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Abstract Background Inadequate consumption of dairy products without appropriate dietary substitution may have deleterious health consequences. Social research reveals the factors that may impede compliance with dietary recommendations. This is particularly important given the recent introduction of functional dairy products. One of the challenges for public health professionals is to demonstrate the efficacy of nutrition education in improving attitudes toward nutrient rich foods. The aim of this study was to explore the salient beliefs of adult weight loss trial participants regarding both traditional and functional dairy products and to compare these with a control group not exposed to nutrition education. Methods Six focus groups were conducted, three with weight loss trial completers (n = 15) that had received nutrition education and three with individuals from the same region (n = 14) to act as controls. Transcribed focus groups were coded using the Theory of Planned Behaviour theoretical framework. Results Non-trial participants perceived dairy foods as weight inducing and were sceptical of functional dairy products. A lack of time/ability to decipher dairy food labels was also discussed by these individuals. In contrast trial participants discussed several health benefits related to dairy foods, practised label reading and were confident in their ability to incorporate dairy foods into their diet. Normative beliefs expressed were similar for both groups indicating that these were more static and less amenable to change through nutrition education than control and behavioural beliefs. Conclusions Nutrition education provided as a result of weight loss trial participation influenced behavioural and control beliefs relating to dairy products. This study provides a proof of concept indication that nutrition education may improve attitudes towards dairy products and may thus be an important target for public health campaigns seeking to increase intake of this food group.

Focuses on the efforts being made to improve the nutritional practices of the elderly poplulation of Africa.

Aim: We obtained calcaneal ultrasound measurements in 198 girls between 7.5 and 11.7 y of age, representing ethnic groups (black [n = 80], white [n = 41], mixed ancestral origin [n = 77]) in South Africa.Methods: Anthropometry was assessed. Demographics, physical activity, habitual dietary calcium intake and pubertal development were quantified by questionnaires. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) of the left calcaneus were measured. Girls in Tanner breast stage 5 and/or those menstruating were excluded from analysis.Results: Black girls were lighter than white girls (31.4 +/- 7.8 vs 34.8 +/- 7.5 kg; p < 0.05), and shorter than girls of mixed ancestral origin (1.29 +/- 0.08 vs 1.34 +/- 0.07 m; p < 0.001) and white girls (1.35 +/- 0.07 m; p < 0.001), after adjusting for age. Reported calcium intake scores were higher in black than white girls (21.6 +/- 11.1 vs 16.1 +/- 8.4; p < 0.01). Total peak bone strain score (TPBSS) was higher in white compared to black girls (6.8 +/- 4.8 vs 5.0 +/- 4.7; p < 0.05), while walking energy expenditure (MET h/wk) was higher in black girls compared to the other groups (p < 0.001). BUA and SOS were higher in the black girls (59.6 +/- 13.7 dB/MHz; 1575.1 +/- 22.6 m/s; p < 0.001) and girls of mixed ancestral origin (59.0 +/- 12.5 dB/MHz; 1567.8 +/- 26.1 m/s; p < 0.01) than in the white girls (50.4 +/- 8.7 dB/MHz; 1552.1 +/- 19.5 m/s). Co-varying for age and weight did not affect these results. Walking energy expenditure (r = 0.20) and calcium score (r = 0.17) were correlated (p < 0.05) with SOS for the whole group.Conclusion: Ultrasound parameters were lower in the white compared to the black girls, who consumed more calcium on average, but who were lighter, shorter and performed less impact activity. This suggests that interactions between ethnicity and lifestyle factors determine bone quality in premenarcheal girls. [ABSTRACT FROM AUTHOR]

