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Data from 98 women recruited in the Metformin in Gestational Diabetes trial and dual‐energy X‐ray absorptiometry studies of their children at nine years were analysed to investigate associations between maternal measures during pregnancy and their children's size and adiposity. Mothers of boys (n = 56) and girls (n = 42) had been randomised to metformin or insulin treatment at 30.1 ± 2.8 and 29.3 ± 4.1 weeks gestation, respectively. In boys, fat‐free mass indexed to height squared was associated with maternal weight, body mass index, maternal glycaemia and metformin treatment. In boys and girls, fat mass indexed to height squared was associated with maternal glycaemia measures before gestational diabetes treatment. [ABSTRACT FROM AUTHOR]

The RT3 is a relatively new triaxial accelerometer that has replaced the TriTrac. The aim of this study was to validate the RT3 against doubly labeled water (DLW) in a free-living, mixed weight sample of adults. Total energy expenditure (TEE) was measured over a 15-day period using DLW. Activity-related energy expenditure (AEE) was estimated by subtracting resting energy expenditure and thermic effect of feeding from TEE. The RT3 triaxial accelerometer was worn over 14 consecutive days. TEE and AEE were estimated using the RT3 proprietary equation. Thirty-six adults ages 18-56 years (56% women) with an average weight of 75.9 kg (SD = 14.8) completed all measurements. Compared to DLW, the RT3 underestimated TEE by 539 kJ (4%) and AEE by 485 kJ (15%) on average. The RT3 provided a relatively accurate assessment of free-living activity-related energy expenditure at the group level and generally underestimated total and activity-related energy expenditure compared to DLW. (Contains 2 tables, 2 figures, and 3 notes.)

We examined the association between availability (count), proxy physical activity intensity opportunities from physical activity outlets and obesity prevalence in New Zealand. This cross-sectional study collected data from two urban and 51 rural geographical locations in Waikato and Lakes District (May 2004-March 2006). Physical activity outlets were recorded by referring to online business directory and Waikato and Lakes District Councils database and confirming it with expert Māori community health workers. METs (Metabolic equivalent of task) was used as a proxy indicator to signify the physical activity intensity opportunity offered by physical activity outlets, which was averaged to obtain a unified score for each geographic location. Information regarding median income and type of location was derived from 2006 New Zealand census of Population and Dwelling. Bivariate analysis reported a significant difference in obesity prevalence using Māori BMI cut-offs between clusters with proxy METs < 5.12 (n = 15) and proxy METs ≥5.12 (n = 10), 56.20 ± 0.22 vs 43.30 ± 0.07% obesity prevalence, t(17.77) = 1.45, p = 0.03. This inverse relationship between low physical activity intensity opportunity (proxy METs) and percent obesity prevalence remained significant after controlling for income and type of locality (β = -0.421, p = 0.03). Furthermore, results highlighted that low income (below the median, ≤ NZ $24,400), moderated the inverse relationship between mean METs proxy indicator and obesity prevalence using Māori BMI cut-offs, b = -0.4661, 95% CI (-0.6054, -0.3268, p < 0.001). These findings support the development of physical activity related public health programs in low-income Māori communities in New Zealand to manage obesity prevalence. [ABSTRACT FROM AUTHOR]

Measurement of body composition is increasingly important in research and clinical settings but is difficult in very young children. Bioelectrical impedance analysis (BIA) and air displacement plethysmography (ADP) are well-established but require specialist equipment so are not always feasible. Our aim was to determine if anthropometry and skinfold thickness measurements can be used as a substitute for BIA or ADP for assessing body composition in very young New Zealand children. We used three multi-ethnic cohorts: 217 children at a mean age of 24·2 months with skinfold and BIA measurements; seventy-nine infants at a mean age of 20·9 weeks and seventy-three infants at a mean age of 16·2 weeks, both with skinfold and ADP measurements. We used Bland–Altman plots to compare fat and fat-free mass calculated using all potentially relevant equations with measurements using BIA or ADP. We also calculated the proportion of children in the same tertile for measured fat or fat-free mass and tertiles (i) calculated using each equation, (ii) each absolute skinfold, and (iii) sum of skinfold thicknesses. We found that even for the best equation for each cohort, the 95 % limits of agreement with standard measures were wide (25–200 % of the mean) and the proportion of children whose standard measures fell in the same tertile as the skinfold estimates was ≤69 %. We conclude that none of the available published skinfold thickness equations provides good prediction of body composition in multi-ethnic cohorts of very young New Zealand children with different birth history and growth patterns. [ABSTRACT FROM AUTHOR]

Social learning is a process suited to developing understanding and concerted action to tackle complex resource dilemmas, such as freshwater management. Research has begun to recognise that in practice social learning encounters a variety of institutional challenges from the shared habits and routines of stakeholders (organised by rules, norms and strategies) that are embedded in organisational structures and norms of professional behaviour. These institutional habits and routines influence the degree of willingness to engage with stakeholders, and expectations of behaviours in social learning processes. Considering this, there has been a call to understand how institutions influence social learning and emergent outcomes. We addresses this by presenting a heuristic for implementing social learning cognisant of institutional context to answer three questions: (i) How institutional influences impact implementation of social learning design; (ii) how implementation of social learning design modifies institutions influencing social learning; and (iii) how these changes in design and institutions together shape social learning outcomes? To answer these questions a freshwater planning exercise was designed, implemented and evaluated as a social learning process with community groups in two New Zealand catchments. Incorporating participatory reflection enabled the project team to modify social learning design to manage institutional influences hindering progress toward outcomes. Findings emphasise that social learning is underpinned by participants' changing assumptions about what constitutes the institution of learning itself—from instruction to a dynamic, collective and emergent process. Reflecting on these assumptions also challenged participants' expectations about their own and others' behaviours and roles in freshwater planning. [ABSTRACT FROM AUTHOR]

