Search

Social media data are rapidly evolving and accessible, which presents opportunities for research. Data science techniques, such as sentiment or emotion analysis which analyse textual emotion, provide an opportunity to gather insight from social media. This paper describes a systematic scoping review of interdisciplinary evidence to explore how sentiment or emotion analysis methods alongside other data science methods have been used to examine nutrition, food and cooking social media content. A PRISMA search strategy was used to search nine electronic databases in November 2020 and January 2022. Of 7325 studies identified, thirty-six studies were selected from seventeen countries, and content was analysed thematically and summarised in an evidence table. Studies were published between 2014 and 2022 and used data from seven different social media platforms (Twitter, YouTube, Instagram, Reddit, Pinterest, Sina Weibo and mixed platforms). Five themes of research were identified: dietary patterns, cooking and recipes, diet and health, public health and nutrition and food in general. Papers developed a sentiment or emotion analysis tool or used available open-source tools. Accuracy to predict sentiment ranged from 33·33% (open-source engine) to 98·53% (engine developed for the study). The average proportion of sentiment was 38·8% positive, 46·6% neutral and 28·0% negative. Additional data science techniques used included topic modelling and network analysis. Future research requires optimising data extraction processes from social media platforms, the use of interdisciplinary teams to develop suitable and accurate methods for the subject and the use of complementary methods to gather deeper insights into these complex data.

Objective: Web-based dietary interventions could support healthy eating. The Advice, Ideas and Motivation for My Eating (Aim4Me) trial investigated the impact of three levels of personalised web-based dietary feedback on diet quality in young adults. Secondary aims were to investigate participant retention, engagement and satisfaction. Design: Randomised controlled trial. Setting: Web-based intervention for young adults living in Australia. Participants: 18–24-year-olds recruited across Australia were randomised to Group 1 (control: brief diet quality feedback), Group 2 (comprehensive feedback on nutritional adequacy + website nutrition resources) or Group 3 (30-min dietitian consultation + Group 2 elements). Australian Recommended Food Score (ARFS) was the primary outcome. The ARFS subscales and percentage energy from nutrient-rich foods (secondary outcomes) were analysed at 3, 6 and 12 months using generalised linear mixed models. Engagement was measured with usage statistics and satisfaction with a process evaluation questionnaire. Results: Participants (n 1005, 85 % female, mean age 21·7 ± 2·0 years) were randomised to Group 1 (n 343), Group 2 (n 325) and Group 3 (n 337). Overall, 32 (3 %), 88 (9 %) and 141 (14 %) participants were retained at 3, 6 and 12 months, respectively. Only fifty-two participants (15 % of Group 3) completed the dietitian consultation. No significant group-by-time interactions were observed (P > 0·05). The proportion of participants who visited the thirteen website pages ranged from 0·6 % to 75 %. Half (Group 2 = 53 %, Group 3 = 52 %) of participants who completed the process evaluation (Group 2, n 111; Group 3, n 90) were satisfied with the programme. Conclusion: Recruiting and retaining young adults in web-based dietary interventions are challenging. Future research should consider ways to optimise these interventions, including co-design methods.

In early 2014, the Hazelwood coalmine fire covered the regional Australian town of Morwell in smoke and ash for 45 days. One of the fire’s by-products, PM2.5, has been linked higher rates of COVID-19 infection to increased expression of the ACE2 receptor, which the COVID-19 virus uses to infect cells throughout the body. However, it is unclear whether the effect persists for years after exposure. In this study, we surveyed a cohort established prior to the pandemic to determine whether PM2.5from the coalmine fire increased long-term vulnerability to COVID-19 infection and severe disease.In late 2022, 612 members of the Hazelwood Health Study’s adult cohort, established in 2016/17, participated in a follow-up survey including standardised items to capture COVID-19 infections, hospitalisations, and vaccinations. Associations were evaluated in crude and adjusted logistic regression models, applying statistical weighting for survey response and multiple imputation to account for missing data, with sensitivity analyses to test the robustness of results.A total of 271 (44%) participants self-reported or met symptom criteria for at least one COVID-19 infection. All models found a positive association, with odds of infection increasing by between 4-21% for every standard deviation (12.3µg/m3) increase in mine fire-related PM2.5exposure. However, this was not statistically significant in any model. There were insufficient hospitalisations to examine severity (n=7; 1%).The findings were inconclusive in ruling out an effect of PM2.5exposure from coalmine fire on long-term vulnerability to COVID-19 infection. Given the positive association that was robust to modelling variations as well as evidence for a causal mechanism, it would be prudent to treat PM2.5from fire events as a risk factor for long-term COVID-19 vulnerability until more evidence accumulates.

Demographic and psychosocial factors concerning dietary assessment error have been explored, but few studies have investigated the perceived problems experienced when completing dietary recalls. The aim of this research was to (i) compare the perceived problems encountered in two commonly used self-administered 24-hour dietary recall (24HR) programs (INTAKE24© and ASA24

Aim: To inform future training and professional development for individuals who measure, analyse and interpret dietary intake data. Methods: A cross-sectional online survey was distributed via e-newsletter to members of Dietitians Australia, Dietitian Connection and Nutrition Society Australia. The survey included 37 questions on three key areas of practice: (a) methods used to assess dietary intake, (b) barriers faced when conducting dietary intake assessment and (c) resources needed to optimise collection, analysis and interpretation of dietary intake data. Results: Of 173 responses, 103 respondents provided complete data over 2 weeks. Of these, 76% were APDs. The majority (90%) indicated that dietary assessment was important in their role. Respondents (63%) undertook dietary assessments to inform individual/patient care. When assessing intakes, the majority (79%) were interested in examining food/food group intakes. Paper based methods were most commonly used and diet histories, food frequency questionnaires and 24-hour recalls were the most frequently used methods. The biggest barrier identified to implementing dietary assessment methods into practice was participant burden. Over a third of respondents reported they had received specific training on selecting an appropriate dietary assessment method. The majority of respondents (83%) believed having access to a dietary assessment methods toolkit would be useful. Conclusion: Survey findings provide insight into the need for further capacity building strategies, including professional development to improve collection, analysis and interpretation of dietary intake for Australian nutritionists and dietitians. The creation of online resources could help overcome identified barriers and provide a link to best practice methodologies and contemporary tools.

Communication with young adults about healthy lifestyle behaviours needs to result in improvements in dietary choices to impact the prevalence of diet-related diseases. This paper presents the health beliefs, behaviours, and communication practices in young Australian adults (n = 2019) by their pre-defined psycho-behavioural characteristics: Lifestyle Mavens, Health-Conscious, Aspirational Healthy Eaters, Balanced-All Rounders, Contemplating Another Day, or Blissfully Unconcerned. The Lifestyle Mavens and Health-Conscious groups were more likely to actively seek out health information on social media (p < 0.05). Lifestyle Mavens were the most likely to engage with health and food content on social media, whereas the Blissfully Unconcerned were the least likely to engage (p < 0.05). Lifestyle Mavens are more likely to report creating food and health-related content for social media, whereas Aspirational Healthy Eaters are more likely to report searching for food and health-related content online, but are less likely to share or create content. Contemplating Another Day are more likely to report interactions with commercial content. This paper defines how psycho-behavioural segments communicate about health, where they look for information, how they may prefer to receive health messages, and when they are most receptive to messages. By applying existing robust market segmentation techniques, this paper provides nuanced information that challenges the assumption that online social media health information is preferred by all young adults.

