Publications by authors named "Amanda Devine"

115 Publications

Predictors of nutrition care process knowledge and use among dietitians internationally.

J Hum Nutr Diet 2021 Nov 23. Epub 2021 Nov 23.

School of Medical and Health Science, Institute for Nutrition Research, Edith Cowan University, Joondalup, WA, Australia.

Background: The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem-solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated which factors predict NCP/T knowledge and use among dietetic professionals in an international cohort, aiming to understand how implementation can be strengthened.

Methods: The validated International NCP Implementation Survey was disseminated to dietitians in 10 countries via professional networks. Implementation, attitudes and knowledge of the NCP/T along with workplace and educational data were assessed. Independent predictive factors associated with higher NCP/T knowledge and use were identified using backward stepwise logistic regression.

Results: Data from 6149 respondents was used for this analysis. Enablers that were independent predictors of both high knowledge and frequent use of NCP/T were peer support, recommendation from national dietetic association and workplace requirements (all p < 0.001). Country of residence and working in clinical settings (p < 0.001) were demographic characteristics that were independent predictors of high knowledge and frequent use of NCP/T. A high knowledge score was an independent predictor of frequent NCP/T use (p = 0.002).

Conclusions: Important modifiable enablers for NCP knowledge and use rely on organisational management. National dietetic organisations and key stakeholders such as employers are encouraged to integrate active NCP/T support in their leadership initiatives. This could take the form of policies, formalised and structured training strategies, and informatics initiatives for the integration in electronic health records.
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http://dx.doi.org/10.1111/jhn.12961DOI Listing
November 2021

Digging for data: How sleep is losing out to roster design, sleep disorders, and lifestyle factors.

Appl Ergon 2022 Feb 23;99:103617. Epub 2021 Oct 23.

School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia.

Shift workers employed at a remote mining operation may experience sleep loss, impaired alertness, and consequently negative health and safety outcomes. This study determined the sleep behaviors and prevalence of risk for sleep disorders among shift workers; and quantified alertness for a roster cycle. Sleep duration was significantly less following; night shift by 77 ± 7 min and day shift by 30 ± 7 min. The wake after sleep onset was less by 23 ± 3 min for night shifts and 22 ± 3 min for day shifts (p < 0.05 for all). The prevalence of risk for sleep apnea was 31%, insomnia was 8%, and shiftwork disorder was 44%. Average alertness for all working hours was 75%. Shiftwork in remote mining operations is a significant factor that leads to sleep loss and reduced alertness, which is exacerbated by the high prevalence of risk for sleep disorders.
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http://dx.doi.org/10.1016/j.apergo.2021.103617DOI Listing
February 2022

The knowledge, attitudes and beliefs of midwives on the vaccination coverage rates in Perth's Aboriginal children.

BMC Public Health 2021 10 12;21(1):1845. Epub 2021 Oct 12.

School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.

Background: Midwives are well placed to promote vaccination awareness throughout a women's pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children.

Methods: A purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory of Planned Behavior were used to frame the questionnaire to enable the barriers to greater vaccination coverage to be identified and behaviourally situated. Descriptive statistics described the demographics of the study sample. Chi-square and the Fisher's exact test were used to identify associations between midwife characteristics and awareness of the coverage rates. Significance was set at α = 0.05.

Results: Of the 58 midwives who completed the study questionnaire, 77.2% were unaware of the sub-optimal vaccination coverage in Perth's Aboriginal children. Level of education (p = 0.53) and years worked as a practising midwife (p = 0.47) were not found to be associated with an awareness of the coverage rates. Approximately, 50% of midwives reported some concern over the efficacy of childhood vaccines, 44.4% did not feel confident with their knowledge of vaccines, while 33.3% do not routinely discuss childhood vaccinations with parents prior to hospital discharge.

Conclusions: Key findings in the study identified that a range of educational, leadership and system-based issues are affecting midwives' capacity to play a more substantial role in influencing vaccination coverage in Perth's Aboriginal children.
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http://dx.doi.org/10.1186/s12889-021-11907-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507363PMC
October 2021

Dietary Fibre Intervention for Gut Microbiota, Sleep, and Mental Health in Adults with Irritable Bowel Syndrome: A Scoping Review.

Nutrients 2021 Jun 23;13(7). Epub 2021 Jun 23.

School of Medical and Health Sciences, Edith Cowan University, Joondalup Drive, Perth 6027, Australia.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder affecting 4-5% of the global population. This disorder is associated with gut microbiota, diet, sleep, and mental health. This scoping review therefore aims to map existing research that has administrated fibre-related dietary intervention to IBS individuals and reported outcomes on at least two of the three following themes: gut microbiota, sleep, and mental health. Five digital databases were searched to identify and select papers as per the inclusion and exclusion criteria. Five articles were included in the assessment, where none reported on all three themes or the combination of gut microbiota and sleep. Two studies identified alterations in gut microbiota and mental health with fibre supplementation. The other three studies reported on mental health and sleep outcomes using subjective questionnaires. IBS-related research lacks system biology-type studies targeting gut microbiota, sleep, and mental health in patients undergoing diet intervention. Further IBS research is required to explore how human gut microbiota functions (such as short-chain fatty acids) in sleep and mental health, following the implementation of dietary pattern alteration or component supplementation. Additionally, the application of objective sleep assessments is required in order to detect sleep change with more accuracy and less bias.
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http://dx.doi.org/10.3390/nu13072159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308461PMC
June 2021

Data supporting development and validation of liquid chromatography tandem mass spectrometry method for the quantitative determination of bile acids in feces.

Data Brief 2021 Jun 22;36:107091. Epub 2021 Apr 22.

Centre for Integrative Metabolomics and Computational Biology, School of Science, Edith Cowan University, Joondalup, WA, 6027, Australia.

