Mandatory fortification with folic acid: what would hippocrates say?

In October 2006, the Australian and New Zealand Food Regulation Ministerial Council asked for a review of the proposed food standard permitting mandatory fortification of bread with folic acid. This article contributes to the policy debate associated with the standard&rsquo;s review by discussing the potential benefits and risks to the target population and the wider Australian population with emphasis on recent (2006) literature.<br /

Effective integration of teaching and research in a first year food and nutrition course

Previous research has indicated that undergraduate student learning can be enhanced through active involvement in research. Furthermore, creating an academic environment where teaching and research are intimately linked can facilitate the induction of students into a community of learners where new knowledge is created, explored and critiqued. Scaffolding and supporting student learning via engagement in authentic research experiences can work to ensure graduating students have the capacity to generate and investigate important questions that contributes to the development of new knowledge. This paper presents a case study that outlines curriculum design and pedagogical strategies aimed at integrating teaching and research within the first year of an undergraduate course. First year Food and Nutrition students were asked to partake in a research project where they were asked to complete a series of diet and food related questionnaires, analyse, interpret and critique the resulting data. Students were supported through this learning activity via small group tutorial support and question and answer sessions within the learning management system. Anonymous evaluation of the teaching and learning experience was conducted at the end of the teaching period and the results indicate that the students welcomed the opportunity to engage in an authentic, research based learning activity. Students&rsquo; found the assessment tasks were clearly explained to them (88% agreeing), and felt well supported in approaching this research based assessment task. Furthermore, the qualitative comments indicated that the students&rsquo; found the learning environment to be meaningful and relevant. This case study indicates that it is possible to effectively incorporate authentic research experiences within the curriculum of a first year course. The experiential, inquiry based learning approach used supported the students&rsquo; participation in a systematic, rigorous data collection process required in a structured research environment and blended these requirements with authentic learning of discipline specific skills and knowledge.<br /

The use of table and cooking salt in a sample of Australian adults

Dietary sodium, the major source being salt, is associated with hypertension. Australian adults consume more than the recommended amount of salt and approximately 15% of dietary sodium comes from salt added at the table and during cooking. Objective: To determine the frequency of and the demographic characteristics associated with discretionary salt use. Design: A cross sectional survey conducted in shopping centres within Metropolitan Melbourne. Participants completed a questionnaire assessing discretionary salt use and attitudes to salt intake. Outcomes: Four hundred and seventy four surveys were collected (65% female, 77% Caucasian, 64% holding a university qualification). Eighty nine percent of respondents were classified as salt users and 11% as non-salt users. Of the salt users 52% reported that they always or sometimes add salt during cooking and at the table. Those of Asian descent and younger respondents aged 18-24 years were more likely to be salt users (chi2=12.3, df=2, p&lt;0.001; chi2=19.2, df=5, p&lt;0.01). Conclusion: Discretionary salt use remains high. To successfully reduce population dietary salt intake public health campaigns are urgently required and need to include consumer advice to reduce discretionary salt use, whilst reducing the salt added to processed foods. Such campaigns should include younger age groups and should be appropriate for all ethnic backgrounds to raise the awareness of the risks of a high salt diet on health.<br /

Australian children\u27s consumption of caffeinated, formulated beverages: a cross-sectional analysis

BACKGROUND: Caffeine is a common additive in formulated beverages, including sugar-sweetened beverages. Currently there are no data on the consumption of caffeinated formulated beverages in Australian children and adolescents. This study aimed to determine total intake and consumption patterns of CFBs in a nationally representative sample of Australian children aged 2-16 years and to determine contribution of CFBs to total caffeine intake. Consumption by day type, mealtime and location was also examined. METHODS: Dietary data from one 24-hour recall collected in the 2007 Australian National Children\u27s Nutrition and Physical Activity Survey were analysed. CFBs were defined as beverages to which caffeine has been added as an additive, including cola-type beverages and energy drinks. Socioeconomic status was based on the highest level of education attained by the participant\u27s primary caregiver. Time of day of consumption was classified based on traditional mealtimes and type of day of consumption as either a school or non-school day. Location of consumption was defined by the participant during the survey. RESULTS: On the day of the survey 15% (n = 642) of participants consumed CFBs. Older children and those of low socioeconomic background were more likely to consume CFBs (both P &lt; 0.001). Amongst the 642 consumers mean (95% CI) intakes were 151 (115-187)g/day, 287 (252-321)g/day, 442 (400-484)g/day, and 555 (507-602)g/day for 2-3, 4-8, 9-13 and 14-16 year olds respectively. Consumers of CFBs had higher intakes of caffeine (mean (95% CI) 61 (55-67)mg vs. 11 (10-12)mg) and energy (mean (95% CI) 9,612 (9,247-9978)kJ vs. 8,186 (8,040-8,335)kJ) than non-consumers (both P &lt; 0.001). CFBs contributed 69% of total daily caffeine intake. CFB intake was higher on non-school days compared with school days (P &lt; 0.005) and consumption occurred predominantly at the place of residence (56%), within the &quot;dinner&quot; time bracket (17:00-20:30, 44%). CONCLUSIONS: The consumption of CFBs by all age groups within Australian children is of concern. Modifications to the permissibility of caffeine as a food additive may be an appropriate strategy to reduce the intake of caffeine in this age group. Additional areas for intervention include targeting parental influences over mealtime beverage choices