Cranberry juice is popular remedy for many ills; apart from the pleasant tasting many people drink it to help in preventing UTIs and stones. Authors from Cape Town (where there is the added benefit of an excellent climate) assessed the influence of cranberry juice on urinary risk factors for calcium oxalate calculi in a randomized crossover trial, showing that it has anti-lithogenic properties. In the second paper, authors from Jerusalem report on 14 patients with distal ureteric strictures after kidney transplantation, all of whom were treated endourologically. They found transurethral incision of the distal ureteric stricture to be effective. To investigate the potential influence of cranberry juice on urinary biochemical and physicochemical risk factors associated with the formation of calcium oxalate kidney stones, as this product might affect the chemical composition of urine. Urinary variables were assessed in a randomized cross-over trial in 20 South African men (students) with no previous history of kidney stones. The first group of 10 subjects drank 500 mL of cranberry juice diluted with 1500 mL tap water for 2 weeks, while the second group drank 2000 mL of tap water for the same period. This was followed by a 2-week ‘washout’ period before the two groups crossed over. During the experimental phase subjects kept a 3-day food diary to assess their dietary and fluid intakes; 24-h urine samples were collected at baseline and on day 14 of the trial periods, and analysed using modern laboratory techniques. Urine analysis data were used to calculate the relative urinary supersaturations of calcium oxalate, uric acid and calcium phosphate. Data were assessed statistically by analysis of variance. The ingestion of cranberry juice significantly and uniquely altered three key urinary risk factors. Oxalate and phosphate excretion decreased while citrate excretion increased. In addition, there was a decrease in the relative supersaturation of calcium oxalate, which tended to be significantly lower than that induced by water alone. Cranberry juice has antilithogenic properties and, as such, deserves consideration as a conservative therapeutic protocol in managing calcium oxalate urolithiasis. [ABSTRACT FROM AUTHOR]

ObjectiveThe purpose of this study was to investigate whether differences exist in eating attitudes and body shape concerns amongst adolescent schoolgirls representing South Africa’s ethnically and culturally diverse population currently undergoing epidemiological transition. MethodA questionnaire survey, including the Eating Attitudes Test, Body Shape Questionnaire and a Body Silhouette Chart, was administered to 228 South African schoolgirls (60 black, 83 mixed race and 85 white) aged 15–18 years from five secondary schools in the greater Cape Town area. ResultsBlack girls had significantly higher mean BMI values (24.1 (3.3)) than either white (21.9 (3.0)) or mixed race girls (22.1 (3.7)) (P < 0.05). Controlling for differences in BMI, white subjects scored significantly higher on the Body Shape Questionnaire than did mixed race or black subjects, whereas no ethnic differences were found for Eating Attitude Test scores. A comparable percentage (mean=18.8%) of black, mixed race and white girls had scores indicative of eating disorder pathology on the Eating Attitudes Test, while a higher percentage of white, compared to mixed race and black, girls had abnormal scores on the Body Shape Questionnaire (33%, 26% and 20%, respectively; P < 0.05). The ideal body size desired by white girls was significantly smaller than that of the mixed race or black samples. Dissatisfaction with present body size was significantly higher in white, compared to black or mixed race girls (P < 0.001). ConclusionThese findings suggest that the prevalence of abnormal eating attitudes is equally common in South African schoolgirls from different ethnic backgrounds. White girls exhibit greater body image concerns and body image dissatisfaction than mixed race or black individuals. These findings reinforce the notion that eating disorders are culture-reactive rather than culture-bound phenomena and provide insight into the extent of eating-related problems and body image issues in developing societies. [ABSTRACT FROM AUTHOR]

Background: Concern about the use of epinephrine as a treatment for out-of-hospital cardiac arrest led the International Liaison Committee on Resuscitation to call for a placebo-controlled trial to determine whether the use of epinephrine is safe and effective in such patients.Methods: In a randomized, double-blind trial involving 8014 patients with out-of-hospital cardiac arrest in the United Kingdom, paramedics at five National Health Service ambulance services administered either parenteral epinephrine (4015 patients) or saline placebo (3999 patients), along with standard care. The primary outcome was the rate of survival at 30 days. Secondary outcomes included the rate of survival until hospital discharge with a favorable neurologic outcome, as indicated by a score of 3 or less on the modified Rankin scale (which ranges from 0 [no symptoms] to 6 [death]).Results: At 30 days, 130 patients (3.2%) in the epinephrine group and 94 (2.4%) in the placebo group were alive (unadjusted odds ratio for survival, 1.39; 95% confidence interval [CI], 1.06 to 1.82; P=0.02). There was no evidence of a significant difference in the proportion of patients who survived until hospital discharge with a favorable neurologic outcome (87 of 4007 patients [2.2%] vs. 74 of 3994 patients [1.9%]; unadjusted odds ratio, 1.18; 95% CI, 0.86 to 1.61). At the time of hospital discharge, severe neurologic impairment (a score of 4 or 5 on the modified Rankin scale) had occurred in more of the survivors in the epinephrine group than in the placebo group (39 of 126 patients [31.0%] vs. 16 of 90 patients [17.8%]).Conclusions: In adults with out-of-hospital cardiac arrest, the use of epinephrine resulted in a significantly higher rate of 30-day survival than the use of placebo, but there was no significant between-group difference in the rate of a favorable neurologic outcome because more survivors had severe neurologic impairment in the epinephrine group. (Funded by the U.K. National Institute for Health Research and others; Current Controlled Trials number, ISRCTN73485024 .). [ABSTRACT FROM AUTHOR]