Measuring bile acids in feces has an important role in disease prevention, diagnosis, treatment, and can be considered a measure of health status. Therefore, the primary aim was to develop a sensitive, robust, and high throughput liquid chromatography tandem mass spectrometry method with minimal sample preparation for quantitative determination of bile acids in human feces applicable to large cohorts. Due to the chemical diversity of bile acids, their wide concentration range in feces, and the complexity of feces itself, developing a sensitive and selective analytical method for bile acids is challenging. A simple extraction method using methanol suitable for subsequent quantification by liquid chromatography tandem mass spectrometry has been reported in, "Extraction and quantitative determination of bile acids in feces" [1]. The data highlight the importance of optimization of the extraction procedure and the stability of the bile acids in feces post-extraction and prior to analysis and after several freeze-thaw cycles.
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http://dx.doi.org/10.1016/j.dib.2021.107091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8134654PMC
June 2021

Evaluating the impact of a community-based food security project: The value in facilitating collaboration and understanding.

Health Promot J Austr 2021 May 16. Epub 2021 May 16.

School of Medical and Health Sciences, Edith Cowan University, Bunbury, WA, Australia.

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http://dx.doi.org/10.1002/hpja.502DOI Listing
May 2021

Fruit and vegetable intake is inversely associated with perceived stress across the adult lifespan.

Clin Nutr 2021 05 15;40(5):2860-2867. Epub 2021 Apr 15.

Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia; Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.

Background & Aims: Poor nutritional habits are linked to higher perceived stress, but the relationship between fruit and vegetable (FV) intake and stress is uncertain. The primary aim of this cross-sectional study was to explore the relationship between FV intake and perceived stress in a population-based cohort of men and women aged ≥25 years from the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study. A secondary aim was to investigate the relationship between serum carotenoids, biomarkers of FV intake, and perceived stress.

Methods: In Australian men and women, dietary intake was assessed using a Food Frequency Questionnaire in 1999-2000 (n = 8689). Perceived stress was assessed using a validated Perceived Stress Questionnaire [PSQ index values ranging from 0 (lowest) to 1 (highest)]. Serum carotenoids were measured in a subset of participants (n = 1187) using high-performance liquid chromatography. Multivariable-adjusted linear and logistic regression were performed to investigate the associations between FV intake and perceived stress.

Results: Mean age of participants was 47.4 (SD 14.1) years (49.8% females). Participants with the highest intakes of FV had 10% lower PSQ index values than those with the lowest intake [Q4: 0.27 ± 0.004 vs. Q1: 0.30 ± 0.004 (mean ± SE), p = 0.004]. Similar associations were found for fruits and vegetables, analysed separately. In subgroup analyses higher FV intake was associated with lower perceived stress in the middle-aged adults [≥45-<65 years (p = 0.004)], but not in the younger (<45 years) and older participants (≥65 years). Higher FV intake was also significantly associated with lower perceived stress in men (p = 0.009) and women (p = 0.012), separately. Serum carotenoid levels were inversely associated with perceived stress before, but not after adjusting for age and other confounding factors.

Conclusion: In Australian adults, higher FV intake was associated with lower perceived stress, particularly in the middle-aged adults. These findings support current recommendations that fruit and vegetables are essential for health and well-being.
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http://dx.doi.org/10.1016/j.clnu.2021.03.043DOI Listing
May 2021

Association between Fruit and Vegetable Intakes and Mental Health in the Australian Diabetes Obesity and Lifestyle Cohort.

Nutrients 2021 Apr 24;13(5). Epub 2021 Apr 24.

Institute for Nutrition Research, Edith Cowan University, Perth 6027, Australia.

Increasing prevalence of mental health disorders within the Australian population is a serious public health issue. Adequate intake of fruits and vegetables (FV), dietary fibre (DF) and resistant starch (RS) is associated with better mental and physical health. Few longitudinal studies exist exploring the temporal relationship. Using a validated food frequency questionnaire, we examined baseline FV intakes of 5845 Australian adults from the AusDiab study and estimated food group-derived DF and RS using data from the literature. Perceived mental health was assessed at baseline and 5 year follow up using SF-36 mental component summary scores (MCS). We conducted baseline cross-sectional analysis and prospective analysis of baseline dietary intake with perceived mental health at 5 years. Higher baseline FV and FV-derived DF and RS intakes were associated with better 5 year MCS ( < 0.001). A higher FV intake (754 g/d vs. 251 g/d, Q4 vs. Q1) at baseline had 41% lower odds (OR = 0.59: 95% CI 0.46-0.75) of MCS below population average (<47) at 5 year follow up. Findings were similar for FV-derived DF and RS. An inverse association was observed with discretionary food-derived DF and RS. This demonstrates the association between higher intakes of FV and FV-derived DF and RS with better 5 year mental health outcomes. Further RCTs are necessary to understand mechanisms that underlie this association including elucidation of causal effects.
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http://dx.doi.org/10.3390/nu13051447DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146262PMC
April 2021

Extraction and quantitative determination of bile acids in feces.

Anal Chim Acta 2021 Mar 22;1150:338224. Epub 2021 Jan 22.

Centre for Integrative Metabolomics and Computational Biology, School of Science, Edith Cowan University, Joondalup, WA, 6027, Australia. Electronic address:

With rapid advances in gut microbiome research, fecal bile acids are increasingly being monitored as potential biomarkers of diet related disease susceptibility. As such, rapid, robust and reliable methods for their analysis are of increasing importance. Herein is described a simple extraction method for the analysis of bile acids in feces suitable for subsequent quantification by liquid chromatography and tandem mass spectrometry. A C18 column separated the analytes with excellent peak shape and retention time repeatability maintained across 800 injections. The intra-day and inter-day precision and accuracy was greater than 80%. Recoveries ranged from 83.58 to 122.41%. The limit of detection and limit of quantification were in the range 2.5-15 nM, respectively. The optimized method involved extracting bile acids from wet feces with minimal clean up. A second aliquot of fecal material was dried and weighed to correct for water content. Extracting from dried feces showed reduced recovery that could be corrected for by spiking the feces with deuterated standards prior to drying. Storage of the extracts and standards in a refrigerated autosampler prior to analysis on the LC-MS is necessary. Multiple freeze-thaws of both extracts and standards lead to poor recoveries for some bile acids. The method was successfully applied to 100 human fecal samples.
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http://dx.doi.org/10.1016/j.aca.2021.338224DOI Listing
March 2021

The Sleep of Shift Workers in a Remote Mining Operation: Methodology for a Randomized Control Trial to Determine Evidence-Based Interventions.

