National Physical Activity Research Articles

Mind the gap: Danish school heads’ ability to implement a national physical activity school requirement

In 2014, the Danish government introduced a wide-ranging reform of primary and lower secondary education that applied to all public schools. A distinctive feature was that it became mandatory for schools to provide an average of 45 min of daily physical activity (PA). The capacity for change of local school heads and the schools overall are considered key to fulfilling such a policy-driven requirement. The aim of this study is therefore to explore local school heads' ability to implement the stated requirement of 45 min of daily PA within their local organizational capacity for change. Eleven semi-structured interviews were conducted across 11 schools. Respondents were school staff with management responsibilities (leading teachers with school management responsibilities, deputy heads and school heads). Results indicate that local school heads are central agents in converting the Danish school requirement of 45 min of daily PA into local action. This includes their ability to advance broad aims into concrete goals, secure supportive structures and organize the implementation strategy. Heads also need to support the staff in building sufficient knowledge capacity on how to arrange and incorporate PA into their daily practice, support the widespread dissemination of this knowledge across the school and reserve work hours for such activities. Assigning local PA ambassadors was particularly highlighted as important implementation support, as they can help build and disseminate knowledge while also broadcasting the school head's strategy and focus on integrating and upholding students' PA levels.

Future Directions for Transforming Kinesiology Implementation Science Into Society

Physical activity policy can play a crucial role in ensuring that individuals, communities, and societies can obtain the wide range of health benefits associated with regular physical activity participation. Policies such as Title IX, the Americans With Disabilities Act, and state physical education laws have all increased opportunities for millions of Americans to participate in physical activity. With that said, how policies are developed and implemented vary considerably. The purpose of this manuscript is to contrast an academic conceptual framework with a pragmatic approach for policy implementation. In an ideal world, polices would be developed from foundational knowledge, scaled up to community-level interventions, and implemented in a sequential fashion. However, policy implementation is a disorderly process that requires a practical methodology. The National Physical Activity Plan encompasses strategies and tactics across 10 key societal sectors—and highlights the disorderly process of policy implementation across the various sectors.

P484 Inflammatory Bowel Disease exercise and diet habits (IBDeat) study: chronic metabolic disease risk factors among IBD patients in New Zealand

Abstract Background Recent literature shows that patients with inflammatory bowel disease (IBD) are at higher risk of developing chronic metabolic diseases which may be amenable to a healthy lifestyle. However, this may be challenging for IBD patients as disease symptoms may result in unfavourable lifestyle habits such as avoidance of healthy foods and reduced physical activity. In this study, we aim to describe the nutritional status and lifestyle habits of adults with IBD in New Zealand (NZ). Methods A cross-sectional nationwide study was undertaken from December 2021 to October 2022 in NZ. Participants were recruited through social media and the Dunedin public hospital patient database. An online questionnaire collected demographics, disease severity scores (harvey-bradshaw index and simple clinical colitis activity index), quality of life (QoL), physical activity, and dietary intake data. A subset of patients living in Dunedin had anthropometrics, handgrip strength, blood pressure, body composition (bioelectrical impedance), blood nutritional markers (lipid profile, iron studies, vitamin D, vitamin B12, folate) and faecal calprotectin measured. Descriptive analysis was conducted and data were compared to population reference values. The study received University of Otago, Dunedin, NZ ethical approval (reference: H21/135). Results The questionnaire was completed by 197 adults, median age 37 (IQR 25, 51) of which 72% were female and predominantly NZ European ethnicity (82.4%). In this IBD cohort, 54% had Crohn’s disease and 46% had ulcerative colitis or IBD-unspecified with quiescent-mild disease activity. Two-thirds of patients had at least one comorbidity aside from IBD and one-third of patients had impaired QoL (defined by a score <45). Most patients had nutritional risk factors including low intakes of fruits (91.3%), vegetables (94.4%), fibre (38.3%), and excessive intakes of fat (73.2%) and saturated fat (98.0%). Two-thirds of patients reported IBD-related barriers to exercise mainly due to fatigue (53.9%), abdominal pain (25.7%), bowel incontinence (23.3%), and joint pain (22.3%) in which only 59.7% met national physical activity recommendations. The Dunedin cohort (n=102) had further chronic metabolic disease risk factors such as central adiposity (63.7%), high body fat percentage (43.9%), high cholesterol/HDL ratio (29.3%), high blood pressure (26.5%), and poor handgrip strength (43.9%). Conclusion Findings suggest that NZ adults with IBD have multiple risk factors for chronic metabolic diseases that could be amendable to lifestyle interventions. Future studies should explore the feasibility and efficacy of nutrition and exercise lifestyle interventions to mitigate these risk factors.