FFQ, the primary method of dietary assessment in large-scale nutritional epidemiological studies, preclude an informed evaluation of the timing of dietary intake and meal-specific dietary intake. In this study, we developed the Meal-based Diet History Questionnaire (MDHQ), a self-administered questionnaire designed for estimating food and nutrient intakes for each meal type separately. The development was done based on a 16-d dietary record obtained from 242 Japanese adults. The MDHQ consisted of the three different parts, with a total of 196 items. Part 1 of the MDHQ asks about consumption frequency of generic food groups (n 24) for each meal type: breakfast, morning snack, lunch, afternoon snack, dinner and night snack. Part 2 of the MDHQ asks about relative consumption frequency of sub-food groups within one of the generic food groups which are asked in Part 1. Combining information derived from Parts 1 and 2 enables us to increase the number of foods we can estimate efficiently but within a limited number of questions. Part 3 of the MDHQ asks about general eating behaviours, which are intended to use in a variety of ways during dietary intake calculation. A series of calculation algorithms for food groups, energy and nutrients was also prepared. Given that the MDHQ was empirically developed based on comprehensive information on actual food consumption, this innovative tool may be promising for future epidemiological research on meal patterns and time of day of dietary intake, or chrono-nutrition research. A rigorous evaluation of validity of the MDHQ is warranted.

Introduction Digital technology-based interventions have gained popularity over the last two decades, due to the ease with which they are scalable and low in implementation cost. Multicomponent health promotion programmes, with significant digital components, are increasingly being deployed in the workplace to assess and promote employees’ health behaviours and reduce risk of chronic diseases. However, little is known about workplace digital health interventions in low- and middle- income countries (LMICs). Methods Various combinations of keywords related to “digital health”, “intervention”, “workplace” and “developing country” were applied in Ovid MEDLINE, EMBASE, CINAHL Plus, PsycINFO, Scopus and Cochrane Library for peer-reviewed articles in English language. Manual searches were performed to supplement the database search. The screening process was conducted in two phases and a narrative synthesis to summarise the data. The review protocol was written prior to undertaking the review (OSF Registry:10.17605/OSF.IO/QPR9J). Results The search strategy identified 10,298 publications, of which 24 were included. Included studies employed the following study designs: randomized-controlled trials (RCTs) (n = 12), quasi-experimental (n = 4), pilot studies (n = 4), pre-post studies (n = 2) and cohort studies (n = 2). Most of the studies reported positive feedback of the use of digital wellness interventions in workplace settings. Conclusions This review is the first to map and describe the impact of digital wellness interventions in the workplace in LMICs. Only a small number of studies met the inclusion criteria. Modest evidence was found that digital workplace wellness interventions were feasible, cost-effective, and acceptable. However, long-term, and consistent effects were not found, and further studies are needed to provide more evidence. This scoping review identified multiple digital health interventions in LMIC workplace settings and highlighted a few important research gaps.

This study aimed to describe the prevalence, severity and socio-demographic predictors of food insecurity in Australian households during the COVID-19 pandemic in 2020, from the perspective of women. A cross-sectional online survey of Australian (18–50 years) women was conducted. The survey collected demographic information and utilised the 18-item US Department of Agriculture Household Food Security Survey Module and the Kessler Psychological Distress Scale (K10). A multivariable regression was used to identify predictors of food security status. In this cohort (n = 1005), 19.6% were living in households experiencing food insecurity; with 11.8% experiencing low food-security and 7.8% very low food-security. A further 13.7% of households reported marginal food-security. Poor mental health status (K10 score ≥ 20) predicted household food insecurity at all levels. The presence of more than three children in the household was associated with low food-security (OR 6.24, 95% CI: 2.59–15.03). Those who were renting were 2.10 (95% CI: 1.09–4.05) times likely to experience very low food-security than those owning their own home. The COVID-19 pandemic may have contributed to an increased prevalence of household food insecurity. This study supports the need for a range of responses that address mental health, financial, employment and housing support to food security in Australia. Monash University National Heart Foundation Future Leader Fellowship National Health & Medical Research Council

A better understanding of the relationship between cardiovascular disease risk factors and quality of life (QoL) in older age is needed to inform development of risk reduction strategies. This cross-sectional study investigated the association of QoL with health-related behaviours in older adults at risk of heart failure.Older adults (N = 328) at risk of heart failure residing in Melbourne, Australia, provided data on QoL and health-related behaviours including physical activity, diet, smoking and alcohol consumption. Multiple linear regression modelling was used to examine associations between health-related behaviours, QoL and its constituent domains. After adjustment for age, gender, body mass index and comorbidities, current smoking was found to have a negative association with the mental component score (MCS) of QoL (β = -0.174, p ≤ 0.01), with a positive association seen between MCS and physical activity (β = 0.130, p = 0.01). Current alcohol use had a positive association with the physical component score (PCS) (β = 0.120, p = 0.02) and saturated fat intake consumption had a negative association with the physical functioning domain of QoL (β = -0.105, p = 0.03) but was not associated with either PCS or MCS.Engagement of older adults at increased cardiovascular risk with behavioural risk factor modification using QoL as a driver of change may offer new opportunities to promote healthy ageing. Development of such strategies should consider that for some behaviours which are cardiovascular risk factors (alcohol intake, in particular), the positive association to QoL is complicated and needs further deliberation.

Young adults are a key target age group for lifestyle behaviour change as adoption of healthier behaviours has the potential to impact long term health. This paper arises from a multi-disciplinary research project, Communicating Health, which aims to bridge the gap between nutritionists, media, and social marketing professionals to produce the tools that may be used to improve engagement with young adults and reduce the prevalence of obesity. The aim of this paper is to provide nuanced details of the psycho-behavioral characteristics of each of these Living and Eating for Health Segments (LEHS). The design and validation of the LEHS employed a four-stage mixed methods design underpinned by the Integrated Model of Behaviour Change and incorporating sequential formative, qualitative, and quantitative phases. This paper defines the psycho-behavioural characteristics of six distinct market segments: Lifestyle Mavens, Aspirational Healthy Eaters, Balanced-all Rounders, the Health Conscious, those Contemplating Another Day, and the Blissfully Unconcerned. These psycho-behavioural characteristics are important to understand to help build our capability in designing campaigns that are specifically and purposefully targeting these different market segments of young adults. Social marketing practices can enhance the utility of nutrition and health messages to young adults in order to engage them in adopting positive lifestyle change. Tailoring health promotions to the perceived needs of sub-groups or segments of young adults should lead to increased engagement and uptake of messages and cost-efficient use of health promotion budgets.