Front Neurosci 2020 7;14:579668. Epub 2021 Jan 7.

School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia.

Shiftwork may adversely impact an individual's sleep-wake patterns and result in sleep loss (<6 h. following night shift), due to the circadian misalignment and the design of rosters and shifts. Within a mining operation, this sleep loss may have significant consequences due to fatigue, including an increased risk of accidents and chronic health conditions. This study aims to (i) determine the efficacy of an intervention that comprises a sleep education program and biofeedback through a smartphone app on sleep quality, quantity, and alertness (ii) determine the prevalence of risk for a potential sleep disorder, and (iii) quantify and describe the sleep habits and behaviors of shift workers in a remote mining operation. This study consists of a randomized controlled trial whereby eighty-eight shift workers within a remote mining operation are randomized to a control group or one of three different treatment groups that are: (i) a sleep education program, (ii) biofeedback on sleep through a smartphone app, or (iii) a sleep education program and biofeedback on sleep through a smartphone app. This study utilizes wrist-activity monitors, biomathematical modeling, and a survey instrument to obtain data on sleep quantity, quality, and alertness. A variety of statistical methods will determine the prevalence of risk for a potential sleep disorder and associations with body mass index, alcohol, and caffeine consumption. A generalized linear mixed model will examine the dependent sleep variables assessed at baseline and post-intervention for the control group and intervention groups, as well as within and between groups to determine changes. The findings from this study will contribute to the current understanding of sleep and alertness behaviors, and sleep problems and disorders amongst shift workers. Importantly, the results may inform fatigue policy and practice on interventions to manage fatigue risk within the mining industry. This study protocol may have a broader application in other shiftwork industries, including oil and gas, aviation, rail, and healthcare.
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http://dx.doi.org/10.3389/fnins.2020.579668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817759PMC
January 2021

Australian Consumers Are Willing to Pay for the Health Star Rating Front-of-Pack Nutrition Label.

Nutrients 2020 Dec 18;12(12). Epub 2020 Dec 18.

School of Health and Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.

The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendations set out in the 2019 Health Star Rating System Five Year Review Report. Specifically, the forum supported, in principle, Recommendation 9, to mandate the Health Star Rating if clear uptake targets were not achieved while the system is voluntary. Given that mandatory labelling is being considered, it is important to investigate how much consumers value the Health Star Rating in order to understand potential consumer uptake and inform industry. The aim of this study was to assess consumers' valuation of the Health Star Rating system by analysing their willingness to pay for a packaged food product with the Health Star Rating label, utilising a double-bounded dichotomous choice contingent valuation approach. The results indicate that almost two-thirds of Australian household grocery shoppers were willing to pay more for a product with the Health Star Rating, on average up to an additional 3.7% of the price of the product. However, public health nutrition benefits associated with consumers' willingness to pay more for products with the Health Star Rating is currently limited by the lack of guarantee of the systems' accuracy. Given consumer support, a well validated and comprehensive Health Star Rating labelling system can potentially improve health outcomes, cost effectiveness and reduce environmental impacts.
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http://dx.doi.org/10.3390/nu12123876DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765932PMC
December 2020

Fruit and Vegetable Knowledge and Intake within an Australian Population: The AusDiab Study.

Nutrients 2020 Nov 25;12(12). Epub 2020 Nov 25.

Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6000, Australia.

Understanding the relationship between fruit and vegetable knowledge (FVK) and fruit and vegetable intake (FVI) is an important consideration for improved public health and successful targeting of health promotion messaging. The aim of this study was to investigate the association between FVK and FVI in Australian adults and to identify subgroups most at risk of poor knowledge. Using data from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab), we investigated associations between FVK and FVI, as well as demographic and lifestyle factors. Baseline FVK was measured using two self-reported questions. FVI was assessed using a validated, self-reported, food frequency questionnaire in 1999/00 (baseline), 2004/05, and 2011/12. Amongst the 8966 participants assessed at baseline, 24.1% had adequate, 73.0% had insufficient, and 2.9% had poor FVK. Using linear regression, those with insufficient or poor FVK reported significantly lower FVI (grams/day) compared to those with adequate FVK: baseline (coefficient (95%CI)): -67.1 (-80.0, -54.3) and -124.0 (-142.9, -105.1), respectively, whilst, at 12 years, the differences were -42.5 (-54.6, -30.5) and -94.6 (-133.8, -55.5) grams/day, respectively (all < 0.001). Poor FVK was more likely to be reported in males, older individuals (>65 years), socio-economically disadvantaged, smokers, and those with insufficient physical activity/sedentary behavior. We demonstrate that having adequate knowledge of FVI, defined as knowing to consume fruit and vegetables several times a day for a well-balanced diet, is strongly associated with FVI, with several demographic and lifestyle factors predicting FVK. Health promotion messages aimed at increasing FVK should target these subgroups for maximal effect.
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http://dx.doi.org/10.3390/nu12123628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759833PMC
November 2020

Implementation, mechanisms of impact and key contextual factors involved in outcomes of the Modification of Diet, Exercise and Lifestyle (MODEL) randomised controlled trial in Australian adults: protocol for a mixed-method process evaluation.

BMJ Open 2020 11 11;10(11):e036395. Epub 2020 Nov 11.

School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.

Introduction: The Modification of Diet, Exercise and Lifestyle (MODEL) study aims to examine the impact of providing visualisation and pictorial representation of advanced structural vascular disease (abdominal aortic calcification), on 'healthful' improvements to diet and lifestyle. This paper reports the protocol for the process evaluation for the MODEL study.

