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Objectives: The purpose of this study was to investigate the knowledge and health beliefs regarding osteoporosis risk factors of New Zealand women aged 20-49 years.Design: A descriptive, web-based survey.Subjects: An opportunistic sample of 622 women aged between 20 and 49 years living in Auckland, New Zealand was recruited by email.Results: There was a moderate level of knowledge about osteoporosis risk factors among the women surveyed, with a mean total score for all subjects of 16.4 (standard deviation (SD) 4.0) out of a possible 26 correct responses. Mean scores for osteoporosis knowledge were statistically different by age group, with women aged 40-49 years scoring higher than those aged 30-39 years and 20-29 years (17.3 (SD 4.0), 16.4 (SD 4.1) and 15.8 (SD 3.9), respectively, P<0.001). Overall, about a third of the women perceived that they were likely to develop osteoporosis and 22% believed the disease to be potentially crippling. Most women were aware of the benefits of exercise and optimal calcium nutrition in preventing osteoporosis. Few women perceived barriers to exercise participation and eating calcium-rich foods. Older women (40-49 years) were more motivated to take care of their health than younger women (P<0.001). A large percentage of subjects (77%) thought that calcium-rich foods contained too much cholesterol.Conclusions: Despite reporting higher than average educational attainment and health consciousness, these women demonstrated average levels of knowledge about osteoporosis risk factors. They had low feelings of susceptibility towards development of osteoporosis, but most considered it to be a serious disease. [ABSTRACT FROM AUTHOR]

Abstract Background The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand. Methods/design A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80–90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures - a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples. Discussion A longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined.

Modifying the food environment holds promise for instilling healthier behaviours in children and may be an effective public health strategy for preventing childhood obesity and adverse health outcomes. The school food environment is a valuable setting to influence most children's dietary behaviours from an early age, yet evidence suggests that the New Zealand and Australian school food environment is not conducive to healthy food and drink consumption. The present study aimed to investigate the level of compliance in New Zealand and Australia with government guidelines for food and drink availability within schools and the subsequent effect on food consumption and purchasing behaviours of children. A systematic review utilising three databases; 'PubMed', 'Scopus', and the 'Cochrane Library' was conducted. The research covered peer-reviewed studies from both New Zealand and Australia that met predefined inclusion criteria. Fifteen studies focussed on assessing food availability within schools based on government guidelines, and ten studies explored food purchasing and consumption by students influenced by changes to the school food environment. Results showed low compliance with government healthy food guidelines for schools, and significant socioeconomic disparities. Western Australia's clear targets as well as the mandatory monitoring systems in place stand out as being a significant enabler of greater compliance with government food policies. Interventions aimed at improving healthy food availability and promoting healthy options in the canteen may positively influence student purchasing and consumption habits. Strategies such as feedback models and incentivisation hold promise for promoting healthier school environments and influencing children's food choices.

Habitual dietary intakes and nutrition behaviours developed during childhood and adolescence pave the way for similar behaviours to manifest in adulthood. Childhood obesity rates have now reached a point where one in six children globally are classified as overweight or obese. Schools have the unique ability to reach almost all children during key developmental stages, making them an ideal setting for influencing children's nutrition behaviours. Evidence suggests the school food environment is not always conducive to healthy food choices and may be obesogenic. The aim of this narrative review is to explore factors that influence the healthy food and drink environment in and around schools in New Zealand. The review focused on evidence from New Zealand and Australia given the close resemblance in education systems and school food guidance. Using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework, the school food environment was categorised into the following domains: economic, political, physical and socio-cultural factors. Findings suggest that food policies are not utilised within schools, and guidelines to improve the school food environment are not well implemented. Canteen profit models, lack of staff support and resources, and higher availability of low-cost unhealthy foods are among barriers that hinder implementation. This review highlights recommendations from existing evidence, including canteen pricing strategies, restriction of unhealthy foods and using peer modelling in a time-scarce curriculum to improve the school food environment. Key areas for improvement, opportunities to enhance policy implementation and untapped avenues to improve the food and nutrition behaviours of children are highlighted.