BACKGROUND The assessment of dietary intake underpins population nutrition surveillance and nutritional epidemiology and is essential to inform effective public health policies and programs. Technological advances in dietary assessment that use images and automated methods have the potential to improve accuracy, respondent burden, and cost; however, they need to be evaluated to inform large-scale use. OBJECTIVE The aim of this study is to compare the accuracy, acceptability, and cost-effectiveness of 3 technology-assisted 24-hour dietary recall (24HR) methods relative to observed intake across 3 meals. METHODS Using a controlled feeding study design, 24HR data collected using 3 methods will be obtained for comparison with observed intake. A total of 150 healthy adults, aged 18 to 70 years, will be recruited and will complete web-based demographic and psychosocial questionnaires and cognitive tests. Participants will attend a university study center on 3 separate days to consume breakfast, lunch, and dinner, with unobtrusive documentation of the foods and beverages consumed and their amounts. Following each feeding day, participants will complete a 24HR process using 1 of 3 methods: the Automated Self-Administered Dietary Assessment Tool, Intake24, or the Image-Assisted mobile Food Record 24-Hour Recall. The sequence of the 3 methods will be randomized, with each participant exposed to each method approximately 1 week apart. Acceptability and the preferred 24HR method will be assessed using a questionnaire. Estimates of energy, nutrient, and food group intake and portion sizes from each 24HR method will be compared with the observed intake for each day. Linear mixed models will be used, with 24HR method and method order as fixed effects, to assess differences in the 24HR methods. Reporting bias will be assessed by examining the ratios of reported 24HR intake to observed intake. Food and beverage omission and intrusion rates will be calculated, and differences by 24HR method will be assessed using chi-square tests. Psychosocial, demographic, and cognitive factors associated with energy misestimation will be evaluated using chi-square tests and multivariable logistic regression. The financial costs, time costs, and cost-effectiveness of each 24HR method will be assessed and compared using repeated measures analysis of variance tests. RESULTS Participant recruitment commenced in March 2021 and is planned to be completed by the end of 2021. CONCLUSIONS This protocol outlines the methodology of a study that will evaluate the accuracy, acceptability, and cost-effectiveness of 3 technology-enabled dietary assessment methods. This will inform the selection of dietary assessment methods in future studies on nutrition surveillance and epidemiology. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12621000209897; https://tinyurl.com/2p9fpf2s INTERNATIONAL REGISTERED REPORT DERR1-10.2196/32891

A tacit understanding of the influence of healthy eating on chronic disease risk and quality of life among older adults is essential for successful design and roll-out of healthy ageing policies. Existing research on dietary determinants among older adults is largely outdated owing to the changing geopolitical scenarios including advancements in health and technology and global migration. Studies published between 2000 and 2020 that explored determinants of diet in older adults were identified using five databases, following Preferred Reporting of Systematic review and Meta-Analyses extended for Scoping Review (PRISMA ScR) guidelines. The final 51 studies (25 quantitative, 22 qualitative and 4 mixed methods) were analysed and interpreted to corroborate existing evidence and identify research gaps. The review identified past influences including childhood affluence and future apprehensions regarding loss of independence and fear of disability to be major drivers of food choices. Current socio-economic status, health conditions and cultural contexts were congruent with past and future influences, implying the role of behavioural change programmes in early life to achieve long term health goals for older adults.

To investigate associations between eating behavior constructs (social eating, perceived competence, habit automaticity, self-determined motivation) and diet quality among young adults.Cross-sectional analysis.Young adults (n = 1,005; mean age, 21.7 ± 2.0 years; 85% female) enrolled in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study.Four eating behavior measures collected via online surveys: Social Eating Scale, Perceived Competence in Healthy Eating Scale, Self-Report Behavioral Automaticity Index, and Regulation of Eating Behaviors scales. Diet quality was assessed using the Australian Recommended Food Score (ARFS) and percentage energy from energy-dense, nutrient-poor (EDNP) foods.Multivariate linear regression investigating associations between eating behavior measures (independent variables) and ARFS and EDNP foods (dependent variables), adjusting for sociodemographic and lifestyle confounders.Greater perceived competence in healthy eating and behavioral automaticity for consuming healthy foods, limiting EDNP food intake, and higher intrinsic motivation, integrated regulation, and identified regulation of eating behaviors were associated with higher ARFS and lower percentage energy EDNP foods (P0.001). Greater self-reported social influence on eating behaviors was associated with higher ARFS (P = 0.01). Higher amotivation was associated with greater % energy from EDNP foods (P0.001).Perceived competence, habit automaticity, and self-determined motivation are determinants of diet quality in young adults. These findings support the development of interventions that promote healthy eating habits by focusing on eating behavior constructs and evaluating their use in improving diet quality.

Inadequate dietary intakes are a key modifiable risk factor to reduce the risk of developing non-communicable diseases. To encourage healthy eating and behaviour change, innovative public health interventions are required. Social marketing, in particular segmentation, can be used to understand and target specific population groups. However, segmentation often uses demographic factors, ignoring the reasons behind why people behave the way they do. This review aims to explore the food and nutrition related research that has utilised psycho-behavioural segmentation. Six databases from were searched in June 2020. Inclusion criteria were: published 2010 onwards, segmentation by psycho-behavioural variables, outcome related to food or nutrition, and healthy adult population over 18 years. 30 studies were included; most were quantitative (n = 28) and all studies used post-hoc segmentation methods, with the tools used to segment the population varying. None of the segments generated were targeted in future research. Psycho-behavioural factors are key in understanding people’s behaviour. However, when used in post-hoc segmentation, do not allow for effective targeting as there is no prior understanding of behaviours that need to change within each segment. In future, we should move towards hybrid segmentation to assist with the design of interventions that target behaviours such as healthy eating.

Health promotion campaigns using Social Media have emerged as a potential way to change behaviour in a large, diverse group of people. However, successfully connecting with and engaging the target audience is still a key challenge faced by health professionals and social marketers. This chapter examines the use of co-creation and co-design processes as ways to engage young people in Social Media interventions. This method involves a ‘Wicked Problems’ studio (five-day workshop), where young adults (university students) across multidisciplinary areas and a variety of stakeholders (e.g. health organisations, government bodies, academics, etc.) collaborate to problem-solve. Using this method, we were able to understand what works and what does not work when it comes to co-creation with young adults. Towards a broader outlook, the results from this study will translate into practice through the development of a how-to guide on co-creation and co-design as a procedure for key stakeholders such as government bodies and health organisations.

Health promoters have been unable to reach and engage people on social media (SM) to the extent that food industry brands and lifestyle personalities have. The objective of this study was to identify the SM post strategies associated with higher engagement in nutrition and food-related posts using a retrospective content analysis. The six most engaging posts from both Facebook and Instagram&rsquo, s 10 most successful nutrition and food-related accounts were analysed across four fields. Subjective and objective post strategies were coded on 736 posts, and associations with engagement were explored using the Least Absolute Shrinkage and Selection Operator (LASSO). Lifestyle personalities recorded the highest absolute engagement, while health promoters recorded the highest engagement relative to follower count. Strategies associated with higher Facebook engagement included using hashtags and prompting engagement through announcements, while on Instagram, higher engagement was associated with higher caption counts, providing health information links, prompting engagement through strategies that require an action, and using humorous strategies. Strategies associated with lower Instagram engagement included reposted content, general encouragement to eat strategies, encouragement to exercise strategies, not inducing any emotion/hedonic sensations, and providing a negative tone. Health promoters should adapt SM posts to the different SM platforms and utilise strategies associated with higher engagement to engage with their audience on SM.

