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Background/Objective: Reduced sleep is a strong and independent risk factor for weight gain and obesity. Maternal obesity preconception and throughout gestation can increase the risk of adverse pregnancy outcomes and impact on offspring health in later life. This study investigated the relationship between sleeping behaviour and macronutrient intake in childbearing aged women. Subjects/Methods: We used cross-sectional data from the Australian Longitudinal Study on Women's Health 1973-78 cohort, aged 31-36 years in 2009 (n=8200). Subjective sleeping behaviour was reported and macronutrient intake was measured using a validated food frequency questionnaire. Latent class analysis (LCA) was used to derive sleeping patterns. Multivariate regression analysis was used to investigate the relationships between sleep and macronutrient intake. Results: LCA identified three sleep patterns: (LC1) average sleep (~8 h) with no adverse sleep-related symptoms (n=3570); (LC2) average sleep (~8 h) with sleeping difficulties and severe tiredness (n=2109); and (LC3) short sleep (~6 h) with sleeping difficulties and severe tiredness (n=915). In fully adjusted models, LC2 was inversely associated with percentage energy as protein (b=-0.24; P=0.01) and the protein-to-carbohydrate ratio (b=-0.01; P Conclusions: Sleeping behaviour patterns were associated with macronutrient intake in childbearing aged women. Improved sleep patterns, together with diet and physical activity strategies, may make it easier for women to achieve a balanced diet and optimise their weight status in preparation for pregnancy., Author(s): C J Bennett [sup.1] , H Truby [sup.1] , Z Zia [sup.2] , S W Cain [sup.3] , M L Blumfield [sup.1] Author Affiliations: (1) Department of Nutrition and [...]

BACKGROUND/OBJECTIVES: Nutritional status influences patients' clinical and functional outcomes. The aims were to identify changes in nutritional state during subacute care and associated participant characteristics. SUBJECTS/METHODS: A longitudinal study was undertaken with consecutive patients admitted to subacute care wards during a 3-month period. Participants were recruited under a waiver of consent to reflect the usual demographic. Change in classification (malnourished, at risk of malnutrition, well nourished) of the full Mini Nutritional Assessment (full MNA) between admission and discharge was the primary outcome. Weight (kg), mid-arm and calf circumference (cm) change were secondary outcomes. Hand grip strength (kg) and fat-free mass (kg) (assessed using bioelectrical impedance analysis) were measured for a consenting subgroup. RESULTS: Participants (n = 248, 36.7% male) had a median age of 80 years and a length of stay of 17 days. On admission, 29.1% were classified as malnourished. By discharge, nutritional classification remained stable for 62.0% of participants (n = 132), declined for 10.3% (n = 22) and improved for 27.7% (n = 59, including 52.5% malnourished on admission). Impaired cognition (odds ratio (OR) = 0.169, P =0.002) and higher full MNA score at admission (OR = 0.870, P = 0.001) reduced odds of improvement in full MNA. There was no change in hand grip strength (n = 46), but there was a decline in mean fat-free mass (-1.1 kg, 95% confidence interval: - 0.1 to - 2.2 kg, P = 0.043, n = 24). CONCLUSIONS: Multidisciplinary care supports the nutritional state of most patients admitted to subacute care. Those with cognitive impairments or at risk of malnutrition were less likely to demonstrate improvement and may benefit from more intensive or tailored nutritional care. European Journal of Clinical Nutrition (2016) 70, 607-612; doi: 10.1038/ejcn.2016.2; published online 2 March 2016, INTRODUCTION Malnutrition contributes to worse outcomes for patients and increased costs for health-care providers. (1) This issue is pertinent because, upon discharge from subacute care, malnourished older adults experience poorer [...]

BACKGROUND/OBJECTIVES: Nutritional issues that are associated with Duchenne muscular dystrophy (DMD) remain poorly understood. The aim of this analysis was to describe and explore longitudinal observations of body mass index (BMI) in a cohort of children with DMD. SUBJECTS/METHODS: Anthropometric and clinical characteristics were collected retrospectively and longitudinally for boys with DMD seen in two large neuromuscular clinics. BMI Z-scores were determined using the Centers for Disease Control and Prevention reference values for children (2000). RESULTS: Medical records (n = 193) were examined from which 75% were included for analysis. The mean age of the cohort at the time of data collection was 11.9 years, with 72% of patients currently or previously using steroids. The highest prevalence of obesity based on the BMI Z-score was 50% at the age of 10 years. Longitudinally, BMI Z-scores from the age of 2 to 12 years plot approximately one s.d. above the mean, after which there is a marked and progressive decline. BMI gainers were identified for whom BMI Z-score increased by 1.65 units compared with the 0.09 units in non-gainers. BMI gainers were younger when they had their first BMI measurement (5.9 vs 7.2 years), and this measure was significantly lower compared with the non-gainers (BMI Z-score: 0.04 vs 1.17). In this cohort, BMI was associated with age, ambulatory status and lung function. CONCLUSIONS: This study demonstrates that boys with DMD using steroid therapy experience shifts in BMI. A declining BMI appears to be associated with increasing age. Interpretation of growth patterns is limited here by a lack of normative growth references in DMD. European Journal of Clinical Nutrition (2014) 68, 892-897; doi: 10.1038/ejcn.2014.93; published online 14 May 2014, INTRODUCTION Duchenne muscular dystrophy (DMD) is the most common and severe muscular dystrophy of childhood. Affecting 1 in 3500 boys, the disease causes progressive and relentless muscle weakness, limiting life [...]

Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: −70.67, 95% CI −101.90 to −39.43, P <0.001), 16% (RR: 0.84, 95% CI 0.73–0.98, P =0.026) and 19% (RR: 0.81, 95% CI 0.69–0.96, P =0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD −98.80, 95% CI −178.85 to −18.76, P =0.016) and 65% (RR: 0.35, 95% CI 0.17–0.72, P =0.004). PA interventions reduced the risk of macrosomia by 51% (RR: 0.49, 95% CI 0.26–0.92, P =0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: −210.93, 95% CI −374.77 to −46.71, P =0.012 and WMD:−295.93, 95% CI −501.76 to −90.10, P =0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA. [ABSTRACT FROM AUTHOR]

Abstract: Background: Pregnancy can motivate individuals to adopt lifestyle behaviours that protect the health of their offspring. The aims of the present study were to explore men's and women's beliefs about lifestyle, fertility and pregnancy, as well as where they seek advice. Methods: Participants (2185 women and 221 men, six unspecified) from 104 countries completed a questionnaire that explored their beliefs about what was important for a healthy pregnancy and their advice‐seeking behaviours. Recruitment was via a Massive Open Online Course entitled ‘Food as Medicine’, with food, nutrient and health content. Comparisons of categorical data were performed using a chi‐squared test (P = 0.05). Results: Eating a variety of fruits and vegetables and not smoking (both 93.7%) were the most frequently and equally ranked in the top‐five factors for a healthy pregnancy. Taking prenatal supplements (26.8%) was considered to be less important. Participants in Westernised countries ranked not smoking or drinking alcohol as being significantly more important than those in other countries. Overall, doctors (47.7%) were the most common source of fertility and pregnancy advice. Larger proportions of those aged <40 years used the Internet (<40 years 44.1%, >40 years 18.2% χ2 = 152.7, P < 0.01) and social media (<40 years 16.1%, >40 years 3.6%; χ2 = 110.18, P < 0.01) for health information. Conclusions: There is disconnection between beliefs and actions regarding the lifestyle behaviours considered to be important for a healthy pregnancy, particularly nutrition. Pregnancy advice‐seeking has evolved, with younger men and women utilising the Internet and social media. Health professionals must consider new communication strategies to deliver evidence‐based lifestyle advice, particularly for younger men and women and where access to healthcare is limited. [ABSTRACT FROM AUTHOR]

Abstract: Diet and nutritional status impact on health outcomes. The global rise of diet‐related non‐communicable diseases plus the double burden of obesity and malnutrition means that it is imperative more than ever that all healthcare professionals are able to provide at least basic evidence‐based nutrition advice. Improving an individual's diet requires more than just information provision, it requires consistent and long‐term support to change and maintain new behaviours. Doctors acknowledge that nutrition plays a crucial role in health and agree that providing nutrition advice is part of their role. However, providing sufficiently detailed nutrition advice that is relevant to a patient's health goals, useful for the patient, and that results in measurable changes, is not common in practice settings. Numerous challenges and barriers have been identified for why doctors do not provide nutrition recommendations to their patients. A lack of nutrition education and training, time constraints during appointments, and patients who have access to an ever‐growing body of nutrition and health information via the Internet and social media, together may explain why doctors tend not to include nutrition advice in their care plans. This paper outlines both short‐ and long‐term strategies for improving doctors' engagement with nutrition interventions and collaborative working with dietitians in the context of collaborative care. Having doctors support and advocate for evidenced‐based nutrition practice is a crucial element of the World Health Organization's Decade of Action on Nutrition achieving measurable success. [ABSTRACT FROM AUTHOR]

Background & aims: The aim of this study was to (i) to compare the accuracy of reporting for child's total energy intake from a food frequency questionnaire (FFQ) completed independently by the mother, father and child in comparison to total energy expenditure (TEE) measured using doubly labeled water (DLW) (ii) compare the accuracy of the weighed food record (WFR) and DLW. Methods: Healthy weight children (mean ± SD age 9.8 ± 1.3years, n = 6 girls/3 boys) and their parents independently completed an FFQ about children's intake. A 4-day WFR of child intake was recorded simultaneously. The accuracy of energy intakes reports were determined by the absolute and percentage differences between estimated energy intake and TEE measured by DLW. Results: The mean difference (limits of agreement LOA, ± SD) when compared to DLW was; child 130 (-1518, 1258) kcal or (113 ± 35% of TEE); father 398 (0,796) kcal or (121 ± 13%); mother 807 (-213, 1824) kcal or (144 ± 26%) and for the WFR 153 (1089, 1395) kcal or 95 ± 32%. Conclusions: Children were the most accurate reporters when compared to their parents, with fathers more accurate than mothers. The 4-day WFR was approximately equal to the child report FFQ in estimating El in children 8-11 years. [ABSTRACT FROM AUTHOR]