Sources of Sodium in Australian children\u27s diets and the effect of the application of sodium targets to food products to reduce sodium intake

The average reported dietary Na intake of children in Australia is high: 2694 mg/d (9&ndash;13 years). No data exist describing food sources of Na in Australian children\u27s diets and potential impact of Na reduction targets for processed foods. The aim of the present study was to determine sources of dietary Na in a nationally representative sample of Australian children aged 2&ndash;16 years and to assess the impact of application of the UK Food Standards Agency (FSA) Na reduction targets on Na intake. Na intake and use of discretionary salt (note: conversion of salt to Na, 1 g of NaCl (salt) = 390 mg Na) were assessed from 24-h dietary recall in 4487 children participating in the Australian 2007 Children\u27s Nutrition and Physical Activity Survey. Greatest contributors to Na intake across all ages were cereals and cereal-based products/dishes (43 %), including bread (13 %) and breakfast cereals (4 %). Other moderate sources were meat, poultry products (16 %), including processed meats (8 %) and sausages (3 %); milk products/dishes (11 %) and savoury sauces and condiments (7 %). Between 37 and 42 % reported that the person who prepares their meal adds salt when cooking and between 11 and 39 % added salt at the table. Those over the age of 9 years were more likely to report adding salt at the table (&chi;2 199&middot;5, df 6, P &lt; 0&middot;001). Attainment of the UK FSA Na reduction targets, within the present food supply, would result in a 20 % reduction in daily Na intake in children aged 2&ndash;16 years. Incremental reductions of this magnitude over a period of years could significantly reduce the Na intake of this group and further reductions could be achieved by reducing discretionary salt use.<br /

Creative Education

Previous research has indicated that undergraduate student learning can be enhanced through active involvement in research. Furthermore, creating an academic environment where teaching and research are intimately linked can facilitate the induction of students into a community of learners where new knowledge is created, explored and critiqued. Scaffolding and supporting student learning via engagement in authentic research experiences can work to ensure graduating students have the capacity to generate and investigate important questions that contributes to the development of new knowledge. This paper presents a case study that outlines curriculum design and pedagogical strategies aimed at integrating teaching and research within the first year of an undergraduate course. First year Food and Nutrition students were asked to partake in a research project where they were asked to complete a series of diet and food related questionnaires, analyse, interpret and critique the resulting data. Students were supported through this learning activity via small group tutorial support and question and answer sessions within the learning management system. Anonymous evaluation of the teaching and learning experience was conducted at the end of the teaching period and the results indicate that the students welcomed the opportunity to engage in an authentic, research based learning activity. Students&apos; found the assessment tasks were clearly explained to them (88% agreeing), and felt well supported in approaching this research based assessment task. Furthermore, the qualitative comments indicated that the students&apos; found the learning environment to be meaningful and relevant. This case study indicates that it is possible to effectively incorporate authentic research experiences within the curriculum of a first year course. The experiential, inquiry based learning approach used supported the students&apos; participation in a systematic, rigorous data collection process required in a structured research environment and blended these requirements with authentic learning of discipline specific skills and knowledge

Is socioeconomic status associated with dietary sodium intake in Australian children? A cross-sectional study

Objective To assess the association between socioeconomic status (SES) and dietary sodium intake, and to identify if the major dietary sources of sodium differ by socioeconomic group in a nationally representative sample of Australian children.Design Cross-sectional survey.Setting 2007 Australian National Children\u27s Nutrition and Physical Activity Survey.Participants A total of 4487 children aged 2&ndash;16 years completed all components of the survey.Primary and secondary outcome measures Sodium intake was determined via one 24 h dietary recall. The population proportion formula was used to identify the major sources of dietary salt. SES was defined by the level of education attained by the primary carer. In addition, parental income was used as a secondary indicator of SES.Results Dietary sodium intake of children of low SES background was 2576 (SEM 42) mg/day (salt equivalent 6.6 (0.1) g/day), which was greater than that of children of high SES background 2370 (35) mg/day (salt 6.1 (0.1) g/day; p&lt;0.001). After adjustment for age, gender, energy intake and body mass index, low SES children consumed 195 mg/day (salt 0.5 g/day) more sodium than high SES children (p&lt;0.001). Low SES children had a greater intake of sodium from processed meat, gravies/sauces, pastries, breakfast cereals, potatoes and potato snacks (all p&lt;0.05).Conclusions Australian children from a low SES background have on average a 9% greater intake of sodium from food sources compared with those from a high SES background. Understanding the socioeconomic patterning of salt intake during childhood should be considered in interventions to reduce cardiovascular disease.<br /