Dopamine via G-protein-coupled receptor kinase 4 (GRK-4) regulates sodium (Na) balance in the proximal tubule of the kidney. Single-nucleotide polymorphisms of GRK-4 have been linked to impaired natriuresis and salt-sensitive hypertension. The purpose of this report was to determine the effect of GRK-4 gene polymorphisms on the blood pressure (BP) responses to dietary intervention. Black subjects aged 50-75 years with mild-to-moderate hypertension were randomised to an 8-week dietary intervention (n=40) or standard diet (n=40). BP was measured at baseline and at 8 weeks using 24-h ambulatory BP. All subjects underwent DNA analysis for the R65L and A142V polymorphisms. Data were analysed using generalised linear models. For the whole group, between-diet differences in mean 24-h ambulatory systolic BP was −4.53 mm Hg (95% confidence interval −9.05 to −0.01, P=0.05). In the intervention arm, the combined CC and CT group of the A142V showed a significant reduction in both systolic and diastolic ambulatory BP (−10 mm Hg, P=0.023 and −6.5 mm Hg, P=0.01, respectively), whereas the TT group demonstrated no reduction. Similarly, the combined GG and GT groups of the R65L showed a significant reduction in ambulatory BP (−10.6 mm Hg for systolic, P=0.004 and 5.8 mm Hg for diastolic, P=0.006). There was no response in the TT group. GRK-4 polymorphisms predict BP response to dietary modification in Black subjects with mild-to-moderate hypertension. These data may provide at least one among a range of clinical tools to target selected hypertensives to dietary intervention. [ABSTRACT FROM AUTHOR]

Background/Objectives:Most dietary interventions have metabolic effects in the short term, but long-term effects may require dietary fat changes to influence body composition and insulin action. This study assessed the effect of sustained high polyunsaturated fatty acids (PUFA) intake through walnut consumption on metabolic outcomes in type II diabetes.Subjects/Methods:Fifty overweight adults with non-insulin-treated diabetes (mean age 54±8.7 years) were randomized to receive low-fat dietary advice ±30 g per day walnuts targeting weight maintenance (around 2000 kcal, 30% fat) for 1 year. Differences between groups were assessed by changes in anthropometric values (body weight, body fat, visceral adipose tissue) and clinical indicators of diabetes over treatment time using the general linear model.Results:The walnut group consumed significantly more PUFA than the control (P=0.035), an outcome attributed to walnut consumption (contributing 67% dietary PUFA at 12 months). Most of the effects were seen in the first 3 months. Despite being on weight maintenance diets, both groups sustained a 1–2 kg weight loss, with no difference between groups (P=0.680). Both groups showed improvements in all clinical parameters with significant time effects (P<0.004), bar triacylglycerol levels, but these were just above normal to begin with. The walnut group produced significantly greater reductions in fasting insulin levels (P=0.046), an effect seen largely in the first 3 months.Conclusions:Dietary fat can be manipulated with whole foods such as walnuts, producing reductions in fasting insulin levels. Long-term effects are also apparent but subject to fluctuations in dietary intake if not of the disease process.European Journal of Clinical Nutrition (2009) 63, 1008–1015; doi:10.1038/ejcn.2009.19; published online 8 April 2009 [ABSTRACT FROM AUTHOR]

