Journal of Human Nutrition and Dietetics最新文献_第10页

Designing a behaviour change intervention using COM-B and the Behaviour Change Wheel: Co-designing the Healthy Gut Diet for preventing gestational diabetes 利用 COM-B 和行为改变轮设计行为改变干预措施：共同设计健康肠道饮食，预防妊娠糖尿病。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-07-25 DOI: 10.1111/jhn.13355

Nina Meloncelli, Hannah O'Connor, Susan de Jersey, Alita Rushton, Kelsey Pateman, Samantha Gallaher, Lauren Kearney, Shelley Wilkinson

Background

Evidence suggests that modulating the gut microbiota during pregnancy may help prevent gestational diabetes mellitus (GDM). The Healthy Gut Diet study is a complex behaviour change intervention co-designed with women who have a lived experience of GDM. The aim of the study was to describe the development of the behaviour change dietary intervention, the Healthy Gut Diet.

Methods

This study followed the process for designing behaviour change interventions using the Behaviour Change Wheel. Six researchers and 12 women with lived experience participated in online workshops to co-design the Healthy Gut Diet intervention. This included “diagnosing” the barriers and enablers to two target behaviours: eating more plant foods and eating less ultra processed/saturated fat containing foods. Content analysis of the workshop transcripts and activities was undertaken, underpinned by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF).

Results

Barriers and enablers to the target behaviours were described across all six COM-B components and 10 TDF domains. The intervention functions for the Healthy Gut Diet were education, enablement, environmental restructuring, persuasion and incentivisation. Forty behaviour change techniques were integrated into five modes of delivery for the Healthy Gut Diet intervention. The feasibility, acceptability and effectiveness of the Healthy Gut Diet is being tested within a randomised controlled trial.

Conclusions

Using the Behaviour Change Wheel process in partnership with consumers resulted in a clearly described complex intervention targeting barriers and enablers of dietary behaviour change to improve the gut microbiota diversity in pregnant women.

背景：有证据表明，调整孕期肠道微生物群有助于预防妊娠糖尿病（GDM）。健康肠道饮食研究是一项复杂的行为改变干预措施，由具有 GDM 生活经验的妇女共同设计。研究的目的是描述行为改变饮食干预--健康肠道饮食--的发展过程：本研究采用行为改变轮来设计行为改变干预措施。六名研究人员和 12 名有生活经验的妇女参加了在线研讨会，共同设计健康肠道饮食干预措施。这包括 "诊断 "两种目标行为的障碍和促进因素：多吃植物性食物和少吃超加工/含饱和脂肪的食物。以能力、机会、动机和行为（COM-B）模型和理论领域框架（TDF）为基础，对研讨会记录和活动进行了内容分析：结果：在能力、机会、动机和行为（COM-B）模型和理论领域框架（TDF）的 10 个领域中，对目标行为的障碍和促进因素进行了描述。健康肠道饮食的干预功能包括教育、赋能、环境重组、说服和激励。健康肠道饮食 "干预措施的五种实施模式整合了 40 种行为改变技术。目前正在随机对照试验中测试健康肠道饮食的可行性、可接受性和有效性：结论：通过与消费者合作使用 "行为改变轮 "程序，针对饮食行为改变的障碍和促进因素，制定了一项描述清晰的复杂干预措施，以改善孕妇肠道微生物群的多样性。

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引用次数: 0

Assessing the nutritional status and impact of a series of nutritional interventions on elderly inpatients using bioelectrical impedance analysis: A service evaluation 利用生物电阻抗分析评估老年住院患者的营养状况和一系列营养干预措施的影响：服务评估。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-07-22 DOI: 10.1111/jhn.13352

Claire Constantinou, Joanne Jefford, Marzena Zygo, Judith White, Megan Dale, Rhys Morris, Judyth Jenkins

Background

The aim of the study was to use bioelectrical impedance analysis (BIA) to assess nutritional status of elderly patients admitted to hospital and quantitatively measure the impact of the Cardiff and Vale University Health Board (CAVUHB) model ward. Secondary objectives were to assess the feasibility of using BIA in this patient population and compare nutrition risk screening tools against fat-free mass index (FFMI).

