Nutrition & Dietetics最新文献

Aim: This cross-sectional study aims to explore the nutritional composition, cost, country of origin and fortification status of plant-based milk products available for purchase in Illawarra supermarkets and make various comparisons between types of plant-based milks and cow's milk.

Methods: Plant-based milk information was collected from nutrition information panels on packaging and manufacturer websites. Product ingredient lists, including fortifiers, were analysed to estimate the nutrient composition of the identified plant-based milks, including nutrients beyond those listed by manufacturers. Descriptive statistics were used to summarise the characteristics of the plant-based milks identified in the audit. For non-normally distributed data, a Kruskal-Wallis H test with pairwise multiple comparisons and a Bonferroni adjustment were undertaken to explore the differences between various types of plant-based milk and cow's milk.

Results: One hundred twenty-nine plant-based milk products were identified in the audit, primarily almond, oat and soy-based beverages. Of these, 80.6% were fortified with calcium; however, fortification with other micronutrients was less common, ranging from 27.1% being fortified with vitamin B12 and 3.1% being fortified with iodine. The median plant-based milk cost was AU$3.5/L (Q1-Q3: AU$2.8-4.5/L) and 87.6% of products were Australian made. Overall, particularly due to low fortification rates, plant-based milks identified in the audit had significantly lower levels of protein, sugar, iodine, phosphorus, zinc and vitamins A, B2 and B12 compared to cow's milk. However, there was no significant difference in protein content between soy milk and cow's milk.

Conclusions: The nutritional content of plant-based milks identified in this audit varied, and in most instances, Australian plant-based milks were found to be nutritionally different to cow's milk.

Aims: Researchers were invited by Aboriginal leaders to collaborate on this study which aimed to assess food intake in the Walgett Aboriginal community to inform long-term community-led efforts to improve food and water security and nutrition.

Methods: Aboriginal adults living in or near Walgett, a remote community in north-west NSW, Australia, completed an adapted Menzies Remote Short-item Dietary Assessment Tool, which was administered verbally and face-to-face in early 2022. Aboriginal people were involved in the survey design, training and collection, and analysis of data. Descriptive statistics were tabulated, overall and by gender, age, and location. Differences by sex, age group (18-44 years versus ≥45 years), and location (Walgett town or other) were determined using a chi-square test.

Results: A total of 242 participants completed the survey; 55% were female. Three-quarters of participants reported meeting the recommendations for discretionary foods (73%); however, more than half (56%) exceeded the recommended maximum serves of sugar-sweetened beverages. The proportion of participants meeting core food group guidelines was 72% for meat, 36% for fruit, 20% for bread and cereals, 6% for dairy, and 3% for vegetables. Overall, none of the participants met the recommended serves of all food groups outlined in the Australian Dietary Guidelines.

Conclusion: Findings show that Walgett Aboriginal community members surveyed were consuming a healthier diet than national data reported for Aboriginal and Torres Strait Islander people in Australia. However, none of the participants were meeting all of the national dietary guidelines, placing them at increased risk of diet-related chronic disease. Local Aboriginal community-led efforts to improve food and water security should include specific strategies to improve nutrition.

Aims: To assess test-retest reliability of both food photography and food diary methods and validity of these data against known values derived from food labels.

Methods: Test-retest reliability analyses of food diary and food photography were compared using single foodstuffs using intra-class correlation coefficients, coefficients of variation, and limits of agreement. For food diaries, 24-h test-retest reliability was also examined. Validity was assessed against weighed analyses. As part of habitual intake, a single foodstuff (randomly allocated from 14 common foods) was consumed by 26 participants over 24-h. On two occasions (14 days apart), single-blind dietary analyses allowed estimation of foodstuff-specific energy and macronutrient content and 24-h intakes.

Results: For food diaries, test-retest reliability was acceptable (weight, energy, carbohydrate, protein, and fat: all intra-class correlation coefficients: >0.990, coefficient of variation percentage: <0.1%, limits of agreements: <0.1 to <0.1, p > 0.05, and effect size: <0.01). For food photography, test-retest reliability was acceptable for weight, energy, carbohydrate, and protein (all intra-class correlation coefficients: >0.898, coefficient of variation percentage: 3.6%-6.2%, limits of agreements: 1.1 to - 44.9, and effect size: 0.01-0.12). Food photography validity was worse than food diaries for all variables (percentage difference: 8.8%-15.3%, coefficient of variation percentage: 7.5%-13.8%, all p ≤ 0.05, and effect size: 0.001-0.11).

