Nutrition & Dietetics最新文献

Aims: To quantify the volume of tray-line packaging waste at an Australian metropolitan tertiary hospital and explore current disposal methods and their environmental impact.

Methods: The patient menu ordering system was used to retrospectively quantify packaged menu items served on the tray-line from March 2023 to March 2024, with some of the data extrapolated from a 3-month period to provide an estimate of 12-month quantities. The packaged weight of all menu items was multiplied by the number of times they were plated and served to patients. Carbon emissions (expressed as carbon equivalents) were calculated using the methods outlined in the Australian Government National Greenhouse Accounts Factors 2023.

Results: Packaging waste was analysed for 1068 main meals and 712 mid-meals over 365 days. Sixteen tonnes of food packaging was sent to patients, all of which was sent to landfill. This equates to 7.73 tonnes of carbon equivalents. Of this food packaging, 9.4 tonnes of waste (60%) had the potential to be recycled and diverted from landfill.

Conclusion: This study quantified the annual packing waste generated from this tertiary hospital food service tray-line. Implementation of a recycling system could divert significant packaging waste from landfill and reduce carbon emissions.

Aims: Iodine and selenium are important nutrients for thyroid function; however, the New Zealand food supply is generally low in both minerals. Bread can be a good source of these minerals; although the popularity of lower carbohydrate diets means some people avoid bread. This study aimed to investigate the effect of low bread intakes on iodine and selenium intakes and status, and thyroid function in mid-life women in New Zealand.

Methods: Self-selecting women (n = 46), aged 40-63 years, with a mean daily intake of 1.6 ± 1.5 slices of fortified commercial bread, were recruited into a cross-sectional study in Auckland, New Zealand. Assessment of iodine and selenium intake was via a 3-day diet diary. Iodine and selenium concentrations were measured in 24-h urine samples and selenium concentrations in plasma using inductively coupled plasma mass spectrometry. Thyroid hormones including triiodothyronine and thyroxine were also determined.

Results: Median urinary iodine concentration was 49 (35, 78; 25, 75 centile) μg/L indicating iodine deficiency. Of plasma samples measured, 32% had selenium concentrations below 110 μg/L, suggesting inadequacy. Data suggested at least 40% of participants had low intakes of both nutrients. Only two participants had impaired thyroid function; however, plasma selenium concentrations predicted the ratio of triiodothyronine to thyroxine (p = 0.038).

Conclusions: A high prevalence of inadequate selenium and iodine intake was observed in women with low bread intakes. Those with low bread intakes need to ensure they consume alternative sources such as dairy, fish and seafood, eggs, meat, other grains, and nuts.

Aim: The objective of this study was to explore changes in Australian consumer food behaviours during COVID-19 public health restrictions (lockdown), to provide insights into how this unforeseen crisis event affected dietary behaviour patterns.

Methods: An online cross-sectional survey was conducted in September 2020 with a nationally representative sample of the Australian adult population. Participants were asked to complete questions about (1) meal planning and food purchasing and (2) barriers to cooking, before and during a national-wide COVID-19 lockdown in early 2020. A survey-adjusted logistic regression analysis was used to identify food behaviour changes resulting from the lockdown.

Results: A total of 4022 respondents completed the survey. Overall, food behaviour changes were found to be small and mostly positive. Eight of the 14 meal planning and purchasing related behaviours improved. This included more frequent meal planning and more time to be able to cook. However, not all changes were healthier, with more respondents reporting that they cooked meals at home using healthy ingredients less frequently during the lockdown.

Conclusion: These findings demonstrate that people are willing and able to make some positive changes when they have time but that more work needs to be done to ensure that the improvements in food literacy result in healthier meals. Further consideration also needs to be given to how we can embed and amplify these positive changes into everyday habits now that public health restrictions have lifted and Australia is in post-lockdown reality.

Aims: This qualitative study aimed to explore residents' experiences of autonomy in relation to their meals pre and post-intervention, which implemented a restaurant-style dining service and increased the number of meal choices available in one residential aged care home.