Methods

A prospective, comparative, single-centre, service evaluation of a 'model ward for nutrition and hydration' undertaken in medical and rehabilitation beds in a large UK teaching hospital.

Results

A total of 450 BIA measurements were taken using a Bodystat Multiscan 5000 on 162 patients; several patients had repeated measurements during their hospital stay. Patients tolerated the procedure well, but lack of accurate weight, implanted medical devices and tissue viability precluded some participants.

Conclusions

BIA is quick, non-invasive, simple to complete and can elicit huge data about an individual's body composition. In a larger cohort of medical admissions, BIA could assist in identifying the sensitivity and specificity of the nutrition screening tools. The collective benefit of a series of nutritional interventions preserved nutritional status better in this elderly inpatient population than usual models of care. Although results were not statistically significant, there is an opportunity with the new model of care to better support frail patients and prevent deconditioning.

研究背景该研究旨在使用生物电阻抗分析（BIA）评估入院老年患者的营养状况，并定量测量卡迪夫和淡水河谷大学卫生局（CAVUHB）示范病房的影响。次要目标是评估在这一患者群体中使用 BIA 的可行性，并将营养风险筛查工具与去脂体重指数 (FFMI) 进行比较：方法：在英国一家大型教学医院的医疗和康复病床上对 "营养和水化示范病房 "进行前瞻性、比较性、单中心服务评估：使用 Bodystat Multiscan 5000 对 162 名患者进行了 450 次 BIA 测量；其中几名患者在住院期间进行了重复测量。患者对测量过程的耐受性良好，但由于体重不准确、植入医疗设备和组织存活性等原因，一些患者无法参与测量：结论：BIA 快速、无创、操作简单，可获得有关个人身体成分的大量数据。在更大的医疗入院人群中，BIA 可以帮助确定营养筛查工具的敏感性和特异性。与通常的护理模式相比，一系列营养干预措施的集体效益能更好地保持老年住院病人的营养状况。虽然结果没有统计学意义，但新的护理模式有机会更好地支持体弱病人，防止他们的体质下降。

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引用次数: 0

Transition to work: A qualitative exploration of Australian-trained international dietetic graduates' career trajectories 向工作过渡：对澳大利亚培训的国际营养学毕业生职业轨迹的定性探索。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-07-16 DOI: 10.1111/jhn.13351

Ying Pik Chow, Cho Wan Wong, Merran Blair, Tammie Choi

Background

Interest in the role of employability in student–dietitian transitions is increasing. However, little is known about the cross-cultural transition-to-work experience of Australian-trained dietetic graduates of international backgrounds, as well as strategies to optimise work-readiness. The present study aimed to explore graduates’ career narratives and identify employability capitals that enabled successful transitions to work.

Methods

A qualitative interpretive approach was employed via a cultural lens. Eighteen participants from five Asian countries who had graduated from an Australian university within 3–15 years, with work experience in Australia or in their respective home countries, took part in in-depth interviews. Thematic analysis was performed, guided by the graduate capitals based approach.

Results

Transition-to-work was dynamic and non-linear; four themes and 12 subthemes identified: (1) upon graduation, participants felt ambivalent about their decision to either stay in Australia or return home, influenced by graduate visa restrictions, and individual perceptions of their ability to mobilise cultural strengths to gain employment; (2) to get a foot in the door, participants demonstrated resilience, embraced uncertainty and utilised social networks to increase employment opportunities in Australia and their home countries; (3) regardless of which country they worked, graduates reported struggling with their cross-cultural identities in the workplace; and (4) eventually, these graduates appreciated their ethnic capital, thrived in their work and extended a helping hand to their junior cross-cultural dietitians.

Conclusions

Initiatives facilitating connections to the host country and supporting cultural and ethnic capital development, along with ongoing research reviewing employability capital applications, will benefit cross-cultural dietetic graduates and the communities they potentially will serve.