Communicating evidence-based nutrition messages to the public is challenging and is often in conflict with popular opinions, particularly from social media influencers (SMIs). In order to increase engagement with nutrition professionals (NPs) on social media, we aimed to explore young adults&rsquo, perceptions of the authenticity and trustworthiness of SMIs and NPs Instagram posts. A cross-sectional questionnaire was administered to students (n = 149) from an Australian University. Participants viewed a real-life Instagram profile and one post from both a NP and a SMI. Main outcomes were post authenticity and trustworthiness, and emotional message appeals measured on five-point Likert scales. Regression models were developed to assess whose post (the NP or SMI) was perceived to be more authentic and trustworthy. Participants were young adults (median age (25th, 75th percentiles): 20 (19,21)), with approximately half identifying as female. A high heroic message appeal (+1SD above mean) significantly increased the perceived authenticity of the NPs post only (p = 0.01). Post authenticity enhanced post trustworthiness, but only when a heroic message appeal was used by the NP. When appropriate, NPs should convey positive emotions such as bravery and success to enhance the authenticity and trustworthiness of their posts.

Objectives Mis-reporting is common in dietary assessment, leading to misinterpretation of disease risk and could be important in older adults with increased chronic disease risk. This study investigated the prevalence and characteristics of mis-reporting among older adults and its association with health outcomes including quality of life (QoL). Methods The study was conducted in 335 community-dwelling older adults at increased risk for cardiovascular disease, participating in the SCReening Evaluation of the Evolution of New Heart Failure Study dietary substudy. Diet was assessed using 4-day weighed food diaries, QoL measured through Short Form 36, and physical activity assessed using the European Prospective Investigation into Cancer and Nutrition physical activity questionnaire. Dietary mis-reporting was defined based on Goldberg cutoffs, using individual physical activity levels. Odds ratios were determined to establish associations between mis-reporting and health outcomes. Results The prevalence of mis-reporting among older adults was 49.3%, with 44.5% of women mis-reporting their energy intake. The study found under-reporting of energy to be associated with body mass index, specifically being overweight (odds ratio: 3.08; 95% confidence interval [CI], 1.54–6.15) and obese (odds ratio: 6.60; 95% CI, 3.05–4.26), as well as physical inactivity (odds ratio: 0.24; 95% CI, 0.14–0.43). Only physical inactivity predicted over-reporting of dietary intake (odds ratio: 7.52; 95% CI, 1.57–36.0). Conclusions Dietary under-reporting was associated with being overweight, obese, and physically inactive in addition to the absence of comorbidities, reinforcing the need for further research in older adults to factor in dietary mis-reporting for meaningful diet–disease relationship analyses.

The aim of this study was to assess the relative validity and reproducibility of a six-item Australian Short Dietary Screener (Aus-SDS). The Aus-SDS assessed the daily intake of core food groups (vegetables, fruits, legumes and beans, cereals, protein sources and dairy sources) in 100 Australians (52 males and 48 females) aged &ge, 70 years. Relative validity was assessed by comparing intakes from the Aus-SDS1 with an average of three 24-hour recalls (24-HRs), and reproducibility using two administrations of the Aus-SDS (Aus-SDS1 and Aus-SDS2). Cohen&prime, s kappa statistic between the Aus-SDS1 and 24-HRs showed moderate to good agreement, ranging from 0.44 for fruits and dairy to 0.64 for protein. There was poor agreement for legume intake (0.12). Bland&ndash, Altman plots demonstrated acceptable limits of agreement between the Aus-SDS1 and 24-HRs for all food groups. Median intakes obtained from Aus-SDS1 and Aus-SDS2 did not differ. For all food groups, Cohen&prime, s kappa statistic ranged from 0.68 to 0.89, indicating acceptable agreement between the Aus-SDS1 and Aus-SDS2. Spearman&prime, s correlation coefficient between Aus-SDS1 and 24-HRs across all food groups ranged from 0.64 for fruit to 0.83 for protein. We found the Aus-SDS to be a useful tool in assessing daily intake of core food groups in this population.

This study examined the relationship between diet quality scores and cardiometabolic risk factors in regionally-dwelling older Australian adults with increased cardiovascular risk. This study was a cross-sectional analysis of demographic, anthropometric, and cardiometabolic risk factor data from 458 participants of the Cardiovascular Stream of the Hazelwood Health Study. Participants completed a 120 item semi-quantitative food frequency questionnaire. Multivariable linear regression adjusting for age, sex, smoking, physical activity, education, diabetes, and body mass index was used to examine the relationship between diet and cardiometabolic risk factors. Mean (SD) age of participants was 71 (8) years, and 55% were male. More than half of men and women did not meet recommended intakes of fibre, while 60% of men and 42% of women exceeded recommended dietary sodium intakes. Higher diet quality in terms of intake of vegetables, grains, and non-processed meat, as well as intake of non-fried fish, was associated with more favourable cardiometabolic risk profiles, while sugar-sweetened soft drink intake was strongly associated with adverse cardiometabolic risk factor levels. In older, regionally-dwelling adults, dietary public health strategies that address whole grain products, vegetable and fish consumption, and sugar-sweetened soft-drink intake may be of benefit in reducing cardiometabolic risk.

Young adults (YA) are in a critical stage of life for the encouragement of healthy behaviours such as healthy eating and exercising. This research explored Australian YA values and perceptions related to health, healthy behaviours and health promotion efforts. This qualitative analysis involved n = 166, Australian 18&ndash, 24 year-olds recruited through a market research field house. Participants (63% currently studying at tertiary level) engaged in a facilitated in-depth online conversation around health and healthy eating over four weeks. LeximancerTM and manual inductive thematic coding were utilised for analysis via the lens of emerging adulthood and health communication theories. Health was seen as multi-faceted, with particular importance placed on mental health and exercise. Some participants focussed on physical appearance, often fuelled by comparison to others. Many believed that at their age and health status, adopting health-enhancing behaviours without short-term tangible benefits was not a priority. Participants did not prioritise health-enhancing behaviours due to barriers such as a perceived lack of money, knowledge and time often due to studying or working and perceived effort. Strategies they proposed to encourage healthy eating included: incentivising healthy food, quick and affordable healthy recipes, and communicating the short-term tangible benefits of healthy behaviours. There is a need for focussed health messaging that address the needs and desires of YA and directly address the barriers they face.

Background: Obesity is a global health problem. Understanding how to utilise social media (SM) as a platform for intervention and engagement with young adults (YAs) will help the practitioners to harness this media more effectively for obesity prevention. Aim: Communicating health (CH) aims to understand the use of SM by YAs, including Aboriginal YAs, and in doing so will improve the effectiveness of SM strategies to motivate, engage and retain YAs in interventions to reduce the risk of obesity, and identify and disseminate effective ways for health professionals to deliver obesity prevention interventions via SM. Methods: The present study describes the theoretical framework and methodologies for the CH study, which is organised into four interrelated phases, each building on the outcomes of preceding phases. Phase 1 is a mixed methods approach to understand how YAs use SM to navigate their health issues, including healthy eating. Phase 2 utilises co-creation workshops where YAs and public health practitioners collaboratively generate healthy eating messages and communication strategies. Phase 3 evaluates these messages in a real-world setting. Phase 4 is the translation phase where public health practitioners use outcomes from CH to inform future strategies and to develop tools for SM for use by stakeholders and the research community. Discussion: The outcomes will include a rich understanding of psychosocial drivers and behaviours associated with healthy eating and will provide insight into the use of SM to reach and influence the health and eating behaviours of YAs.