The development of the NOURISHING and MOVING benchmarking tools to monitor and evaluate national governments' nutrition and physical activity policies to address obesity in the European region

Despite assurances of government action, the burden of non-communicable diseases (NCDs) and overweight and obesity is continuing to grow at an alarming rate both globally and in Europe. The NOURISHING and MOVING policy frameworks outline a comprehensive set of policy actions across 6 domains and 16 policy areas in which national governments should take action to promote healthy diets and physical activity. Monitoring and benchmarking these policies is important for assessing progress on obesity and NCD prevention. This paper describes the participatory process for developing benchmarking tools structured around the policy areas of the NOURISHING and MOVING policy frameworks. They consist of a set of indicators and policy attributes that assess government support in promoting healthy nutrition and physical activity. They are adolescent relevant as they capture policy actions that target or impact adolescents. The benchmarking tools are designed to monitor progress on national government action on nutrition and physical activity based on aspirational standards. They will be applied in 27 European countries initially and are aimed at policymakers, researchers, and civil society, to track progress, develop the research infrastructure on effectiveness of NCD prevention policies at population level, and support advocacy efforts.

Hippocampal neurochemicals are associated with exercise group and intensity, psychological health, and general cognition in older adults

Based on the premise that physical activity/exercise impacts hippocampal structure and function, we investigated if hippocampal metabolites for neuronal viability and cell membrane density (i.e., N-acetyl aspartate (NAA), choline (Cho), creatine (Cr)) were higher in older adults performing supervised exercise compared to following national physical activity guidelines. Sixty-three participants (75.3 ± 1.9 years after 3 years of intervention) recruited from the Generation 100 study (NCT01666340_date:08.16.2012) were randomized into a supervised exercise group (SEG) performing twice weekly moderate- to high-intensity training, and a control group (CG) following national physical activity guidelines of ≥ 30-min moderate physical activity ≥ 5 days/week. Hippocampal body and head volumes and NAA, Cho, and Cr levels were acquired at 3T with magnetic resonance imaging and spectroscopic imaging. Sociodemographic data, peak oxygen uptake (VO2peak), exercise characteristics, psychological health, and cognition were recorded. General linear models were used to assess group differences and associations corrected for age, sex, education, and hippocampal volume. Both groups adhered to their training, where SEG trained at higher intensity. SEG had significantly lower NAA/Cr in hippocampal body than CG (p = 0.04). Across participants, higher training intensity was associated with lower Cho/Cr in hippocampal body (p < 0.001). Change in VO2peak, increasing VO2peak from baseline to 3 years, or VO2peak at 3 years were not associated with hippocampal neurochemicals. Lower NAA/Cr in hippocampal body was associated with poorer psychological health and slightly higher cognitive scores. Thus, following the national physical activity guidelines and not training at the highest intensity level were associated with the best neurochemical profile in the hippocampus at 3 years.

Building partnerships: A case study of physical activity researchers and practitioners collaborating to build evidence to inform the delivery of a workplace step count challenge.