Methods: Participants completed semi-structured interviews pre- and post-intervention. Interviews were transcribed and analysed using reflexive thematic analysis. Adopting an interpretivist approach, the researchers prioritised participants' subjective experiences and engaged collaboratively in reflexive practices to examine their positionality while developing themes.

Results: Twenty participants completed pre-interviews and eighteen completed post-interviews. Themes developed from pre-intervention interviews included 'Autonomy in residential aged care homes: Ideal versus reality', 'Values and expectations of residential aged care' and 'Disempowerment within residential aged care systems'. Themes from post intervention interviews included 'Reclaiming Autonomy' 'System design to support autonomy and Autonomy beyond meal choice'.

Conclusion: Residents in residential aged care encounter institutional factors that undermine their sense of autonomy. However, foodservice systems have the potential to enhance choice and autonomy and positively impact residents.

Aim: To analyse the nutritional quality of ready meals produced by a food relief charity in Melbourne, Victoria, to identify areas of nutritional strength and opportunities for improvement.

Methods: Data for this cross-sectional study were collected over 30 consecutive cooking days in January-February, May-June, and October-November 2023. Chefs used pre-specified, standardised forms to collect data such as raw ingredients and cooked weights. Data collected were entered into FoodWorks 10 for analysis. Average nutrient content and number of food group serves per meal were reported. Six criteria were used to assess nutritional quality, for noncommunicable disease prevention: contains ≥1 serve (i.e., ≥75 g) non-starchy vegetables per meal, does not contain processed meats, used wholegrains, sodium <700 mg/meal, sugar <15 g/100 g, and unsaturated: saturated fat ratio ≥2:1.

Results: Ninety meal batches were collected and analysed per single meal serving. All meals contained ≥1 serve of non-starchy vegetables and <15 g of sugar/100 g. Two out of 90 meals contained processed meats (i.e., sausages), and only one meal used wholegrains. Half of all meals met the <700 mg sodium/meal criteria, with the meals containing a mean (SD) 794 mg (378.5) of sodium. Most meals (62%) did not meet the ≥2:1 unsaturated: saturated fat ratio.

Conclusions: Meals contained adequate non-starchy vegetable content, were low in sugar, and had minimal use of processed meats. Improvements could be made to their wholegrain, sodium, and fat content. Improving the nutritional quality of charitable meals could significantly improve recipients' health, without detracting from the call for policy action on food insecurity.

Aim: This qualitative study aimed to gain insights from Australian consumers to inform the development of potential interventions to facilitate better portion control of discretionary foods.

Methods: Four focus group sessions were conducted online with Australian adults (aged 18-65). A semi-structured question guide with proposed interventions in selected settings (cafes and supermarkets) was developed to moderate the discussion. Collected data were analysed using a combined approach; deductive thematic analysis was conducted using a predeveloped codebook, followed by inductive thematic analysis which was used to capture additional patterns raised from the data.

Results: A total of 35 participants completed the study (mean age 38, 19 females). Three major themes were identified; (1) portion control challenges posed by the food environment, (2) support for portion size interventions conditional upon consistent unit pricing, and (3) the trade-off between smaller sizes, cost, and packaging waste. The current food environment was identified as promoting overconsumption, with larger serving sizes reported to be more ubiquitous and better value for money than smaller sizes. Participants mostly supported interventions that improve portion control of discretionary foods by providing a wider range of serving size options that meet their personal preferences, with proportional pricing whilst simultaneously reducing default serving sizes. However, the increase in packaging waste as a result of the greater availability of smaller packages was noted as a concern.

Conclusions: Future research should focus on gathering more representative data from various population subgroups to inform public health recommendations aimed at improving discretionary food portion control.

Aim: Food literacy programs aim to improve food related skills and knowledge and are selected Governments as a strategy to address dietary intakes at a community level. The purpose of this research is to identify behaviour change techniques in a food literacy program, which were assessed by the achievement of participant goals related to food literacy and dietary behaviour changes.

