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Background: Consumption of food groups aligning with dietary guidelines is advised for obesity management and was used in a recent lifestyle intervention trial, the Health Track study. We have conducted a number of dietary pattern analyses on this trial but, with recent access to the new Australian Dietary Guidelines (ADG) food composition database, we can now assess ADG adherence, with the advantage of categorising mixed dishes. The present study aimed to compare changes over time in consumption of ADG food groups., Methods: Secondary analysis of baseline and three-month diet history data was conducted. Participants received individualised dietary advice (I), individualised dietary advice plus 30 g of walnuts per day (IW) or usual care (C). The ADG database was used to determine food group servings with changes in five food groups used as a measure of dietary quality., Results: Fruit and vegetable intakes increased in the IW (+0.4 and +1.1 serves, P < 0.05) and I (+0.5 and +0.4 serves, P > 0.05) arms. Consumption of meat/protein foods increased in the IW arm (+0.3 serves, P > 0.05) but decreased in the I and C arms (both - 0.4 serves, P < 0.05). Consumption of grains and milk/alternatives decreased in all study arms (P < 0.05). Greater improvements in grain and dairy food quality were observed in the intervention arms., Conclusions: The ADG database enabled ADG specific food group analysis, addressed food quality and showed the HealthTrack intervention increased adherence to dietary guidelines compared to usual care., (© 2020 The British Dietetic Association Ltd.)

Objective: Constipation is common in patients with end-stage kidney disease. Nondrug strategies to manage constipation are challenging because of dietary potassium, phosphate, and fluid restrictions. Nuts are a high-fiber food but are excluded from the diet because of the high potassium and phosphate content. The aim of this study was to examine the safety and efficacy of using nuts to improve constipation in adults undertaking hemodialysis (HD)., Design and Methods: Adult patients undertaking HD were recruited to this nonrandomized, 10-week repeated measures, within-subject, pragmatic clinical trial, conducted in two HD units. The intervention consisted of consumption of 40g of raw almonds daily for four weeks, followed by a two-week washout and four-week control period. The primary safety outcome measures were change in predialysis serum potassium and phosphate levels. The primary efficacy outcome was reduction in constipation, measured using the Bristol Stool Form Scale and Palliative Care Outcome Scale (POS-S) renal symptom score. Secondary outcomes included quality of life, selected uremic toxins, cognition, gut microbiota profile, and symptom burden., Results: Twenty patients completed the trial (median age: 67 [interquartile range: 57.5-77.8] years, 51% male). After controlling for dialysis adequacy, anuria, dietary intake, bicarbonate, and parathyroid hormone, there were no statistically significant changes in serum potassium (P = 0.21) or phosphate (P = 0.16) associated with daily consumption of almonds. However, statistically significant improvements in constipation were seen at weeks 2, 3, 4, and 10. There were statistically significant improvements in quality of life (P = 0.030), overall symptom burden (P = 0.002), vomiting (P = 0.020), itching (P = 0.006), and skin changes (P = 0.002)., Conclusion: Daily consumption of almonds for four weeks was safe, effective, and well tolerated. Improvements in quality of life and symptom burden warrant further research to elucidate potential mechanisms. The findings support the potential reinclusion of foods such as nuts into the diet of patients who underwent HD., (Copyright © 2019 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Introduction: Global public health recommendations advise limiting the intake of red and processed meats. There is a need for more comprehensive information on meat consumption in Australia, specifically usual intake of meat from a nationally representative sample. The aim of this study was to use the National Cancer Institute (NCI) method to examine usual meat intakes in the 2011-12 National Nutrition and Physical Activity Survey (NNPAS)., Methods: This was a secondary analysis of the cross-sectional 2011-12 NNPAS, which contains observations for 12 153 respondents (9341 adults and 2812 children/adolescents). Usual consumption of all meat, red and processed meats was calculated using the NCI method. Consumption of meat was explored by age and gender groups, as well as by household type., Results: Amongst adults and children/adolescents, consumption of all meat was significantly higher in males (adults: 187.1 g day -1 ; children/adolescents: 125.0 g day -1 ) than females (adults: 125.5 g day -1 ; children/adolescents: 95.4 g day -1 ). Similar patterns were observed for red (males: adults 85.5 g day -1 , children/adolescents 42.9 g day -1 ; females: adults 57.1 g day -1 , children/adolescents 34.9 g day -1 ) and processed meat, although intakes of processed meats in children and adolescents (males: 26.5 g day -1 ; females: 16.8 g day -1 ) were found to be similar to those of adults aged ≥19 years (males: 28.3 g day -1 ; females: 15.3 g day -1 ). Patterns of meat consumption across household types appeared to differ between genders., Conclusions: The present study suggests that Australians are likely to be exceeding population recommendations for meat intakes, with differing patterns observed across gender and household types. These findings highlight a need for targeted dietetic and population strategies aimed at promoting a healthy consumption of meats within the Australian population., (© 2020 The British Dietetic Association Ltd.)