Walking is an integral part of Scotland's National Physical Activity Strategy, and the charity Paths for All's Workplace Step Count Challenge is a flagship programme within this strategy to promote physical activity. Effectively promoting physical activity requires collaborative engagement between stakeholders. However, there is limited guidance on how to do this. The aim of this case study is to share an example of a partnership between Paths for All and researchers to inform the development and delivery of the Workplace Step Count Challenge. An overview of the partnership, example activities, reflections on opportunities and challenges, and suggestions for future partnership working are considered. The partnership has evolved and strengthened over time through building trust. Many of the research activities provide an evidence base for the intervention. This work is mutually beneficial providing support for the work of the organisation, and opportunities for researchers to undertake "real world" research, leading to formal outputs and funding. The "real world" nature is challenging to integrate the most robust research designs. Recommendations for developing future partnerships were identified. Promoting physical activity effectively requires partnership working, and this paper provides insight into how such partnerships can work to inform future collaborations.

PHYSICAL ACTIVITY, COGNITIVE HEALTH, AND LONGEVITY IN OLDER ADULTHOOD

Abstract Research suggests that physical activity (PA) protects against cognitive impairment in older adulthood; however, the extent to which PA engagement throughout older adulthood influences the simultaneous risk of transitioning to cognitively impaired states and death is unclear. Applying coordinated data analysis across 14 studies, multi-state survival models (MSM) were independently fit to data from fourteen longitudinal studies (NTotal=52,039). PA was synthesized across studies using the metabolic equivalent of task approach. Adjusting for demographics and chronic conditions, meta-analytic results indicated that engaging in more PA was associated with a reduced risk of transitioning from no cognitive impairment to mildly impaired cognitive functioning (HR=0.94, 95%CI’s=0.89,0.99) and death (HR=0.72, 95%CI’s=0.65,0.80). Based on MSM estimates, multinomial regression models computed total life expectancy stratified by national PA recommendations. Meta-analytic results indicate a positive linear effect of PA, such that more PA is associated with longevity. This presentation will include discussion of knowledge translation efforts.

Ultra-processed food consumption deteriorates the profile of micronutrients consumed by Portuguese adults and elderly: the UPPER project.

This study aims to describe micronutrient intake according to food processing degree and to investigate the association between the dietary share of ultra-processed foods and micronutrient inadequacies in a representative sample of Portuguese adult and elderly individuals. Cross-sectional data from the National Food, Nutrition and Physical Activity Survey (2015/2016) were used. Food consumption data were collected through two 24-h food recalls, and food items were classified according to the NOVA system. Linear regression models were used to assess the association between the micronutrient density and the quintiles of ultra-processed food consumption-crude and adjusted. Negative Binomial regressions were performed to measure the prevalence ratio of micronutrient inadequacy according to ultra-processed food quintiles. For adults, all evaluated vitamins had significantly lower content in the fraction of ultra-processed foods compared to unprocessed or minimally processed foods, except vitamin B2. For the elderly, out of ten evaluated vitamins, seven presented significantly less content in ultra-processed foods compared to non-processed ones. The higher energy contribution of ultra-processed foods in adults was associated with a lower density of vitamins and minerals. This association was not observed in the elderly. For adults, compared with the first quintile of ultra-processed food consumption, the fifth quintile was positively associated with inadequate intakes of vitamin B6 (PR 1.51), vitamin C (PR 1.32), folate (PR 1.14), magnesium (PR 1.21), zinc (PR 1.33), and potassium (PR 1.19). Our results corroborate the importance of public health actions that promote a reduction in the consumption of ultra-processed foods.