背景：人们越来越关注就业能力在学生-营养师过渡中的作用。然而，人们对具有国际背景的澳大利亚营养学毕业生的跨文化工作过渡经历以及优化工作准备的策略知之甚少。本研究旨在探索毕业生的职业生涯叙事，并确定能够帮助他们成功过渡到工作岗位的就业能力资本：方法：采用文化视角的定性阐释法。来自五个亚洲国家、毕业于澳大利亚大学3-15年内、在澳大利亚或本国有工作经验的18名参与者参加了深度访谈。在以毕业生资本为基础的方法指导下进行了专题分析：结果：向工作的过渡是动态和非线性的；确定了四个主题和 12 个次主题：(1) 毕业时，受毕业生签证限制的影响，以及个人对其调动文化优势以获得就业的能力的认识，参与者对留在澳大利亚或回国的决定感到矛盾；(2) 为了获得就业机会，参与者表现出了坚韧不拔的精神，接受了不确定性，并利用社会网络增加了在澳大利亚和本国的就业机会；(3) 无论在哪个国家工作，毕业生都表示在工作场所与自己的跨文化身份作斗争；以及 (4) 最终，这些毕业生欣赏自己的民族资本，在工作中茁壮成长，并向他们的初级跨文化营养师伸出援助之手。结论：促进与东道国的联系、支持文化和种族资本发展的举措，以及正在进行的审查就业能力资本应用的研究，将使跨文化营养学毕业生和他们可能服务的社区受益。

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引用次数: 0

An app promoting weight gain prevention via healthy behaviours amongst young women with a family history of breast cancer: Acceptability and usability assessment 在有乳腺癌家族史的年轻女性中推广通过健康行为预防体重增加的应用程序：可接受性和可用性评估。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-07-14 DOI: 10.1111/jhn.13347

Mary Pegington, Rhiannon E. Hawkes, Alan Davies, Julia Mueller, Anthony Howell, D. Gareth Evans, Sacha J. Howell, David P. French, Michelle Harvie

Background

Breast cancer is the most frequent female malignancy in the UK. Around 20% of cases are linked to weight gain, excess weight and health behaviours. We designed a weight gain prevention, health behaviour intervention for young women at increased risk.

Methods

The study comprised a single arm observational study over 2 months testing acceptability and usability of the intervention: online group welcome event, app and private Facebook group. Females aged 18–35 years at moderate or high risk of breast cancer (>17% lifetime risk) were recruited via invite letters and social media posts. The app included behaviour change techniques and education content. Online questionnaires were completed at baseline, as well as at 1 and 2 months. We also assessed feasibility of study procedures.

Results

Both recruitment methods were successful. Thirty-five women were recruited, 26% via social media posts. Median age was 33 (interquartile range = 28.2–34.5) years, the majority (94.1%) were of White ethnicity. Thirty-four participants were included in the analyses, of which 94% downloaded the app. Median self-monitoring logs per participant during the study period was 10.0 (interquartile range = 4.8–28.8). App quality mean (SD) score was 3.7 (0.6) at 1 and 2 months (scale: 1–5). Eighty-nine per cent rated the app at average or above at 1 month and 75.0% at 2 months. Nineteen women (55.9%) joined the Facebook group and there were 61 comments and 83 reactions and votes from participants during the study period.

Conclusions

This first iteration of the app and intervention was well received and is suitable to progress to the next stage of refining and further testing.

背景：乳腺癌是英国最常见的女性恶性肿瘤：乳腺癌是英国最常见的女性恶性肿瘤。约 20% 的病例与体重增加、体重过重和健康行为有关。我们为高危年轻女性设计了一种预防体重增加的健康行为干预方法：研究包括为期两个月的单臂观察研究，测试干预措施的可接受性和可用性：在线小组欢迎活动、应用程序和私人 Facebook 小组。通过邀请信和社交媒体帖子招募 18-35 岁的中度或高度乳腺癌风险女性（终生风险大于 17%）。应用程序包括行为改变技巧和教育内容。在基线以及 1 个月和 2 个月时填写在线问卷。我们还评估了研究程序的可行性：两种招募方法都很成功。共招募了 35 名女性，其中 26% 通过社交媒体发布。年龄中位数为 33 岁（四分位间范围 = 28.2-34.5），大多数（94.1%）为白人。34 名参与者参与了分析，其中 94% 的人下载了应用程序。每位参与者在研究期间的自我监测日志中位数为 10.0（四分位间范围 = 4.8-28.8）。1 个月和 2 个月时，应用程序质量的平均值（标度）为 3.7 (0.6)（评分标准：1-5）。89% 的人在 1 个月和 2 个月时将应用程序评为平均或以上，75.0% 的人将应用程序评为平均或以上。19 名妇女（55.9%）加入了 Facebook 群组，在研究期间，参与者共发表了 61 条评论，作出了 83 次反应和投票：该应用程序和干预措施的首次迭代广受好评，适合进行下一阶段的改进和进一步测试。

