Journal of Human Nutrition and Dietetics最新文献

Aims

Pregnancy is a key opportunity to support women in achieving healthy dietary patterns due to increased motivation and frequent exposure to healthcare professionals. However, it is unclear whether changes made during pregnancy can be maintained postpartum. This study examined the impact of an antenatal dietary intervention, initiated early to mid pregnancy, on postpartum dietary intake.

Methods

In the Healthy Gut Diet (HGD) study, participants were randomised to a dietary intervention or usual care. The intervention was integrated with behaviour change techniques and informed by the lived experience of women with Gestational Diabetes Mellitus (GDM). Dietary intake was assessed using food frequency questionnaires at baseline, 36 weeks' gestation, and 12 weeks' postpartum. Outcomes included alignment with the Australian Guide to Healthy Eating, intakes of core food groups, key macro- and micronutrient intakes, prebiotic and fermented food intake, and overall diet quality. Between-group differences postpartum were assessed using independent t-tests, and longitudinal effects were evaluated with linear mixed-effect models adjusted for pre-pregnancy Body Mass Index (BMI) and recent GDM. Secondary analyses explored associations between maternal characteristics, depressive symptoms, diet quality, fibre and saturated fat intake.

Results

The intervention group had significantly (p < 0.05) higher diet quality, greater intakes of core food groups, fibre, prebiotic, and monounsaturated fat and lower saturated fat than usual care at 12 weeks postpartum. More women in the intervention group met recommendations for fibre, magnesium, iron and folate, and core food group serves of vegetables, fruit and meat/meat alternatives. Mixed-effect models showed sustained improvements postpartum in the intervention group. Antenatal depressive symptoms were associated with lower postpartum diet quality (p = 0.01), and lower income was associated with lower saturated fat intakes.

Conclusions

Well-designed, behaviourally informed antenatal interventions can support sustained dietary improvements postpartum. Addressing social and psychological factors is essential for maximising their impact.

Introduction

Mealtime experience is a multidimensional concept extending beyond meal satisfaction. Many existing patient meal satisfaction tools fail to capture this complexity. This study examines the internal consistency, test–retest reliability and validity of the Austin Health Patient Mealtime Experience Tool.

Methods

The Austin Health Patient Mealtime Experience Tool was developed through a literature review and stakeholder input. Participants from acute, sub-acute and rehabilitation wards at Austin Health completed the tool (Test 1) alongside the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire on Day 1. A follow-up assessment was conducted 7 days later (Test 2). Factor analysis assessed construct validity. Concurrent and convergent validity were determined by correlating scores with the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire. Internal consistency was assessed using Cronbach's coefficient α, and test–retest reliability was evaluated through correlation analysis.

Results

A total of 143 completed surveys were collected from participants aged 19–101 years (mean age: 72.1 ± 17.6 years), with 48.3% identifying as female. The Austin Health Patient Mealtime Experience Tool demonstrated strong internal consistency (Cronbach's coefficient α = 0.75) and test–retest reliability (correlation coefficient = 0.73, p < 0.001, n = 94). Concurrent validity (correlation coefficient = 0.67, p < 0.001, n = 126) and convergent validity were also supported.

Conclusion

The Austin Health Patient Mealtime Experience Tool is a valid and reliable tool for assessing patient mealtime experience beyond meal satisfaction. It enables efficient data collection on key factors influencing mealtime experience, supporting informed decision-making to enhance patient care.

Objectives

This review aimed to synthesise current evidence on the effects of gastrostomy in Parkinson's disease (PD) and parkinsonism, Multiple Sclerosis (MS) and Huntington's disease (HD).

Purpose

Evidence regarding the risks and benefits of gastrostomy insertion and use in progressive neurological diseases, excluding Motor Neurone Disease (MND), is lacking, causing gastrostomy decision-making discussions to arise as a matter of debate in practice.

Methods

Three databases (Web of Science, Ovid Medline and Embase) were searched for research on the impacts of gastrostomy, including survival, complication rates, nutrition changes, in adults with progressive neurological diseases, excluding MND. Quality was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist: Primary Research, and a narrative synthesis was conducted.