Background: Anthocyanins represent an important subgroup of non-nutritive components of food as evidence continues to build related to their beneficial bioactive effects. Using a recently developed Australian anthocyanin database, the present study aimed to estimate the intake of both total anthocyanins and their subclasses, identify food sources of anthocyanins, and determine associations between anthocyanin intake and measured blood pressure (BP)., Methods: The present study comprised a secondary analysis of the 2011-12 National Nutrition and Physical Activity component of the Australian Health Survey. Anthocyanin intake was estimated using an Australian anthocyanin database. Usual anthocyanin intake, as estimated from 24-h diet recall data, was computed using multiple source methods, whereas food sources were determined by calculating contribution of food groups to total anthocyanin intake. Regression analysis, adjusted for covariates (age, gender, body mass index, high BP diagnosis, smoking status and physical activity) assessed the relationship between anthocyanin intake and BP in adults aged ≥50 years., Results: Mean anthocyanin intake was 24.17 ± 0.32 mg day -1 . Across age groups, berries were the top sources: blackberry (5-65%), cherry (2-24%), blueberry (2-13%) and raspberry (3-12%). There was a significant inverse association between anthocyanin intake and systolic BP (β = -0.04, F = 16.8, d.f. = 6, r 2  = 0.05, P < 0.01) and diastolic BP (β = 0.01, F = 5.35, d.f. = 6, R 2  = 0.013, P < 0.01), in models that adjusted for covariates., Conclusions: In comparison with the world composite database, anthocyanin intake in the Australian population was above average [mean (SD): 24.17 (0.32) mg day -1 versus 18.05 (21.14) mg day -1 ]. Berries were the primary source of anthocyanins. Anthocyanin intake in older adults aged ≥50 years was inversely associated with BP., (© 2019 The British Dietetic Association Ltd.)

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system. Current research into potential causes, risk factors, and treatment is largely based around the immune response involved in the pathophysiology of the disease, including factors that contribute to the augmentation of this immune response. This review aimed to determine the role of sodium as a risk factor for increased autoimmunity and inflammation in relation to MS pathogenesis. This systematic review searched the Scopus, MEDLINE, and PubMed scientific databases for studies related to MS and sodium. Studies were included if they addressed sodium intake and MS but were not limited to a disease type or to a study design. Study quality was assessed through the use of the quality rating checklist of the Academy of Nutrition and Dietetics. A total of 12 studies were included in the review, including human, animal, and cellular studies. The studies related to the proinflammatory effect of sodium, the blood-brain barrier, and an effect on autoimmunity. The data presented throughout this review provide insight into the emerging evidence base for sodium intake as a risk factor for MS disease progression and potentially onset of disease. More studies are needed to determine if the influence of sodium is as a single nutrient or has a combined effect as part of an overall eating pattern. This review was registered at PROSPERO as CRD42016039174., (Copyright © American Society for Nutrition 2019.)