Methods: Consensus methods were applied to map behaviour change techniques to an adult food literacy program. A second phase investigation applied content analysis of participant process evaluation data (collected between 2016 and June 2021) to align target behaviours and behaviour change techniques. Chi-square and ANCOVA were used to assess the statistically significant demographic characteristics, food literacy, and dietary behaviour scores for participants who set goals and recorded changes.

Results: A total of 4697 program participants provided evaluation data from the 4-week food literacy program. Participants who set goals and made changes were statistically more likely to have higher food literacy factor scores (p < 0.001) and fruit serves (p = 0.004). Statistical analysis showed that participants were more likely to have set goals and recorded changes if they were female (p < 0.001), older (p < 0.001), higher education level (p < 0.001), had a higher socioeconomic status (p = 0.049), lived with children (p = 0.014), were born in Australia (p = 0.019), or did not identify as Indigenous (p < 0.001). The behaviour change technique mapping process identified nine techniques used weekly and a total of 22 techniques used over the entire 4 week program curriculum.

Conclusions: This is the first Australian study to link the contribution of behaviour change techniques to food literacy and dietary behaviour change in an established effective food literacy program. Knowing the behaviour change techniques associated with effective programs will facilitate replication of effective interventions.

Aim: The Australian Academy of Science's Decadal Plan for the science of nutrition emphasised research investment combined with system wide changes to improve the population's nutritional health. This study applied a Delphi consensus process with the aim to develop a definition for 'paediatric nutrition research' alongside identifying research themes and specific key priorities.

Methods: Multidisciplinary health professionals with expertise in paediatric nutrition were invited to participate in an on-line survey. Panellists contributed to refining a new definition of paediatric nutrition research. Consensus was sought on nine priority areas under which more specific topics were listed, with panellists using a 7-point Likert scale to rate priority statements. Approval was considered where agreement was reached by ≥70% of participants, with a ranked score ≥6.

Results: Participants (n = 104) were invited with n =31 agreeing (response rate: 30%). The majority (n = 28) also completed round 2. The proposed definition of paediatric nutrition research was agreed by 86% of first round respondents. This process generated 7 research themes containing 30 specific topic priorities. The themes were: growth and development; health equity and priority populations; food systems and food access; Aboriginal and Torres Strait Islander Peoples; strengthening prevention and treatment; empowering children, parents, and caregivers to maximise healthy development; and strengthening the workforce.

Conclusions: This study will support the prioritisation of critical nutrition research questions and inform the skills and expertise required within cross-disciplinary teams needed to tackle the identified priorities. Consultation with Aboriginal and Torres Strait Islander leaders and consumer representatives is required to understand the specific needs of priority communities.

Aims: The integration of behaviour change science into dietetics education is crucial for developing competent health practitioners. However, the ability of final placements to provide student dietitians with the opportunity to practice skills for supporting dietary behaviour change is not yet understood. This study aims to explore how placements shape the development of dietetics students' knowledge and skills in behaviour change through the novel approach of drawing on practice educator and student perspectives.

Methods: Using a constructivist approach, qualitative data were collected through semi-structured interviews with practice educators and focus groups with graduating dietitians. Questions aimed to explore the practice educator role in developing student behaviour change skills and aspects of hospital placement that improved student confidence. Data were transcribed verbatim and analysed using inductive thematic analysis to identify key themes and sub-themes.

Results: Eleven hospital-based practice educators and eight dietetics graduands participated. Three key themes were identified: (1) limited modelling of behaviour change within a hospital placement; (2) experiential learning needed to consolidate behaviour change skill development; and (3) the need to strengthen behaviour change science in dietetics. Throughout each theme, educators and students described challenges to skill development on placement, such as limited opportunities to practise behaviour change interventions, insufficient attention to behaviour change in feedback and assessment, and differing educator confidence in teaching these skills.

Conclusions: This study suggests a need to strengthen opportunities for students to link theoretical and practical learning of behaviour change skills to work toward producing a workforce of confident behaviour change agents.