste investigated and measured in this setting. However, measurement of other types of waste such as production and spoilage waste was limited and is an area for future research. This review provides several strategies to reduce food waste in this setting, and future research evaluating these strategies will be valuable for reducing total food waste in residential aged care.

Aims: Nutrition content claims and health claims are commonly displayed on food packaging and are known to influence consumer preferences and purchasing of labelled foods. This study aimed to assess the prevalence of content and health claims found on ready meals in the Australian food supply and examine their alignment with the Nutrient Profiling Scoring Criterion and Standard 1.2.7 of the Food Standards Code.

Methods: In a cross-sectional analysis, ready meal products were identified from the Australian FoodSwitch 2023 database to record serving size, nutrition information, Health Star Rating and claims for each product. The Nutrient Profiling Score was calculated for each product and claim compliance was assessed against Standard 1.2.7. Descriptive statistics were conducted to explore the data for prevalence of content and health claims, and alignment with the relevant standard.

Results: A total of n = 777 ready meals were identified in the database. Eighty-eight percent of products met threshold criteria for eligibility to carry a health claim. In total, 2051 claims were identified, with nutrition content claims the most common (93% of all claims). In total, 92% of nutrition content claims and 39% of general-level health claims complied with all provisions of Standard 1.2.7.

Conclusions: This study highlights the widespread use of claims, particularly nutrition content claims, on ready meal products sold in Australia. Strengthened guidelines and stricter enforcement of claim compliance are essential to prevent misleading claims in the Australian food supply.

Aim: To capture published research describing aged care residents' experiences with food, eating and mealtime environments.

Methods: A scoping review involved a comprehensive search of six electronic databases: Medline, EMBASE, Scopus, CINAHL, Ageline and PsychInfo. No date and language limits were applied. Original research papers using qualitative methods and residents as participants to explore food, eating and/or the mealtime environment were included. Study selection involved screening and then full-text review completed in duplicate. Data from the included studies was extracted and charted and then thematic analysis and interpretive synthesis were applied.

Results: From 3421 studies identified in the database search, 11 studies were included. They explored aged care residents' experiences with food, eating and/or the mealtime environment through interviews, focus groups or observations. Five themes were identified: (1) respecting autonomy; (2) connection and community with others; (3) provision of quality, diverse and culturally appropriate foods; (4) mealtimes and the dining/eating environment; and (5) relationships, availability and skills of staff.

Conclusions: Mealtimes, food and dining experiences have a direct impact on residents' intake. Positive mealtime experiences, quality and varied food choices will maintain and improve outcomes for aged care residents. This review captures how residents experience mealtimes, what food means to them, and the barriers and enablers to resident-centred care. Understanding these may support aged care homes to align with Quality Standards.