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引用次数: 0

Feasibility and preliminary efficacy of an online nutrition education intervention for those with a sleeve gastrectomy: A pilot randomised control trial 针对袖状胃切除术患者的在线营养教育干预的可行性和初步疗效：随机对照试验。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-07-14 DOI: 10.1111/jhn.13348

Cathy Harbury, Vanessa A. Shrewsbury, Clare E. Collins, Robin Callister

Background

A sleeve gastrectomy (SG) is a lifelong treatment that improves health and better outcomes are associated with follow-up. However, there is lack of access or high attrition to aftercare. This potentially contributes to sub-optimal dietary intake and a lack of evidence for nutrition interventions. The present study assessed the feasibility and preliminary efficacy of a nutrition intervention to improve diet quality in Australian adults living with a SG.

Methods

Adults (n = 96) post-SG were recruited into a cross-sectional diet quality study, with 68 eligible for randomisation to an intervention or wait-list control group. Over 10 weeks, a Facebook group was used to post daily nutrition education. Feasibility outcomes included participant recruitment, engagement, retention and acceptability. Preliminary efficacy was assessed using change in Australian Recommended Food Score (ARFS). Linear mixed models were used to measure differences in mean outcome between the experimental groups over time.

Results

Sixty-eight participants (97% female) aged 48.2 ± 9.8 years, body mass index 33.1 ± 5.8 kg/m², and mean ± SD ARFS 39 ± 9 points were randomised to the intervention, with 66% retention at 10 weeks. At follow-up, diet quality increased for the intervention group (mean ARFS, 95% confidence interval = 0.2 [−1.5 to 1.9]) and decreased for the control group (mean ARFS, 95% confidence interval= −2.0 [−5.2 to 1.2]) with no between group difference (p = 0.2). Participants (n = 30) rated the intervention positively.

Conclusions

Recruiting and retaining adults post-SG into a nutrition intervention is feasible. Low-cost recruitment attracted strong interest from women to identify greater support to know what to eat following SG. A future fully powered trial to assess intervention efficacy is warranted.

背景：袖带胃切除术（SG）是一种可改善健康状况的终生治疗方法，其更好的效果与后续治疗有关。然而，人们缺乏接受术后护理的机会，或术后护理的流失率很高。这可能会导致饮食摄入量低于最佳水平，而且缺乏营养干预的证据。本研究评估了营养干预的可行性和初步效果，以改善澳大利亚成年 SG 患者的饮食质量：一项横断面饮食质量研究招募了 SG 后成年人（n = 96），其中 68 人符合随机分配到干预组或候补对照组的条件。在为期 10 周的时间里，Facebook 小组每天都会发布营养教育信息。可行性结果包括参与者招募、参与、保留和可接受性。初步效果通过澳大利亚推荐食物评分（ARFS）的变化进行评估。线性混合模型用于测量实验组之间随着时间推移平均结果的差异：68 名参与者（97% 为女性）被随机分配到干预组，年龄为 48.2 ± 9.8 岁，体重指数为 33.1 ± 5.8 kg/m2，平均± SD ARFS 为 39 ± 9 分，其中 66% 的参与者在 10 周后继续接受干预。在随访中，干预组的饮食质量有所提高（平均 ARFS，95% 置信区间 = 0.2 [-1.5 至 1.9]），对照组的饮食质量有所下降（平均 ARFS，95% 置信区间 = -2.0 [-5.2 至 1.2]），组间无差异（P = 0.2）。参与者（n = 30）对干预措施给予了积极评价：结论：招募并留住 SG 后成年人参与营养干预是可行的。低成本招募吸引了女性的强烈兴趣，她们希望获得更多支持，以了解 SG 后的饮食。未来有必要开展一项全面的试验来评估干预效果。

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引用次数: 0

Consensus study on UK weight management services' response to COVID-19: best practices in outpatient management, governance and digital solutions 英国体重管理服务响应 COVID-19 的共识研究：门诊管理、治理和数字解决方案的最佳实践。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-07-11 DOI: 10.1111/jhn.13346

Guy Holt, David Hughes

Background

The COVID-19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID-19 pandemic.

