Assessing the relative validity of the Scottish Collaborative Group FFQ for measuring dietary intake in adults

Acknowledgements: The authors would like to thank Jacqueline Burr and Lindsey Shaw for collecting the data for this study. Data coding and entry for the food diaries was completed by Dr Lindsey Masson. The authors would also like to acknowledge the Scottish Health Survey Team, the Scottish Government and the National Centre for Social Research for their support in conducting this research. Financial support: This work was supported by funding from the Rural and Environment Science and Analytical Services Division (RESAS) programme of the Scottish Government (J.L.H., L.C.A.C., S.W. and G.Mc.N.). The RESAS programme had no role in the design, analysis or writing of this article. Conflict of interest: None. Authorship: J.L.H., L.C.A.C., S.W. and G.Mc.N. were responsible for the design of the study and formulated the research question. L.C.A.C. and S.W. carried out the study. J.L.H. completed the literature review, conducted the statistical analysis and drafted the initial paper. All authors were responsible for drafting and revising the manuscript and have approved the final version. Ethics of human subject participation: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by the Rowett Human Studies Ethical Review Panel. Written informed consent was obtained from all participants.Peer reviewedPostprintPostprintPostprintPostprintPostprintPostprintPostprintPostprin

The Physical Activity 4 Everyone Cluster Randomized Trial : 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents

Acknowledgments The Physical Activity 4 Everyone intervention trial was funded by the New South Wales Ministry of Health through the New South Wales Health Promotion Demonstration Research Grants Scheme and conducted by Hunter New England Population Health (a unit of the Hunter New England Local Health District), in collaboration with the University of Newcastle and University of Wollongong. Infrastructure support was provided by Hunter Medical Research Institute. The research team acknowledges the importance of making research data publically available. Access to the accelerometer data from this study may be made available to external collaborators following the development of data transfer agreements. Further results arising from the study can be found at www.goodforkids.nsw.gov.au/high-schools/. No financial disclosures were reported by the authors of this paper.Peer reviewedPublisher PD

Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Can a relatively low-intensity intervention by health professionals prevent weight gain in mid-age women? 12-Month outcomes of the 40-Something randomised controlled trial

Background: Weight gain in perimenopausal women results in increased visceral adipose tissue, leading to metabolic syndrome and associated comorbidities. Despite a high prevalence of weight gain at this life stage, interventions to prevent menopausal obesity are lacking. Aim: To test the effectiveness of an intervention delivered by health professionals using a motivational interviewing (MI) counselling style in preventing weight gain in non-obese (body mass index (BMI) 18.5 and 29.9 kg m⁻²) women in late premenopause. Methods: In a randomised controlled trial, 54 women (mean (s.d.) age 47.3 (1.8) years; BMI 25.1 (2.4) kg m⁻²) who had menstruated within the preceding 3 months were randomly assigned to an MI intervention (n=28) (five health professional MI counselling sessions) or a self-directed intervention (SDI) (print materials only) (n=26). The primary outcome, body weight (kg) and secondary outcomes (blood lipids, glucose, body fat %, lean mass % and waist circumference) were measured at baseline and postintervention (12 months), and intention-to-treat analysis was conducted. Results: Forty women completed all measures and adhered to all protocols. The weight at 12 months for the MI group of 65.6 kg (95% CI: 64.5; 66.8) was significantly different (P=0.034) from the SDI group of 67.4 kg (95% CI: 66.2; 68.6). When stratified by baseline BMI category, the MI group lost significantly more weight (−2.6 kg; 95% CI: −3.9; −1.2) than the SDI group (−0.1 kg; 95% CI: −1.2; 1.0, P=0.002) for the healthy weight women. The overweight women lost weight regardless of the intervention group, with no between-group difference (−3.5 kg; 95% CI: −6.1, −1.0 and −2.3; 95% CI: −4.1, −0.5, P=0.467). Conclusion: This relatively low-intensity intervention, incorporating MI into health professional counselling, not only effectively prevented weight gain but also achieved significant weight loss and decreased diastolic blood pressure. Further refinements are required to optimise outcomes for overweight women

Effectiveness of Interventions using motivational interviewing for dietary and physical activity modification in adults: A systematic review

Review Objective: The objective of this review is to synthesise the best available evidence on the effectiveness of interventions using motivational interviewing (MI) to modify dietary and physical activity behaviours. Inclusion criteria: Types of Participants: This review will consider studies that include adults, aged 18 years and older. The review will report data separately for: 1. women only interventions (or where data has been reported separately for women) 2. men only interventions (or where data has been reported separately for men) 3. interventions which do not separate results by gender. Types of interventions: This review will consider quantitative studies that investigate the effectiveness of MI intervention and interventions employing components of MI on dietary and physical activity behaviour change. Studies must separate subjects into at least 1 group receiving the MI based intervention and one group receiving an attention control.The intervention may either use MI as the sole intervention strategy or as an intervention component. The review will be divided into studies examining: 1. Dietary modification 2. Physical activity modification. Types of outcomes: This review will consider studies that include the following outcome measures: Primary outcomes: - Dietary: E.g. Energy intake, intake of core food groups, macronutrient composition of the diet, diet quality or diet index. - Activity: E.g. Physical activity or sedentary behaviours: energy expenditure, steps taken per day, time spent participating in physical activity, sitting time

Does motivational interviewing align with international scope of practice, professional competency standards, and best practice guidelinesin dietetics practice?