Background: Abdominal aortic aneurysm (AAA) rupture carries a high fatality rate. AAAs can be detected before rupture by abdominal ultrasound imaging, allowing elective repair. Population‐based screening for AAA in older men reduces AAA‐related mortality by about 40 per cent. The UK began an AAA screening programme offering one‐off scans to men aged 65 years in 2009. Sweden has a similar programme. Currently, there is no AAA screening programme in New Zealand. This cost–utility analysis aimed to assess the cost‐effectiveness of a UK‐style screening programme in the New Zealand setting. Methods: The analysis compared a formal AAA screening programme (one‐off abdominal ultrasound imaging for about 20 000 men aged 65 years in 2011) with no systematic screening. A Markov macrosimulation model was adapted to estimate the health gains (in quality‐adjusted life‐years, QALYs), health system costs and cost‐effectiveness in New Zealand. A health system perspective and lifetime horizon was adopted. Results: With New Zealand‐specific inputs, the adapted model produced an estimate of about NZ $15 300 (€7746) per QALY gained, with a 95 per cent uncertainty interval (UI) of NZ $8700 to 31 000 (€4405 to 15 694) per QALY gained. Health gains were estimated at 117 (95 per cent UI 53 to 212) QALYs. Health system costs were NZ $1·68 million (€850 535), with a 95 per cent UI of NZ $820 200 to 3·24 million (€415 243 to €1·65 million). Conclusion: Using New Zealand's gross domestic product per capita (about NZ $45 000 or €22 100) as a cost‐effectiveness threshold, a UK‐style AAA screening programme would be cost‐effective in New Zealand. [ABSTRACT FROM AUTHOR]

Background Gestational diabetes mellitus ( GDM) is a risk factor for subsequent development of type 2 diabetes mellitus (T2 DM). We have investigated the extent of this risk among Māori women without known diabetes. Materials and methods We recruited 2786 Māori women aged 28-86 years between 2004 and 2006, without diagnosed diabetes from the Waikato and Southern Lakes regions, via media, community and general practitioner channels, and invited them for an oral glucose tolerance test ( OGTT). Results Fifty (1.8%) women reported previous GDM ( pGDM). The prevalence decreased significantly with age ( P = 0.009). Women aged <50 years with pGDM had higher body mass index (35.6 ± 6.7 vs 32.4 ± 7.7 kg/m2, P < 0.01), waist circumference (105.3 ± 18.8 vs 96.9 ± 16.6 cm, P < 0.01), fasting blood glucose (5.5 ± 1.0 vs 5.1 ± 0.8 mmol/L, P ≤ 0.01), two-hour post-prandial blood glucose (6.6 ± 3.0 vs 5.6 ± 2.1 mmol/L, P < 0.01) and HbA1c (6.0 ± 0.8 vs 5.8 ± 0.6%, P < 0.05) than women without pGDM. PGDM was a significant risk factor for undiagnosed diabetes (odds ratio 4.0; (5% confidence interval 1.67-9.71). Undiagnosed diabetes was significantly more prevalent among women with than without pGDM aged <40 years (20.0% vs 1.5%). Conclusion Self-reported past GDM was a significant risk factor for undiagnosed diabetes in this Māori population, particularly among women aged <40 years, highlighting the importance of targeting this group for more intensive screening. [ABSTRACT FROM AUTHOR]

Background and Objectives: A high prevalence of vitamin B-12 (B-12) deficiency among young women of South Asian origin predisposes to significant health risks for these women and their future offspring. Vegetarian or low-meat based dietary practices contribute to B-12 deficiency. This study validated a nutrient-specific, semi-quantitative food frequency questionnaire (B12FFQ), developed to estimate dietary B-12 intake in South Asian women.Methods and Study Design: The B12FFQ was developed, then tested in 60 apparently healthy South Asian women aged 18-50 years, living in Auckland, New Zealand. Participants recalled the frequency and quantity of vitamin B-12-containing foods consumed in the preceding three months. Pearson's correlations measured the associations between dietary B-12 intake and B-12 biomarkers (serum B-12 and holotranscobalamin [holoTC]). Likelihood of B12 insufficiency was calculated for vegetarian and non-vegetarian dietary practices.Results: The B12FFQ was a valid measure of dietary B-12 intake - supported by moderate positive associations with serum B-12 (r=0.50, p<0.001, 95% CI [0.28, 0.67]) and holoTC (r=0.55, p<0.001, 95% CI [0.34, 0.71]). A dietary B-12 intake of less than 2.4 µg/day increased the likelihood of serum B-12 (X2 (1)=11.79, p=0.001) or holoTC (X2 (1)=6.33, p=0.012) insufficiency. A dietary B-12 intake of less than the recommended dietary allowance (2.4 µg/day), occurred in 61% (n=20/33) of participants with vegetarian and 22% (n=6/27) with non- vegetarian dietary practices.Conclusions: The B12FFQ provides a valid estimate of dietary B-12 intake. This easily administered food frequency questionnaire has the potential to identify low dietary B-12 intake as a contributor to B-12 depletion or deficiency. [ABSTRACT FROM AUTHOR]