Objective: To determine the nutrition risk prevalence and associated health and social risk factors amongst community-living Māori and non-Māori older adults in New Zealand., Methods: As part of the 2014 Health, Work and Retirement postal survey, 2914 community-living older adults (749 Māori) aged 49-87 years completed the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN II-AB) to determine nutrition risk status and sociodemographic and health measures., Results: Half (50.2%) of Māori and 32.7% of non-Māori were at nutrition risk. Independent risk factors were as follows: for Māori, being unpartnered and rating general health as fair, and for non-Māori, being unpartnered and rating general health as fair or poor, lower life satisfaction, higher number of health conditions and emotional loneliness., Conclusions: Findings highlight the need for culturally appropriate intervention strategies, which provide opportunity for older adults to eat with others, especially for those who are unpartnered and lonely., (© 2021 AJA Inc.)

Objectives: To investigate the association between domains of nutrition risk with hospitalisations and mortality for New Zealand Māori and non-Māori in advanced age., Methods: Within LiLACS NZ, 256 Māori and 399 non-Māori octogenarians were assessed for nutrition risk using the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN II) questionnaire according to three domains of risk. Sociodemographic and health characteristics were established. Five years from inception, survival analyses examined associations between nutrition risk from the three domains of SCREEN II with all-cause hospital admissions and mortality., Results: For Māori but not non-Māori, lower nutrition risk in the Dietary Intake domain was associated with reduced hospitalisations and mortality (Hazard Ratios [HR] [95%CI] 0.97 [0.95-0.99], p=0.009 and 0.91 [0.86-0.98], p=0.005, respectively). The 'Factors Affecting Intake' domain was associated with mortality (HR, [95%CI] 0.94 [0.89-1.00], p=0.048), adjusted for age, gender, socioeconomic deprivation, education, previous hospital admissions, comorbidities and activities of daily living., Conclusion: Improved dietary adequacy may reduce poor outcomes for older Māori. Implications for public health: Nutrition risk among older Māori is identifiable and treatable. Effort is needed to engage relevant community and whānau (family) support to ensure older Māori have food security and cultural food practices are met., (© 2018 The Authors.)

Objectives: To establish the prevalence of high nutrition risk and associated health and social risk factors for New Zealand Māori and non-Māori in advanced age., Design: A cross sectional analysis of inception cohorts to LiLACS NZ., Setting: Bay of Plenty and Lakes region of the North Island, New Zealand., Participants: 255 Māori and 400 non- Māori octogenarians., Measurements: Nutrition risk was assessed using a validated questionnaire Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN II). Demographic, social, physical and health characteristics were established using an interviewer administered questionnaire. Health related quality of life (HRQOL) was assessed with the SF-12, depressive symptoms using the GDS-15., Results: Half (49%) of Māori and 38% of non-Māori participants were at high nutrition risk (SCREEN II score <49). Independent risk factors were for Māori younger age (p=0.04), lower education (p=0.03), living alone (p<0.001), depressive symptoms (p=0.01). For non- Māori high nutrition risk was associated with female gender (p=0.005), living alone (p=0.002), a lower physical health related quality of life (p=0.02) and depressive symptoms (p=0.002)., Conclusion: Traditional risk factors apply to both Māori and non-Māori whilst education as indicative of low socioeconomic status is an additional risk factor for Māori. High nutrition risk impacts health related quality of life for non-Māori. Interventions which socially facilitate eating are especially important for women and for Māori to maintain cultural practices and could be initiated by routine screening.

Objectives: To determine the nutrition risk status and factors associated with nutrition risk among older adults enrolled in the Brief Risk Identification Geriatric Health Tool (BRIGHT Trial)., Design: A cluster randomised controlled trial., Setting: Three main centres in New Zealand., Participants: A total of 3,893 older adults were recruited from 60 general practices in three of the District Health Board (DHB) regions aged 75 years and older (or 65 years and older if Māori)., Measurements: Nutrition risk was assessed using the Australian Nutrition Screening Initiative (ANSI). Validated questionnaires were used to establish quality of life (WHOQOL-BREF), physical function (the Nottingham Extended Activities of Daily Living) and depressive symptoms (15 item Geriatric Depression Scale). Demographic, standard of living and health data were established., Results: Sixty two percent of participants were identified to be at moderate or high nutrition risk. The mean ANSI score was 4.9 (range 0-21, maximum 29). Factors which independently predicted moderate or high nutrition risk were female gender, being Māori and other ethnicities versus European, not being married, taking multiple medications, having more depressive symptoms, cardiovascular disease and diabetes. Protective factors independently related to low nutrition risk were living with others, higher physical and social health related QOL and higher functional status. WHOQOL environmental and psychological factors were not associated with nutrition risk when other predictive factors were taken into account., Conclusion: Nearly two thirds of participants were identified to be at higher nutrition risk. Women, living alone, taking multiple medications, with depressive symptoms, cardiovascular disease and ndiabetes were factors associated with higher nutrition risk. Those at low nutrition risk had a better functional status and physical and social health related QOL.

