Describing socioeconomic gradients in children\u27s diets - does the socioeconomic indicators used matter?

Background:&nbsp;Children of low socioeconomic position (SEP) generally have poorer diets than children of high SEP.&nbsp;However there is no consensus on which SEP variable is most indicative of SEP differences in children&rsquo;s diets. This&nbsp;study investigated associations between diet and various SEP indicators among children aged 9&ndash;13 years.Method: Families (n = 625) were recruited from 27 Adelaide primary schools in 2010. Children completed&nbsp;semi-quantitative food frequency questionnaires providing intake scores for fruit, vegetables, non-core foods,&nbsp;sweetened drinks, and healthy and unhealthy eating behaviours. Parents reported demographic information by&nbsp;telephone interview. Differences in dietary intake scores were compared across parental education, income, occupation,&nbsp;employment status and home postcode.Results: Across most SEP indicators, lower SEP was associated with poorer dietary outcomes, including higher intake&nbsp;of non-core foods and sweetened drinks, and more unhealthy behaviours; and lower intake of fruit and vegetables,&nbsp;and fewer healthy behaviours. The number and type of significant SEP-diet associations differed across SEP indicators&nbsp;and dietary outcomes. Mother&rsquo;s education appeared most frequently as a predictor of children&rsquo;s dietary intake, and&nbsp;postcode was the least frequent predictor of children&rsquo;s dietary intake.Conclusion: Socioeconomic gradients in children&rsquo;s dietary intake varied according to the SEP indicator used,&nbsp;suggesting indicator-specific pathways of influence on children&rsquo;s dietary intake. Researchers should consider multiple&nbsp;indicators when defining SEP in relation to children&rsquo;s eating.</div

People with schizophrenia and depression have a low omega-3 index

Cardiovascular disease (CVD) is higher in people with mental illness and is associated with a 30 year higher mortality rate in this population. Erythrocyte docosahexaenoic acid (DHA) plus eicosapentaenoic acid (EPA) (omega-3 index)≤4% is a marker for increased mortality risk from CVD while \u3e8% is protective. Omega-3 polyunsaturated fatty acids are also important for brain function and may ameliorate symptoms of mental illness. We investigated the erythrocyte omega-3 index in people with mental illness. One hundred and thirty adults aged 18-65 years (32.6% male) with schizophrenia (n=14) and depression (n=116) provided blood samples and completed physiological assessments and questionnaires. Both populations had risk factors for metabolic syndrome and CVD. The average omega-3 index was 3.95% (SD=1.06), compared to an estimated 5% in the Australian population. These data indicate an unfavourable omega-3 profile in people with mental illness that could contribute to higher CVD risk

Development of an initiatives package to increase children’s vegetable intake in long day care centres using the Multiphase Optimisation Strategy (MOST) randomised factorial experiment

Abstract Objective: To inform a package of initiatives to increase children’s vegetable intake while in long day care (LDC) by evaluating the independent and combined effects of three initiatives targeting food provision, the mealtime environment and the curriculum. Design: Using the Multiphase Optimisation Strategy (MOST) framework, a 12-week, eight-condition (n 7 intervention, n 1 control) randomised factorial experiment was conducted. Children’s dietary intake data were measured pre- and post-initiative implementation using the weighed plate waste method (1× meal and 2× between-meal snacks). Vegetable intake (g/d) was calculated from vegetable provision and waste. The optimal combination of initiatives was determined using a linear mixed-effects model comparing between-group vegetable intake at follow-up, while considering initiative fidelity and acceptability. Setting: LDC centres in metropolitan Adelaide, South Australia. Participants: 32 centres, 276 staff and 1039 children aged 2–5 years. Results: There were no statistically significant differences between any of the intervention groups and the control group for vegetable intake (all P > 0·05). The curriculum with mealtime environment group consumed 26·7 g more vegetables/child/day than control (ratio of geometric mean 3·29 (95 % CI 0·96, 11·27), P = 0·06). Completion rates for the curriculum (> 93 %) and mealtime environment (61 %) initiatives were high, and acceptability was good (4/5 would recommend), compared with the food provision initiative (0–50 % completed the menu assessment, 3/5 would recommend). Conclusion: A programme targeting the curriculum and mealtime environment in LDC may be useful to increase children’s vegetable intake. Determining the effectiveness of this optimised package in a randomised controlled trial is required, as per the evaluation phase of the MOST framework

New rapid assessment tools to measure obesity related behaviours in 0- to 5-year-olds.

Quick and robust measurement of lifestyle behaviours in young children is needed for monitoring population trends and evaluating early obesity prevention programs. CRE-EPOCH members have used a comprehensive, best practice process to develop a suite of brief tools that measure diet and movement behaviours in 0-5-year-old children. The tools are designed to be completed by parents, and can be used by policymakers, researchers, and practitioners.The development process combined information from systematic reviews, expert consultation, and cognitive interviews with parents. This multistage process identified item selection and informed question wording and design. The brief tools (10-15 questions, <5 minutes to complete) ask parents to report how frequently over the past week their infant, toddler or preschool-aged child has consumed a range of foods and drinks or frequency and duration of activities including outdoor play, use of mobile devices, and sleep.Testing with parents (n=367) of young children to determine validity and reliability is nearing completion. Parents completed the tools twice over a 1–2-week period and provided data on dietary intake, physical activity, screen time and sleep using established reference methods.Early results are promising, indicating that the tools are well understood by parents and will provide validated, reliable and fit-for-purpose solutions for measuring lifestyle behaviours (dietary intake, physical activity, screen time, sleep) in infants, toddlers and preschool-aged children. These rapid, validated tools measuring key behaviours in children 0-5 years can provide a platform for routine and harmonised measurement of behavioural outcomes across research and practice, including the evaluation of scaled-up early obesity prevention programs. There are opportunities to explore translation for use in healthcare settings e.g. screening, referral, monitoring, feedback to families. User-friendly, accessible online resources (measurement tool plus data management and analytical protocols) to facilitate the use and adoption of the tool(s) will be available in late 2021