Prevention of childhood obesity is a global priority. The school setting offers access to large numbers of children and the ability to provide supportive environments for quality physical activity and nutrition. This article describes Project Energize, a through-school physical activity and nutrition programme that celebrated its 10-year anniversary in 2015 so that it might serve as a model for similar practices, initiatives and policies elsewhere. The programme was envisaged and financed by the Waikato District Health Board of New Zealand in 2004 and delivered by Sport Waikato to 124 primary schools as a randomised controlled trial from 2005 to 2006. The programme has since expanded to include all 242 primary schools in the Waikato region and 70 schools in other regions, including 53,000 children. Ongoing evaluation and development of Project Energize has shown it to be sustainable (ongoing for >10 years), both effective (lower obesity, higher physical fitness) and cost effective (one health related cost quality adjusted life year between $18,000 and $30,000) and efficient ($45/child/year) as a childhood 'health' programme. The programme's unique community-based approach is inclusive of all children, serving a population that is 42 % Māori, the indigenous people of New Zealand. While the original nine healthy eating and seven quality physical activity goals have not changed, the delivery and assessment processes has been refined and the health service adapted over the 10 years of the programme existence, as well as adapted over time to other settings including early childhood education and schools in Cork in Ireland. Evaluation and research associated with the programme delivery and outcomes are ongoing. The dissemination of findings to politicians and collaboration with other service providers are both regarded as priorities. [ABSTRACT FROM AUTHOR]

Preliminary research has suggested that wearable cameras may reduce under-reporting of energy intake (EI) in self-reported dietary assessment. The aim of the present study was to test the validity of a wearable camera-assisted 24 h dietary recall against the doubly labelled water (DLW) technique. Total energy expenditure (TEE) was assessed over 15 d using the DLW protocol among forty adults (n 20 males, age 35 (sd 17) years, BMI 27 (sd 4) kg/m2 and n 20 females, age 28 (sd 7) years, BMI 22 (sd 2) kg/m2). EI was assessed using three multiple-pass 24 h dietary recalls (MP24) on days 2–4, 8–10 and 13–15. On the days before each nutrition assessment, participants wore an automated wearable camera (SenseCam (SC)) in free-living conditions. The wearable camera images were viewed by the participants following the completion of the dietary recall, and their changes in self-reported intakes were recorded (MP24+SC). TEE and EI assessed by the MP24 and MP24+SC methods were compared. Among men, the MP24 and MP24+SC measures underestimated TEE by 17 and 9 %, respectively (P< 0·001 and P= 0·02). Among women, these measures underestimated TEE by 13 and 7 %, respectively (P< 0·001 and P= 0·004). The assistance of the wearable camera (MP24+SC) reduced the magnitude of under-reporting by 8 % for men and 6 % for women compared with the MP24 alone (P< 0·001 and P< 0·001). The increase in EI was predominantly from the addition of 265 unreported foods (often snacks) as revealed by the participants during the image review. Wearable cameras enhance the accuracy of self-report by providing passive and objective information regarding dietary intake. High-definition image sensors and increased imaging frequency may improve the accuracy further. [ABSTRACT FROM PUBLISHER]

Project Energize, a region-wide whole-school nutrition and physical activity programme, commenced as a randomised controlled trial (RCT) in the period 2004–6 in 124 schools in Waikato, New Zealand. In 2007, sixty-two control schools were engaged in the programme, and by 2011, all but two of the 235 schools in the region were engaged. Energizers (trained nutrition and physical activity specialists) work with eight to twelve schools each to achieve the goals of the programme, which are based on healthier eating and enhanced physical activity. In 2011, indices of obesity and physical fitness of 2474 younger (7·58 (sd 0·57) years) and 2330 older (10·30 (sd 0·51) years) children attending 193 of the 235 primary schools were compared with historical measurements. After adjusting for age, sex, ethnicity, socio-economic status (SES) and school cluster effects, the combined prevalence of obesity and overweight among younger and older children in 2011 was lower by 31 and 15 %, respectively, than that among ‘unEnergized’ children in the 2004 to 2006 RCT. Similarly, BMI was lower by 3·0 % (95 % CI − 5·8, − 1·3) and 2·4 % (95 % CI − 4·3, − 0·5). Physical fitness (time taken to complete a 550 m run) was significantly higher in the Energized children (13·7 and 11·3 %, respectively) than in a group of similarly aged children from another region. These effects were observed for boys and girls, both indigenous Māori and non-Māori children, and across SES. The long-term regional commitment to the Energize programme in schools may potentially lead to a secular reduction in the prevalence of overweight and obesity and gains in physical fitness, which may reduce the risk of developing obesity and type 2 diabetes. [ABSTRACT FROM PUBLISHER]

Through-school nutrition and physical activity interventions are designed to help reduce excess weight gain and risk of chronic disease. From 2004 to 2006, Project Energize was delivered in the Waikato Region of New Zealand as a longitudinal randomised controlled study of 124 schools (year 1–6), stratified by rurality and social deprivation, and randomly assigned to intervention or control. Children (686 boys and 662 girls) aged 5 (1926) and 10 (1426) years (692 interventions and 660 controls) had height, weight, body fat (by bioimpedance) and resting blood pressure (BP) measured at baseline and 2 years later. Each intervention school was assigned an ‘Energizer’; a trained physical activity and nutrition change agent, who worked with the school to achieve goals based on healthier eating and quality physical activity. After adjustment for baseline measures, rurality and social deprivation, the intervention was associated with a reduced accumulation of body fat in younger children and a reduced rate of rise in systolic BP in older children. There was some evidence that the pattern of change within an age group varied with rurality, ethnicity and sex. We conclude that the introduction of an ‘Energizer led’ through-school programme may be associated with health benefits over 2 years, but the trajectory of this change needs to be measured over a longer period. Attention should also be paid to the differing response by ethnicity, sex, age group and the effect of rurality and social deprivation. [ABSTRACT FROM PUBLISHER]

