Nutrition & Dietetics最新文献

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.

Aim: To modify the Australian and New Zealand Health Star Rating to account for ultra-processing and compare the alignment of the modified ratings with NOVA classifications and the current Australian Dietary Guidelines classifications of core (recommended foods) and discretionary (foods to limit).

Methods: Data was cross-sectionally analysed for 25 486 products. Four approaches were compared to the original Health Star Rating: (1) five 'negative' points added to ultra-processed products (modification 1; inclusion approach); (2) ultra-processed products restricted to a maximum of 3.0 Health Stars (modification 2; capping approach); (3 and 4) same approach used for modifications 1 and 2 but only applied to products that already exceeded 10 'negative' points from existing Health Star Rating attributes (modifications 3 and 4, respectively; hybrid approaches). Alignment occurred when products (i) received <3.5 Health Stars and were NOVA group 4 (for NOVA comparison) or discretionary (for Dietary Guidelines comparison), or (ii) received ≥3.5 Health Stars and were NOVA groups 1-3 or core.

Results: All Health Star Rating modifications resulted in greater alignment with NOVA (ranging from 69% to 88%) compared to the original Health Star Rating (66%). None of the modifications resulted in greater alignment to the Dietary Guidelines classifications overall (69% to 76%, compared with 77% for the original Health Star Rating), but alignment varied considerably by food category.

Conclusions: If ultra-processing were incorporated into the Australian and New Zealand Health Star Rating, consideration of ultra-processing within the broader dietary guidance framework would be essential to ensure coherent dietary messaging to Australians.

Aims: To (1) synthesise evidence from Health at Every Size® interventions on physical and psychological health in people with overweight and obesity and (2) report between-group differences within interventions evaluating the impact of Health at Every Size® interventions on health and health-related outcomes.

Methods: Six databases (Medline, Embase, Cochrane, PsychInfo, CINAHL, and Scopus) were searched from inception until November 2022. Included studies were conducted in adults with overweight or obesity, used Health at Every Size®-based interventions compared with control interventions and reported dietary, physical and/or psychological outcomes, including diet quality, anthropometry, or quality of life. Data on between-group differences were extracted. Risk of bias was assessed using ROB2. Random-effects meta-analyses were undertaken for outcomes with at least three studies reporting the same or comparable data.

Results: From 128 studies identified, 19 full-text articles (10 unique studies, 6 published since 2017), were included. Meta-analysis found a significant reduction for susceptibility to hunger in Health at Every Size® intervention groups relative to controls (p = 0.005), with no significant difference (p > 0.05) between Health at Every Size® interventions and control groups for anthropometric, psychological or cardiometabolic outcomes (total cholesterol, HDL cholesterol, triglycerides, systolic or diastolic blood pressure).

Conclusion: Health at Every Size® interventions had similar results compared with weight-based interventions on anthropometric outcomes and cardiometabolic outcomes. Health at Every Size® interventions had a significant benefit for reducing susceptibility to hunger. The decision to use a Health at Every Size®-based intervention should be personalised to individual needs. Further research in more diverse populations is required using standardised outcome measures to facilitate future meta-analyses.

Aims: This cross-sectional observational study quantified Australian Football League Women's athletes' match volume, and compared match-day dietary intakes against recommendations.

Methods: Self-report, direct observation, and fluid measurements determined dietary intake (n = 17, 25 ± 4.5 years, 22.8 ± 1.8 kg/m²) on five home match days (early or late starting). Global positioning system software captured match volume. Linear mixed effects models evaluated differences in early versus late match volume and nutrient intakes. Data are presented as mean ± standard deviation.

Results: Athletes covered 6712 ± 622 m during matches, with similar numbers of very high-intensity running efforts over equal distances in early and late matches (early vs. late efforts [no.]: 8.5 ± 4.9 vs. 9.5 ± 5.5; distance [m]: 203 ± 127 vs. 212 ± 113). Across all match days, 71% (n = 12) of athletes met their predicted daily energy requirements. However, 82% (n = 14) failed to meet minimum daily carbohydrate recommendations; intake was lower on early compared with late match days (4.7 g/day vs. 5.4 g/kg/day, p = 0.027). On average, no athletes met carbohydrate recommendations in the 2 h prior to a match and only 24% (n = 4) met recommendations during matches. All athletes met post-match carbohydrate and protein requirements.

Conclusion: Athletes cover large distances during games with frequent bursts of high-intensity running. However, they do not adjust their intake to meet the energy demands of competition, with inadequate fuelling prior to and during matches. These findings emphasise the need for greater athlete education and dietary support to maximise strategic fuelling to optimise athletic performance.