Objective: To develop a nutrition screening tool for use in older South Africans.Design: A cross-sectional validation study in 283 free-living and institutionalised black South Africans (60+ years).Methods: Trained field-workers administered a 24-hour recall and the Mini Nutritional Assessment (MNA) screening tool, and performed anthropometric measurements and physical function tests. Cognitive function was assessed using a validated version of the Six-Item Cognitive Impairment Test. Biochemical indicators assessed included serum albumin, haemoglobin, ferritin, vitamin B12, red-blood-cell folate, cholesterol and vitamin C. The MNA was used as the gold standard against which a novel screening tool was developed using a six-step systematic approach, namely: correspondence analysis; identification of key questions; determination of internal consistency; correlational analyses with objective measures; determination of reference cut-off values for categories of nutritional risk; and determination of sensitivity and specificity.Results: The new screening tool includes nine separate concepts, comprising a total of 14 questions, as well as measurement of mid-upper arm circumference. The new tool score was positively associated with level of independence in either basic activities of daily living (r = 0.472) or the more complex instrumental activities of daily living (r = 0.233). A three-category scoring system of nutritional risk was developed and shown to significantly characterise subjects according to physical function tests, level of independence and cognitive function. The new tool has good sensitivity (87.5%) and specificity (95.0%) compared with the MNA scoring system. It has a very high negative predictive value (99.5%), which means that the tool is unlikely to falsely classify subjects as well nourished/at risk when they are in fact malnourished.Conclusion: A novel screening tool has been shown to have content-, construct- and criterion-related validity, and the individual items have been shown to have good internal consistency. Further validation of the tool in a new population of elderly Africans is warranted. [ABSTRACT FROM AUTHOR]

Objectives: To determine the level of knowledge regarding iodine nutrition and its relationship with socio-economic status in the South African population.Design: A cross-sectional population survey collecting questionnaire information on knowledge of iodine nutrition and sociodemographic variables in a multistage, stratified, cluster study sample, representative of the adult South African population.Setting: Home visits and personal interviews in the language of the respondent.Subjects: Data were collected from one adult in each of the selected 2164 households, and the participation rate was 98%.Results: Only 15.4% of respondents correctly identified iodised salt as the primary dietary source of iodine, 16.2% knew the thyroid gland needs iodine for its functioning, and a mere 3.9% considered brain damage, and 0.8% considered cretinism, as the most important health consequence of iodine deficiency. Compared with respondents from high socio-economic households, respondents from low socio-economic households were considerably less informed about aspects of iodine nutrition covered in this study.Conclusions: The knowledge level of iodine nutrition is low among South Africans, particularly among the low socio-economic groups. These data suggest that the international emphasis on brain damage resulting from iodine deficiency has not been conveyed successfully to the consumer level in this country. [ABSTRACT FROM AUTHOR]

Objective: There is a paucity of data on the micronutrient status of low-income, lactating South African women and their infants under 6 months of age. The aim of this study was to elucidate the level of anaemia and vitamin A deficiency (VAD) in peri-urban breast-feeding women and their young infants.Design: Cross-sectional study including anthropometric, biochemical and infant feeding data.Setting: Peri-urban settlement in Cape Town, South Africa.Subjects: Breast-feeding women (n=113) and their infants (aged 1-6 months) attending a peri-urban clinic.Results: Mean (standard deviation (SD)) haemoglobin (Hb) of the lactating mothers was 12.4 (1.3) g dl(-1), with 32% found to be anaemic (Hb<12 g dl(-1)). Maternal serum retinol was 49.8 (SD 13.3) microg dl(-1), with 4.5% VAD. Using breast milk, mean (SD) retinol concentration was found to be 70.6 (24.6) microg dl(-1) and 15.7 (8.3) microg/g milk fat, with 13% below the cut-off level of <8 microg/g fat. There was no correlation found between breast milk retinol and infant serum retinol. Z-scores (SD) of height-for-age, weight-for-age and weight-for-height were -0.69 (0.81), 0.89 (1.01) and 1.78 (0.83), respectively. Mean (SD) infant Hb was 10.9 (1.1) g dl(-1), with the prevalence of anaemia being 50%, 33% and 12% using Hb cut-offs below 11 g dl(-1), 10.5 g dl(-1) and 9.5 g dl(-1), respectively. Mean (SD) infant serum retinol was 26.9 (7.2) microg dl(-1), with 10% being VAD. None of the infants was exclusively breast-fed, 22% were predominantly breast-fed and 78% received complementary (mixed) breast-feeding. Thirty-two per cent of infants received weaning foods at an exceptionally young age (< or =1 month old).Conclusion: A high rate of anaemia is present in lactating women residing in resource-poor settings. Moreover, their seemingly healthy infants under 6 months of age are at an elevated risk of developing early-onset anaemia and at lower risk of VAD. [ABSTRACT FROM AUTHOR]