Food-health claims are an important method of translating nutrition research to consumers. Whey and colostrum are thought to exert health benefits to adults, but it is unclear what measurable, objective health benefits they impart. This review aimed to identify the objective health benefits of bovine whey or colostrum-based beverages to healthy adults aged ≥35 years to substantiate a food-health claim. Seven databases were systematically searched. Eligible articles were RCTs that involved healthy adults aged ≥35 years, consuming whey or colostrum in beverage form and measuring objective health markers. Quality assessment and data extraction was conducted in duplicate. The searches identified 9943 papers and 16 were included in this review; 13 studies, reported across 15 papers, related to whey, one study to colostrum. The outcomes identified were body composition, bone mineral density, biochemical markers, such as blood glucose and lipids, and muscle strength and synthesis. Heterogeneous outcomes, high risk of bias and inconsistent findings resulted in inconclusive evidence to substantiate a food-health claim. Clearer reporting and consensus on a minimum set of objective measures would allow for more robust recommendations regarding food-health claims. Protecting consumers from misleading health claims will require collaboration between regulators, researchers, and the food industry.

Background Nutrition science is currently facing issues regarding the public’s perception of its credibility, with social media (SM) influencers increasingly becoming a key source for nutrition-related information with high engagement rates. Source credibility and, to an extent, authenticity have been widely studied in marketing and communications but have not yet been considered in the context of nutrition or health communication. Thus, an investigation into the factors that impact perceived source and message credibility and authenticity is of interest to inform health communication on SM. Objective This study aims to explore the factors that impact message and source credibility (which includes trustworthiness and expertise) or authenticity judgments on SM platforms to better inform nutrition science SM communication best practices. Methods A total of 6 databases across a variety of disciplines were searched in March 2019. The inclusion criteria were experimental studies, studies focusing on microblogs, studies focusing on healthy adult populations, and studies focusing on either source credibility or authenticity. Exclusion criteria were studies involving participants aged under 18 years and clinical populations, gray literature, blogs, WeChat conversations, web-based reviews, non-English papers, and studies not involving participants’ perceptions. Results Overall, 22 eligible papers were included, giving a total of 25 research studies. Among these studies, Facebook and Twitter were the most common SM platforms investigated. The most effective communication style differed depending on the SM platform. Factors reported to impact credibility included language used online, expertise heuristics, and bandwagon heuristics. No papers were found that assessed authenticity. Conclusions Credibility and authenticity are important concepts studied extensively in the marketing and communications disciplines; however, further research is required in a health context. Instagram is a less-researched platform in comparison with Facebook and Twitter.

Background Poor dietary choices are a risk factor for non-communicable diseases. Young adults have low levels of engagement towards their health and may not see the importance in the adoption of healthy eating behaviours at this stage in their lives. Here we utilise social marketing principles, digital ethnography and online conversations to gain insights into young adults’ attitudes and sentiments towards healthy eating. Methods Young Australian adults who use social media at least twice a day were recruited by a commercial field house. Using a mixture of methods, combining online polls, forums and conversations, participants (n = 195, 18–24 years old) engaged in facilitated discussions over an extended 4 week period about health and eating-related topics. Data were analysed using thematic analysis constant comparison approach. A post-hoc conceptual framework related to religion was theorised and used as a metaphor to describe the results. Results Findings demonstrate that different segments of young adults with varying attitudes and interest towards healthy eating exist. We developed a conceptual framework based on consumer segmentation which adopted religious metaphors as a typology of ‘consumers’. Some young adults practice and believe in the message of healthy eating (saints), whilst some oppose these messages and are not motivated to make any change (sinners), another segment are both aware of and interested in the issues but do not put healthy eating behaviours as a current priority (person in the pew). Conclusions Consumer segmentation and social marketing techniques assist health professionals to understand their target audience and tailor specific messages to different segments. Segmentation provides insights on which groups may be most easily influenced to adopt the desired behaviours. The typology presented may be a useful tool for health professionals and social marketers to design strategies to engage young adults in healthy eating, particularly those in the pew who are contemplating a change but lacking the motivation. The utilisation of marketing segmentation in health promotion has the potential to enhance health messaging by tailoring messages to specific segments based on their needs, beliefs and intentions and therefore drive the efficient use of resources towards those most likely to change.

OBJECTIVES: Behavior change in young adults (YA) is notoriously difficult. Psycho-behavioral segmentation, used by marketing, may be more effective to foster change than grouping by demographic characteristics alone. The aim was to determine whether previously developed Living and Eating for Health Segments (LEHS) were applicable in a nationally representative sample of 18–24 yr olds. METHODS: YA were asked to select one of six LEHS: Lifestyle Mavens (LM), Health Conscious (HC), Aspirational Healthy Eaters (AHE), Balanced All-Rounders (BAR), Contemplating Another Day (CAD), Blissfully Unconcerned (BU) and answer demographic and SM usage questions RESULTS: Approximately 64% (n = 2019) of YA completed the survey, mean age of 21 (SD ± 2), mostly healthy weight (54.6%), females (51.8%), with 2.0% identifying as non-binary/gender fluid. All LEHS were selected: LM = 15.4% were primarily males (62%); HC = 21.1% slightly more males 54%; AHE = 27.5%, were predominately females (61%); BAR = 21.4% higher prevalence of females (62%); CAD = 11.2% slightly more females (51.8%); BU = 3.4% slightly more males 56.5% with 4.3% identifying as non-binary. All LEHS agreed the internet was ‘helpful to see other people's health-related experiences’ (61.1% to 91.8%). All segments apart from BU were intending to search online for health/food information over the next month. SM platform usage varied by LEHS: highest users were AHE, with extensive use of Facebook (40.8%), YouTube (45.9%) Instagram (43.2%) Snapchat (34%) and Spotify (35.3%) on Apple devices (48.1%). CAD (48.7%) reported using YouTube extensively and were the highest (17.7%) to report not using Instagram. BAR were most likely to use laptops (44.2%) with extensive use of Facebook (39.2%) but did not use Twitter (56.0%). BU were more likely to report not using Snapchat (29.4%), Spotify (35.3%) and Apple devices (40.6%), but were the most extensive users of Android Smartphones (37.7%). CONCLUSIONS: Enabling YA to self-nominate into segments forces researchers to challenge existing stereotypes and assumptions about young adults perceptions and behaviors. Continued analysis will further explore how effective interventions and SM campaigns might be co-designed. FUNDING SOURCES: National Health and Medical Research Council, Australia. Qualtrics LLC recruited participants for the online survey developed by the research team.

