Danielle Baird

Combined Home and School Obesity Prevention Interventions for Children What Behavior Change Strategies and Intervention Characteristics Are Associated With Effectiveness

This review identifies studies describing interventions delivered across both the home and school/community setting, which target obesity and weight-related nutrition and physical activity behaviors in children. Fifteen studies, published between 1998 and 2010, were included and evaluated for effectiveness, study quality, nutrition/activity content, behavior change techniques, and theoretical basis, using validated assessment tools/taxonomies. Seven studies were rated as effective. Behavior change techniques used to engage families, and techniques associated with intervention effectiveness were coded. Effective studies used about 10 behavior change techniques, compared with 6.5 in ineffective studies. Effective interventions used techniques including providing general information on behavior–health links, prompting practice of behavior, and planning for social support/social changes. Different behavior change techniques were applied in the home and school setting. The findings of this review provide novel insights into the techniques associated with intervention effectiveness that can inform the development of public health obesity prevention strategies.

Improving children's dairy food and calcium intake: can intervention work? A systematic review of the literature

OBJECTIVE Strategies are needed to address the shortfall in childrens dairy food and Ca intakes. The present review identified interventions targeting an increase in childrens dairy food or Ca intakes, and determined characteristics associated with successful intervention. DESIGN A systematic literature search identified fourteen intervention studies, published in English, between 1990 and 2010. Studies were evaluated for study population, setting and mode of delivery, dietary targets and outcome measures, measures of intervention intensity, intervention description, the use of behaviour change techniques and intervention effectiveness. SETTING Interventions targeting an increase in dairy food or Ca intake. SUBJECTS Children aged 5-12 years. RESULTS Ten of the fourteen studies were considered to be effective. Studies focusing on encouraging intake of dairy foods or Ca alone were all effective, compared with 55 % of studies promoting dairy within the context of a healthy diet. Effective interventions tended to be higher in intensity, provide dairy foods and were delivered across a variety of settings to a range of primary targets. The number of behaviour change techniques used did not differentiate effective and ineffective interventions, but the use of taste exposure and prompting practice appeared to be important for effective intervention. CONCLUSIONS Interventions that target an increase in childrens dairy food or Ca intake could potentially increase childrens dairy food intake by about one serving daily. Research conducted outside the USA is needed. The review has identified some promising strategies likely to be part of effective interventions for improving dairy and Ca intakes in countries where childrens intake is insufficient.

Strategies to increase children's vegetable intake in home and community settings: a systematic review of literature

A systematic review was undertaken to identify intervention characteristics associated with increasing consumption of vegetables in children (2-12 years). PubMed, PsychINFO and CABabstracts were used to identify studies published between 2004-2014 that had measures of vegetable consumption, a minimum of 3-month follow-up and were conducted in home and community settings (outside of schools). Twenty-two studies were included in the review. Details of the study design, population, setting, intervention characteristics, target behaviour, behaviour change techniques used and vegetable intake were extracted. Study quality and intensity were scored. Overall, 12/22 studies were effective short-term, and 6/10 were effective long-term (6 + months); mean short-term change in vegetable intake was 29%, equating to an increase of a quarter to a half of a serving of vegetables. Intervention effectiveness was associated with number of settings targeted and frequency of contact but not length of intervention. Planning for social support, vegetable exposure and provision of staff training were commonly used behaviour change techniques in effective interventions. This review has identified strategies that may optimise effectiveness of future home-based and community-based interventions aiming to increase vegetable intake in young children.

Overconsumption of Energy and Excessive Discretionary Food Intake Inflates Dietary Greenhouse Gas Emissions in Australia.