Objectives: (1) To identify the major sources of nutrition information, and the perceived credibility thereof, among urban black South African women; and (2) to determine the level of knowledge regarding nutrition, particularly regarding the topic of obesity.Design: A cross-sectional descriptive study that was both qualitative (focus groups) and quantitative (individual questionnaires). Three hundred and ninety-four black women aged 17-49 years were conveniently sampled from the Western Cape and Gauteng provinces in South Africa.Methods: Four focus groups were held with 39 women to identify common themes relating to nutrition knowledge. Based on these data, a questionnaire instrument was developed and administered to 394 women by trained fieldworkers.Results: The most frequently encountered source of nutrition information was the media, particularly the radio and TV (73.4% and 72.1% of subjects, respectively, obtained information from this source in the past year), followed by family/friends (64.6%). Despite only 48.5% of subjects having received nutrition information from a health professional, this was the most highly credible information source. Factors being most influential in choice of foods were taste, preferences of the rest of the family, and price. A lack of knowledge on certain aspects of nutrition was identified, as well as misconceptions regarding diet and obesity.Conclusion: To improve nutrition knowledge and the effectiveness of nutrition education activities in South Africa, it is recommended that health and nutrition educators become more actively involved with the training of health professionals, particularly those engaged in delivery of services at primary care level, and in turn encourage health professionals to engage more with media sources. Nutrition messages delivered from health professionals via the media will enable public exposure to nutrition information which is not only easily accessible but also perceived to be highly credible. [ABSTRACT FROM AUTHOR]

A cross-sectional analytical study was undertaken to describe the nutritional status and dietary intake of the elderly black population of Cape Town. A stratified proportional sample of 148 men and women aged 60 years and older (mean = 68.9+/-5.7) was selected from informal and formal peri-urban settlements. The study population was predominantly urbanized, although most subjects had migrated from non-urban areas. Trained fieldworkers conducted a 24-h recall dietary assessment and performed anthropometrical measurements. Mean energy intakes fell below the recommended dietary allowance (RDA) for both men and women; 27% and 36% of men and women, respectively, had energy intakes <67% RDA. Total fat intake was low and contributed 24-26% total energy. Mean dietary fibre intake was low at 11-16 g/day. Mean intakes fell below the RDA for vitamin D, calcium, zinc and vitamin B6. Less than two and a half servings per day were consumed from the vegetable and fruit group and less than one serving per day from the calcium-rich food group. Over half (51.3%) of the women and 18% of the male were obese (body mass index > or =30). We concluded that older black subjects in Cape Town have energy profiles in line with prudent dietary guidelines and more favorable than other elderly groups in the country, with regard to atherogenic risk. However, micronutrient and dietary fiber intake is inadequate, largely due to low reported energy intakes, particularly in women. [ABSTRACT FROM AUTHOR]