Objective. Pacific children living in New Zealand exhibit considerably higher rates of overweight and obesity than their non-Pacific peers. The study aim was to identify physical activity and sedentary behaviors related to increased body size in Pacific children, to inform future intervention development for improved activity profiles and body size outcomes in this population. Methods. Three hundred and ninety-three 6-year-old Pacific children and their mothers living in Auckland, New Zealand were invited to participate. Activity was assessed over 8 days using accelerometry and mothers reported on their child's sedentary behaviours. Children's height, weight, and body fatness was assessed and body mass index (BMI) and body fat z-scores calculated. Maternal height, weight, and waist circumference were assessed and BMI calculated. Associations between children's body fat z-scores and potential related factors were determined using regression analyses. Results. Of the 254 children who registered, 102 (27% overweight, 32% obese) were included in analyses. Almost all mothers were overweight or obese. On average, children's body fat z-scores were 1.75 standard deviations above the reference group (range −0.6, 3.14). After accounting for all other factors, watching television every day and having a mother with a high waist circumference were associated with increased body fat z-scores. Conclusions. Strategies for obesity reduction in Pacific children and their mothers living in New Zealand are urgently required. Multifaceted, family based interventions that include the promotion of healthy nutritional practices and television free days may be efficacious in improving activity profiles and body size outcomes for Pacific children. [ABSTRACT FROM AUTHOR]

This paper aimed to identify frequently consumed traditional foods at hui amongst Māori people living in the Waikato and Southern Lakes Districts, at the start of the Te Wai o Rona Diabetes Prevention Strategy. Responses from 2,669 self-identified Māori (90.5%) and members of the same household aged ≥28 years were analysed. "Boil-ups" were consumed at least annually by four out of five respondents and salad was the food most frequently consumed at hui (25.5%); followed by kaimoana (seafood, 19.6%) and meat (17.8%). When the marae was located within 5 km of the coast, kaimoana was more frequently eaten at hui and more often listed as a traditional food. Diverse tribal affiliations were also evident. Education in relation to the need to cut fat off meat, to skim fat off a boil-up and increase fruit consumption should be encouraged in any new community and environmental programmes designed to reduce the burden of chronic disease in Māori people. [ABSTRACT FROM AUTHOR]

Objective: Uptake of advice for lifestyle change for obesity and diabetes prevention requires access to affordable 'healthy' foods (high in fibre/low in sugar and fat). The present study aimed to examine the availability and accessibility of 'healthy' foods in rural and urban New Zealand. Design: We identified and visited ('mapped') 1230 food outlets (473 urban, 757 rural) across the Waikato/Lakes areas (162 census areas within twelve regions) in New Zealand, where the Te Wai O Rona: Diabetes Prevention Strategy was underway. At each site, we assessed the availability of 'healthy' foods (e.g. wholemeal bread) and compared their cost with those of comparable 'regular' foods (e.g. white bread). Results: Healthy foods were generally more available in urban than rural areas. In both urban and rural areas, 'healthy' foods were more expensive than 'regular' foods after adjusting for the population and income level of each area. For instance, there was an increasing price difference across bread, meat, poultry, with the highest difference for sugar substitutes. The weekly family cost of a 'healthy' food basket (without sugar) was 29·1% more expensive than the 'regular' basket ($NZ 176·72 v. $NZ 136·84). The difference between the 'healthy' and 'regular' basket was greater in urban ($NZ 49·18) than rural areas ($NZ 36·27) in adjusted analysis. Conclusions: 'Healthy' foods were more expensive than 'regular' choices in both urban and rural areas. Although urban areas had higher availability of 'healthy' foods, the cost of changing to a healthy diet in urban areas was also greater. Improvement in the food environment is needed to support people in adopting healthy food choices. [ABSTRACT FROM AUTHOR]

Objective: To evaluate levels of vitamin D3 and HDL-cholesterol (HDL-C), and the ratio of HDL-C to LDL-cholesterol (LDL-C), in schoolchildren receiving vitamin-Dfortified, fat-depleted, high-Ca milk in schools. Design: Cross-sectional study of previously randomised schools receiving supplemental milk, compared with a matched control group. Setting: Low-decile Year 1-6 schools in the Waikato region of New Zealand. Subjects: Year 3 children from either milk schools or control schools, consenting to blood sampling. Results: For eighty-nine children receiving supplementary daily milk, vitamin D3 levels were significantly higher than in eighty-three control children matched for age, sex, body composition and ethnicity (mean (SD): 49·6 (15·8) v. 43·8 (14·7) nmol/l, P=0·011), as were HDL-C levels (mean (SD): 1·47 (0·35) v. 1·35 (0·29) mmol/l, P=0·024) and HDL-C:LDL-C (median: 0·79 v. 0·71, P=0·026). LDL-C levels were similar in both groups (mean (SD): 2·07 (0·55) v. 2·16 (0·60) mmol/l, P=0·31). Of control children, 32/83 (38·6%) had vitamin D3 levels below the cut-off for vitamin D insufficiency (<37·5 nmol/l), compared with 18/89 (20·2%) of the milk group (Pearson's χ2=7·00, P=0·008). Mean 25-hydroxyvitamin D (vitamin D3) levels in the milk group were still below the lower end of the recommended normal range (60 nmol/l). Conclusions: Vitamin D3 levels are low in low-decile Year 3 children in midwinter. Levels are improved with vitamin-D-fortified milk but still below the recommended range. HDL-C and HDL-C:LDL-C levels are improved in the milk-supplemented group. This supports the supply of vitamin-D-fortified, fat-reduced milk to schools. [ABSTRACT FROM AUTHOR]