Purpose of Review: The relationship between dietary patterns and cardiovascular disease has been the subject of much research, but an important methodological consideration is the interdependence between the nutrient composition of foods and the recognition of healthy dietary patterns. This review considers some of the challenges in researching dietary patterns with implications for translation to public health promotions., Recent Findings: A number of statistical methods have emerged for analysing dietary patterns using population dietary data. There are limitations in the assumptions underpinning food categorisation, but this research is able to consistently identify foods and dietary patterns that are positively related to health. Aligned to this activity is the ongoing development of food composition databases which has its own limitations such as keeping up to date with changing foods and newly identified components, sampling of foods, and developments in chemical analytical methods. Finally, dietary patterns form the basis for current dietary guidelines and related public health-oriented programs, but the issues raised for research (e.g. food categorisation and cuisine influences on dietary patterns) can also translate to these settings. The study of dietary patterns in cardiovascular disease prevention presents with a number of methodological challenges relating to the way food groups are formed and the limitations of food composition databases. Added to this are new considerations for the environmental impact of recommended dietary patterns. Future research across the entire knowledge chain should target more accurate methods in a number of analytical areas.

Translating food intake data into phytochemical outcomes is a crucial step in investigating potential health benefits. The aim of this review was to examine the tools for determining dietary-derived polyphenol intakes for estimated intake studies. Published studies from 2004 to 2014 reporting polyphenol food composition information were sourced with 157 studies included. Six polyphenol subclasses were identified. One quarter of studies (n=39) reported total flavonoids intake with 27% reporting individual flavonoid compounds. Assessing multiple compounds was common with approximately 10% of studies assessing seven (n=13), six (n=12) and five (n=14) subclasses of polyphenol. There was no pattern between reported flavonoids compounds and subclass studied. Approximately 60% of studies relied on publicly accessible food composition data to estimate dietary polyphenols intake with 33% using two or more tools. This review highlights the importance of publicly accessible composition databases for estimating polyphenol intake and provides a reference for tools available globally., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: The trend of added sugar (AS) intake has not been investigated in the Australian population, including in older adults. The present study aimed to assess trends and food sources of AS intake among a cohort of older Australians during 15 years of follow-up., Methods: Dietary data from participants of the Blue Mountains Eye Study (1264 men and 1614 women), aged ≥49 years at baseline, were collected. Dietary intakes were assessed at 5-yearly intervals (1992-94 to 2007-09) using a 145-item food frequency questionnaire (FFQ). AS content of FFQ food items was estimated using a stepwise systematic method. Trends for AS intake between baseline and the three follow-up periods were assessed using linear mixed modelling., Results: In men, the mean (SEM) percentage of energy provided by AS intake (EAS%) declined from 10.4% (0.1%) at baseline to 9.4% (0.2%) at 15-year follow-up (P trend = 0.028). Women's mean (SEM) EAS% intake at baseline and 15-year follow-up was 9.2% (0.1%) and 8.8% (0.2%), respectively (P trend = 0.550). EAS% intake of men was significantly higher than that of women for 10 years (P < 0.05). Sugar products (table sugar, syrup, jam and honey) were the major sources of AS at all-time points and contributed to more than 40% and 35% of AS intake in men and women, respectively. Intake of sugar products decreased in men during follow-up (P trend < 0.001)., Conclusions: An overall downward trend was observed in AS intake in both genders, however, was only significant for men during 15 years of follow-up. Table sugar and sugar-containing spreads represent the major source of AS in this cohort of older Australians., (© 2016 The British Dietetic Association Ltd.)

The importance of monitoring dietary intake within a randomized controlled trial becomes vital to justification of the study outcomes when the study is food-based. A systematic literature review was conducted to determine how dietary assessment methods used to monitor dietary intake are reported and whether assisted technologies are used in conducting such assessments. OVID and ScienceDirect databases 2000-2010 were searched for food-based, parallel, randomized controlled trials conducted with humans using the search terms "clinical trial," "diet$ intervention" AND "diet$ assessment," "diet$ method$," "intake," "diet history," "food record," "food frequency questionnaire," "FFQ," "food diary," "24-hour recall." A total of 1364 abstracts were reviewed and 243 studies identified. The size of the study and country of origin appear to be the two most common predictors of reporting both the dietary assessment method and details of the form of assessment. The journal in which the study is published has no impact. Information technology use may increase in the future allowing other methods and forms of dietary assessment to be used efficiently.