Introduction: Promising evidence is emerging for the procognitive, anti-inflammatory and neuroprotective properties of dietary flavonoids, particularly anthocyanins that provide red, purple and blue plant pigments., Methods and Analysis: The 'Food for Thought' study is a multicentre, 6-month randomised, parallel 3-arm clinical trial. Its primary aim is to investigate whether anthocyanin consumption, either through diet or supplementation, can prevent memory loss progression and improve inflammatory and cardiovascular health in older adults at risk for dementia. Eligible participants will include those aged 60-85 years with a diagnosis of amnestic mild cognitive impairment or with a self-referral of memory concerns and scoring ≤13 on the Memory Index Score within the Telephone Montreal Cognitive Assessment screening test. Participants will be randomised to one of three arms: High anthocyanin ('purple foods') diet (aiming for a target of 250 mg anthocyanins/day); freeze-dried product derived from blackcurrants (250 mg anthocyanins/day); or control (coloured maltose powder). The primary outcome is auditory anterograde memory functioning assessed by the Buschke and Grober Free and Cued Selective Reminding Test-Immediate Recall. Secondary outcomes are additional cognitive functions including processing speed, working memory, aspects of executive functioning (attentional shifting and word generativity) and premorbid estimate as well as subjective memory problems and self-reported depression symptoms. Additional secondary outcomes are blood pressure, inflammatory biomarkers, brain-derived neurotrophic factor, fatty acid profile, apolipoprotein E and polyphenol metabolites, gut microbiota composition and function and vascular and microvascular endothelial function tests. Repeated measures analysis of variance and/or mixed linear modelling will evaluate changes over time, with the inclusion of covariates., Ethics and Dissemination: Ethics approval has been obtained from the Greater Western Human Research Ethics Committee (2021/ETH12083). A Consumer Advisory Group was established to guide and review the protocol and dissemination strategy. The results of this trial are intended to be published in a peer-reviewed journal., Trial Sponsor: National Health and Medical Research Centre Dementia Collaborative Research Centre.Start date of clinical trial: 02 September 2022.Expected end date: 11 October 2024., Trial Registration Number: ACTRN12622000065796., Competing Interests: Competing interests: HB is or has been an advisory board member or consultant to Biogen, Eisai, Eli Lilly, Medicines Australia, Roche and Skin2Neuron. He is a Medical/Clinical Advisory Board member for Montefiore Homes and Cranbrook Care. There are no other conflicts of interest among the other authors., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Importance: Sleep disorders are associated with a range of health conditions, with poor sleep often further exacerbating individuals' health, well-being, and ability to participate in daily occupations. Weighted blankets offer a potentially simple nonpharmacological sleep intervention option., Objective: To summarize available literature on instrumentation and outcomes associated with overnight use of weighted blankets for therapeutic purpose., Evidence Review: A scoping review following the PRISMA review guidelines was conducted. Sources included MEDLINE, Cochrane Library, CINAHL, PsycINFO, Scopus, Embase, and Google. Included studies reported on overnight use of weighted blankets. Critical appraisal of studies was conducted with standardized tools., Findings: Eighteen studies met the inclusion criteria. Positive outcomes were reported for adults, including improved sleep, reduction in medication use, and improved mood. Sleep outcomes were mixed for children and adolescents but included improved occupational performance. Methodological quality of included studies regarding effectiveness was variable. Ten studies included details of the intervention, whereas only one study reported on implementation. No specific guidelines for use were included., Conclusions and Relevance: Weighted blankets are used as a sleep intervention for individuals across the life span experiencing a range of health conditions. Currently, there is more evidence of effectiveness with adults, although parents are favorable regarding weighted blanket use for children. Implementation and recommendation of weighted blankets are typically led by occupational therapists, with knowledge of the intervention facilitating use. This review provides information to inform occupational therapists' clinical decision-making and continued implementation of weighted blankets for individuals with sleep problems. Plain-Language Summary: This scoping review summarizes what is known about the use of weighted blankets as a sleep intervention for people of all ages. There is more evidence for overnight use of weighted blankets for adults, with improvements reported in sleep, mood, medication use, and pain. Although there is little evidence of improvement in sleep for children, some children show improvement in everyday functioning, and parents report positive outcomes from overnight use of weighted blankets. These findings suggest that occupational therapists should consider offering or recommending weighted blankets as a sleep intervention option for people of all ages, alongside consideration of individuals' preferences. Development of practice guidelines that incorporate current research findings is urgently needed to support occupational therapists' use of weighted blankets., (Copyright © 2024 by the American Occupational Therapy Association, Inc.)

Amidst a backdrop of attacks on both LGBTQ+ individuals and LGBTQ+ venues coupled with the ongoing changing landscape of urban queer spaces across the UK, this article offers a timely autoethnographic and socio-spatial account of queer "safety." This article examines when and how queer spaces are experienced as "safe." Specifically, the article offers reflections from the author's experience of two queer spaces: (1) The Proud Place, a purpose-built community center in Manchester, England and (2) The concert of a queer female artist that took place in Bristol, England. The article concludes that queer spaces are contextually safe spaces. Through an analysis of (in)visibility and exclusivity in queer spaces, the article reveals the social structures and power dynamics impacting perceptions of safety.

