This study aimed to determine if beneficial effects of individualized feedback of fracture risk on osteoporosis preventive behaviors and bone mineral density observed in a 2-year trial were sustained ...long-term.
This was a 10-year follow-up of a 2-year RCT in 470 premenopausal women aged 25–44 years, who were randomized to one of two educational interventions (the Osteoporosis Prevention and Self-Management Course OPSMC or an osteoporosis information leaflet) and received tailored feedback of their relative risk of fracture in later life (high versus normal risk groups). Bone mineral density of lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry. Physical activity, dietary calcium intake, calcium and vitamin D supplements, and smoking status were measured by questionnaires.
From 2 to 12 years, the high-risk group had a smaller decrease in femoral neck bone mineral density (β=0.023, 95% CI=0.005, 0.041 g/cm2) but similar lumbar spine bone mineral density change as the normal-risk group. They were more likely to use calcium (relative risk=1.66, 95% CI=1.22, 2.24) and vitamin D supplements (1.99, 95% CI=1.27, 3.11). The OPSMC had no effects on bone mineral density change. Both high-risk (versus normal-risk) and the OPSMC groups (versus leaflet) had a more favorable pattern of smoking behavior change (relative risk=1.85, 95% CI=0.70, 4.89 and relative risk=2.27, 95% CI=0.86, 6.01 for smoking cessation; relative risk=0.33, 95% CI=0.13, 0.80 and relative risk=0.28, 95% CI=0.10, 0.79 for commenced or persistent smoking).
Feedback of high fracture risk to younger women was associated with long-term improvements in osteoporosis preventive behaviors and attenuated femoral neck bone mineral density loss. Therefore, this could be considered as a strategy to prevent osteoporosis.
Australian New Zealand Clinical Trials Registry (ANZCTR) NCT00273260.
The consumption of sugar and non-nutritive sweeteners has been associated with poor health outcomes. The aim of this paper was to provide a comparison of the range of sweetened or flavoured beverages ...between two high-income countries in the Asia-Pacific region: Australia and Singapore. Following the FoodTrackTM methodology, nutrition, labelling, and price data were collected from major Australian and Singaporean supermarket chains and convenience stores. The nutrient profiles of products were tested for differences using Kruskal−Wallis and Mann−Whitney U tests. The greatest number of products collected in Australia were from the ‘carbonated beverages’ category (n = 215, 40%), and in Singapore the greatest number of products were from the ‘tea and coffee ready-to-drink’ category (n = 182, 35%). There were more calorically sweetened beverages in Singapore compared with Australia (n = 462/517 vs. n = 374/531, p < 0.001). For calorically sweetened products, the median energy of Singaporean products was significantly higher than Australian products (134 kJ vs. 120 kJ per 100 mL, p = 0.009). In Australia, 52% of sweetened or flavoured beverages displayed a front-of-pack nutrient signposting logo, compared with 34% of sweetened or flavoured beverages in Singapore. These findings also indicate that the consumption of just one serving of calorically sweetened carbonated beverages or energy drinks would exceed the WHO maximum daily free sugar recommendations.
Dairy food consumption is important for Australian children as it contributes key nutrients such as protein and Ca. The aim of the present paper is to describe dietary intake from dairy foods for ...Australian children aged 2-16 years in 2007.
Secondary analysis of a quota-sampled survey using population-weighted, 1 d (24 h) dietary recall data.
Australian national survey conducted from February to August 2007.
Children (n 4487) aged 2-16 years.
Most Australian children consumed dairy foods (84-98 %), with the proportion consuming tending to decrease with age and males consuming significantly more than females from the age of 4 years. Milk was the most commonly consumed dairy food (58-88 %) and consumed in the greatest amount (243-384 g/d). Most children consumed regular-fat dairy products. The contribution of dairy foods to total energy intake decreased with age; from 22 % of total energy at age 2-3 years to 11 % at age 14-16 years. This trend was similar for all nutrients analysed. Dairy food intake peaked between 06.00 and 10.00 hours (typical breakfast hours) corresponding with the peak in dairy Ca intake. Australian children (older than 4 years) did not reach recommendations for dairy food intake, consuming ≤2 servings/d.
The under-consumption of dairy foods by Australian children has important implications for intake of key nutrients and should be addressed by multiple strategies.