In search of consistent predictors of children\u27s physical activity

Physical activity is pivotal for children\u27s health and well-being, yet participation declines across teenage years. Efforts to increase physical activity need to be strengthened to combat this, however, evidence for the design and planning of physical activity promotion in children is lacking. The aim was to identify predictors of physical activity that were relatively consistent across three different measures of physical activity, in pre- and early adolescent South Australians. This is the first study to compare correlates of physical activity across three measures of physical activity in a single sample, in this age group. Children (n = 324) aged 9-13 years and their parents were surveyed on personal, interpersonal and environmental correlates of physical activity. Child physical activity was objectively measured using pedometers (7 days). Self-reported physical activity was determined from organised sport participation and the Physical Activity Questionnaire for Adolescents. Regression models were used to identify consistent predictors of three physical activity measures. Consistent predictors across multiple physical activity measures were: parent support for physical activity, having appropriate clothing for sport, enjoyment of physical activity and perceived availability of sporting clubs. These predictors identify potential avenues for directing intervention efforts to increase physical activity in early adolescents

Stakeholder Generated Ideas for Alternative School Food Provision Models in Australia Using the Nominal Group Technique

Good nutrition is important for children&rsquo;s learning, growth, and development, yet food intake during school hours does not align with recommendations. In Australia, most school children currently bring a packed lunch from home, but what if there was a different way? This project aimed to engage a diverse range of stakeholders to (1) generate, refine and prioritize ideas for novel models of food provision to Australian children within school hours, and (2) to determine and rank the potential barriers and facilitators to changing the school food provision system. This study used nominal group technique virtual workshops&mdash;three idea generation workshops (n = 21 participants) and one consensus workshop (n = 11 participants). School lunch prepared onsite was the top ranked food provision model option based on impact and achievability. Potential barriers (n = 26) and facilitators (n = 28) to changing the school food system were generated. The top ranked barrier and facilitator related to government support. This study highlights that there is an opportunity to explore partnerships and utilize existing skills and infrastructure to introduce a universal school-provided lunch model in Australia. The next steps should focus on building the business case capturing the social value of investing in school lunches, including considering parent-paid and subsidized options

Regional Differences in Correlates of Daily Walking among Middle Age and Older Australian Rural Adults: Implications for Health Promotion

Rural Australians are less physically active than their metropolitan counterparts, and yet very little is known of the candidate intervention targets for promoting physical activity in rural populations. As rural regions are economically, socially and environmentally diverse, drivers of regular physical activity are likely to vary between regions. This study explored the region-specific correlates of daily walking among middle age and older adults in rural regions with contrasting dominant primary industries. Participants were recruited through print and electronic media, primary care settings and community organisations. Pedometers were worn by 153 adults for at least four days, including a weekend day. A questionnaire identified potential intra-personal, social and environmental correlates of physical activity, according to a social ecological framework. Regression modelling identified independent correlates of daily walking separately in the two study regions. In one region, there were independent correlates of walking from all levels of the social ecological framework. In the other region, significant correlates of daily walking were almost all demographic (age, education and marital status). Participants living alone were less likely to be physically active regardless of region. This study highlights the importance of considering region-specific factors when designing strategies for promoting regular walking among rural adults

Using Item Response Theory to evaluate items that measure intake of energy-dense, nutrient-poor foods amongst toddlers

Purpose: This study used item response theory (IRT) to evaluate measurement properties of items for assessing intake of energy-dense, nutrient-poor (non-core) foods amongst toddlers. The aim was to identify discriminating items suitable for inclusion in a short-form tool to assess obesity-related behaviours. Methods: This is a secondary analysis of dietary data collected via three 24-hour recalls on 18-month old children in the Melbourne InFANT trial. A food frequency questionnaire (FFQ) assessed frequency of intake in the past month, measured on a nine point scale. The responses of 463 parents to 15 questions on the FFQ were analysed using IRT. Analyses were performed using SPSS v25 and Winsteps (4.0.1). Data were screened for missing responses and floor/ceiling effects. Unidimensionality was assessed using principal components analysis (PCA) with direct oblimin rotation. Infit and outfit mean squares assessed the fit between items and the rasch model. Item performance was assessed using item characteristic curves, category response curves, and item-person maps. Results: Median non-core food and drink intake measured via 24-hour recalls was 65g/day (IQR=34-121). Distribution of all FFQ items was left-skewed, and therefore responses were dichotomised into ‘never or Conclusions: Where measurement of dietary behaviours is of interest, IRT provides a useful item-reduction technique