Kim Colyvas

Validation of Overweight Children's Fruit and Vegetable Intake Using Plasma Carotenoids

Assessing dietary intake in children is difficult and limited validated tools exist. Plasma carotenoids are nutritional biomarkers of fruit and vegetable intake and therefore suitable to validate reported dietary intakes. The aim of this study was to examine the comparative validity of a food frequency questionnaire (FFQ), completed by parents reporting child fruit and vegetable intake compared to plasma carotenoid concentrations. A sample of children aged 5–12 years (n = 93) from a range of weight categories were assessed. Dietary intake was measured using a 137‐item semi‐quantitative FFQ. Plasma carotenoids were measured using reverse phase high‐performance liquid chromatography. Pearson correlation coefficients between reported dietary intake of carotenoids and plasma carotenoid concentrations were strongest after adjustment for BMI (β‐carotene (r = 0.56, P < 0.05), α‐carotene (r = 0.51, P < 0.001), cryptoxanthin (r = 0.32, P < 0.001)). Significantly lower levels (P < 0.05) of all plasma carotenoids, except lutein, were found among overweight and obese children when compared to healthy weight children. Parental report of childrens carotenoid intakes, using a FFQ can be used to provide a relative validation of fruit and vegetable intake. The lower plasma carotenoid concentrations found in overweight and obese children requires further investigation.

Multi-site randomized controlled trial of a child-centered physical activity program, a parent-centered dietary-modification program, or both in overweight children: the HIKCUPS study

OBJECTIVE To evaluate whether a child-centered physical activity program, combined with a parent-centered dietary program, was more efficacious than each treatment alone, in preventing unhealthy weight-gain in overweight children. STUDY DESIGN An assessor-blinded randomized controlled trial involving 165 overweight/obese 5.5- to 9.9- year-old children. Participants were randomly assigned to 1 of 3 interventions: a parent-centered dietary program (Diet); a child-centered physical activity program (Activity); or a combination of both (Diet+Activity). All groups received 10 weekly face-to-face sessions followed by 3 monthly relapse-prevention phone calls. Analysis was by intention-to-treat. The primary outcome was change in body mass index z-score at 6 and 12 months (n=114 and 106, respectively). RESULTS Body mass index z-scores were reduced at 12-months in all groups, with the Diet (mean [95% confidence interval]) (-0.39 [-0.51 to 0.27]) and Diet + Activity (-0.32, [-0.36, -0.23]) groups showing a greater reduction than the Activity group (-0.17 [-0.28, -0.06]) (P=.02). Changes in other outcomes (waist circumference and metabolic profile) were not statistically significant among groups. CONCLUSION Relative body weight decreased at 6 months and was sustained at 12 months through treatment with a child-centered physical activity program, a parent-centered dietary program, or both. The greatest effect was achieved when a parent-centered dietary component was included.

Movement skills and physical activity in obese children: randomized controlled trial

PURPOSE The purpose of this study was to evaluate the Hunter Illawarra Kids Challenge Using Parent Support physical activity program in overweight children. METHODS A multisite randomized controlled trial was conducted with three intervention arms: 1) child-centered physical activity skill development program (Activity), 2) parent-centered dietary modification program (DIET), or 3) both programs combined (PA+DIET). Movement skill proficiency, perceived athletic competence, accelerometer-assessed physical activity, and parent-reported time spent in screen behaviors were assessed at baseline, 6 months, and 12 months in 165 prepubertal children aged 5.5-9 yr (59% girls, 78% obese). Differences in changes in outcomes between groups were assessed using linear mixed models. RESULTS Compared with the diet group, the activity group (mean (95% confidence interval): +7.7 units (3.8-11.6 units)) and the activity + diet group (+6.7 units (2.9-10.5 units)) displayed 11%-13% greater improvement in overall movement skill proficiency (gross motor quotient) at 6 months. Perceived athletic competence increased across groups at follow-up (across groups: 6 months = +0.21 units (0.11-0.31 units), 12 months = +0.21 units (0.07-0.35 units)). Groups did not differ statistically for change in physical activity outcomes. Total screen time (min·wk(-1)) decreased in all groups at 6 months (across groups: -385.4 (-501.0 to -269.8)) and in the activity group (-261.8 (-470.5 to -53.1)) and activity + diet group (-340.5 (-534.6 to -146.4)) at 12 months. The diet group reported greater reductions in TV or DVD viewing time at 6 months compared with the activity group (248.6 (24.0-473.3)). CONCLUSIONS The activity and the activity + diet programs were efficacious in improving overweight childrens movement skill proficiency. All programs were efficacious in reducing time spent in screen behaviors. Other correlates may need to be targeted in addition to movement skills to increase physical activity among overweight children.