Food consumption patterns of adolescents aged 14-16 years in Kolkata, India

BACKGROUND: The nutrition transition has brought about rapid changes in the structure of the Indian diet. The replacement of traditional home-cooked meals with ready-to-eat, processed foods has contributed to an increased risk of chronic diseases in urban Indians. Improving the nutrition of Indians by promoting healthy food consumption in early life and in adolescence would help to reduce these health risks. However, little is known about the quality and quantity of foods and beverages consumed by urban Indian adolescents. Therefore, the aim of this study was to describe the food consumption patterns in a sample of urban Indian adolescents. METHODS: A self-administered, semi-quantitative, 59-item meal-based food frequency questionnaire (FFQ) was developed to assess the dietary intake of adolescents over the previous day. A total of 1026 students (aged 14-16&nbsp;years) attending private, English-speaking schools in Kolkata, India completed the survey. RESULTS: Overall, the adolescents reported poor dietary intakes; over one quarter (30%) reported no consumption of vegetables and 70% reported eating three or more servings of energy-dense snacks, on the previous day. Nearly half of the respondents (45%) did not consume any servings of fruits and 47% reported drinking three or more servings of energy-dense beverages. The mean consumption of food groups in serves/day varied from 0.88 (SD&nbsp;=&nbsp;1.36) for pulses and legumes to 6.25 (SD&nbsp;=&nbsp;7.22) for energy-dense snacks. In general, girls had more nutritious dietary intakes than boys. CONCLUSIONS: The Indian adolescents reported poor food consumption patterns, and these findings highlight the need to design effective nutrition promotion strategies to encourage healthy eating in adolescence and targeting food supply and availability

Dietary salt intake assessed by 24 h urinary sodium excretion in Australian schoolchildren aged 5–13 years

Objective To measure total daily salt intake using 24 h urinary Na excretion within a sample of Victorian schoolchildren aged 5&ndash;13 years and to assess discretionary salt use habits of children and parents.Design Cross-sectional study.Setting Completed within a convenience sample of independent primary schools (n 9) located in Victoria, Australia.Subjects Two hundred and sixty children completed a 24 h urine collection over a school (34 %) or non-school day (66 %). Samples deemed incomplete (n 18), an over-collection (n 1) or that were incorrectly processed at the laboratory (n 3) were excluded.Results The sample comprised 120 boys and 118 girls with a mean age of 9&middot;8 (sd 1&middot;7) years. The average 24 h urinary Na excretion (n 238) was 103 (sd 43) mmol/24 h (salt equivalent 6&middot;0 (sd 2&middot;5) g/d). Daily Na excretion did not differ by sex; boys 105 (sd 46) mmol/24 h (salt equivalent 6&middot;1 (sd 2&middot;7) g/d) and girls 100 (sd 41) mmol/24 h (salt equivalent 5&middot;9 (sd 2&middot;4) g/d; P = 0&middot;38). Sixty-nine per cent of children (n 164) exceeded the recommended daily Upper Limit for Na. Reported discretionary salt use was common: two-thirds of parents reported adding salt during cooking and almost half of children reported adding salt at the table.Conclusions The majority of children had salt intakes exceeding the recommended daily Upper Limit. Strategies to lower salt intake in children are urgently required, and should include product reformulation of lower-sodium food products combined with interventions targeting discretionary salt use within the home

Mobile phone app aimed at improving iron intake and bioavailability in premenopausal women: a qualitative evaluation

BACKGROUND: Low iron intake can lead to iron deficiency, which can result in impaired health and iron-deficiency anemia. A mobile phone app, combining successful dietary strategies to increase bioavailable iron with strategies for behavior change, such as goal setting, monitoring, feedback, and resources for knowledge acquisition, was developed with the aim to increase bioavailable iron intake in premenopausal women. OBJECTIVE: To evaluate the content, usability, and acceptability of a mobile phone app designed to improve intake of bioavailable dietary iron. METHODS: Women aged 18-50 years with an Android mobile phone were invited to participate. Over a 2-week period women were asked to interact with the app. Following this period, semistructured focus groups with participants were conducted. Focus groups were audio recorded and analyzed via an inductive open-coding method using the qualitative analysis software NVivo 10. Themes were identified and frequency of code occurrence was calculated. RESULTS: Four focus groups (n=26) were conducted (age range 19-36 years, mean 24.7, SD 5.2). Two themes about the app\u27s functionality were identified (frequency of occurrence in brackets): interface and design (134) and usability (86). Four themes about the app\u27s components were identified: goal tracker (121), facts (78), photo diary (40), and games (46). A number of suggestions to improve the interface and design of the app were provided and will inform the ongoing development of the app. CONCLUSIONS: This research indicates that participants are interested in iron and their health and are willing to use an app utilizing behavior change strategies to increase intake of bioavailable iron. The inclusion of information about the link between diet and health, monitoring and tracking of the achievement of dietary goals, and weekly reviews of goals were also seen as valuable components of the app and should be considered in mobile health apps aimed at adult women