Defining Anaemia across the Lifecycle in Healthy Reference Populations: An Analysis for Guideline Development

Background Detection of anaemia is critical for clinical medicine and public health in high and low income settings, but anaemia definitions are uncertain, causing discordance across different laboratories and guidelines. Current WHO anaemia definitions, set in 1968 using limited data, reflect the 5th centile of the haemoglobin distribution in apparently healthy populations. WHO is now reviewing these definitions. Haemoglobin concentration is sensitive to iron and other nutrient deficiencies, inflammation, renal impairment, and genetic conditions, and thus conservative criteria to obtain a healthy reference population is crucial in estimating the 5th centile. To support WHO definitions, this study estimated the 5th centile for haemoglobin in healthy reference populations derived from a secondary analysis of large cohorts. Methods We identified data sources from which sufficient clinical and laboratory data were available to identify an apparently healthy reference sample. These comprised the National Health and Nutrition Examination Survey (NHANES, USA, 8 survey years); Health Survey for England (HSE, England, 4 survey years); the Australian Health Survey (AHS), comprising 2 separate surveys: National Health Survey (NHS, Australia) and National Nutrition and Physical Activity Survey (NNPAS, Australia); TARGetKids! (prospective longitudinal cohort of children, Canada); BRISC (trial of oral iron in infants, Bangladesh); Generation R (prospective cohort of pregnant women, Netherlands). Markers or iron status and inflammation were available in all surveys, with exclusions for ferritin<15ug/L (or <12ug/L in children <5 years), or C-Reactive Protein (CRP) >5mg/L. Where possible, exclusions were applied based on renal function, folate, and active B12. Clinical data from all surveys (except Generation R) excluded individuals with pre-existing health conditions, use of medication (other than contraception), recent illness or hospital admission. In the pregnant Generation R group, those with pregnancy complications were excluded. In all groups, current smokers and those who consumed excess alcohol were excluded. Adults with BMI <18.5 or >30kg/m2 were excluded; children were excluded if growth z-scores were <-2 or >+2. In children <24months, those with birth complications or prematurity were excluded. Thresholds were defined in adult men (18-65 years), adult non-pregnant women (18-65 years), pregnant women (18-45 years, by trimester), and children (6-23 months, 24-59 months, 5-11 years, 12-17 years). Discrete 2.5th and 5th centiles were estimated along with two-sided 90% confidence intervals for each data set and estimates were combined across all data sources using a fixed-effect meta-analysis approach. Results In non pregnant adult men and women (total n=57,896 individuals), exclusions resulted in an apparently healthy group of 15-20% of each survey (less where survey years were missing required biochemistry). A broad range of self-reported ethnicities/ancestries were represented. For example in healthy adults: NHANES 17-33% of participants identified as White; HSE >90% identified as White; AHS 50-60% reported European ancestry. 5th centiles of the distribution of haemoglobin values in the derived reference samples were obtained (see Figure 1 for example in non-pregnant women). Pooled estimates for each sample are shown in Table 1. The results generally align with current WHO thresholds, other than adult men, where a 5th centile of 135.1g/L (90% CI 134.4-135.7) is above the WHO threshold of 130g/L, and in children 6-23 months where the 5th centile of 104.5g/L (90% CI 103.6-105.4) is lower than the current value of 110g/L. Our data support the current threshold in non-pregnant adult women of 120g/L. Sensitivity analyses suggest persons of Black race or ethnicity may have 5th centiles lower than values of White persons (predominantly within the US surveys), but presence of haemoglobinopathy as well as other contributing factors cannot be excluded. Conclusion In this analysis using stringent criteria to define healthy reference group at low risk of iron/ other nutrient deficiency, or inflammation, we have estimated statistical thresholds to define anaemia across the lifecycle. These data contribute to WHO guideline development, and provide a platform for harmonisation of thresholds across different laboratories and clinical guidelines. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Using Popular Foods Consumed to Inform Development of Digital Tools for Dietary Assessment and Monitoring.

Knowing the type and quality of the most popular foods consumed by a population can be useful in the design of technologies for monitoring food intake and interventions. The aim of this research was to determine the most frequently consumed foods and beverages among the Australian population and provide recommendations for progressing the design of dietary assessment technologies. Analysis of the first 24 h recall of the most recent Australian National Nutrition and Physical Activity Survey was conducted. The most popular foods and beverages consumed by energy (kJ) and by frequency were calculated. There were 4515 separate foods and beverages reported by 12,153 people. Overall, the top 10 foods that contributed most energy included full fat milk, beer, white rice, white bread, red wine, cola soft drinks, bananas, red apples, wholewheat breakfast cereal and white sugar. The five most frequently reported foods and beverages were tap water, black tea, full fat milk, instant coffee, and sugar. Understanding the most popular foods and beverages consumed can support innovations in the design of digital tools for dietary surveillance and to reduce under-reporting and food omissions. These findings could also guide the development of more tailored and relevant food databases that underpin these technologies.