Children and adolescents on intensive insulin therapy maintain postprandial glycaemic control without precise carbohydrate counting

Aims  Carbohydrate (CHO) quantification is used to adjust pre‐meal insulin in intensive insulin regimens. However, the precision in CHO quantification required to maintain postprandial glycaemic control is unknown. We determined the effect of a ±10‐g variation in CHO amount, with an individually calculated insulin dose for 60 g CHO, on postprandial glycaemic control.

Clinical outcomes associated with depression, anxiety and social support among cardiac rehabilitation attendees

Objective: To utilize existing medical record information in order to examine the relationship between depression, anxiety, levels of social support and clinical outcomes in cardiac rehabilitation attendees. Method: In a tertiary care centre 389 records for cardiac rehabilitation outpatients were analysed. Hospital Anxiety and Depression Scales scores collected at week 4 of their cardiac rehabilitation programme were linked with medical record information on demographic, lifestyle, medical and other coronary heart disease risk factors, as well as follow-up cardiovascular events and readmissions for an average of 2.6 years. Variables of interest were anxiety and depression scores and proxy measures of social support. Clinical outcome measures were number of hospital admissions, length of stay and mortality. Results: Multiple variable analysis revealed higher anxiety scores were associated with more hospital admissions and higher depression scores were associated with longer length of stay after controlling for other established prognostic risk factors. Depression, anxiety and social support were not associated with mortality, however there was a low mortality rate in the present study. Conclusion: A comprehensive summary of the characteristics of cardiac rehabilitation patients was gathered through the linkage and examination of existing clinical databases. The results of this study provide some support for a prognostic role of depressive and anxiety symptoms and highlight the need for screening for psychological distress and provision of appropriate interventions when indicated.

IGF1 is a modifier of disease risk in hereditary non-polyposis colorectal cancer.

Patients diagnosed with HNPCC harbouring a confirmed germline mutation in DNA mismatch repair (MMR) genes have an 80% lifetime risk of developing an epithelial malignancy. There is, however, considerable variation in the age of disease onset in these patients. Insulin‐like growth factor‐I (IGFI) has been implicated in colorectal cancer (CRC), and elevated plasma IGFI levels are associated with both sporadic and hereditary CRC risk. In this study, we further investigate the cytosine‐adenine (CA) dinucleotide repeat polymorphism located near the promoter region of IGF1 and its relation to early onset CRC risk in 443 Australian and Polish MMR gene mutation carriers using DNA sequencing, Kaplan‐Meier survival curves and Cox proportional hazard regression analysis. A significantly smaller number of IGF1 CA repeats was observed in the Polish patient population, which was associated with an earlier age of disease onset compared to the Australian patients. The threshold for the observed modifying effect was again shown to be in patients with 17 or less CA repeats compared to those with 18 or more. Furthermore, when MMR mutation group (i.e., MLH1 or MSH2), gender and family clustering were included in the final Cox model we observed a more robust trend for the role of the IGF1 CA repeat in predicting age of disease onset in HNPCC patients. In addition, this effect was shown to be equal in both MLH1 and MSH2 mutation carrier groups and not restricted to a particular MMR subgroup (p = 0.001). We conclude that the IGF1 CA repeat is an important modifier of disease onset in HNPCC and the first polymorphism to yield consistent results across different populations.

Global participation in sport and leisure-time physical activities: a systematic review and meta-analysis.

This review aimed to determine the most popular physical activities performed by children, adolescents, and adults globally. Statistic bureau websites and article databases Scopus, ProQuest, SPORTDiscus, and Science Direct were searched between November 17th, 2014 and April 31st, 2015. Eligible studies were published in the last 10years with participation rates for specific physical activities among individuals five years or older. Data extraction for included articles (n=64) was assessed independently and agreed upon by two authors. A random-effects model was used to calculate participation rates in specific activities for each age group and region. In total 73,304 articles were retrieved and 64 articles representing 47 countries were included in the final meta-analysis. Among adults, walking was the most popular activity in the Americas (18.9%; 95% CI 10.2 to 32.5), Eastern Mediterranean (15.0%; 95% CI 5.8 to 33.6), Southeast Asia (39.3%; 95% CI 0.9 to 98.0) and Western Pacific (41.8%; 95% CI 25.2 to 60.6). In Europe and Africa, soccer (10.0%; 95% CI 6.5 to 15.1) and running (9.3%; 95% CI 0.9 to 53.9), respectively, were top activities. Child and adolescent participation results were highly dependent upon region. American youth team sport participation was high, while youth from the Eastern Mediterranean and Western Pacific were more likely to report participation in lifelong physical activities. Global data for adults reflects a consistent pattern of participation in running and walking. Among all age groups and regions soccer was popular. In children and adolescents, preferences were variable between regions.