Methods

This study utilised a semi-structured interview and a modified Delphi methodology to develop a consensus of best practice recommendations identified by specialist weight management services during the pandemic.

Results

Twenty-three healthcare professionals working in weight management service across the United Kingdom participated in the study. Analysis of interview transcripts identified four key thematic domains: outpatient, patient education and support, perioperative care and team working. Of the initial 43 unique recommendations, 30 reached consensus agreement. Outpatient recommendations focused on communication strategies, patient self-monitoring and remote patient tracking. Patient education and support recommendations addressed the development of online educational resources and support groups. Perioperative care recommendations emphasised case prioritisation, waiting list support and postoperative care. Team working recommendations targeted the use of digital collaboration tools and strategies for effective teamwork.

Conclusion

Developing consensus recommendations on best practice is a critical step for weight management and outpatient services to achieve higher standards of care. These recommendations provide a springboard for departmental discussions, paving the way for improved experiences for individuals living with obesity as they progress along their weight management journey.

背景：COVID-19 大流行给体重管理服务带来了前所未有的压力。这些服务机构需要进行调整，以便继续为肥胖症患者提供护理服务。本研究旨在就英国体重管理服务机构在 COVID-19 大流行期间采用的最佳实践解决方案提出共识建议：本研究采用半结构式访谈和改良的德尔菲方法，就大流行期间专业体重管理服务机构确定的最佳实践建议达成共识：英国各地体重管理服务机构的 23 名专业医护人员参与了这项研究。对访谈记录的分析确定了四个关键主题领域：门诊、患者教育和支持、围手术期护理和团队合作。在最初的 43 项独特建议中，有 30 项达成了一致意见。门诊建议侧重于沟通策略、患者自我监控和远程患者追踪。患者教育和支持建议涉及在线教育资源和支持小组的开发。围手术期护理建议强调病例优先排序、候诊名单支持和术后护理。团队工作建议针对数字协作工具的使用和有效团队合作的策略：就最佳实践制定共识建议是体重管理和门诊服务实现更高标准护理的关键一步。这些建议为各部门的讨论提供了跳板，为改善肥胖患者在体重管理过程中的体验铺平了道路。

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引用次数: 0

Supporting the nutrition-related health and well-being of people experiencing socio-economic disadvantage: Findings from a national survey 支持社会经济弱势人群与营养相关的健康和福祉：一项全国性调查的结果。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-07-11 DOI: 10.1111/jhn.13340

Verena T. Vaiciurgis, Annabel K. Clancy, Karen E. Charlton, Anita Stefoska-Needham, Eleanor J. Beck

Background

People experiencing socio-economic disadvantage face significantly higher rates of diet-related health inequities. This study aimed to explore barriers, opportunities and potential solutions in providing food and nutrition services to people experiencing socio-economic disadvantage from the perspective of services providers. The present study is part of a broad co-design model to improve service provision for people experiencing socio-economic disadvantage.

Methods

A cross-sectional online survey involving 33 open and closed-ended questions was distributed to Australian governmental and non-governmental organisations providing nutrition-related support to people experiencing socio-economic disadvantage aged 16 years and over. Data were analysed using frequency distributions and conceptual content analyses.

Results

Sixty-eight responses were analysed. Services are predominantly offered by charitable organisations (90%), funded through private donations (66%) and reliant on volunteers (100%). Barriers to supporting clients’ nutrition needs include financial constraints, limited community engagement, understaffing, insufficient resources and knowledge gaps. Opportunities and solutions for enhancing support include increasing government funding, advocacy initiatives, stronger community collaboration and more holistic, customised services. Proposed recommendations include establishing purpose-built facilities or wrap-around services to expand access to health services, life skills, training and educational programs.