© 2019 Dietitians Association of Australia Aim: Negative body image increases the risk of engaging in unhealthy dieting and disordered eating patterns. This review evaluated the impact of habitual social media engagement or exposure to image-related content on body image and food choices in healthy young adults (18-30 years). Methods: A systematic search of six databases of observational literature published 2005-2019, was conducted (PROSPERO Registration No. CRD42016036588). Inclusion criteria were: studies reporting social media engagement (posting, liking, commenting) or exposure to image-related content in healthy young adults. Outcomes were: body image (satisfaction or dissatisfaction) and food choices (healthy eating, dieting/restricting, overeating/binging). Two authors independently screened, coded and evaluated studies for methodological quality. Results: Thirty studies were identified (n = 11 125 participants). Quantitative analysis (n = 26) identified social media engagement or exposure to image-related content was associated with higher body dissatisfaction, dieting/restricting food, overeating, and choosing healthy foods. Qualitative analysis (n = 4) identified five themes: (i) social media encourages comparison between users, (ii) comparisons heighten feelings about the body, (iii) young adults modify their appearance to portray a perceived ideal image, (iv) young adults are aware of social media's impact on body image and food choices, however, (v) external validation via social media is pursued. Most studies (n = 17) controlled for some confounding variables (age, gender, BMI, ethnicity). Conclusions: Social media engagement or exposure to image-related content may negatively impact body image and food choice in some healthy young adults. Health professionals designing social media campaigns for young adults should consider image-related content, to not heighten body dissatisfaction.

There are many health and economic consequences for patients with osteopenia, the precursor to osteoporosis. A range of treatments may provide positive outcomes for otherwise healthy adults, including dietary and exercise approaches, either alone or in combination. The primary aim of this systematic review was to evaluate the effect of dietary approaches (including diet alone, diet with dietary supplements, both with or without physical activity intervention) on bone mineral density (BMD) to treat adults aged ≥18 years who were classified as having osteopenia. Six databases (Ovid MEDLINE including Ovid Medline in process, Cochrane Library, EMBASE, CINAHL Plus, Web of Science and Scopus) were searched systematically to identify randomised controlled trials of dietary approaches to treat osteopenic adults published from 1994 to November 2014. Study eligibility was determined, and included studies were assessed for risk of bias. Outcome data, particularly the primary outcomes of BMD T- and Z-scores or other measures of bone density, were combined narratively. The searches yielded 3511 papers, with three studies fulfilling the inclusion criteria. These studies included 254 participants, all free-living post-menopausal females with confirmed osteopenia. Vitamin D interventions were tested in all included studies, with none showing significant differences between intervention and placebo groups on BMD. This review has identified a lack of evidence to guide clinical practice in this area. Opportunities exist for future research to determine the effect of non-pharmacological approaches to osteopenia treatment in healthy populations, especially research that considers younger-aged and male populations, physical activity, habitual dietary intake and key bone health nutrients.

Nudging or ‘choice architecture’ refers to strategic changes in the environment that are anticipated to alter people’s behaviour in a predictable way, without forbidding any options or significantly changing their economic incentives. Nudging strategies may be used to promote healthy eating behaviour. However, to date, the scientific evidence has not been systematically reviewed to enable practitioners and policymakers to implement, or argue for the implementation of, specific measures to support nudging strategies. This systematic review investigated the effect of positional changes of food placement on food choice. In total, seven scientific databases were searched using relevant keywords to identify interventions that manipulated food position (proximity or order) to generate a change in food selection, sales or consumption, among normal-weight or overweight individuals across any age group. From 2576 identified articles, fifteen articles comprising eighteen studies met our inclusion criteria. This review has identified that manipulation of food product order or proximity can influence food choice. Such approaches offer promise in terms of impacting on consumer behaviour. However, there is a need for high-quality studies that quantify the magnitude of positional effects on food choice in conjunction with measuring the impact on food intake, particularly in the longer term. Future studies should use outcome measures such as change in grams of food consumed or energy intake to quantify the impact on dietary intake and potential impacts on nutrition-related health. Research is also needed to evaluate potential compensatory behaviours secondary to such interventions.

Obesity, sedentary behaviour, and poor dietary habits amongst young adults are growing concerns, with this age group being in a worse state of health and nutrition than adolescents and adults. This paper presents the procedures for establishing a new instrument for defining behaviours in relation to healthy lifestyle and food choices amongst young adults (Living and Eating for Health Segments: LEHS). The aim of this paper is to outline the instrument design protocol for external validation and to permit replication in other studies. The instrument design process used a multi-step social marketing instrument design method. This approach has previously been used in designing valid and reliable measures in marketing and consumer research, including social marketing. The protocol established six psycho-behavioural LEHS profiles for young adults. These profiles are: Lifestyle Mavens (15.4%), Aspirational Healthy Eaters (27.5%), Balanced-all Rounders (21.4%), Health Conscious (21.1%), Contemplating Another Day (11.2%), and Blissfully Unconcerned (3.4%). Each of these profiles provided insights into psycho-behavioural characteristics that can be used in designing apposite social media social marketing campaigns.

To reduce errors in portion size estimation, a number of aids have been developed and tested. This systematic review synthesizes what is known about error associated with use of different portion size estimation aids (PSEAs) within self-reported dietary recall studies in children (aged ≤18 years). Eight electronic databases were searched using relevant keywords. From 8184 records identified and screened, 327 full texts were retrieved, with 10 records representing 9 studies meeting inclusion criteria. Studies using proxy reporting were excluded. Thirteen PSEAs were identified. To facilitate comparisons between different types of aids they were categorized into 'physical 2-dimensional (2D)', 'digital 2D' and '3-dimensional' PSEAs. Seven were physical 2D (e.g. food atlas), two were digital 2D (i.e. computer-based), and four were 3D (e.g. modelling clay, household items). Comparisons of PSEAs within studies found the smallest estimation errors for digital 2D and largest for 3D aids. Errors in relation to food type were varied, with portions of amorphous foods overestimated in multiple studies. No effects for recall interval time or sex were identified. One study reported a significant improvement in estimation error with increasing age. Across studies, large variations in study design and reporting of estimation error hindered the synthesis of evidence regarding the influence of different types of PSEAs on accuracy. While a definitive conclusion about the most accurate PSEA could not be drawn, a check-list to guide future PSEA development and testing has been proposed in the current review. This will assist comparability with future studies of PSEAs for children facilitate development of more accurate PSEAs in the future.

Obesity is a global health problem. Understanding how to utilise social media (SM) as a platform for intervention and engagement with young adults (YAs) will help the practitioners to harness this media more effectively for obesity prevention.Communicating health (CH) aims to understand the use of SM by YAs, including Aboriginal YAs, and in doing so will improve the effectiveness of SM strategies to motivate, engage and retain YAs in interventions to reduce the risk of obesity, and identify and disseminate effective ways for health professionals to deliver obesity prevention interventions via SM.The present study describes the theoretical framework and methodologies for the CH study, which is organised into four interrelated phases, each building on the outcomes of preceding phases. Phase 1 is a mixed methods approach to understand how YAs use SM to navigate their health issues, including healthy eating. Phase 2 utilises co-creation workshops where YAs and public health practitioners collaboratively generate healthy eating messages and communication strategies. Phase 3 evaluates these messages in a real-world setting. Phase 4 is the translation phase where public health practitioners use outcomes from CH to inform future strategies and to develop tools for SM for use by stakeholders and the research community.The outcomes will include a rich understanding of psychosocial drivers and behaviours associated with healthy eating and will provide insight into the use of SM to reach and influence the health and eating behaviours of YAs.