Conclusions: Greater reliability and validity occurred in food diaries versus food photography. These findings suggest that using food photography may lead to an underestimation of energy and macronutrient content, which may have implications for dietary interventions and nutritional strategies.

Aim: The aim of this study was to examine expectations, perceptions and attitudes about dietetics services among the Australian and New Zealand public, to provide insights for building a future dietetics workforce that will meet consumer needs.

Methods: A cross-sectional, anonymous, online survey was employed to gain perspectives of a representative sample of Australian and New Zealand adults. Questions were purposely designed to collect views regarding sources of dietary information, expectations of dietetics service providers and factors influencing choice of dietetics service provider. Data were analysed descriptively and using Pearson's chi-square test to assess relationships between categorical variables. Free-text responses were analysed using content analysis.

Results: Of 2601 respondents, approximately one third (32%) had seen a dietitian. Doctors were the most trusted sources of dietary information (87%), particularly with participants over 60 years (χ(1) = 44.168, V = 0.130, p < 0.001). Cost was the most frequently reported factor influencing choice of dietetics services (56%), with 88% of respondents interested in accessing a dietitian, preferably in-person (64%), if they could do so for no cost. Participants anticipated that dietitians would offer services like meal plans (59%) and nutritional analysis (48%) as well as weight and other body measurements (56%). Some expectations such as blood tests (54%) were outside the usual scope of dietetic practice.

Conclusion: The results of this study have implications for practising dietitians, dietetics educators, and funders of dietetics services. Cost as a barrier suggests that advocacy to government for funding type, duration and number of visits to dietitians is still required.

Aim: In 2021, infection control guidelines, including those specific to feeding environments, were introduced by the International Olympic and Paralympic Committees to reduce virus transmission at the Tokyo 2020 Summer and Beijing 2022 Winter games. This observational cross-sectional study aimed to investigate caterers' compliance to these guidelines which included measures for personal hygiene, sanitisation, and physical distancing at these events.

Methods: Expert sport dietitians attending Tokyo (n = 15) and Beijing (n = 7) games were surveyed to rate 11 COVID-19 countermeasures as fully (100%), partially or non-compliant at nine dining locations across both events. Descriptive analysis of each countermeasure based on observed compliance and location was conducted and reported as a proportion of the total responses. To better understand participant perspectives of the factors influencing compliance, open responses were systematically coded into themes and sub-themes by researchers through content analysis. Themes generated from participant comments were categorised based on their relevance to specific countermeasures and locations to identify commonalities and disparities in participant experiences, perceptions, and observations.

Results: All main dining halls at both events were observed as 100% compliant to countermeasures on more occasions compared with Tokyo's venues and satellite villages. However, Beijing's three main dining halls, showed a greater compliance compared with Tokyo's main dining hall, likely due to overcrowding in Tokyo. Comments suggested that smaller dining spaces, with overcrowding, may have contributed to reduced compliance to physical distancing measures. Food safety concerns were raised about gastrointestinal distress in Beijing due to food cross-contamination.

Conclusion: Findings suggest that the food service environment may influence caterers' abilities to comply with foodservice safety and infection control guidelines. In the post-pandemic era, enhanced quality control and standardised risk mitigation strategies are needed to improve athletes' health at international sporting events.

Aims: To describe an Aboriginal cultural immersion delivered to dietetics students at a large university in Australia and assess its effectiveness as a method to teach Aboriginal history, culture, diet, and health in dietetics.

Methods: Taking a strength-based approach, Aboriginal processes of learning were privileged, with the cultural immersion being co-designed with immersion educators, a First Nations researcher, and dietetics academic. The cultural immersion consisted of an opening ceremony and four stations of yarning, weaving, bush tucker, and artefacts/medicines. A mixed-methods approach was used, with triangulation of data from pre- and postsurveys, station mapping, and focus group interviews. Quantitative and qualitative data were simultaneously analysed from participating first-year Master of Nutrition and Dietetics students and then drawn together for an integrated understanding of the impact of the cultural immersion on student learnings.