Methods And Analysis: The overall aim of the process evaluation is to understand the processes that took place during participation in the MODEL study trial and which elements were effective or ineffective for influencing 'healthful' behavioural change, and possible ways of improvement to inform wider implementation strategies. A mixed-method approach will be employed with the use of structured questionnaires and semistructured in-depth interviews. All 200 participants enrolled in the trial will undertake the quantitative component of the study and maximum variation sampling will be used to select a subsample for the qualitative component. The sample size for the qualitative component will be determined based on analytical saturation. Interviews will be digitally recorded and transcribed verbatim. Qualitative data will be analysed thematically and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Ethics And Dissemination: The MODEL study process evaluation has received approval from Edith Cowan University Human Research Ethics Committee (Project Number: 20513 HODGSON). Written informed consent will be obtained from all participants before they are included in the study. The study results will be shared with the individuals and institutions associated with this study as well as academic audiences through peer-reviewed publication and probable presentation at conferences.

Trial Registration Number: ACTRN12618001087246.
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http://dx.doi.org/10.1136/bmjopen-2019-036395DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661373PMC
November 2020

Modification of diet, exercise and lifestyle (MODEL) study: a randomised controlled trial protocol.

BMJ Open 2020 11 11;10(11):e036366. Epub 2020 Nov 11.

School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.

Introduction: Most cardiovascular disease (CVD)-related events could be prevented or substantially delayed with improved diet and lifestyle. Providing information on structural vascular disease may improve CVD risk factor management, but its impact on lifestyle change remains unclear. This study aims to determine whether providing visualisation and pictorial representation of structural vascular disease (abdominal aortic calcification (AAC)) can result in healthful diet and lifestyle change.

Methods And Analysis: This study, including men and women aged 60-80 years, is a 12-week, two-arm, multisite randomised controlled trial. At baseline, all participants will have AAC assessed from a lateral spine image captured using a bone densitometer. Participants will then be randomised to receive their AAC results at baseline (intervention group) or a usual care control group that will receive their results at 12 weeks. All participants will receive information about routinely assessed CVD risk factors and standardised (video) diet and lifestyle advice with three simple goals: (1) increase fruit and vegetable (FV) intake by at least one serve per day, (2) improve other aspects of the diet and (3) reduce sitting time and increase physical activity. Clinical assessments will be performed at baseline and 12 weeks.

Outcomes: The primary outcome is a change in serum carotenoid concentrations as an objective measure of FV intake. The study design, procedures and treatment of data will adhere to Standard Protocol Items for Randomized Trials guidelines.

Ethics And Dissemination: Ethics approval for this study has been granted by the Edith Cowan University and the Deakin University Human Research Ethics Committees (Project Numbers: 20513 HODGSON and 2019-220, respectively). Results of this study will be published in peer-reviewed academic journals and presented in scientific meetings and conferences. Information regarding consent, confidentiality, access to data, ancillary and post-trial care and dissemination policy has been disclosed in the participant information form.

Trial Registration Number: Australian New Zealand Clinical Trial Registry (ACTRN12618001087246).
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http://dx.doi.org/10.1136/bmjopen-2019-036366DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661361PMC
November 2020

Food community: Understanding community needs for a food security website to support rural and remote Western Australians.

Health Promot J Austr 2021 Oct 12;32 Suppl 2:283-291. Epub 2020 Nov 12.

School of Medical and Health Sciences, Edith Cowan University, Bunbury, WA, Australia.

Objective: The South West Food Community (SWFC) project (2018) was implemented to identify initiatives working to enhance healthy food availability, access and use in the South West region of Western Australia (SWWA); and enhance how they functioned as a system. The SWFC project participants included government and community members. This study aimed to understand how a tailored food security website could be developed as a support mechanism to increase understanding of food security, connect participants and enhance the effectiveness of SWFC initiatives.

Methods: Initiative leaders from the SWFC project (n = 46) were invited to participate in semi-structured telephone interviews which sought to understand needs for a food security website. Fifteen stakeholders completed the interviews (32% response rate). Data relating to desirable and undesirable website components were analysed thematically using QSR NVivo 12.

Results: Participants requested the website to include concise content, food security resources, inviting/useful images and information about initiatives. Undesirable features included academic literature, difficult-to-use functions, discussion boards and hard-to-view images.

Conclusion: A tailored, co-designed website that is monitored, user-friendly and functional were key stakeholder requirements.

Implications For Public Health: A tailored, co-designed food security website that promotes partnership development, builds networks, increases understanding and communication about food security and implementation strategies is needed.
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http://dx.doi.org/10.1002/hpja.433DOI Listing
October 2021

South West Food Community: understanding systemic change, and its associated challenges and successes, among food security projects.

Aust N Z J Public Health 2020 Dec 12;44(6):493-501. Epub 2020 Oct 12.

School of Medical and Health Sciences, Edith Cowan University, Western Australia.

Objective: The South West Food Community (SWFC) project (2018) aimed to identify initiatives working to support food security in the South West region of Western Australia, and to enhance how these initiatives functioned as a system. The SWFC project used a Systemic Innovation Lab approach that, prior to this study, had not been evaluated. This evaluation aimed to: i) measure system transitions (changes) to initiatives; and ii) understand the challenges and successes associated with system transitions.

Methods: SWFC initiative leaders (n=46) such as directors, managers or coordinators, volunteers or committee members were invited to participate in this evaluation. Fifteen stakeholders completed the telephone interviews (32% response rate).

Results: Twenty-five desirable changes in practice were observed. Challenge and success statements determined themes of 'participation' and 'bureaucracy'. Participation sub-themes included: limited time; poor initiative attendance; community support; organisational support; and effective partnerships. Bureaucracy sub-themes included: regulation or policy requirements; limited resources; and funding opportunities.

Conclusion: The Australian-first SWFC project has the capacity to support region-to-region comparisons; this evaluation increases evidence for scaling to other regions. Implications for public health: This approach can be used to increase collaboration between initiatives, support resource-sharing between organisations and enhance policies (at local government level) to support food security.
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http://dx.doi.org/10.1111/1753-6405.13046DOI Listing
December 2020

To dine in or not to dine in: A comparison of food selection and preparation behaviours in those with and without food security.