Background/Objectives:To investigate the relationships between body mass index (BMI), body fatness, ethnicity, age and blood lipids.Subjects/Method:In a subsample (N=643) of the 2002 New Zealand Child Nutrition Survey (N=3275, age 5–14 years) consisting Māori (89 boys, 69 girls), Pacific (154 boys, 194 girls) and European (71 boys, 66 girls) ethnic groups, fat-free mass (FFM) was determined by bioimpedance analysis. FFM index (FFMI, FFM/height2), fat mass index (FMI, fat mass/height2) and percentage body fat (%BF) were derived. Plasma total cholesterol and high-density lipoprotein (HDL) cholesterol were measured in 515 (80%) of these children.Results:For the same BMI, %BF was lower in Pacific Island (P<0.0001) and Māori (P<0.0001) girls compared with European but for boys there were no ethnic differences. Cross-sectional analysis across ages using Hattori charts clearly showed sexual dimorphism with girls having a higher FMI, FFMI and BMI than boys by the age of 13 year. Both Pacific girls and boys showed upward trends in FFMI and FMI with age that were significantly higher than those of the other ethnicities. Adjusting for age, sex and ethnicity, %BF was a better predictor (R2=0.090, P=0.0002) of total cholesterol than BMI (R2=0.061, P=0.049) or waist (R2=0.075, P=0.013) while FFMI was the best predictor of HDL cholesterol (R2=0.15, P<0.0001) and waist was the best predictor of the total cholesterol/HDL cholesterol ratio (R2=0.17, P<0.0001).Conclusions:Measurements of body fat and indices of body fatness additional to BMI in multiethnic paediatric populations allow changes in fat mass and FFM to be tracked and improve the ability to predict dyslipidaemia.European Journal of Clinical Nutrition (2009) 63, 627–633; doi:10.1038/ejcn.2008.15; published online 27 February 2008 [ABSTRACT FROM AUTHOR]

When an infant is brought home to the family, it is often a time of emotional, economic and physical stress due to the extra demands placed on parents. Household food security means "access at all times to enough and nutritionally appropriate food to provide the energy and nutrients needed to maintain an active and healthy life". Questions about food security were asked of 1376 Pacific Island mothers (as part of the Pacific Island Family Study) approximately six weeks after the birth of their baby. Due to lack of money food sometimes ran out in 39.8% of households and in a further 3.8% food often ran out. Variety of foods was limited by lack of money in 39.3%. Foods that were still bought when money was limited included bread (97%), milk (95%), meat and chicken (91%), vegetables and fruit (83%), rice or pasta (82%), breakfast cereals (69%), fish or shellfish (50%) and biscuits or chips (44%). Alcohol (1%), soft drinks (11%), ice cream (12%) and fruit juice (21%) were the least often bought. Energy density (MJ/kg) and nutrient-density of typical foods limited by lack of money were analysed. Rice, bread and fatty meats provided the most calories per dollar and fruit and vegetables the least. The best protein-value for money was from minced beef, chicken and tinned tuna and the most fibre-rich foods included baked beans and mixed vegetables. Food security is a major problem for Pacific families. The environment of food availability, choice and cost requires attention to help close the health gap. [ABSTRACT FROM AUTHOR]

Objective:To investigate body composition differences, especially the relationship between body mass index (BMI) and percent body fat (%BF), among five ethnic groups.Design:Cross-sectional.Subjects:Seven hundred and twenty-one apparently healthy women aged 18–60 years (BMI: 17.4–54.0 kg/m2) from South Africa (SA, 201 black, 94 European) and New Zealand (NZ, 173 European, 76 Maori, 84 Pacific, 93 Asian Indian).Measurements:Anthropometry, including waist circumference, and total, central and peripheral body fat, bone mineral content and total appendicular skeletal muscle mass (ASMM) derived from dual X-ray absorptiometry.Results:Regression analysis determined that at a BMI of 30 kg/m2, SA European women had a %BF of 39%, which corresponded to a BMI of 29 for SA black women. For a BMI of 30 kg/m2 in NZ Europeans, equivalent to 43% body fat, the corresponding BMIs for NZ Maori, Pacific and Asian Indian women were 34, 36 and 26 kg/m2, respectively. Central fat mass was lower in black SA than in European SA women (P<0.001). In NZ, Pacific women had the lowest central fat mass and highest ASMM, whereas Asian Indian women had the highest central fat mass, but lowest ASMM and bone mineral content.Conclusions:The relationship between %BF and BMI varies with ethnicity and may be due, in part, to differences in central fatness and muscularity. Use of universal BMI or waist cut-points may not be appropriate for comparison of obesity prevalence among differing ethnic groups, as they do not provide a consistent reflection of adiposity and fat distribution across ethnic groups.International Journal of Obesity (2007) 31, 1232–1239; doi:10.1038/sj.ijo.0803576; published online 6 March 2007 [ABSTRACT FROM AUTHOR]

Background: Accurate measurement of physical activity is a pre-requisite for monitoring population health and for evaluating effective interventions. The International Physical Activity Questionnaire (IPAQ) is used as a comparable and standardised self-report measure of habitual physical activity of populations from different countries and socio-cultural contexts. The IPAQ has been modified to produce a New Zealand physical activity questionnaire (NZPAQ). The aim of this study was to validate the IPAQ and NZPAQ against doubly labelled water (DLW). Method: Total energy expenditure (TEE) was measured over a 15-day period using DLW. Activity-related energy expenditure (AEE) was estimated by subtracting the energy expenditure from resting metabolic rate and thermic effect of feeding from TEE. The IPAQ (long form) and NZPAQ (short form) were completed at the end of each 7-day period. Activity-related energy expenditure (IPAQAEE and NZPAQAEE) was calculated from each questionnaire and compared to DLWAEE. Results: Thirty six adults aged 18 to 56 years (56% female) completed all measurements. Compared to DLWAEE, IPAQAEE and NZPAQAEE on average underestimated energy expenditure by 27% and 59%, respectively. There was good agreement between DLWAEE and both IPAQAEE and NZPAQAEE at lower levels of physical activity. However there was marked underestimation of questionnaire-derived energy expenditure at higher levels of activity. Conclusion: Both the IPAQ and NZPAQ instruments have a demonstrated systematic bias toward underestimation of physical activity-related energy expenditure at higher levels of physical activity compared to DLW. Appropriate calibration factors could be used to correct for measurement error in physical activity questionnaires and hence improve estimation of AEE. [ABSTRACT FROM AUTHOR]