Results: Fifty-three students completed pre- and postsurveys and 36 participated in focus groups. Through sharing lived experiences, learning through culture, and keeping sessions practical and Aboriginal leadership, each cultural immersion station utilised Aboriginal processes of learning that meaningfully engaged students with Aboriginal education content, appreciate holistic health and increased their general knowledge on Aboriginal history, culture, diet, and health (all p < 0.001).

Conclusion: Cultural immersion is one teaching method to enhance student knowledges and can be a part of a programmatic and integrated approach that embeds Aboriginal content throughout the whole curriculum. It is necessary that institutions recognise the value of cultural immersions to student learnings and commit to providing ongoing support.

Aims: This study aimed to review meta-analyses of randomised controlled trials that evaluated the effectiveness of the Mediterranean Diet for the primary and secondary prevention of cardiovascular disease.

Methods: Five databases (Medline, Embase, Cochrane, CINAHL and ProQuest) were searched from inception to November 2022. Inclusion criteria were: (i) systematic review of randomised controlled studies with metanalysis; (ii) adults ≥18 years from the general population with (secondary prevention) and without (primary prevention) established cardiovascular disease; (iii) Mediterranean Diet compared with another dietary intervention or usual care. Review selection and quality assessment using AMSTAR-2 were completed in duplicate. GRADE was extracted from each review, and results were synthesised narratively.

Results: Eighteen meta-analyses of 238 randomised controlled trials were included, with an 8% overlap of primary studies. Compared to usual care, the Mediterranean Diet was associated with reduced cardiovascular disease mortality (n = 4 reviews, GRADE low certainty; risk ratio range: 0.35 [95% confidence interval: 0.15-0.82] to 0.90 [95% confidence interval: 0.72-1.11]). Non-fatal myocardial infarctions were reduced (n = 4 reviews, risk ratio range: 0.47 [95% confidence interval: 0.28-0.79] to 0.60 [95% confidence interval: 0.44-0.82]) when compared with another active intervention. The methodological quality of most reviews (n = 16/18; 84%) was low or critically low and strength of evidence was generally weak.

Conclusions: This review showed that the Mediterranean Diet can reduce fatal cardiovascular disease outcome risk by 10%-67% and non-fatal cardiovascular disease outcome risk by 21%-70%. This preventive effect was more significant in studies that included populations with established cardiovascular disease. Better quality reviews are needed.

Aim: Shocks to the food system (such as extreme weather events, wars, and pandemics) are felt by institutional food systems. For hospitals, these shocks affect the quantity, quality, and variety of foods that can be offered to patients. One strategy to buffer the hospital food supply from external threats is to prioritise ingredients produced locally. Thus, the aim of the current research is to describe the country of origin of all foods purchased by a large, metropolitan healthcare organisation and to identify opportunities for improving the locality of the food supply.

Methods: This study was of a cross-sectional, observational design. The country of origin for all foods procured over a 1-year period by a large, urban healthcare organisation was determined by proportion of food budget spend. State of origin was identified for fresh fruit, vegetables, and meat. The organisation was in Queensland, Australia and utilised a cook-fresh, room-service foodservice model. Descriptive analysis was used to to determine the number of items and the proportion of budget spend on all foods produced in Australia, and by food category. Similar descriptive statistics were generated to determine the proportion of the budget spend on fresh fruits, vegetables and meats produced in Queensland.

Results: Over the 1-year period, 659 individual food items were purchased by the hospital foodservice, and 502 food items were included in the anlaysis. In total, 53% of the food budget was spent on Australian foods (100% Australian ingredients) and almost all fruit (73%) and vegetables (91%) were Australian grown. Procuring fresh fruit (28%), vegetables (35%), and meat (46%) from within the state was less common, and this may reflect the primary states of production across Australia, and seasonal variability of the food supply.

Conclusions: Findings offer priority areas for improving the locality of the food supply. Future research to determine if procuring more foods locally has benefits to consistency of the food supply is warranted.