Health Promot J Austr 2021 Oct 20;32 Suppl 2:267-282. Epub 2020 Oct 20.

Edith Cowan University, Joondalup, WA, Australia.

Issue Addressed: Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside and outside of the home.

Methods: An online survey was completed by adults (n = 1292) residing in one of five Australian states. The questionnaire comprised of the six-item US Household Food Security Survey Module, 12 socio-demographic variables and 32 questions related to elements of food literacy.

Results: Food insecure respondents were more likely to frequent fast food vs (P = .002), takeaway (P < .001) and food courts (P < .001) than their food secure counterparts. Food secure respondents reported greater use of raw (P = .043) and fresh, pre-prepared produce (P = .002) when cooking, whereas food insecure respondents were more likely to prepare food using only frozen, pre-packaged products (P < .001). No significant differences were found between food security status and the enjoyment and social bonding derived from cooking.

Conclusions: Food insecure respondents appeared to be accessing a poorer quality of food through greater consumption of takeaway and fast food. These dietary compromises are most likely related to perceived financial, time or cooking facility constraints and to a lesser extent food literacy skills. SO WHAT?: This study highlights some of the health and social inequities apparent within food insecure populations. Food insecure households should be supported to access healthy fresh food and in-home cooking practices. While a multi strategy approach is required, healthy food environment policy, particularly in disadvantaged areas, should be considered to guarantee that all Australians have dignified access to nutritious food.
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http://dx.doi.org/10.1002/hpja.427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597035PMC
October 2021

Childcare Food Provision Recommendations Vary across Australia: Jurisdictional Comparison and Nutrition Expert Perspectives.

Int J Environ Res Public Health 2020 09 17;17(18). Epub 2020 Sep 17.

School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.

Early childhood is a critical stage for nutrition promotion, and childcare settings have the potential for wide-reaching impact on food intake. There are currently no Australian national guidelines for childcare food provision, and the comparability of existing guidelines across jurisdictions is unknown. This project aimed to map and compare childcare food provision guidelines and to explore perspectives amongst early childhood nutrition experts for alignment of jurisdictional childcare food provision guidelines with the Australian Dietary Guidelines (ADG). A desktop review was conducted and formed the basis of an online survey. A national convenience sample of childhood nutrition experts was surveyed. Existing guideline recommendations for food group serving quantities were similar across jurisdictions but contained many minor differences. Of the 49 survey respondents, most (84-100%) agreed with aligning food group provision recommendations to provide at least 50% of the recommended ADG serves for children. Most (94%) agreed that discretionary foods should be offered less than once per month or never. Jurisdictional childcare food provision guidelines do not currently align, raising challenges for national accreditation and the provision of support and resources for services across jurisdictions. Childhood nutrition experts support national alignment of food provision guidelines with the ADG.
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http://dx.doi.org/10.3390/ijerph17186793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558074PMC
September 2020

Does Fibre-fix provided to people with irritable bowel syndrome who are consuming a low FODMAP diet improve their gut health, gut microbiome, sleep and mental health? A double-blinded, randomised controlled trial.

BMJ Open Gastroenterol 2020 08;7(1)

School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.

Introduction: A diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) is an effective way to reduce gut symptoms in people with irritable bowel syndrome (IBS). This diet reduces the intake of fermentable fibres, leading to changes of the gut microbiota and insufficient fermentation in the large bowel, resulting in reduced production of short-chain fatty acids (SCFAs), such as butyrate, which has unfavourable implications for gut health, sleep and mental health. This study will examine the effect of Fibre-fix, a supplement containing a mix of dietary fibres, on the human gut microbiome composition, fermentative capacity, sleep, quality of life (QOL) and mental health of people with IBS who consume a low FODMAP diet (LFD).

Methods And Analysis: A randomised, double-blind, placebo-controlled, study design is proposed to examine whether Fibre-fix added to an existing LFD may help modulate gastrointestinal function, improve markers of sleep, mental health and promote QOL in patients with IBS. Participants will provide stool and blood samples, daily bowel symptoms diaries and 3-day diet records. Additionally, they will complete validated questionnaires relating to FODMAP intake, sleep, mental health and QOL before and after a 3-week intervention. Gut health will be assessed via faecal microbiome composition, faecal pH and SCFA levels. Alteration of sleep will be recorded using an actigraphy device worn by all participants over the whole study. Multivariate analysis will be used to examine the gut microbiome and repeated measures Analysis of variance (ANOVA) will be used for dependent variables from questionnaires related to bowel symptoms, stool type, sleep, mental health and QOL to assess the differences between intervention and control groups after adjustment for confounding variables.

Ethics And Dissemination: Ethics approval was obtained from the Human Research Ethics Committee of Edith Cowan University (2019-00619-YAN). Results will be disseminated in peer-review journal publications, and conference presentations. Participants will be provided with a summary of findings once the study is completed. If Fibre-fix is shown to result in favourable changes in gut microbial composition, SCFA production, sleep and mental well-being without exacerbating symptoms, this will provide additional dietary management options for those with IBS following an LFD.

Trial Registration Number: ACTRN12620000032954.
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http://dx.doi.org/10.1136/bmjgast-2020-000448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7437697PMC
August 2020

Cruciferous vegetable intake is inversely associated with extensive abdominal aortic calcification in elderly women: a cross-sectional study.

Br J Nutr 2021 02 17;125(3):337-345. Epub 2020 Jul 17.

School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA6027, Australia.