Background: Individuals with low socio-economic status (SES) have disproportionate rates of cardio- vascular disease (CVD) but poorer engagement with preventative health. This study aimed to compare characteristics of individuals with and without hyperlipidaemia and describe their health behaviours., Methods: A mixed-methods study between January and December 2022. Patients aged ≥40 years using the ambulance service with blood pressure of ≥140/90 had their total cholesterol measured using a point of care device. Data including blood pressure, smoking status, National Early Warning Score 2 and clinical frailty scale (CFS) were analysed., Results: Of 203 patients (59% female, mean age 65.7 years), 115 (56.7%) had total cholesterol ≥5.1 mmol/L. Thirty patients (14.8%) sought treatment and received either statins (n = 9; 4.4%), dietary modification (n = 7; 3.4%) or no further intervention (n = 14; 6.9%), whilst 85 patients (41.9%) took no further action. Lower CFS (OR 0.53 [0.31-0.93]) and higher total cholesterol (OR 2.07 [1.03-2.76]) predicted seeking further management. SES was not associated with hyperlipidaemia or likelihood of seeking further management, rather this was dictated by competing co-morbidity, poor health literacy and digital divide., Conclusions: Undiagnosed hyperlipidaemia exists in patients using the ambulance service, irrespective of SES. Individual and healthcare system factors prevent engagement in cholesterol lowering behaviours., (© The Author(s) 2024. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To examine associations between three different plant-based diet quality indices, chronic kidney disease (CKD) prevalence and related risk factors in a nationally representative sample of the Australian population., Design: Cross-sectional analysis. Three plant-based diet scores were calculated using data from two 24-h recalls: an overall plant-based diet index (PDI), a healthy PDI (hPDI) and an unhealthy PDI (uPDI). Consumption of plant and animal ingredients from 'core' and 'discretionary' products was also differentiated. Associations between the three PDI scores and CKD prevalence, BMI, waist circumference (WC), blood pressure (BP) measures, blood cholesterol, apo B, fasting TAG, blood glucose levels (BGL) and HbA1c were examined., Setting: Australian Health Survey 2011-2013., Participants: n 2060 adults aged ≥ 18 years (males: n 928; females: n 1132)., Results: A higher uPDI score was associated with a 3·7 % higher odds of moderate-severe CKD (OR: 1·037 (1·0057-1·0697); P = 0·021)). A higher uPDI score was also associated with increased TAG ( P = 0·032) and BGL ( P < 0·001), but lower total- and LDL-cholesterol ( P = 0·035 and P = 0·009, respectively). In contrast, a higher overall PDI score was inversely associated with WC ( P < 0·001) and systolic BP ( P = 0·044), while higher scores for both the overall PDI and hPDI were inversely associated with BMI ( P < 0·001 and P = 0·019, respectively)., Conclusions: A higher uPDI score reflecting greater intakes of refined grains, salty plant-based foods and added sugars were associated with increased CKD prevalence, TAG and BGL. In the Australian population, attention to diet quality remains paramount, even in those with higher intakes of plant foods and who wish to reduce the risk of CKD.

Background: In Australia, the prevalence of food insecurity increased by 1.5% between 2014 and 2016 and 2018 and 2020 due to effects of the COVID-19 pandemic. OzHarvest offers a 6-week Nutrition Education and Skills Training (NEST) programme to adults at risk of food insecurity. NEST provides 2.5-h weekly cooking workshops on simple, healthy and affordable meals. This study aimed to determine the immediate (post) and longer-term (6 months) impacts of participation in NEST., Methods: A quasi-experimental study with pre-post surveys (n = 258) and 6-month follow-up surveys (n = 20) was conducted from June 2019 to July 2022. Survey results were obtained from NEST programme participants (≥18 years) from six major Australian cities., Results: Participants demonstrated immediate improvement in nutrition knowledge (p < 0.001), food preparation behaviours (p < 0.001) and confidence and self-efficacy (n = 222; p < 0.001). Intake of discretionary foods decreased (p < 0.001), whereas fruit, vegetable and water intake increased (p < 0.001). Food security improved from 57% to 68% immediately after the completion of the programme (p < 0.001). Participants demonstrated longer-term improvements in nutrition knowledge (p < 0.001), cooking confidence (n = 8; p = 0.03), food preparation behaviours (p = 0.003) and increased vegetable (p = 0.03) and fruit intake (p = 0.01)., Conclusions: Participation in OzHarvest's NEST programme results in short-term improvements in food security levels and dietary behaviours. Over the longer term, these changes were sustained but to a lesser degree, indicating that systemic changes are required to address underlying socio-economic disadvantages., (© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)