Facilitating change in client behavior is a key challenge for registered dietitian nutritionists (RDNs). RDN frustration occurs when clients do not adhere to the behavior change plans developed during consultations. The client may return for future appointments having made minimal or no lifestyle changes, or showing a decline in diet and physical activity behaviors. Despite many clients having the knowledge, skills, and need to make nutritious dietary choices and to participate in regular physical activity, many still struggle to maintain behavior change in the long term. Clients may be ambivalent when it comes to the need to make behavior changes. Ambivalence is a state of mixed feelings resulting in an inability to choose between two courses of action. When confronted with feelings of ambivalence in clients, an RDN may take the role of arguing for change, hoping to convince a client of the benefits of changing behavior. In response, a client may feel judged and criticized, and may rationalize his or her current behavior by providing arguments to maintain the status quo, stop engaging with the RDN, or may silently resolve not to change

The 40-something randomised controlled trial improved fruit intake and nutrient density of the diet in mid-age women

Aim: The 40-Something Randomised Controlled Trial (RCT) aimed to determine if a 12-month health professional-led intervention could improve dietary intake and increase physical activity for weight gain prevention in non-obese premenopausal women. Methods: Fifty-four women were randomised to a motivational interviewing intervention (MI) (n = 28; five health professional consultations) or a self-directed intervention (SDI; n = 26; written advice). Weight control behaviours including dietary intake (four-day weighed food record) and physical activity (pedometer steps; minutes spent in light, moderate and vigorous activity; sitting time) were measured at baseline, and at 3 and 12 months. Participants completed a questionnaire containing demographic questions, Short Form 36 and the International Physical Activity Questionnaire at baseline and 12 months. Linear mixed model analyses adjusting for baseline and 3-month behaviour, covariates and interactions were used to test for between-group differences. Results: At 12 months, the MI group had diets significantly more nutrient dense in iron (<i>P</i> = 0.01) and potassium (<i>P</i> = 0.04), and consumed more fruits (<i>P</i> = 0.02) than the SDI women. Women who achieved their weight control goals consumed significantly more daily fruit servings (+0.76 servings/day, <i>P</i> = 0.02) and less meat/meat alternatives (-0.34 servings/day, <i>P</i> < 0.01) than women who did not achieve weight control. The lack of changes in physical activity indicates that more emphasis may need to be placed on promoting physical activity. Conclusions: The findings demonstrated the effectiveness of the 40-Something RCT in improving iron and potassium nutrient density and fruit servings per day in women soon to commence menopause

The 40-Something randomized controlled trial to prevent weight gain in mid-age women

Background: Obesity prevention is a major public health priority. Despite the health risks associated with weight gain, there has been a distinct lack of research into effective interventions to prevent, rather than treat, obesity particularly at high risk life stages such as menopause in women. This paper describes the rationale for and design of a 2-year randomized controlled trial (RCT) (the 40-Something Study) aimed at testing the feasibility and efficacy of a relatively low intensity intervention designed to achieve weight control in non-obese women about to enter the menopause transition. Methods and design: The study is a parallel-group RCT consisting of 12 months of intervention (Phase 1) and 12 months of monitoring (Phase 2). Non-obese pre-menopausal healthy females 44–50 years of age were screened, stratified according to Body Mass Index (BMI) category (18.5-24.9 and 25–29.9 kg/m2) and randomly assigned to one of two groups: motivational interviewing (MI) intervention (n = 28), or a self-directed intervention (SDI) (control) (n = 26). The MI intervention consisted of five consultations with health professionals (four with a Dietitian and one with an Exercise Physiologist) who applied components of MI counselling to consultations with the women over a 12 month period. The SDI was developed as a control and these participants received print materials only. Outcome measures were collected at baseline, three, 12, 18 and 24 months and included weight (primary outcome), waist circumference, body composition, blood pressure, plasma markers of metabolic syndrome risk, dietary intake, physical activity and quality of life. Analysis of covariance will be used to investigate outcomes according to intervention type and duration (comparing baseline, 12 and 24 months). Discussion: The 40-Something study is the first RCT aimed at preventing menopausal weight gain in Australian women. Importantly, this paper describes the methods used to evaluate whether a relatively low intensity, health professional led intervention will achieve better weight control in pre-menopausal women than a self-directed intervention. The results will add to the scant body of literature on obesity prevention methods at an under-researched high-risk life stage, and inform the development of population-based interventions