Conclusions

Services face challenges including volunteer reliance, limited resources and inadequate government support, hindering food provision. Client barriers include transportation costs and lack of social support. With dedicated financial support, services can offer comprehensive assistance, including community spaces, staffing, health and social services and training. Community partnerships can maximise funding impact. Solutions must address overall well-being and broader social determinants such as income inequality and housing.

背景：社会经济处境不利的人群面临着与饮食相关的更高比例的健康不平等。本研究旨在从服务提供者的角度探讨为社会经济弱势人群提供食品和营养服务的障碍、机遇和潜在解决方案。本研究是广泛的共同设计模式的一部分，旨在改善为社会经济弱势人群提供的服务：方法：向为 16 岁及以上社会经济弱势人群提供营养相关支持的澳大利亚政府和非政府组织分发了一份横向在线调查，其中包括 33 个开放式和封闭式问题。采用频率分布和概念内容分析对数据进行了分析：对 68 份回复进行了分析。服务主要由慈善机构提供（90%），资金来自私人捐款（66%），并依赖志愿者（100%）。满足服务对象营养需求的障碍包括财政限制、社区参与有限、人员不足、资源不足和知识差距。加强支持的机会和解决方案包括增加政府资金、开展宣传活动、加强社区合作以及提供更全面的定制服务。提出的建议包括建立专门的设施或配套服务，以扩大获得保健服务、生活技能、培训和教育计划的机会：服务面临的挑战包括对志愿者的依赖、资源有限以及政府支持不足，这些都阻碍了食品供应。服务对象面临的障碍包括交通费用和缺乏社会支持。有了专门的资金支持，服务机构就能提供全面的援助，包括社区空间、人员配备、健康和社会服务以及培训。社区伙伴关系可以最大限度地发挥资金的影响。解决方案必须解决整体福祉和更广泛的社会决定因素，如收入不平等和住房问题。

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引用次数: 0

Greenhouse gas emissions of school lunches provided for children attending school nurseries: A cross-sectional study 为幼儿园儿童提供的学校午餐的温室气体排放：一项横断面研究。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-07-02 DOI: 10.1111/jhn.13345

Claire J. Wall, Jo Pearce

Background

Schools and early years settings provide an opportunity to promote healthy and sustainable food, but standards and guidance in England focus predominantly on nutritional quality. The present study estimated greenhouse gas emissions (GHGE) of school lunches provided for children attending school nurseries, including comparison between meal options.

Methods

Menus, recipes and portion weights for lunches provided for 3–4-year-old children attending nine school nurseries were collected daily for one week. GHGE for each food and recipe were calculated using Foodprint functionality of Nutritics software. GHGE were calculated for each menu option (main, vegetarian, jacket potato and sandwich) provided in each school, and for meals with and without meat/fish.

Results

In total, 161 lunches including 273 foods were analysed. Median GHGE across all meals was 0.53 kgCO₂e (i.e. kilograms of carbon dioxide equivalent) per portion, with significantly higher GHGE associated with main meals (0.71 kgCO₂e per portion) compared to all other meal types (0.43–0.50 kgCO₂e per portion; p < 0.001) which remained after adjustment for meal size and energy density. Red meat-based meals were highest in GHGE (median 0.98 kgCO₂e per portion and 0.34 kgCO₂e per 100 g) and meals containing any meat/fish were significantly higher in GHGE (median 0.58 kgCO₂e per portion) than vegetarian meals (median 0.49 kgCO₂e per portion) (p = 0.014). Meals with higher adherence to the nutrient framework underpinning the early years guidelines had significantly higher GHGE than meals with lower adherence (p < 0.001).

Conclusions

The results were comparable to previous estimates of school lunch GHGE and highlight variation by meal option. Consideration of GHGE alongside the nutritional quality of lunches by caterers could support provision of healthy and sustainable lunches.