We have previously shown that higher intake of cruciferous vegetables is inversely associated with carotid artery intima-media thickness. To further test the hypothesis that an increased consumption of cruciferous vegetables is associated with reduced indicators of structural vascular disease in other areas of the vascular tree, we aimed to investigate the cross-sectional association between cruciferous vegetable intake and extensive calcification in the abdominal aorta. Dietary intake was assessed, using a FFQ, in 684 older women from the Calcium Intake Fracture Outcome Study. Cruciferous vegetables included cabbage, Brussels sprouts, cauliflower and broccoli. Abdominal aortic calcification (AAC) was scored using the Kauppila AAC24 scale on dual-energy X-ray absorptiometry lateral spine images and was categorised as 'not extensive' (0-5) or 'extensive' (≥6). Mean age was 74·9 (sd 2·6) years, median cruciferous vegetable intake was 28·2 (interquartile range 15·0-44·7) g/d and 128/684 (18·7 %) women had extensive AAC scores. Those with higher intakes of cruciferous vegetables (>44·6 g/d) were associated with a 46 % lower odds of having extensive AAC in comparison with those with lower intakes (<15·0 g/d) after adjustment for lifestyle, dietary and CVD risk factors (ORQ4 v. Q1 0·54, 95 % CI 0·30, 0·97, P = 0·036). Total vegetable intake and each of the other vegetable types were not related to extensive AAC (P > 0·05 for all). This study strengthens the hypothesis that higher intake of cruciferous vegetables may protect against vascular calcification.
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http://dx.doi.org/10.1017/S0007114520002706DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844610PMC
February 2021

The study protocol for a pseudo-randomised pre-post designed controlled intervention trial to study the effects of a 7-week cooking program on self-efficacy and biomarkers of health: the ECU lifestyle and biomarkers get connected study (ECULABJMOF) including the Jamie's Ministry of Food WA participant experience.

BMC Public Health 2020 Jun 30;20(1):1037. Epub 2020 Jun 30.

School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, WA, 6027, Australia.

Background: Australia, like other nations, has experienced a shift in dietary patterns away from home cooking of nutritious foods, towards a reliance on pre-prepared convenience meals. These are typically energy-dense, nutrient-poor and contribute to the rising prevalence of obesity and chronic disease burden. The aims of this study were to evaluate whether a community-based cooking program instigated a change to participants' skills, attitudes, knowledge, enjoyment and satisfaction of cooking and cooking confidence (self-efficacy).

Methods: The pseudo-random, pre-post study design consisted of an intervention and a control group. Participant recruitment and group allocation was based on their program start dates. Intervention participants were surveyed three times (baseline, 7 weeks and 6 months) and the control group were surveyed at baseline and 5 weeks. All participants were registered via an online website and were 18 years or over. Upon consent, participants were offered four levels of commitment, defined by different assessments. The minimum participation level included an online survey and levels 2, 3 and 4 involved attendance at a clinic with increasing functional, anthropometric and biomarker measurements. Primary endpoints were participants' cooking confidence as a proxy for self-efficacy. Secondary endpoints were dietary intake, physical activity levels, body composition, anthropometry, blood, urine and faecal biomarkers of systemic, physical and mental health.

Discussion: The community cooking program provided participants with information and advice on food sourcing, preparation and nutrition to improve home cooking skills. The study was designed to explore whether food literacy programs are efficacious in improving participant physical health and well-being in order to combat the rise in obesity and diet-related disease. It will support future use of public health cooking program initiatives aimed at improving food literacy, self-efficacy and physical and mental health. The extensive data collected will inform future research into the relationship between diet, the gut-microbiota and human health.

Trial Registration: Retrospectively registered on 16.08.2019 with the Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12619001144101 . Protocol version 4.
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http://dx.doi.org/10.1186/s12889-020-09124-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325354PMC
June 2020

The effects of vitamin K-rich green leafy vegetables on bone metabolism: A 4-week randomised controlled trial in middle-aged and older individuals.

Bone Rep 2020 Jun 26;12:100274. Epub 2020 Apr 26.

School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.

Background: High vegetable intake is associated with beneficial effects on bone. However, the mechanisms remain uncertain. Green leafy vegetables are a rich source of vitamin K1, which is known to have large effects on osteoblasts and osteocalcin (OC) metabolism.

Objective: To examine the effects of consumption of two to three extra serves of green leafy vegetables daily on bone metabolism.

Methods: Thirty individuals (mean age 61.8 ± 9.9 years, 67% male) completed three experimental phases in a randomised controlled crossover design, each lasting four weeks, with a washout period of four weeks between phases (clinical trial registration: ACTRN12615000194561). The three experimental phases were: (i) increased dietary vitamin K1 by consuming green leafy vegetables (H-K; ~200 g/d containing 164.3 [99.5-384.7] μg/d of vitamin K1); (ii) low vitamin K1 by consuming vitamin K1-poor vegetables (L-K; ~200 g/d containing 9.4 [7.7-11.6] μg/d of vitamin K1); and (iii) control (CON) where participants consumed an energy-matched non-vegetable control. OC forms, total OC (tOC), carboxylated OC (cOC) and undercarboxylated OC (ucOC), were measured in serum pre- and post-intervention for each experimental phase using a sandwich-electrochemiluminescence immunoassay.

Results: Pre-intervention tOC, ucOC and ucOC:tOC levels were similar between phases ( > .05). Following H-K, but not L-K, tOC, ucOC and ucOC:tOC levels were significantly lower compared to pre-intervention levels ( ≤ .001) and compared to CON (~14%, 31% and 19%, respectively, all  < .05), while cOC remained unchanged.

Conclusions: In middle-aged healthy men and women, an easily achieved increase in dietary intake of vitamin K1-rich green leafy vegetables substantially reduces serum tOC and ucOC suggesting increased entry of OC into bone matrix, where it may improve the material property of bone. In conjunction with previous epidemiological and randomised controlled trial data, these findings suggest that interventions to increase vegetable intake over extended periods should include bone end points including fracture risk.
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http://dx.doi.org/10.1016/j.bonr.2020.100274DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235933PMC
June 2020

A randomised controlled crossover trial investigating the short-term effects of different types of vegetables on vascular and metabolic function in middle-aged and older adults with mildly elevated blood pressure: the VEgetableS for vaScular hEaLth (VESSEL) study protocol.

Nutr J 2020 05 12;19(1):41. Epub 2020 May 12.

School of Medical and Health Sciences, Edith Cowan University, Royal Perth Hospital Research Foundation, Rear 50, Murray Street, Joondalup, Perth, WA, 6000, Australia.