Impact of a postdischarge smoking cessation intervention for smokers admitted to an inpatient psychiatric facility: A randomized controlled trial

INTRODUCTION Persons with a mental disorder smoke at higher rates and suffer disproportionate tobacco-related burden compared with the general population. The aim of this study was to determine if a smoking cessation intervention initiated during a psychiatric hospitalization and continued postdischarge was effective in reducing smoking behaviors among persons with a mental disorder. METHODS A randomized controlled trial was conducted at an Australian inpatient psychiatric facility. Participants were 205 patient smokers allocated to a treatment as usual control (n = 101) or a smoking cessation intervention (n = 104) incorporating psychosocial and pharmacological support for 4 months postdischarge. Follow-up assessments were conducted at 1 week, 2, 4, and 6 months postdischarge and included abstinence from cigarettes, quit attempts, daily cigarette consumption, and nicotine dependence. RESULTS Rates of continuous and 7-day point prevalence abstinence did not differ between treatment conditions at the 6-month follow-up; however, point prevalence abstinence was significantly higher for intervention (11.5%) compared with control (2%) participants at 4 months (OR = 6.46, p = .01). Participants in the intervention condition reported significantly more quit attempts (F[1, 202.5] = 15.23, p = .0001), lower daily cigarette consumption (F[4, 586] = 6.5, p < .001), and lower levels of nicotine dependence (F[3, 406] = 8.5, p < .0001) compared with controls at all follow-up assessments. CONCLUSIONS Postdischarge cessation support was effective in encouraging quit attempts and reducing cigarette consumption up to 6 months postdischarge. Additional support strategies are required to facilitate longer-term cessation benefits for smokers with a mental disorder.

Crop yield components – photoassimilate supply- or utilisation limited-organ development?

Yield potential is the genome-encoded capacity of a crop species to generate yield in an optimal growth environment. Ninety per cent of plant biomass is derived from the photosynthetic reduction of carbon dioxide to organic carbon (photoassimilates - primarily sucrose). Thus, development of yield components (organ numbers and individual organ masses) can be limited by photoassimilate supply (photosynthesis arranged in series with phloem transport) or by their inherent capacity to utilise imported photoassimilates for growth or storage. To this end, photoassimilate supply/utilisation of crop yield has been quantitatively re-evaluated using published responses of yield components to elevated carbon dioxide concentrations across a selection of key crop species including cereal and pulse grains, fleshy fruits, tubers and sugar storing stems and tap roots. The analysis demonstrates that development of harvested organ numbers is strongly limited by photoassimilate supply. Vegetative branching and, to a lesser extent, flower/pod/fleshy fruit abortion, are the major yield components contributing to sensitivity of organ numbers to photoassimilate supply. In contrast, harvested organ size is partially dependent (eudicots), or completely independent (cereals), of photoassimilate supply. Processes limiting photoassimilate utilisation by harvested organs include membrane transport of soluble sugars and their allocation into polymeric storage products.

Propositional Idea Density in women's written language over the lifespan: Computerized analysis

The informativeness of written language, as measured by Propositional Idea Density (PD), has been shown to be a sensitive predictive index of language decline with age and dementia in previous research. The present study investigated the influence of age and education on the written language of three large cohorts of women from the general community, born between 1973 and 1978, 1946-51 and 1921-26. Written texts were obtained from the Australian Longitudinal Study on Womens Health in which participants were invited to respond to an open-ended question about their health. The informativeness of written comments of 10 words or more (90% of the total number of comments) was analyzed using the Computerized Propositional Idea Density Rater 3 (CPIDR-3). Over 2.5 million words used in 37,705 written responses from 19,512 respondents were analyzed. Based on a linear mixed model approach to statistical analysis with adjustment for several factors including number of comments per respondent and number of words per comment, a small but statistically significant effect of age was identified for the older cohort with mean age 78 years. The mean PD per word for this cohort was lower than the younger and mid-aged cohorts with mean age 27 and 53 years respectively, with mean reduction in PD 95% confidence interval (CI) of .006 (.003, .008) and .009 (.008, .011) respectively. This suggests that PD for this population of women was relatively more stable over the adult lifespan than has been reported previously even in late old age. There was no statistically significant effect of education level. Computerized analyses were found to greatly facilitate the study of informativeness of this large corpus of written language. Directions for further research are discussed in relation to the need for extended investigation of the variability of the measure for potential application to the identification of acquired language pathologies.