BACKGROUND Health campaigns have struggled to gain traction with young adults using social media, even though more than 80% of young adults are using social media at least once per day. Many food industry and lifestyle brands have been successful in achieving high levels of user engagement and promoting their messages; therefore, there may be lessons to be learned by examining the successful strategies commercial brands employ. OBJECTIVE This study aims to identify and quantify social media strategies used by the food industry and lifestyle brands, and health promotion organizations across the social networking sites Facebook and Instagram. METHODS The six most engaging posts from the 10 most popular food industry and lifestyle brands and six health promotion organizations were included in this study. A coding framework was developed to categorize social media strategies, and engagement metrics were collected. Exploratory linear regression models were used to examine associations between strategies used and interactions on Facebook and Instagram. RESULTS Posts from Facebook (143/227, 63.0%) and Instagram (84/227, 37.0%) were included. Photos (64%) and videos (34%) were used to enhance most posts. Different strategies were most effective for Facebook and Instagram. Strategies associated with higher Facebook interactions included links to purchasable items (beta=0.81, 95% CI 0.50 to 1.13, P CONCLUSIONS Health promotion professionals and organizations can improve engagement using positive messaging and tailoring posts appropriate for different social media channels.

Background: Health campaigns have struggled to gain traction with young adults using social media, even though more than 80% of young adults are using social media at least once per day. Many food industry and lifestyle brands have been successful in achieving high levels of user engagement and promoting their messages; therefore, there may be lessons to be learned by examining the successful strategies commercial brands employ. Objective: This study aims to identify and quantify social media strategies used by the food industry and lifestyle brands, and health promotion organizations across the social networking sites Facebook and Instagram. Methods: The six most engaging posts from the 10 most popular food industry and lifestyle brands and six health promotion organizations were included in this study. A coding framework was developed to categorize social media strategies, and engagement metrics were collected. Exploratory linear regression models were used to examine associations between strategies used and interactions on Facebook and Instagram. Results: Posts from Facebook (143/227, 63.0%) and Instagram (84/227, 37.0%) were included. Photos (64%) and videos (34%) were used to enhance most posts. Different strategies were most effective for Facebook and Instagram. Strategies associated with higher Facebook interactions included links to purchasable items (beta=0.81, 95% CI 0.50 to 1.13, P

The present analysis aimed to investigate the changes in the reported portion sizes (PS) of foods and beverages commonly consumed by Irish adults (18–64 years) from the North South Ireland Food Consumption Survey (NSIFCS) (1997–2001) and the National Adult Nutrition Survey (NANS) (2008–10). Food PS, which are defined as the weight of food (g) consumed per eating occasion, were calculated for comparable foods and beverages in two nationally representative cross-sectional Irish food consumption surveys and were published in NSIFCS and NANS. Repeated measure mixed model analysis compared reported food PS at the total population level as well as subdivided by sex, age, BMI and social class. A total of thirteen commonly consumed foods were examined. The analysis demonstrated that PS significantly increased for five foods (‘white sliced bread’, ‘brown/wholemeal breads’, ‘all meat, cooked’, ‘poultry, roasted’ and ‘milk’), significantly decreased for three (‘potatoes’, ‘chips/wedges’ and ‘ham, sliced’) and did not significantly change for five foods (‘processed potato products’, ‘bacon/ham’, ‘cheese’, ‘yogurt’ and ‘butter/spreads’) between the NSIFCS and the NANS. The present study demonstrates that there was considerable variation in the trends in reported food PS over this period.

Body fat distribution has been shown to be a predictor of adhesion molecule and inflammatory marker expression albeit the effect of modest weight change on concentrations of adhesion molecules and inflammatory markers in postmenopausal women are not fully understood. The primary aim was to investigate the effects of weight change on adhesion molecules and inflammatory markers over 24 months in postmenopausal women. Body composition was assessed in 254 healthy postmenopausal women using dual-energy X-ray absorptiometry (DXA). Adhesion molecules and inflammatory markers were analysed by multiplex ELISA. Participants weight gain/loss at 24 months was defined as any value that was either above/below the weight value recorded at baseline. Postmenopausal women with an average weight loss of 3% had significantly decreased leptin concentrations by 18% at 24 months (P

Background The present study aimed to compare the nutritional quality (NQ) and energy costs (EC) (£ MJ–1) of own brand (OB) versus market brand (MB) foods in 2010 and 2012. Methods A list of processed foods (n = 32) was identified based on the most frequently consumed foods in the UK. Total fat, saturated fat, sugars, salt and energy density (ED) (kJ g−1) in 2010 and 2012 were compared for six OB and one MB version of each food using a NQ scoring method based on the Food Standards Agency's Traffic Light System (TLS). Additional information (fruit, vegetable and nut content; protein; fibre and sodium) was recorded in 2012, and NQ was assessed using the Food Standards Agency's nutrient profiling model (NPM). The EC of the food baskets (FB) was compared in 2010 and 2012. Results There were no differences in overall NQ between OB and MB FB in 2010 (TLS, P = 0.978) or 2012 (TLS, P = 0.840; NPM, P = 0.696). However, the MB FB was highest in EC in 2010 and 2012 (both P

Nutrition labelling is an important strategic approach for encouraging consumers to make healthier food choices. The availability of highly palatable foods labelled as 'low fat or reduced calorie' may encourage the over-consumption of these products. This study aimed to determine whether the manipulation of nutrition labelling information can influence food portion size consumption. Normal and overweight men (n=24) and women (n=23) were served an identical lunch meal on three separate days, but the information they received prior to consuming the lunch meal was manipulated as follows: "baseline", "high fat/energy" and "low fat/energy". Food and energy intake was significantly increased in the low fat/energy condition compared with both baseline and the high fat/energy condition. An additional 3% (162 kJ) energy was consumed by subjects under the low fat/energy condition compared to baseline. No differences were observed between the baseline and high fat/energy condition. Subjects who consumed most in the low fat/energy condition were found to be mostly men, to have a higher BMI and to be overweight. Low fat/energy information can positively influence food and energy intake, suggesting that foods labelled as 'low fat' or 'low calorie' may be one factor promoting the consumption of large food portions.

To compare portion size (PS) estimates, perceived energy density (ED) and anticipated consumption guilt (ACG) for healthier vs standard foods. Three pairs of isoenergy dense (kJ per 100 g) foods—healthier vs standard cereals, drinks and coleslaws—were selected. For each food, subjects served an appropriate PS for themselves and estimated its ED. Subjects also rated their ACG about eating the food on a scale of 1 (not at all guilty) to 5 (very guilty). Subjects (n=186) estimated larger portions of the healthier coleslaw than that of the standard version, and perceived all healthier foods to be lower in ED than their standard alternatives, despite being isoenergy dense. Higher ACG was associated with the standard foods. Portion estimates were generally larger than recommendations and the ED of the foods was underestimated. The larger portions selected for the ‘reduced fat’ food in association with lower perceived ED and ACG suggests that such nutrition claims could be promoting inappropriate PS selection and consumption behaviour. Consumer education on appropriate portions is warranted to correct such misconceptions.