背景：学校和幼儿教育机构提供了推广健康和可持续食品的机会，但英格兰的标准和指南主要侧重于营养质量。本研究估算了学校为托儿所儿童提供的午餐的温室气体排放量（GHGE），包括不同膳食方案之间的比较：方法：每天收集九所托儿所为 3-4 岁儿童提供的午餐的菜单、食谱和份量，为期一周。使用 Nutritics 软件的 Foodprint 功能计算每种食物和食谱的 GHGE。对每所学校提供的每种菜单选项（主食、素食、夹心土豆和三明治）以及有肉/鱼和无肉/鱼的膳食进行了温室气体基因组学计算：共分析了包括 273 种食物在内的 161 份午餐。所有膳食的 GHGE 中位数为每份 0.53 kgCO2e（即千克二氧化碳当量），与所有其他膳食类型（每份 0.43-0.50 kgCO2e）相比，主食的 GHGE 明显更高（每份 0.71 kgCO2e）。50 kgCO2e；每份 p 2e 和每 100 克 0.34 kgCO2e），含有任何肉类/鱼类的膳食的 GHGE（中位数为每份 0.58 kgCO2e）明显高于素食（中位数为每份 0.49 kgCO2e）（p = 0.014）。较严格遵守幼儿指南营养框架的膳食，其 GHGE 明显高于较不严格遵守的膳食（p 结论：膳食中的 GHGE（中位数为每份 0.58 kgCO2e）高于素食膳食（中位数为每份 0.49 kgCO2e）：研究结果与之前对学校午餐 GHGE 的估计值相当，并突出了不同膳食方案之间的差异。膳食供应商在考虑午餐营养质量的同时，考虑 GHGE，有助于提供健康和可持续的午餐。

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引用次数: 0

The effects of nutrition education on nutritional knowledge and dietary behaviours in primary school students in Zhongshan city 营养教育对中山市小学生营养知识和膳食行为的影响。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-06-30 DOI: 10.1111/jhn.13343

Xinxue Yu, Xiaoxia Huang, Xiaoping Liang, Qian Ou, Liuqiao Sun, Jieru Ren, Qiongmei Wu, Hangjun Chen, Qiaoli Huang, Hanqing Zhao, Jun Wei, Feng Wu, Sizhe Huang, Lijun Wang

Background

Adequate nutritional knowledge and healthy dietary behaviours are essential for promoting rational nutrition for children. However, lack of nutritional knowledge and unhealthy dietary behaviours are common among Chinese children. Therefore, we developed a school-based nutrition education (NE) program to assess its impacts on nutritional knowledge and dietary behaviours in pupils.

Methods

In this trial, one school was assigned as an intervention group (n = 199) and the other two schools were designated as a control group (n = 140). Children in the intervention group received the NE program in addition to their regular health curriculum, whereas the control group continued with their usual health curriculum without any NE program materials.

Results

Concerning nutritional knowledge, the mean difference (follow-up minus baseline) of average knowledge scores in the intervention group was significantly higher than that in the control group (1.99 ± 3.22 vs. 0.66 ± 3.60, p = 0.001). However, subgroup analysis revealed that this difference disappeared among boys and students with malnutrition status. Regarding dietary behaviours, the NE program significantly increased the proportion of children exhibiting high frequencies of meat and nuts consumption in the intervention group, along with diverse food choice at breakfast. Additionally, it markedly reduced the proportion of children exhibiting high frequencies of sugar-sweetened beverages and fast food consumption. Structural equation modelling analyses indicated a significant direct effect of NE intervention on nutritional knowledge and an indirect effect on dietary behaviours.

Conclusions

The NE program effectively enhanced nutritional knowledge scores and further improved dietary behaviours among Chinese primary school students. Future NE programs should pay more attention to boys and children with malnutrition.