Objective : Decreased HLA-G expression has been linked to a number of pregnancy disorders, including preeclampsia, and a genetic basis for HLA-G regulation has yet to be found. The aim of this study was to determine whether a C-to-T base substitution 56 base pairs (bp) upstream from the HLA-G transcription start site is associated with preeclampsia. Methods : 277 nulliparous women consisting of 113 normotensive, 118 preeclamptic, and 46 eclamptic patients were typed for the -56T polymorphism using restriction fragment length polymorphism and allelic discrimination analysis. Results : -56T allele frequencies for eclamptic, preeclamptic, and normotensive women were 0.053, 0.030, and 0.035, respectively. A χ 2 test indicated that there was no significant association with the polymorphism in preeclamptic or eclamptic women with p > 0.05. Conclusion : The -56T HLA-G polymorphism is not associated with preeclampsia or eclampsia in our population. [ABSTRACT FROM AUTHOR]

Abstract: An increasing frequency of nutrition-related disorders within New Zealand led us to consider whether a realistic and sustainable group intervention in the workplace could improve risk factors. In 12 healthy volunteers, measurements were made at 0, 3, 6, and 9 weeks of the study. At week 3, all participants received group advice to change diet and physical activity. At week 6, 6 randomly selected volunteers consumed a daily dose of kiwifruit and the other 6 were asked not to eat kiwifruit, but all were encouraged to continue lifestyle change. Measurements included administration of food frequency and physical activity questionnaires, fasting plasma glucose, insulin and lipids, and recording of pedometer steps in weeks 3, 6, and 9. Cancer risk was assessed using the single cell electrophoresis assay in leukocytes following a challenge with the known strand-breaking agent, hydrogen peroxide. The reported diet and level of physical exercise were improved postintervention, but there were no significant effects on plasma glucose, insulin, and lipids, and no overall weight reduction. Although the measured levels of DNA damage were not affected by entry to the study nor by dietary or exercise advice, regular kiwifruit consumption led to a significant increase in the ability of leukocytes to repair DNA breakage by free radicals (P < .008). “Prescription” of daily kiwifruit may provide a sustainable population intervention that could reduce some of the risk factors associated with cancer. However, more aggressive interventions may be necessary to reduce the risk of other lifestyle diseases. [Copyright &y& Elsevier]

OBJECTIVE:: To compare percentage body fat (%BF) for a given body mass index (BMI) among New Zealand European, Maori and Pacific Island children. To develop prediction equations based on bioimpedance measurements for the estimation of fat-free mass (FFM) appropriate to children in these three ethnic groups. DESIGN:: Cross-sectional study. Purposive sampling of schoolchildren aimed at recruiting three children of each sex and ethnicity for each year of age. Double cross-validation of FFM prediction equations developed by multiple regression. SETTING:: Local schools in Auckland. SUBJECTS:: Healthy European, Maori and Pacific Island children (n=172, 83 M, 89 F, mean age 9.4±2.8(s.d.), range 5-14?y). MEASUREMENTS:: Height, weight, age, sex and ethnicity were recorded. FFM was derived from measurements of total body water by deuterium dilution and resistance and reactance were measured by bioimpedance analysis. RESULTS:: For fixed BMI, the Maori and Pacific Island girls averaged 3.7% lower %BF than European girls. For boys a similar relation was not found since BMI did not significantly influence %BF of European boys (P=0.18). Based on bioimpedance measurements a single prediction equation was developed for all children: FFM (kg)=0.622?height (cm)2/resistance+0.234 weight (kg)+1.166, R2=0.96, s.e.e.=2.44?kg. Ethnicity, age and sex were not significant predictors. CONCLUSIONS:: A robust equation for estimation of FFM in New Zealand European, Maori and Pacific Island children in the 5-14?y age range that is more suitable than BMI for the determination of body fatness in field studies has been developed. SPONSORSHIP:: Maurice and Phyllis Paykel Trust, Auckland University of Technology Contestable Grants Fund and the Ministry of Health.European Journal of Clinical Nutrition (2003) 57, 1394-1401. doi:10.1038/sj.ejcn.1601701 [ABSTRACT FROM AUTHOR]

Two groups of samples spanning 16 years are reported for methylmercury and total mercury. All the samples had been taken from commercial catches and represent 33 different commercially important New Zealand marine fish species. Results show the New Zealand fish species sampled have mean contents of total mercury that range between 0.02 and 2.48 mg kg[sup -1] and mean contents of methylmercury that range from less than 0.04 to 1.97 mg kg[sup -1]. [ABSTRACT FROM AUTHOR]

Tamarillo is a nutrient-dense fruit with a unique aroma from its volatile compounds (VCs). In this study, we aimed to compare the volatile profiles: (i) of fresh and freeze-dried tamarillo; (ii) detected using Thermal Desorption–Gas Chromatography–Mass Spectrometry (TD–GC–MS) and Solid-Phase MicroExtraction–Gas Chromatography-Mass Spectrometry (SPME–GC–MS); (iii) of freeze-dried pulp and peel of New Zealand grown tamarillo. The possible antibacterial activity of freeze-dried tamarillo extracts was also investigated. We show that freeze-drying maintained most of the VCs, with some being more concentrated with the loss of water. The most abundant VC in both fresh and freeze-dried tamarillo was hexanoic acid methyl ester for pulp (30% and 37%, respectively), and (E)-3-Hexen-1-ol for peel (36% and 29%, respectively). With the use of TD–GC–MS, 82 VCs were detected for the first time, when compared to SPME–GC–MS. Methional was the main contributor to the overall aroma in both peel (15.4 ± 4.2 μg/g DW) and pulp (118 ± 8.1 μg/g DW). Compared to water as the control, tamarillo extracts prepared by water and methanol extraction showed significant antibacterial activity against E. coli, P. aeruginosa, and S. aureus with zone of inhibition of at least 13.5 mm. These results suggest that freeze-dried tamarillo has a potential for use as a natural preservative to enhance aroma and shelf life of food products. [ABSTRACT FROM AUTHOR]