It's electric! Measuring energy expenditure and perceptual differences between bicycles and electric-assist bicycles

BackgroundOne way to promote regular activity in communities is through bike share systems, which are increasingly integrating electric-assist pedal bikes (e-bikes). This study quantified the differences in energy expenditure, perceptions of difficulty, and acceleration between regular bikes and e-bikes in a bike share system. MethodsFirst, participants (n = 15) completed a bicycle maximal fitness test and had body composition assessed. Then, two, 1 hr long steady-state bicycle rides were completed at a local park, once on a regular bike and once on an e-bike. During each ride, heart rate and speed were continuously measured with a heart rate monitor. Participants reported perceived exertion at four intervals within each ride as well as perceived enjoyment, difficulty, and tiredness at the end of each ride. Paired t-tests were used to assess differences between the e-bike and regular bike share rides. ResultsParticipants exerted more energy at a greater percentage of maximum heart rate on the regular bike (mean = 69.6%) compared to the e-bike (mean = 61.5%, p = 0.006). Enjoyment was higher on the e-bike (mean = 4.6) than the regular bike (mean = 3.8; p = 0.009; 5-point Likert scale). Perceived exertion and difficulty were lower on the e-bike compared to the regular bike ride. ConclusionsE-bike share rides resulted in lower energy expenditure than regular bike share rides. Both bike rides resulted in moderate-intensity physical activity category, which can contribute to meeting national physical activity guidelines. In bike share systems, e-bikes may be attractive for integrating activity in daily routines since participants reported less difficulty and more enjoyment.

P132 Self-reported indicators of sleep health in Australia: a cross-sectional population-based study

Abstract Introduction Poor sleep health is associated with adverse physical and mental health outcomes. This study aims to examine the indicators of sleep health in an Australian-based population and to analyse the relationship between sleep and sociodemographic characteristics and health conditions. Method We investigated a nationally representative sample of adults aged over 18 (n = 21,562) who participated in the 2011-2013 Australian Health Survey (AHS). Participants in the AHS were assigned to either the National Health Survey (NHS) or the National Nutrition and Physical Activity Survey (NNPAS). The NHS collected data on sleeping tablets taken for a mental health condition. Sleep duration was self-reported in the NNPAS which we categorised into three groups: short sleep (&amp;lt; 7 hours), recommended sleep (7 to 9hours) and long sleep (&amp;gt; 9 hours). Progress to Date Prevalence of sleeping tablets use among Australian adults who had a mental health condition was 9.5%. The majority used sleeping tablets for a duration of 6 months or more (73.9%) and many took it every night (42.0%). On a typical night, a majority self-reported having the recommended amount of sleep for adults (67.2%). The sociodemographic characteristics and health conditions are currently being analysed. Intended Outcome and Impact Adequately monitoring the domains of sleep health can potentially improve the overall health and wellbeing of a population. This study will highlight the current gap in the surveillance of sleep health in Australia. With limited Australian data available, there is a need to prioritise sleep-related indicators in future national health surveys.