Objective: To determine the validity of the nutrition screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II' (SCREEN II) among a purposive sample of octogenarians., Design: Cross-sectional validation study., Setting: Bay of Plenty, New Zealand., Participants: Forty-five community-living residents aged 85-86 years. Equal proportions of participants were recruited at low, medium and high nutrition risk based on their SCREEN II score 12 months prior., Measurements: Nutrition risk was assessed using SCREEN II. Demographic and health data were established. Using established criterion a dietitian's nutrition risk rating assessment ranked participants from low risk (score of 1) to high risk (score of 10). The assessment included a medical history, anthropometric measures and dietary intake. Dietary intake was established from three 24 hour multiple pass recalls (MPR). A Spearman's correlation determined the association between the SCREEN II score and the dietitian's risk score. Receiver operating characteristic (ROC) curves were completed to determine the sensitivity and specificity of the cut-off point for high nutrition risk., Results: The SCREEN II score was significantly correlated with the dietitian's risk rating (rs = -0.76 (p<0.01). A newly defined cut-off point <49 was established for high nutrition risk derived from ROC curves and AUC (0.87, p < 0.01); sensitivity 90% and specificity 86%., Conclusion: SCREEN II is a simple, easy to use, 14 item questionnaire and appears to be a valid tool for detection of nutrition risk people aged 85-86 years.

Objectives: To identify factors associated with nutrition risk among a purposive sample of those in advanced aged., Design: A cross sectional feasibility study., Setting: Three North Island locations in New Zealand., Participants: One hundred and eight community-living residents aged 75- 85 years., Measurements: Nutrition risk was assessed using a validated questionnaire, Seniors in the Community: Risk Evaluation for Eating and Nutrition, Version II (SCREEN II). A Physical Activity Scale for the Elderly (PASE) was used to determine level of physical activity. Markers of body composition, grip strength and fasting blood samples were collected., Results: Fifty-two percent of participants were at high nutrition risk (SCREEN II score < 50; range 29-58; out of maximum score 64). The mean score for SCREEN II was higher for older people who lived with others (50.3 ± 5.1) compared to those who lived alone (46.4 ± 5.8) p=0.001. The SCREEN II score was positively correlated with the total PASE score r= 0.20 (p=0.042), grip strength r=0.20 (p=0.041), and muscle mass percentage r=0.31 (p=0.004). Lower levels of haemoglobin, serum zinc and physical activity were associated with higher nutrition risk., Conclusion: Half the participants were at high nutrition risk. They tended to be widowed or live alone and had lower levels of haemoglobin and serum zinc. Those at lower nutrition risk had greater muscle mass and strength, lower body fat, consumed alcohol more frequently and engaged in more physical activity. Strategies which encourage older people to eat meals and be physically active with others may assist to improve their health.

Aim: To assess a nutrition risk screening tool amongst Maori and non-Maori of advanced age., Method: A cross sectional feasibility study was conducted in three North Island locations. One hundred and eight community-living residents aged 75- 85 years were assessed for nutrition risk using 'the validated questionnaire 'Seniors in the Community: Risk Evaluation for Eating and Nutrition', Version II (SCREENII) and level of physical activity using the 'Physical Activity Scale for the Elderly' (PASE). Physical assessments included height and weight., Results: Fifty-two percent of participants were assessed to be at high nutrition risk (SCREENII score <50; range 29-58; out of maximum score 64). Nutrition risk factors amongst Maori and non-Maori respectively differed for weight change in the previous six months (45.2% and 18.7%, p=0.005), skipping meals (54.8% and 13.3%, p<0.001), fruit and vegetable intake (77.4% and 18.7%, p<0.001) and the use of meal replacements (28.1% and 9.3%, p=0.013). Process evaluation showed that Maori took different meaning from the individual question items in SCREENII. Level of physical activity (PASE score) was higher for Maori, median (IQR): 125 (74) than non-Maori, 72 (74) (p<0.001) especially for leisure-time and household related activity. BMI was higher for Maori median (IQR): 31.5 kg/m2 (6.8) compared to non-Maori 24.7 kg/m2 (5.4) (p<0.001)., Conclusions: The nutrition risk tool suggested that Maori were at high risk for malnutrition despite higher BMI and higher levels of activity. Several items of the screening tool were interpreted differently among Maori compared to non-Maori. Further development is needed to ensure accurate assessment.