Background: Since 2004, Sport Waikato has delivered Project Energize, a through-school nutrition and physical activity program to primary schools in the Waikato. As part of the program's continued assessment and quality control, the programme was evaluated in 2011 and 2015. This paper's aim was to compare the cardiorespiratory fitness (time to run 550 m (T550)) levels of children participating in Project Energize in 2011 and 2015. Methods: In the 2011 evaluation of Project Energize, gender specific- T550-for-age Z scores (T550AZ) were derived from the T550 of 4832 Waikato children (2527 girls; 2305 boys; 36% Māori) aged between 6 and 12 years. In 2015, T550 was measured for 4798 (2361 girls; 2437 boys; 32% Māori) children, representative of age, gender and school socioeconomic status (SES). The T550AZ for every child in the 2015 study and 2011 evaluation were derived and differences in T550 between 2015 and 2011 by gender, SES and age were determined using independent t-tests. Multiple regression analysis predicted T550 Z score and run time, using year of measurement, gender, ethnicity, age and school SES. Results: With and without adjustment, children in 2015 ran 550 m faster than in 2011 (adjusted Z score 0.06, time 11 s). Specifically, girls ran at a similar speed in 2015 as 2011 but boys were faster than in 2011 (Z score comparison P < 0.001, mean difference 0.18 95%CI 0.12, 0.25). Regression analysis showed time taken to run 550 m was 11 s less in 2015 compared with 2011. Boys ran it 13 s faster than girls (Z score 0.07) and for each 1 year age increase, children were 8 s slower (Z score 0.006). For each 10% decrease in SES, children were 3 s slower (Z score 0.004) and Māori children were 5 s slower than Non-Māori children (Z score 0.15). Conclusions: The findings from this study support the continuation of the delivery of Project Energize in the Waikato region of New Zealand, as cardiorespiratory fitness scores in 2015, compared to 2011, were improved, particularly for lower SES schools and for Māori children. Ethnically diverse populations, schools with higher deprivation and girls, continue to warrant further attention to help achieve equity. [ABSTRACT FROM AUTHOR]

Amber (yellow), Laird's Large (red) and Mulligan (purple–red) cultivars of New Zealand tamarillo fruit were separated into pulp (endo- and mesocarp) and peel (exocarp), and analyzed by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) for carotenoids, α-tocopherol and ascorbic acid contents. Fresh Mulligan pulp had the highest content of β-carotene (0.9 mg/100 g), α-tocopherol (1.9 mg/100 g), and ascorbic acid (28 mg/100 g). Higher concentrations of β-carotene and ascorbic acid, and lower concentrations of α-tocopherol were detected in pulps compared with peels. Compared with standard serves of other fruit, tamarillo had the highest β-carotene (9–20% RDI (recommended dietary intake)/serve), high ascorbic acid (67–75% RDI/serve), and α-tocopherol (16–23% adequate intake/serve). All cultivars had diverse carotenoid profiles dominated by provitamin A carotenoids (β-carotene and β-cryptoxanthin) and xanthophyll carotenoids (lutein; zeaxanthin and antheraxanthin). Favorable growth conditions (high light intensity and low temperature) may explain the higher antioxidant vitamin content in New Zealand tamarillos compared to those from other countries. Tamarillo peels may be used as natural food coloring agent to reduce waste and deliver sustainable production. [ABSTRACT FROM AUTHOR]

Summary: Project Energize, a multicomponent through-school physical activity and nutrition programme, is delivered to all primary school children in the Waikato region. The programme aim is to improve the overall health and reduce the rate of weight gain of all Waikato primary school children. An existing economic model was used to extrapolate the programme effects, initial costs, lifetime health treatment cost structures, quality-adjusted-life-years gained and increased life expectancy to the general and Māori child population of New Zealand. In March 2011, a sample of 2474 younger (7.58±0.57 years, mean±SD) and 2330 older (10.30±0.51 years) children (36% Māori) attending Energize schools had body mass index measured and compared using mixed effect modelling with unEnergized comparison children from 2004 and 2006 from the same region. In 2011 the median body mass index reduction compared with the comparison younger children was −0.504 (90% CI −0.435 to −0.663)kg/m2 and in the older children −0.551 (−0.456 to −0.789)kg/m2. In 2010 there were 42,067 children attending Energize schools and in the same year NZ$1,891,175 was spent to deliver the programme; a cost of $44.96/child/year. Compared to the comparison children the increment in cost/quality-adjusted-life-year gained was $30,438 for the younger and $24,690 for the older children, and lower for Māori (younger $28,241, older $22,151) and for the middle socioeconomic status schools ($23,211, $17,891). Project Energize would improve quality and length of life and when compared with other obesity prevention programmes previously assessed with this model, it would be relatively cost-effective from the health treatment payer's perspective. [Copyright &y& Elsevier]