Epidemiologic evidence on the influence of dietary glycemic index (GI) and glycemic load (GL) on the development of obesity is limited.This prospective study examined the associations between dietary GI and GL and changes in body composition measures during adolescence.In a representative sample of Northern Irish adolescents aged 12 years at baseline and 15 years at follow-up (n=426), dietary intake was assessed by a diet history interview. Body composition measures included body mass index (BMI; kg m(-2)), BMI z-score, sum of four skinfold thicknesses, percentage body fat, fat mass index (FMI; kg m(-2)) and fat-free mass index (kg m(-2)).After adjustment for potential confounding factors, baseline GI was associated with increased change in FMI. Mean (95% confidence interval) values of changes in FMI according to tertiles of baseline GI were 0.41 (0.25, 0.57), 0.42 (0.26, 0.58) and 0.67 (0.51, 0.83) kg m(-2), respectively (P for trend=0.03). There was no significant association of baseline GI with changes in other body composition measures (P for trend≥0.054). Conversely, baseline GL showed no association with changes in any of the measures (P for trend≥0.41). Furthermore, changes in GI or GL were not associated with changes in any of the measures (P for trend≥0.16).Dietary GI at age 12 years was independently associated with increased change in FMI between ages 12 and 15 years in a representative sample from Northern Ireland, whereas dietary GL showed no association with changes in any of the body composition measures examined.

ObjectiveThis qualitative study aimed to investigate consumer opinions on the usefulness of portion size estimation aids (PSEA); consumer preferences in terms of format and context for use; and the level of detail of guidance considered necessary for the effective application of PSEA.DesignSix focus groups (three to eight participants per group) were conducted to elicit views on PSEA. The discussions were recorded, transcribed verbatim and analysed by two independent researchers using a template approach.SettingThe focus groups were conducted in 2013 by an experienced moderator in various sites across the island of Ireland (three in the Republic of Ireland and three in Northern Ireland) including local leisure, community and resource centres; the home environment; and a university meeting room.ParticipantsGeneral population, males (n = 17) and females (n = 15) aged 18–64 years old. Participants were recruited from both urban and rural locations representing a range of socio-economic groups.ResultsThe majority of participants deemed the coloured portion pots and disposable plastic cup (household measures) to be useful particularly for the estimation of amorphous cereal products (e.g. breakfast cereals). Preferences were evident for “visual” PSEA (reference objects, household measures and food packaging) rather than ‘quantities and measures’ such as weighing in grams or ounces. Participants stated that PS education should be concise, consistent, from a reputable source, initiated at school age and communicated innovatively e.g. mobile app or TV advertisement. Guidance in relation to gender, age and activity level was favoured over a “one size fits all” approach.ConclusionsThis study identified consumer preferences and acceptance of “visual” PSEA such as portion pots/cups to estimate appropriate PS of amorphous grain foods such as breakfast cereals, pasta and rice. Concise information from a reputable source in relation to gender, age and activity level should accompany PSEA.

ObjectiveThe present study aimed to evaluate the precision, ease of use and likelihood of future use of portion size estimation aids (PSEA).DesignA range of PSEA were used to estimate the serving sizes of a range of commonly eaten foods and rated for ease of use and likelihood of future usage.SettingFor each food, participants selected their preferred PSEA from a range of options including: quantities and measures; reference objects; measuring; and indicators on food packets. These PSEA were used to serve out various foods (e.g. liquid, amorphous, and composite dishes). Ease of use and likelihood of future use were noted. The foods were weighed to determine the precision of each PSEA.SubjectsMales and females aged 18–64 years (n 120).ResultsThe quantities and measures were the most precise PSEA (lowest range of weights for estimated portion sizes). However, participants preferred household measures (e.g. 200 ml disposable cup) – deemed easy to use (median rating of 5), likely to use again in future (all scored either 4 or 5 on a scale from 1=‘not very likely’ to 5=‘very likely to use again’) and precise (narrow range of weights for estimated portion sizes). The majority indicated they would most likely use the PSEA preparing a meal (94 %), particularly dinner (86 %) in the home (89 %; all PConclusionsHousehold measures may be precise, easy to use and acceptable aids for estimating the appropriate portion size of amorphous grain foods.

Dietary patterns may be related to quality of life (QoL) of older adults, although evidence from literature is conflicting. The demographic shifts toward ageing populations in many countries increases the importance of understanding the relationship between diet and QoL in older adults. This review was designed to investigate associations between dietary patterns and QoL in older adults. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic databases were searched to identify articles published in English from January 1975 to March 2018 that investigated associations between dietary patterns and QoL in older adults. Relevant studies were identified based on set inclusion and exclusion criteria, data were extracted and analysed to examine the relationships and possible implications for public health recommendations. The systematic review included 15 articles (One randomized control trial, six prospective cohorts and eight cross sectional). The studies looked at correlations between different dietary patterns and/or adherence to particular dietary patterns and self-reported QoL or self-rated health status. Excluding two studies which showed no significant association, healthy dietary patterns were associated with better self-rated health and QoL in one or more domains, and adherence to healthy dietary patterns like the Mediterranean diet were significantly associated with improvement in at least one of the QoL domains.

Despite the potential link between snack food intake and obesity and the reportedly high prevalence of snacking among adolescents, adolescent snack food patterns (types of foods consumed, frequency and portion size) have not been extensively examined. This study examines these issues using data on the snacking patterns of adolescents aged 13–16 years who took part in the 1997 National Diet and Nutrition Survey (NDNS) and that from a Northern Irish (NI) cohort of adolescents collected 8 years later, in 2005. Overall energy intake was significantly higher in the NI adolescents in 2005 compared with the NDNS adolescents in 1997 (P P v. 29·8 %, respectively). Sugar-sweetened carbonated and soft drinks remained the most popular choice of snack over this 8-year period; however, both the portion size consumed and frequency of consumption were significantly higher among the adolescents in 2005 compared with those in 1997 (P = 0·022 and P = 0·014, respectively). Despite the lower popularity, and correspondingly lower frequency of milks and beverages, the portion size of both food groups was significantly higher among the adolescents in 2005 compared with those in 1997 (P P = 0·007, respectively). These findings may provide scope for policy interventions to place particular emphasis on reducing typical portion sizes consumed of popular snack choices, in particular high-energy carbonated and soft drinks, among UK adolescents.

With the increasing prevalence of childhood obesity, there is an urgent need to identify risk factors that are amenable to preventative action. However, there is a remarkable lack of consistency between studies that have investigated the relationships between measurements of physical activity and energy expenditure and body fatness in children. This disparity could be because energy intake is a more important determinant in preventing obesity. Alternatively, some of the conflicting results could be related to methodological limitations in assessing activity and body composition. Erroneous conclusions may be drawn if physical activity energy expenditure is not adjusted for differences in body composition, or body fat is not appropriately adjusted for body size. For public health purposes it may be more informative to evaluate the amount and intensity of physical activity required to prevent fat-mass gain than to assess energy expended in physical activity. The lack of consensus in the cut-off points applied to define intensity levels is severely hindering comparisons between studies using accelerometers that have examined relationships between activity intensity and body fatness. Thus, it is not currently possible to develop a firm evidence base on which to establish physical activity recommendations until the limitations are addressed and more prospective studies undertaken. In order to turn research into effective prevention strategies a clearer understanding of the psycho-social, behavioural and environmental factors that influence activity is needed, including the interactions between physical activity and other behaviours such as time spent sedentary, sleeping and eating. Childhood obesity: Physical activity: Energy expenditure: Body fatness