背景：充足的营养知识和健康的饮食行为对促进儿童合理营养至关重要。然而，营养知识的缺乏和不健康的饮食行为在中国儿童中十分普遍。因此，我们开发了一个以学校为基础的营养教育（NE）项目，以评估其对学生营养知识和饮食行为的影响：在本次试验中，一所学校被指定为干预组（n = 199），另外两所学校被指定为对照组（n = 140）。干预组的儿童在学习常规健康课程的同时接受营养教育课程，而对照组的儿童则继续学习常规健康课程，不使用任何营养教育课程材料：结果：在营养知识方面，干预组平均知识得分的平均差（随访减去基线）明显高于对照组（1.99 ± 3.22 vs. 0.66 ± 3.60，p = 0.001）。然而，分组分析表明，男生和营养不良学生的这一差异消失了。在饮食行为方面，干预组中高频率食用肉类和坚果的儿童比例以及早餐食物选择多样化的儿童比例在 NE 项目中均有显著提高。此外，该计划还显著降低了儿童高频率饮用含糖饮料和食用快餐的比例。结构方程模型分析表明，NE干预对营养知识有显著的直接影响，对饮食行为有间接影响：结论：营养教育项目有效提高了中国小学生的营养知识得分，并进一步改善了他们的饮食行为。未来的NE项目应更多地关注男童和营养不良儿童。

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引用次数: 0

Informal caregiver and healthcare professional perspectives on dementia and nutrition 非正规护理人员和医疗保健专业人员对痴呆症和营养的看法。

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics

Pub Date : 2024-06-27 DOI: 10.1111/jhn.13344

Corinne Labyak, Claudia Sealey-Potts, Lauri Wright, Crystal Kriek, Stephenie Dilts

Background

Persons living with dementia and informal caregivers are at a higher risk for malnutrition. Most caregivers are not experts at identifying nutritional complications of dementia. Therefore, we aimed to identify nutrition knowledge and challenges related to feeding and caring for persons with dementia to develop a meaningful intervention.

Methods

A mixed-methods approach was used. Eight focus groups were conducted with caregivers of persons living with dementia (n = 28) and healthcare professionals (n = 23). Data was analysed using NVivo software. A questionnaire was administered to identify nutritional challenges. A modified food frequency questionnaire assessed food patterns of caregivers and persons with dementia. Results were compared to Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) dietary guidelines. Data were analysed using SPSS software.

Results

Four major themes emerged: forgetting to eat, developing food aversions, strong preferences for sweets and weight changes. Findings revealed common strategies used to improve nutrition intake included cueing, supplements and quiet eating environment. Caregivers were impacted by stress leading to poorer food choices and exhaustion. Recommendations for a caregiver program made by participants included education, resources and support. Findings from the food frequencies questionnaire survey showed most participants had a lower dietary diversity compared to the MIND diet guidelines.

Conclusions

With both groups being more prone to malnutrition, this research shows that participants were less likely to obtain adequate nutrition for brain health. Additionally, caregivers are dealing with nutrition issues themselves and their person living with dementia. The findings support the need for registered dietitians to provide tailored nutrition interventions for these families.

背景：痴呆症患者和非正规护理人员营养不良的风险较高。大多数护理人员并不是识别痴呆症营养并发症的专家。因此，我们旨在确定与喂养和护理痴呆症患者有关的营养知识和挑战，以制定有意义的干预措施：我们采用了混合方法。我们与痴呆症患者的护理人员（28 人）和医疗保健专业人员（23 人）进行了八次焦点小组讨论。数据使用 NVivo 软件进行分析。发放了一份调查问卷，以确定营养方面的挑战。经修改的食物频率问卷调查评估了护理人员和痴呆症患者的饮食模式。调查结果与地中海-DASH 神经退行性延迟干预（MIND）饮食指南进行了比较。数据使用 SPSS 软件进行分析：出现了四大主题：忘记进食、对食物产生厌恶、对甜食有强烈偏好以及体重变化。研究结果显示，改善营养摄入的常用策略包括提示、补充剂和安静的进食环境。护理人员受到压力的影响，导致食物选择不当和疲惫不堪。参与者提出的照顾者计划建议包括教育、资源和支持。食物频率问卷调查结果显示，与 MIND 饮食指南相比，大多数参与者的饮食多样性较低：结论：由于两组人都更容易营养不良，这项研究表明，参与者获得充足营养以促进大脑健康的可能性较低。此外，照顾者自己和他们的痴呆症患者都要面对营养问题。研究结果支持注册营养师为这些家庭提供量身定制的营养干预措施的必要性。

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引用次数: 0