Results

Twelve (n = 12) studies were eligible for inclusion, with either retrospective cohort (n = 12) or cross-sectional (n = 1) design, examining the effects of percutaneous endoscopic gastrostomy (PEG) (n = 8), radiologically inserted gastrostomy (RIG) (n = 1) or gastrostomy not further defined (n = 4) in adults with PD (n = 6), parkinsonism (n = 3), MS (n = 3), or HD (n = 3). There was variability in outcomes and comparators with inconclusive results. Quality was assessed as positive (n = 3) or neutral (n = 9). Gastrostomy appears to be associated with increased care needs in the population of interest.

Conclusions

Gastrostomy insertion and use in this cohort is poorly investigated. High-quality prospective studies, especially with well-defined nutrition-related outcome measures, and robust statistical analyses are needed to determine the potential benefits of gastrostomy in this population.

Trial Registration: PROSPERO: CRD42024604136.

Background

Sales and consumption of energy drinks (EDs) continue to rise, especially amongst young people, yet the reason remains unclear. In 2018, a campaign by Jamie Oliver resulted in a voluntary sales ban to under 16-year-olds. Also in 2018, the Department of Health and Social Care ran a consultation to end the sales of EDs to under 16 s in England. In the Kings Speech (July 2024), the incoming Labour Government promised to restrict the sale of energy drinks to children. The aim of this mixed method study is to understand children and young people′s perceptions of EDs in North East England UK, post the 2018 voluntary ban and to analyse consumption patterns via focus groups and a survey.

Methods

Fifty students from Years 5 and 6 (n = 38 aged 9–11 years) and Year 9 (n = 12, aged 13–14 years) were involved in eight semi-structured focus groups exploring perceptions of EDs; and twenty-two Year nine students (aged 13–14 years) were involved in a survey measuring consumption of EDs and reasons for use.

Results

This study presents a complex picture of children perceptions of EDs and the emergence of a new popular hydration drink, defined as those marketed as replenishing electrolytes, having low(er) sugar, and improving functional wellness. The survey reported that 81.8% consume EDs. More males consumed EDs in comparison to females and most consumed EDs 2–4 days a week. Qualitative analysis showed factors influencing consumption included marketing, brand association, taste, influence of friends and family, cost and easy access.

Conclusion

Children and young people had a strong understanding around the use of branding and marketing as a powerful tool to encourage purchasing behaviours.

Introduction

The purpose of the present observational study was to assess the inter-rater reliability and validity of two free nutrition apps, MyFitnessPal (MFP) and Cronometer (CRO), among Canadian endurance athletes.

Methods

Two raters independently input 43 three-day food intake records (FIR) (27M/16F) into MFP and CRO, and one rater input each FIR into ESHA Food Processor® using the reference standard 2015 Canadian Nutrient File (CNF) database.

Results

MFP showed a consistent difference in measurements between raters for total energy and carbohydrates (absolute reliability), but the difference was too small to be clinically meaningful; further, raters were inconsistent for sodium and sugar (relative reliability), particularly among men. MFP showed poor validity for total energy, carbohydrates, protein, cholesterol, sugar, and fibre, with discrepancies for total energy, carbohydrates and sugar being driven by women, and protein differences by men. Rationale for low reliability and validity may be due to the copious options for each food entry in MFP, including non-verified consumer entries. Possible rationale for gender differences may be more detailed and descriptive FIRs (reliability) and generally more varied dietary patterns (validity) in women compared to men. Conversely, CRO showed good to excellent inter-rater reliability for all nutrients and good validity for all nutrients except for fibre and vitamins A and D, with no differences between genders. Rationale for low validity of fibre may be due to how it is represented in the software (i.e., total vs. soluble), and rationale for vitamins A and D may be due to fortification practices differing between brands and countries. Bland-Altman plots for inter-rater reliability and validity revealed smaller bias, narrower LOAs, and better horizonal spread of data when using CRO compared to MFP.

Conclusion

Given the unique energy and nutrient needs of athletes, they should be aware that MFP may provide dietary information that does not accurately reflect true intake, and that CRO could serve as a promising alternative.