Abstract 13572: Feasibility and Preliminary Efficacy of a Novel YouTube Based Physical Activity Intervention in Adults With Overweight/Obesity

Background: Only 14% of adults with obesity attain the national recommended guidelines for physical activity (PA). Yet, there is a paucity of interventions designed to address individuals’ barriers to PA. We designed a web-based Physical Activity for The Heart (PATH) intervention to address this gap. Purpose: To test the feasibility and preliminary efficacy of PATH in promoting PA and reducing cardiovascular disease (CVD) risk in adults with overweight/obesity. Methods: In a randomized controlled trial (RCT) with 12-week follow-up, participants were randomized to PATH (n=41) or wait-list control (n=41) groups. The PATH group received access to the PATH website and met twice/month with a remote coach. The control group received a self-help PA guide and twice/month newsletters on general health. Moderate-to-vigorous intensity PA (MVPA) was assessed via waist-worn Actigraph GT3X, steps via Fitbit Charge 2™, weight via smart scale, blood pressure (BP) via Omron BP machine, and lipids and HbA1C via dry blood spot. Generalized linear mixed modeling was applied to examine between- and within-group differences in PA, adherence to PA, and CVD risk factors. Results: The sample (N=82) was on average 55.9 ±8.2 years old; 57.3% white; 80.5% female; 79% obese (BMI 35.5 ±6.2 kg/m 2 ;) and 62.2% had ≥4yr of college. Recruitment lasted 6 months, and retention was 96.3%. Nearly all intervention participants accessed the PATH website ≥twice/week (92.1%), spent ≥10 min/visit (89.5%), and reported that the site was very appealing (68.4%), navigable (97.4%) and culturally appropriate (79%). At 12 weeks, the PATH group had greater mean changes in weekly MVPA (+59.2 min vs. +1.1 min, p=.024) and daily steps (+1,243.9 steps vs. -61.1 steps, p=.002) compared to the control group. While no between-group differences were detected for meeting the national PA guidelines or CVD risk factors over time, the PATH group showed modest but significant improvements in weight, BMI, body fat, waist circumference, and systolic BP (all p&lt;.05). Conclusion: This pilot RCT demonstrated that the PATH intervention is feasible and acceptable and provided preliminary efficacy in promoting PA among adults with overweight/obesity. Work is in progress to test the PATH intervention in a larger scale RCT.

Results from the Australian 2022 Report Card on physical activity for children and young people

Background/ObjectivePast Physical Activity Report Cards have indicated a minority of Australian children and young people are sufficiently active. The purpose of this paper is to summarise grades across 10 indicators of the 2022 Australian Physical Activity Report Card, to assess physical activity behaviours and supports. MethodsA development team consisting of research experts synthesised and evaluated national and state level data to inform grades for each indicator. Data were drawn from nationally and state/territory representative datasets spanning 2016–2021. ResultsOverall Physical Activity Levels and Screen Time were both assigned grades of D-, remaining the worst performing indicators. Australia's best performing indicator was Community and the Built Environment (A-), followed by Organised Sport and Physical Activity (B-). Remaining indicators were Family and Peers (C+), School (C+), Strategies and Investments (C-), Active Transport (D-) and Physical Fitness (D-). Active Play was unable to be graded, due to lack of consensus on a primary metric for this indicator and a lack of representative data. ConclusionEvidence suggests that physical activity levels of Australian children remain consistently low, despite access to and availability of facilities and open spaces. There is a strong need for a National Physical Activity Plan to address this. The theme for the 2022 Australian Physical Activity Report Card, REBOOT! Reimagining physically active lives encourages us all to think more imaginatively about how we might engage all children and young people through diverse physical activity opportunities to be more active.

Macronutrient (im)balance drives energy intake in an obesogenic food environment: An ecological analysis.

The protein leverage hypothesis (PLH) postulates that strong regulation of protein intake drives energy overconsumption and obesity when human diets are diluted by fat and carbohydrates. The two predictions of the PLH are that humans (i) regulate intake to maintain protein within a narrow range and that (ii) energy intake is an inverse function of percentage energy from protein because absolute protein intake is maintained within narrow limits. Multidimensional nutritional geometry was used to test the predictions of the PLH using dietary data from the Australian National Nutrition and Physical Activity Survey. Both predictions of the PLH were confirmed in a population setting: the mean protein intake was 18.4%, and energy intake decreased with increasing energy from protein (L=-0.18, p &lt; 0.0001). It was demonstrated that highly processed discretionary foods are a significant diluent of protein and associated with increased energy but not increased protein intake. These results support an integrated ecological and mechanistic explanation for obesity, in which low-protein highly processed foods lead to higher energy intake because of the biological response to macronutrient imbalance driven by a dominant appetite for protein. This study supports a central role for protein in the obesity epidemic, with significant implications for global health.