Background: A diet rich in fruits and vegetables is recommended for cardiovascular health. However, the majority of Australians do not consume the recommended number of vegetable servings each day. Furthermore, intakes of vegetables considered to have the greatest cardiovascular benefit are often very low. Results from prospective observational studies indicate that a higher consumption of cruciferous vegetables (e.g. broccoli, cabbage, cauliflower) is associated with lower cardiovascular disease risk. This may be due to the presence of specific nutrients and bioactive compounds found almost exclusively, or at relatively high levels, in cruciferous vegetables. Therefore, the aim of this randomised controlled crossover trial is to determine whether regular consumption of cruciferous vegetables results in short-term improvement in measures related to cardiovascular disease risk, including ambulatory blood pressure, arterial stiffness, glycaemic control, and circulating biomarkers of oxidative stress and inflammation.

Methods: Twenty-five participants (50-75 years) with mildly elevated blood pressure (systolic blood pressure 120-160 mmHg) will complete two 2-week intervention periods in random order, separated by a 2-week washout period. During the intervention period, participants will consume 4 servings (~ 300 g) of cruciferous vegetables per day as a soup (~ 500-600 mL/day). The 'control' soup will consist of other commonly consumed vegetables (potato, sweet potato, carrot, pumpkin). Both soups will be approximately matched for energy, protein, fat, and carbohydrate content. All measurements will be performed at the beginning and end of each intervention period.

Discussion: The findings of this study will provide evidence regarding the potential cardiometabolic health benefits of cruciferous vegetables, which may contribute to the revision of dietary and clinical guidelines.

Trial Registration: The trial was registered with the Australian New Zealand Clinical Trial Registry on 19th September 2019 (ACTRN12619001294145).
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http://dx.doi.org/10.1186/s12937-020-00559-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218618PMC
May 2020

Definitions, Sources and Self-Reported Consumption of Regionally Grown Fruits and Vegetables in Two Regions of Australia.

Nutrients 2020 Apr 8;12(4). Epub 2020 Apr 8.

School of Medical and Health Sciences, Edith Cowan University, Mount Lawley, Western Australia 6050, Australia.

Regional food systems are complex networks, with numerous retail sources that underpin a local economy. However, evidence is limited regarding how consumers define, identify, and source regionally grown fresh fruits and vegetables (RGFFV). A cross-sectional study was conducted in Tasmania (TAS) and South Western Australia (SWA) to compare how RGFFV are defined, identified and sourced by consumers, including self-reported consumption of selected RGFFV. Survey data were analyzed using the Chi-square test and t-tests. Results (TAS = 120, SWA = 123) identified that consumers had mixed perceptions of how RGFFV are defined, including produce sold at farmers markets, or grown within their region (TAS/SWA). RGFFV were commonly identified using product labelling (55% TAS, 69% SWA; > 0.05). Respondents reported frequently shopping for RGFFV at major supermarkets, with more TAS respondents shopping weekly in comparison to SWA respondents (67% vs. 38%; < 0.001). Supermarkets offered convenience and consumers enjoyed the experience of farmers' markets, especially in TAS (42%) in comparison to SWA (21%; = 0.012). The major RGFFV consumed were root vegetables and apples/pears, but consumers were frequently unsure about the produce's provenance. Our findings indicate multiple opportunities to improve consumption of fresh, regional produce in TAS and SWA, which may positively impact regional economic growth and community health.
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http://dx.doi.org/10.3390/nu12041026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230907PMC
April 2020

Increasing Food Expenditure in Long Day-care by an Extra $0.50 per Child/Day Would Improve Core Food Group Provision.

Nutrients 2020 Mar 31;12(4). Epub 2020 Mar 31.

School of Medical and Health Sciences, Edith Cowan University, Joondalup, Perth 6027, Australia.

Early childhood education and care services are a significant feature of Australian family life, where nearly 1.4 million children attended a service in 2019. This paper reports on the cost of food provided to children in long day-care (LDC) services and extrapolates expenditure recommendations to support food provision compliance. A cross-sectional audit of LDC services in metropolitan Perth was conducted to determine food group provision by weighing raw ingredients of meal preparation-morning tea, lunch, and afternoon tea (MT, L, AT). Ingredients were costed at 2017 online metropolitan pricing from a large supermarket chain. Across participating services, 2 days of food expenditure per child/day ranged between $1.17 and $4.03 across MT, L, AT, and averaged $2.00 per child/day. Multivariable analysis suggests that an increase of $0.50 per child/day increases the odds of a LDC service meeting >50% of Australian Dietary Guideline (ADG) recommendations across ≥4 core food groups by fourfold ( = 0.03). Given the fact that the literature regarding food expenditure at LDC services is limited, this study provides information about food expenditure variation that impacts planning and provision of nutritionally balanced menus recommended for children. An average increase of food expenditure of $0.50 per child/day would increase food provision compliance.
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http://dx.doi.org/10.3390/nu12040968DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231155PMC
March 2020

South West Food Community: how government and community initiatives are supporting systemic change towards enhanced food security.

Aust N Z J Public Health 2020 Apr 26;44(2):129-136. Epub 2020 Feb 26.

School of Medical and Health Sciences, Edith Cowan University, Western Australia.

Objective: Food security refers to adequate physical, social and economic access to food and is regarded as a complex, 'wicked' issue. This research aimed to understand the perspectives of initiative leaders (stakeholders), regarding their project relating to food security and its possession of characteristics associated with system change to enhance food security.

Methods: Stakeholders (n=51) participated in semi-structured interviews that evaluated initiatives (n=52) against 36 desirable characteristics for system change. Transcripts were analysed using QSR NVivo and Wicked Lab's Tool for Systemic Change.

Results: Community-based initiatives often harnessed the passion of local communities to enhance food security through awareness-raising activities and partnerships. Few initiatives created conflict to disrupt the current way of working. The largest 'window of opportunity' included better connection between government and community groups.