We describe a cost effective method of continuously monitoring relative trends in recreational effort and harvest, based on web camera imagery and interview data provided by a concurrent low intensity creel survey. The number of boats returning to three boat ramps in separate regions on the north eastern coast of New Zealand’s North Island fluctuated over a ten year period between 2004–05 and 2013–14. The most pronounced change occurred in the Hauraki Gulf, where most recreational fishing occurs. Web camera monitoring detected a 34% decline in the number of boats returning to one of the busiest ramps in the Hauraki Gulf over a three year period between 2011–12 and 2013–14, which was mirrored by a 58% decline in snapper catch rates over the same period. The combined result was a 71% decline in the weight of snapper landed annually at the monitored ramp over this three year period, which was far more rapid than anticipated given differences seen between harvest estimates provided by infrequent large scale surveys in the past. Trends in effort and harvest derived from data collected at a small number of ramps will only have utility, however, if they reflect trends in the wider fishery. The relative difference in snapper harvest estimates provided by aerial-access surveys of the entire Hauraki Gulf fishery in 2004–05 and 2011–12, closely matched the difference in the harvest landed at the high traffic ramp that was monitored in the Gulf during these years. This independent confirmation of relative trends inferred from combined web camera and creel survey monitoring at a small number of sites has further highlighted the need to continuously monitor recreational fisheries, which are potentially far more dynamic than previously thought. We discuss strategies that we have progressively developed to minimise the cost of monitoring these recreational fisheries and how they could be applied to continuously monitor recreational fisheries elsewhere. [ABSTRACT FROM AUTHOR]

Body fatness, physical activity, and nutritional behaviours were assessed in 112 (50 male, 62 female) Asian Indians living in New Zealand. Participants were aged 44-91 years (mean 67.5 ± 7.6) and had lived in New Zealand on average 51 months. Height, weight, and waist circumference were measured to determine body mass index (BMI) and central adiposity. Bioelectrical impedance was used to derive fat free mass, fat mass, and percentage body fat. Pedometers were worn to record daily steps taken over each of seven consecutive days. A lifestyle and health questionnaire was administered to collect information on nutrition behaviours. Average BMI for the sample was 27.2 ± 4.7 kg/m² with females (28.0 ± 5.4 kg/m²) significantly higher than males (25.6 ± 5.4 kg/m²). Using Asian Indian specific cut-offs 69% of the sample was obese (BMI≥25 kg/m²) and a further 13.7% overweight (23≥BMI<25 kg/m²). Average percentage body fat for the sample was 41.1 ± 9.1 with females significantly higher than males. The majority (74%) reported some form of chronic condition, with 35% diagnosed with diabetes. Physical activity levels for the sample were low (5,977 ± 3,560 steps/day) and significantly different between males (6,982 ± 4,426) and females (5,159 ± 2,401). Higher pedometer steps were associated with lower waist circumference. After adjustment for age, physical activity was lower, but nutritional habits better for those who had spent a longer time in New Zealand. In summary, Asian Indian immigrants to New Zealand have low physical activity levels and high levels of overweight/obesity and lifestyle disease. [ABSTRACT FROM AUTHOR]

Objective: To identify demographic and lifestyle risk factors for excess body fatness in a multiethnic sample of New Zealand children. Design: Cross-sectional study. Participants: A total of 1229 European, Polynesian, Asian, and 'Other' children aged 5-11 y (603 male, 626 female) living in New Zealand. Measurements: Percentage body fat (%BF) was measured using hand-to-foot bioelectrical impedance analysis, and overfat participants were defined as those with a %BF greater than 25% (boys) and 30% (girls). A parent proxy questionnaire was developed for assessing demographic and lifestyle factors, and multiday memory pedometers were used to estimate physical activity levels over five days. Results: After controlling for differences in sex, age, and socioeconomic status (SES), Asian children were more likely to have excess body fat than European children. The adjusted odds of overfat also increased with age and decreased with SES. Three lifestyle risk factors related to fat status were identified: low physical activity, skipping breakfast, and insufficient sleep on weekdays. Clustering of these risk factors resulted in a cumulative increase in the prevalence of overfat. Active transport, sports participation, lunch bought at school, fast food consumption, sugary drink consumption, and weekend sleep duration were not associated with fat status after adjustment for the selected demographic variables. Conclusion: The findings from this study enhance our understanding of the risk factors for excess body fatness in New Zealand children, and highlight key demographic and lifestyle priorities for future interventions. [ABSTRACT FROM AUTHOR]

Background: Clinically useful treatment moderators of Major Depressive Disorder (MDD) have not yet been identified, though some baseline predictors of treatment outcome have been proposed. The aim of iSPOT-D is to identify pretreatment measures that predict or moderate MDD treatment response or remission to escitalopram, sertraline or venlafaxine; and develop a model that incorporates multiple predictors and moderators., Methods/design: The International Study to Predict Optimized Treatment - in Depression (iSPOT-D) is a multi-centre, international, randomized, prospective, open-label trial. It is enrolling 2016 MDD outpatients (ages 18-65) from primary or specialty care practices (672 per treatment arm; 672 age-, sex- and education-matched healthy controls). Study-eligible patients are antidepressant medication (ADM) naïve or willing to undergo a one-week wash-out of any non-protocol ADM, and cannot have had an inadequate response to protocol ADM. Baseline assessments include symptoms; distress; daily function; cognitive performance; electroencephalogram and event-related potentials; heart rate and genetic measures. A subset of these baseline assessments are repeated after eight weeks of treatment. Outcomes include the 17-item Hamilton Rating Scale for Depression (primary) and self-reported depressive symptoms, social functioning, quality of life, emotional regulation, and side-effect burden (secondary). Participants may then enter a naturalistic telephone follow-up at weeks 12, 16, 24 and 52. The first half of the sample will be used to identify potential predictors and moderators, and the second half to replicate and confirm., Discussion: First enrolment was in December 2008, and is ongoing. iSPOT-D evaluates clinical and biological predictors of treatment response in the largest known sample of MDD collected worldwide., Trial Registration: International Study to Predict Optimised Treatment - in Depression (iSPOT-D) ClinicalTrials.gov Identifier: NCT00693849. URL: http://clinicaltrials.gov/ct2/show/NCT00693849?term=International+Study+to+Predict+Optimized+Treatment+for+Depression&rank=1