The cross-sectional 2007 Australian National Children's Nutrition and Physical Activity Survey collected detailed dietary information from a representative sample of more than 4400 children by 24-h ...dietary recall. Dairy food intake by Australian children is substantially lower than recommendations, and decreases as a percentage of energy intake as children grow older. Children aged 2 to 16 years are, on average, 2.3 times more likely to have a dairy food at the first daily occasion of eating, than at the second occasion. For children who consumed any dairy food at the first occasion of eating, the total daily intake of dairy foods was 129% (95% CI 120%-138%) greater than for children who did not consume a dairy food at the first occasion of eating. Their dairy food intake for the rest of the day following the first occasion of eating was also greater by 29% (95% CI 21%-37%). Younger age group, male sex, location of eating being at home or in a residence and starting the first occasion of eating from 6 a.m. to 9 a.m. are all jointly associated with having a dairy food at the first occasion of eating. A simple strategy to increase Australian children's intake from the dairy and alternatives food group may be to make sure that the first occasion of eating each day includes a dairy food or a nutritional equivalent.
Single dietary questions are used as a rapid method of monitoring diet. The aim of this investigation was to assess the performance of questions to measure population group intake compared to the ...mean of two 24-h recalls. Data from the Australian National Children's Nutrition and Physical Activity Survey 2007 was used (n = 4487). Children reported their intake on three questions relating to usual serves of fruit, vegetables and type of milk. Age, gender and body weight status were assessed as modifiers of the relationship between methods. There was a stepwise increase in fruit and vegetable intake (p < 0.001) measured by recall when grouped by response category of the short question. By recall, fruit consumption decreased with age (F = 12.92, p < 0.001) but this trend was not detectable from the short question (F = 2.31, p = 0.075). The difference in fruit intake between methods was greatest for obese children. Almost 85% of children who consumed whole milk by short question consumed mainly whole fat milk by recall, but agreement was lower for other milk types. Saturated fat and volume of milk was highest in whole milk consumers. Ease of administration suggests that short questions, at least for some aspects of diet, are a useful method to monitor population intakes for children.
The burden of malnutrition in Indigenous people is a major health priority and this study's aims are to understand health outcomes among Indigenous and non-Indigenous patients. This cohort study ...includes 608 medical inpatients in three regional hospitals. Participants were screened for malnutrition using the Subjective Global Assessment tool. Hospital length of stay, discharge destination, 30-day and six-month hospital readmission and survival were measured. Although no significant difference was observed between Indigenous participants who were malnourished or nourished (
= 0.120), malnourished Indigenous participants were more likely to be readmitted back into hospital within 30 days (Relative Risk (
) 1.53, 95% CI 1.19⁻1.97,
= 0.002) and six months (
1.40, 95% Confidence Interval (CI) 1.05⁻1.88,
= 0.018), and less likely to be alive at six months (
1.63, 95% CI 1.20⁻2.21,
= 0.015) than non-Indigenous participants. Malnutrition was associated with higher mortality (Hazards Ratio (
) 3.32, 95% CI 1.87⁻5.89,
< 0.001) for all participants, and independent predictors for six-month mortality included being malnourished (
2.10, 95% CI 1.16⁻3.79,
= 0.014), advanced age (
1.04, 95% CI 1.02⁻1.06,
= 0.001), increased acute disease severity (Acute Physiology and Chronic Health Evaluation score,
1.03, 95% CI 1.01⁻1.05,
= 0.002) and higher chronic disease index (Charlson Comorbidity Index,
1.36, 95% CI 1.16⁻3.79,
= 0.014). Malnutrition in regional Australia is associated with increased healthcare utilization and decreased survival. New approaches to malnutrition-risk screening, increased dietetic resourcing and nutrition programs to proactively identify and address malnutrition in this context are urgently required.
The cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations.
We used optimisation modelling to examine ...the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods.
A twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet.
Simultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B) met all nutrient targets except sodium (146.2% and 148.9% of the respective target) and saturated fat (12.0% and 11.7% of energy). Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day) and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (-90%) and refined cereals (-90%) and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals.
This modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Background High sodium intake during infancy and early childhood can change salt preference and blood pressure trajectories across life, representing a modifiable cardiovascular risk factor. ...Describing young children's sodium intake is important for informing effective targets for sodium reduction. Objective This study aimed to describe food sources and demographic and behavioral correlates of sodium intake in 295 young Australian children using three unscheduled 24-hour recalls (when children were 9 and then 18 months of age) with mothers participating within an existing randomized controlled trial, the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program. Methods Differences in individual-level and family-level demographic and behavioral variables were assessed across tertiles of sodium density (mg/1,000 kcal). Descriptive statistics were used to describe food-group contributions to total energy and sodium intakes at both ages. Results Mean sodium intake was 486 mg (standard deviation=232 mg) at 9 months and had more than doubled to 1,069 mg (standard deviation=331 mg) at 18 months of age. Fifty-four percent of children at 18 months exceeded the Recommended Daily Upper Level for sodium intake, with bread, cheese, breakfast cereal, soup, and mixed dishes all important sources of sodium at both ages. Yeast extracts, processed meats, and bread products became important additional sources at 18 months. A greater proportion of children in the highest sodium-density tertile had ceased breastfeeding and had commenced solids at an earlier age. Conclusions The key food sources of sodium for children younger than 2 years are those that contribute to the whole population's high salt burden and highlight the essential role governments and food industry must play to reduce salt in commonly consumed foods.