Objective: To develop meal plans using grain-based foods demonstrating how to incorporate wholegrain foods into a balanced diet for weight maintenance for different cuisines. The present study examines the ability of meal plans with ≥4 grain-based servings daily to meet nutrient recommendations using lacto-ovo vegetarian and rice-based cuisines., Design: Eighteen plans from each cuisine for three age brackets for both genders were developed. Plans aimed for ≥4 servings of grain-based foods daily, with separate plans for all wholegrain, all refined-grain and half wholegrain-half refined-grain foods. Meal plans followed an isoenergetic approach and were designed to meet specific Australian nutrient reference values and serving sizes., Results: All plans met the Recommended Dietary Intake or Adequate Intake for targeted nutrients except for Fe in the rice-based meal plan for females aged ≥19 years (17 mg). In the plans for 14-18 year and ≥19 year age groups, four servings of grain-based foods could be accommodated. In the plans for 9-13 years, increasing the number of grain-based food servings to four reduced micronutrients levels delivered by the total diet. Specific food choices were made to ensure nutrient targets were met across each category for wholegrain and refined-grain plans. The major difference in nutrients between wholegrain and refined-grain foods was found in the vegetarian cuisine, where the meal plans containing whole grains produced on average 30 % higher fibre (38-53 g) levels than those with refined grains (27-40 g)., Conclusions: With careful food selection, meal plans with ≥4 servings of grain-based foods daily can meet nutrient reference values for lacto-ovo vegetarian and rice-based cuisines.

Dietary trials may link macronutrient intakes to health outcomes, but adherence to dietary targets requires advice based on an understanding of food composition and consumption patterns. Using data from a weight loss trial, we hypothesized that structured advice would be required for significant fat modification to occur. We compared participants' food choice patterns in response to advice based on a structured "whole-of-diet" model vs a general approach to healthy eating. Overweight participants (n = 122) were randomized to 2 advice arms (saturated fat [SFA] < 10% energy [E]): (1) general low fat (LF) control-(a) isoenergy, (b) -2000 kJ; and (2) structured LF high polyunsaturated fat (PUFA) (∼10% energy PUFA; PUFA to SFA ratio ≥1) (LF-PUFA)-(a) isoenergy, (b) -2000 kJ. Intakes of E and fat and fat from food groups (percentage of total fat intake) were compared at baseline, 3 months, P < .05. Baseline diets were similar, with most fat from high-SFA foods (59%): meat and milk-based staple meals and high-fat snacks. By 3 months, all groups reduced E and met the SFA target. Polyunsaturated fat targets were met by the LF-PUFA groups only (P < .001), enabling targeted between-group differences. In response to general advice, LF groups simply switched to LF alternatives of the same foods (P < .05). In comparison, LF-PUFA groups shifted fat intake to high-PUFA choices (54%), consuming more fat than controls from nuts (P < .001), whole grains (P < .001), and oils and spreads (P < .05). Significant reductions in E were achieved regardless of advice, but significant shifts in dietary fat profile relied on structured whole-of-diet advice on a range of meal and snack food sources of fat subtypes., (Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.)

Background -- An automated dietary assessment website has been developed for patients with metabolic syndrome. Objective -- This study outlines the profile of patients using the website and their rates of completion of the assessment. Design -- Computers have been set up in local GP practices to which the GP may refer their patients. These patients enter their dietary information into the website and receive an individualised dietary prescription put together by a dietitian. Outcomes -- Recruited patients were primarily female (70%). Ranging between 22 and 75 years of age patients reported to be overweight (99%), have high cholesterol concentrations (47%), elevated blood pressure (41%) and/or type 2 diabetes mellitus. Intermediate levels of computer experience were reported with most patients preferring to use the website at home as opposed to in their GP practice. Of the 73 patients recruited 57 completed the entire assessment, 17 allowed their accounts to expire and the remainder had partially completed the assessment. Conclusions -- Results indicated that use of a computer for dietary assessment appears to capture a large proportion of the population who otherwise would not be able or willing to receive face-to-face advice from a dietitian. Such an application is highly useful in the field of nutrition due to the ever increasing rates of overweight and obesity within Australia. [ABSTRACT FROM AUTHOR]