Population dietary guidelines have started to include information about the environmental impacts of food choices, but more quantifiable evidence is needed, particularly about the impacts associated with discretionary foods. This paper utilised the 2011–2012 Australian Health Survey food intake data along with a highly disaggregated input–output model to estimate the greenhouse gas emissions (GHGe) of Australians’ dietary intake, and compare current patterns of eating which vary in diet quality and GHGe to the recommended diet. The average dietary GHGe were 18.72 ± 12.06 and 13.73 ± 8.72 kg CO2e/day for male and female adults, respectively. The correlation between total energy and GHGe was r = 0.54 (p < 0.001). Core foods contributed 68.4% and discretionary foods 29.4%. Within core foods, fresh meat and alternatives (33.9%) was the greatest contributor. The modelling of current dietary patterns showed the contribution of discretionary foods to GHGe was 121% greater in the average diet and 307% greater in the “lower quality, higher GHGe” diet compared to the recommended diet. Reducing discretionary food intake would allow for small increases in emissions from core foods (in particular vegetables, dairy and grains), thereby providing a nutritional benefit at little environmental expense. Public health messages that promote healthy eating, eating to one’s energy needs and improved diet quality will also contribute to lowering GHGe.

Consumption of beef/veal/lamb in Australian children: Intake, nutrient contribution and comparison with other meat, poultry and fish categories

Aim To describe reported consumption of meat for children using the 2007 Australian National Childrens Nutrition and Physical Activity Survey. Methods One-day, weighted data are described for consumption of meat, poultry and fish consumed as ‘cuts’ and from mixed dishes. Data are presented for all children by age groups (2–3 years, 4–8 years, 9–13years, 14–16 years) and gender. Trimming practices, time and place of consumption, and nutrient contributions are described. Results Ninety per cent of children reported consuming meat, poultry or fish on the day surveyed. Reported mean consumption of all beef/veal/lamb, pork/ham/bacon, poultry and fish ranged from 52 g in 2 to 3-year-old boys to 161 g in 14 to 16-year-old boys; and was lower in 9 to 16-year-olds girls; 98 g. Mean reported consumption of beef/veal/lamb was 21–64 g for boys and 23–36 g for girls, depending on age group. For meals where the meat, poultry or fish were identified individually, meals with beef/veal/lamb contained more vegetables (159 g) than pork/ham/bacon (50 g) and poultry (110 g). The beef/veal/lamb was fully (20%) or semi-trimmed (58%), and 49% of minced beef/veal/lamb was lean. Sixty-eight per cent of respondents reported eating poultry with the skin removed. Across all age groups, beef/veal/lamb in cuts and mixed dishes contributed 4% of total energy, 6% of total fat, 5% of saturated fat, 46% of haem iron, 18% of zinc and 21% of long-chain omega-3 fatty acid intake. Conclusions These findings help to inform evidence-based individual or population-level recommendations.

The CSIRO Healthy Diet Score: An Online Survey to Estimate Compliance with the Australian Dietary Guidelines

There are few dietary assessment tools that are scientifically developed and freely available online. The Commonwealth Scientific and Industrial Research Organisation (CSIRO) Healthy Diet Score survey asks questions about the quantity, quality, and variety of foods consumed. On completion, individuals receive a personalised Diet Score—reflecting their overall compliance with the Australian Dietary Guidelines. Over 145,000 Australians have completed the survey since it was launched in May 2015. The average Diet Score was 58.8 out of a possible 100 (SD = 12.9). Women scored higher than men; older adults higher than younger adults; and normal weight adults higher than obese adults. It was most common to receive feedback about discretionary foods (73.8% of the sample), followed by dairy foods (55.5%) and healthy fats (47.0%). Results suggest that Australians’ diets are not consistent with the recommendations in the guidelines. The combination of using technology and providing the tool free of charge has attracted a lot of traffic to the website, providing valuable insights into what Australians’ report to be eating. The use of technology has also enhanced the user experience, with individuals receiving immediate and personalised feedback. This survey tool will be useful to monitor population diet quality and understand the degree to Australians’ diets comply with dietary guidelines.