SummaryBackground/aimsIndigenous people experience a higher burden of nutrition-related conditions and are more likely to experience food insecurity compared to non-Indigenous people. Consequently, ...they remain at increased risk of malnutrition; particularly when residing in regional or remote areas. This study aims to compare and characterise the burden and nature of malnutrition among a representative cohort of Indigenous and non-Indigenous Australians admitted to regional hospitals for medical inpatient care.MethodsThis was a cross-sectional survey conducted in three regional hospitals in the Northern Territory and Far North Queensland of Australia from February 2015 to September 2015. A total of 1606 adult medical inpatients were screened for eligibility. Of these, 608 eligible patients were screened for malnutrition using the validated Malnutrition Screening Tool and assessed for malnutrition using the Subjective Global Assessment. Socio-economic and health-related variables and anthropometric measurements were collected to identify the correlates of malnutrition.ResultsOf the 271 Indigenous patients and 337 non-Indigenous patients screened and assessed for malnutrition, 250/608 (41.7%, 95% CI 40.1–52.3%) were found to be malnourished. Significantly higher rates of malnutrition (46.1%, 95% CI 40.1–52.3% versus 37.1%, 95% CI 31.9–42.5%) were found in Indigenous patients compared to non-Indigenous patients ( P = 0.024). Higher rates of malnutrition were observed in Indigenous patients residing in Central Australia (56.7%, 95% CI 46.7–66.4%) than in the Top End of the Northern Territory (40.7%, 95% CI 31.7–50.1%) and in Far North Queensland (36.7%, 95% CI 23.4–51.7%). Factors independently predictive of malnutrition for both Indigenous and non-Indigenous participants included residence in Central Australia (OR 4.31, 95% CI 2.63–7.90, P < 0.001); an increased Charlson Comorbidity Index prognostic score (OR 1.37 per incremental score, 95% CI 1.19–1.59, P < 0.001); and an underweight Body Mass Index (OR 29.97, 95% CI 3.68–244.0, P < 0.001). Of the 250/608 patients who were malnourished, the positive predictor value (PPV) for malnourished patients who were underweight was 96.6% (95% CI 88.3–99.6%); for Indigenous Australians who were malnourished and underweight, the PPV was 100%. A mid-upper arm circumference of less than 23 cm demonstrated a strong PPV for all patients who were malnourished (96.1%, 95% CI 89.0–99.2%). ConclusionThis is the first study to characterise malnutrition in adult Indigenous Australians in a hospital inpatient setting. Compared to non-Indigenous patients the burden and pattern of malnutrition was both higher and markedly different among Indigenous patients. These data highlight the critical importance for actively screening for and responding to malnutrition in this vulnerable patient population in regional and remote settings.
To contribute to the current debate as to the relative influences of dietary intake and physical activity on the development of adiposity in community-based children.
Participants were 734 boys and ...girls measured at age 8, 10 and 12 years for percent body fat (dual emission x-ray absorptiometry), physical activity (pedometers, accelerometers); and dietary intake (1 and 2-day records), with assessments of pubertal development and socioeconomic status.
Cross-sectional relationships revealed that boys and girls with higher percent body fat were less physically active, both in terms of steps per day and moderate and vigorous physical activity (both sexes p<0.001 for both measures). However, fatter children did not consume more energy, fat, carbohydrate or sugar; boys with higher percent body fat actually consumed less carbohydrate (p = 0.01) and energy (p = 0.05). Longitudinal analysis (combined data from both sexes) was weaker, but supported the cross-sectional findings, showing that children who reduced their PA over the four years increased their percent body fat (p = 0.04). Relationships in the 8 year-olds and also in the leanest quartile of all children, where adiposity-related underreporting was unlikely, were consistent with those of the whole group, indicating that underreporting did not influence our findings.
These data provide support for the premise that physical activity is the main source of variation in the percent body fat of healthy community-based Australian children. General community strategies involving dietary intake and physical activity to combat childhood obesity may benefit by making physical activity the foremost focus of attention.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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