Objective: Community kitchens have been implemented by communities as a public health strategy to prevent food insecurity through reducing social isolation, improving food and cooking skills and empowering participants. The aim of the present paper was to investigate whether community kitchens can improve the social and nutritional health of participants and their families.Design: A systematic review of the literature was conducted including searches of seven databases with no date limitations.Setting: Community kitchens internationally.Subjects: Participants of community kitchens across the world.Results: Ten studies (eight qualitative studies, one mixed-method study and one cross-sectional study) were selected for inclusion. Evidence synthesis suggested that community kitchens may be an effective strategy to improve participants' cooking skills, social interactions and nutritional intake. Community kitchens may also play a role in improving participants' budgeting skills and address some concerns around food insecurity. Long-term solutions are required to address income-related food insecurity.Conclusions: Community kitchens may improve social interactions and nutritional intake of participants and their families. More rigorous research methods, for both qualitative and quantitative studies, are required to effectively assess the impact of community kitchens on social and nutritional health in order to confidently recommend them as a strategy in evidence-based public health practice. [ABSTRACT FROM AUTHOR]

Objective: To investigate which anthropometric measure of overweight status, BMI or waist-to-height ratio (WHtR), is most closely associated with parents' perception of their child's overweight status.Design: The sensitivity and specificity of parental perception against child-specific BMI and WHtR definitions of overweight were tested.Setting: Primary schools in Queensland, Australia.Subjects: Boys and girls aged 9·00-11·99 years (n 1431).Results: Of the 138 boys and 202 girls who were classified as overweight according to BMI, only 27·5 % (boys) and 22·7 % (girls) were also perceived as overweight by their parents. Using WHtR, 206 boys and 333 girls were classified as overweight, of whom only 21·9 % and 13·8 %, respectively, were perceived as overweight. Perception of overweight was underestimated in approximately 15 % of boys and 21 % of girls when compared with BMI. Underestimation was higher when compared with WHtR: 25 % (boys) and 39 % (girls). Overweight prevalence was significantly lower according to perception than according to BMI or WHtR. Mother's education level was significantly associated with accurate perception of overweight status (P < 0·001).Conclusions: The sensitivity of parental perception of child overweight was higher when BMI was used. However, emphasis needs to be placed on using WHtR as an actual measure of overweight because high central adiposity is associated with increased risk of CVD. The combined use of WHtR, body-shape images rather than word responses regarding perception and public health messages that educate parents and children about body shape and associated health risks may be the best combination in improving parents' perception of their child's overweight status. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relative efficacy of four popular weight-loss programmes on plasma lipids and lipoproteins as measures of CVD risk. Design: A multi-centred, randomised, controlled trial of four diets -- Dr Atkins' New Diet Revolution, The Slim-Fast Plan, Weight Watchers Pure Points programme and Rosemary Conley's 'Eat yourself Slim' Diet and Fitness Plan -- against a control diet, in parallel for 6 months. Setting and subjects: The trial was conducted at five universities across the UK (Surrey, Nottingham, Ulster (Coleraine), Bristol and Edinburgh (Queen Margaret University College)) and involved the participation of 300 overweight and obese males and females aged 21-60 years in a community setting. Results: Significant weight loss was achieved by all dieting groups (5-9 kg at 6 months) but no significant difference was observed between diets at 6 months. The Weight Watchers and Rosemary Conley (low-fat) diets were followed by significant reductions in plasma LDL cholesterol (both -12.2% after 6 months, P < 0.01), whereas the Atkins (low-carbohydrate) and Weight Watchers diets were followed by marked reductions in plasma TAG (-38.2% and -22.6% at 6 months respectively, P,0?01). These latter two diets were associated with an increase in LDL particle size, a change that has been linked to reduced CVD risk. Conclusions: Overall, these results demonstrate the favourable effects of weight loss on lipid-mediated CVD risk factors that can be achieved through commercially available weight-loss programmes. No detrimental effects on lipid-based CVD risk factors were observed in participants consuming a low-carbohydrate diet. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To test the reliability of the Children's Body Image Scale (CBIS) and assess its usefulness in the context of new body size charts for children. METHOD: Participants were 281 primary schoolchildren with 50% being retested after 3 weeks. The CBIS figure scale was compared with a range of international body mass index (BMI) reference standards. RESULTS: Children had a high degree of body image dissatisfaction. The test-retest reliability of the CBIS was supported. CONCLUSIONS: The CBIS is a useful tool for assessing body image in children with sound scale properties. It can also be used to identify the body size of children, which lies outside the healthy weight range of BMI. [ABSTRACT FROM AUTHOR]