Conclusions: This novel contribution provided in-depth understanding of individual initiatives and patterns of working among the food security system in the South West region of Western Australia. Implications for public health: Recommendations to better foster connection between the government and community initiatives include: ensuring government worker responsibilities include task and indicator-related measures; and strengthening understanding of food security among community groups of staff and elected member roles within local government and the ways local government could be supported to harness community knowledge.
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http://dx.doi.org/10.1111/1753-6405.12975DOI Listing
April 2020

The role of a plant-based diet in the pathogenesis, etiology and management of the inflammatory bowel diseases.

Expert Rev Gastroenterol Hepatol 2020 Mar 26;14(3):137-145. Epub 2020 Feb 26.

School of Medicine and Pharmacology, University of Western Australia, Murdoch, Australia.

: Inflammatory Bowel Disease (IBD) carries a significant burden on an individual's quality-of-life and on the healthcare system. The majority of patients use dietary modifications to manage their symptoms, despite limited research to support these changes. There is emerging data that a plant-based diet will be of benefit to IBD patients.: A literature review on the pathogenesis and potential benefits of dietary management of IBD.: A Westernized diet has been associated with IBD risk and relapse; hence a plant-based diet may be of benefit to IBD patients through reducing inflammation and restoring symbiosis. Dietary therapy can be an important adjunct therapy, however, better quality studies are still required.
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http://dx.doi.org/10.1080/17474124.2020.1733413DOI Listing
March 2020

Sharing is Caring: A Study of Food-Sharing Practices in Australian Early Childhood Education and Care Services.

Nutrients 2020 Jan 16;12(1). Epub 2020 Jan 16.

Edith Cowan University, School of Medical & Health Sciences, WA 6027, Perth, Australia.

Food connects people, and can significantly impact the physical, social and emotional development of young children. Food sharing and family-style mealtimes can support healthy eating practices and psychological well-being among young children, and carersother than family members, such as Early Childhood Education and Care staff, play an important role in the provision of these practices. Despite increasing numbers of Australian children attending Early Childhood Education and Care services, there is often reluctance among staff to promote such mealtime practices, to the detriment of children's social and emotional development. The aim of this paper was to focus on the potential role of Early Childhood Education and Care services in facilitating food sharing and family-style mealtime practices in the earliest stages of the lifespan. A qualitative, netnographic approach was used, and data was collected as part of the broader 'Supporting Nutrition for Australian Childcare' (SNAC) study, via online conversation threads, observations and qualitative interviews. Findings demonstrated that whilst many Early Childhood Education and Care services are committed to supporting food sharing and family-style mealtime practices, a number of barriers were reported. These included the perception that babies and toddlers could not participate in these practices, concerns about food hygiene and cross contamination of allergens, and negative parental influences on food sharing. In conclusion, this paper supports the practice of food sharing in Early Childhood Education and Care settings and calls for them to become embedded in everyday operations to support the physical, social and emotional development of Australia's future generations.
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http://dx.doi.org/10.3390/nu12010229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019312PMC
January 2020

Australian Consumer Perceptions of Regionally Grown Fruits and Vegetables: Importance, Enablers, and Barriers.

Int J Environ Res Public Health 2019 12 20;17(1). Epub 2019 Dec 20.

School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA 6027, Australia.

Fresh fruits and vegetables are a cornerstone of a balanced diet; their consumption has health, environmental, ethical, and economic implications. This pilot study aimed to: (i) measure fruit and vegetable consumption; (ii) understand consumer perceptions of the perceived importance of regionally grown fresh fruit and vegetables (RGFFV); and (iii) identify the barriers and enablers of access and consumption of RGFFV. The study took place in Tasmania (TAS) and South Western Australia (SWA). A 54-item survey included questions relating to purchasing and consumption patterns; barriers and enablers related to access and consumption of RGFFV; and sociodemographic information. Survey data were analyzed using Chi-square test and binary logistic regression. A total of = 120 TAS and = 123 SWA adult respondents participated. SWA respondents had higher intakes of fruit ( < 0.001) and vegetables ( < 0.001). Almost all respondents (97%) rated purchasing of RGFFV as important. Top enablers included produce freshness (97%), and to financially support local farmers (94%) and the local community (91%). Barriers included limited seasonal availability of the produce (26%), the belief that RGFFV were expensive (12%) and food budgetary constraints (10%). Recommendations include broader marketing and labelling of seasonal RGFFV; increasing 'buy local' campaigns; consumer information about how RGFFV benefits producers and communities; and pricing produce according to quality.
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http://dx.doi.org/10.3390/ijerph17010063DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982335PMC
December 2019

Characterizing the Composition of the Pediatric Gut Microbiome: A Systematic Review.

Nutrients 2019 Dec 19;12(1). Epub 2019 Dec 19.

School of Medical and Health Sciences, Edith Cowan University, Perth, WA 6027, Australia.

The consortium of trillions of microorganisms that live inside the human gut are integral to health. Little has been done to collate and characterize the microbiome of children. A systematic review was undertaken to address this gap (PROSPERO ID: CRD42018109599). MEDLINE and EMBASE were searched using the keywords: "healthy preadolescent children" and "gut microbiome" to 31 August 2018. Of the 815 journal articles, 42 met the inclusion criteria. The primary outcome was the relative abundance of bacteria at the phylum, family, and genus taxonomic ranks. α-diversity, short chain fatty acid concentrations, diet, sequencing region, and geographical location were documented. The preadolescent gut microbiome is dominated at the phylum level by Firmicutes (weighted overall average relative abundance = 51.1%) and Bacteroidetes (36.0%); genus level by (16.0%), (8.69%), (7.51%), and (5.47%). Geographic location and sequencing region were independently associated with microbial proportions. There was limited consensus between studies that reported α-diversity and short chain fatty acids. Broadly speaking, participants from non-Western locations, who were less likely to follow a Westernized dietary pattern, had higher α-diversity and SCFA concentrations. Confirmatory studies will increase the understanding of the composition and functional capacity of the preadolescent gut microbiome.
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http://dx.doi.org/10.3390/nu12010016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7019424PMC
December 2019
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