Changes in Food Intake in Australia: Comparing the 1995 and 2011 National Nutrition Survey Results Disaggregated into Basic Foods

As nations seek to address obesity and diet-related chronic disease, understanding shifts in food intake over time is an imperative. However, quantifying intake of basic foods is not straightforward because of the diversity of raw and cooked wholefoods, processed foods and mixed dishes actually consumed. In this study, data from the Australian national nutrition surveys of 1995 and 2011, each involving more than 12,000 individuals and covering more than 4500 separate foods, were coherently disaggregated into basic foods, with cooking and processing factors applied where necessary. Although Australians are generally not eating in a manner consistent with national dietary guidelines, there have been several positive changes. Australians are eating more whole fruit, a greater diversity of vegetables, more beans, peas and pulses, less refined sugar, and they have increased their preference for brown and wholegrain cereals. Adult Australians have also increased their intake of nuts and seeds. Fruit juice consumption markedly declined, especially for younger Australians. Cocoa consumption increased and shifts in dairy product intake were mixed, reflecting one of several important differences between age and gender cohorts. This study sets the context for more detailed research at the level of specific foods to understand individual and household differences.

Australia’s nutritional food balance: situation, outlook and policy implications

Australia is a food trading nation with a complex food system. Change can have important implications for rural communities, employment, trade, public health nutrition and food security. This study compares Australian food intake scenarios to 2050 with linear projections for Australian agricultural production. The study is distinguished by its nutritional perspective, characterising food balance in terms of basic foods rather than food energy or macronutrients, as well as its systems perspective, taking into account the transformations that occur in food processing and cooking, livestock feed requirements, as well as supply chain and kitchen losses. With Australia’s population projected to increase from around 23 million in 2015 to 37.5 million in 2050, substantial increases in domestic food supply will be required. Although the situation and outlook differ for each commodity, in most respects demand is projected to increase at a greater rate than local production. This suggests that the Australian food system is on a trajectory toward reduced net food exports and increased dependence on imports. This will have implications for Australia’s role in the global food system and presents a change in some of the determinants of national food security. The trajectory of the food system also appears to be at odds with the massive public health challenges associated with diet related disease. These and other implications of an enlarging and increasingly international food system are discussed.

Dairy food at the first occasion of eating is important for total dairy food intake for Australian children.

The cross-sectional 2007 Australian National Children’s Nutrition and Physical Activity Survey collected detailed dietary information from a representative sample of more than 4400 children by 24-h dietary recall. Dairy food intake by Australian children is substantially lower than recommendations, and decreases as a percentage of energy intake as children grow older. Children aged 2 to 16 years are, on average, 2.3 times more likely to have a dairy food at the first daily occasion of eating, than at the second occasion. For children who consumed any dairy food at the first occasion of eating, the total daily intake of dairy foods was 129% (95% CI 120%–138%) greater than for children who did not consume a dairy food at the first occasion of eating. Their dairy food intake for the rest of the day following the first occasion of eating was also greater by 29% (95% CI 21%–37%). Younger age group, male sex, location of eating being at home or in a residence and starting the first occasion of eating from 6 a.m. to 9 a.m. are all jointly associated with having a dairy food at the first occasion of eating. A simple strategy to increase Australian children’s intake from the dairy and alternatives food group may be to make sure that the first occasion of eating each day includes a dairy food or a nutritional equivalent.

Short communication: a food-systems approach to assessing dairy product waste.

Concern about world population increase, food security, and the environmental burdens of food production have made food-waste reduction a social and environmental priority. In this context, the quantification of dairy product waste is especially difficult due to the varied means of disposal, by solid and liquid waste streams, and due to inclusion as an ingredient in many processed foods. In this study, food intake data from the Australian National Nutrition Survey (>13,000 participants; >4,500 food items) were disaggregated into basic foods and total national dairy product intake was expressed in whole-milk equivalents. This result was compared with total domestic milk supply, indicating a level of waste of 29% for dairy products in the Australian food system. With national food-waste reduction targets becoming increasingly common, reliable estimates of food waste at the national scale are important for goal setting, baseline reporting, and performance monitoring. For this purpose, the systems approach to assessing food waste demonstrated in this project is deemed to have advantages over other common methods of food-waste assessment, such as bin audits, waste diaries, and surveys.