A family-based approach examining perceptions of a TRYathlon series on children’s health and development

Introduction: Regular physical activity supports children’s physical and psychological health and wellbeing, and provides opportunities to build social and emotional skills such as resilience, confidence and self-efficacy. Nonetheless, most Australian children do not meet national physical activity guidelines. Further, a considerable proportion of children who were once sufficiently active are no longer. Research has demonstrated that mass participation sporting events can serve as important social and environmental correlates of physical activity.

Towards healthier and more sustainable diets in the Australian context: comparison of current diets with the Australian Dietary Guidelines and the EAT-Lancet Planetary Health Diet

BackgroundThere is increasing focus on moving populations towards healthier and more environmentally sustainable dietary patterns. The Australian Dietary Guidelines provide dietary patterns that promote health and wellbeing. It is unclear how these guidelines align with the more recently published global recommendations of the EAT-Lancet Planetary Health Reference Diet, and how Australian diets compare to both sets of recommendations.MethodsData from one 24-h recall collected for the 2011–13 National Nutrition and Physical Activity Survey were analysed for 5,920 adults aged 19–50 years. Subgroups of this population were identified by diet quality and lower or higher consumption of foods often considered to be environmentally intensive (higher animal meat and dairy foods) or associated with healthiness (higher vegetables and lower discretionary choices). Food group and nutrient composition of Australian diets were compared to diets modelled on the Australian Dietary Guidelines and Planetary Health Reference Diet. The environmental impacts of diets were estimated using an index of combined metrics.ResultsCompared with the Planetary Health Reference Diet, the Australian Dietary Guidelines contained more servings of the vegetable, dairy and alternatives, fruit, and discretionary choices. The amount of meat and alternatives was higher in the Planetary Health Reference Diet than Australian Dietary Guidelines due to the inclusion of more plant-based meat alternatives. The average Australian diet contained two to almost four times the Australian Dietary Guidelines and Planetary Health Reference Diet maximum recommended intake of discretionary choices, and provided inadequate amounts of the vegetables, cereals, unsaturated fats and meats and alternatives food groups, primarily due to lower intakes of plant-based alternatives. The average Australian diet also contained less dairy and alternatives than the Australian Dietary Guidelines. In the average Australian diet, red meat and poultry contributed 73% to the total servings of meat and alternatives compared to 33% and 10% for the Australian Dietary Guidelines and Planetary Health Reference Diet respectively. The modelled Australian Dietary Guidelines diet met the relevant nutrient reference value for all 22 nutrients examined, whereas the Planetary Health Reference Diet contained an inadequate amount of calcium. The environmental impact scores of the Planetary Health Reference Diet and Australian Dietary Guidelines were 31% and 46% lower than the average Australian diet.ConclusionsSignificant changes are required for Australians’ dietary intake to align more closely with national and global dietary recommendations for health and environmental sustainability.

Do sauces, condiments and seasonings contribute important amounts of nutrients to Australian dietary intakes?

Dietary assessment commonly focuses on particular foods/food groups as indicators of overall dietary intake. Accompaniments such as sauces are not often a focus. The present study describes daily intakes of sauces, condiments and seasonings (SCS) using the most recent Australian National Nutrition and Physical Activity Survey (NNPAS), as well as the contribution to total energy and selected nutrient intakes. NNPAS dietary data were collected by one 24-h recall for 12,153 individuals aged ≥ 2 years (53% female, 29% aged 31-50 years). SCS (i.e., any food items not normally consumed as a food itself, consumed as an addition to a dish after cooking/preparation to enhance flavour) were identified/coded within the dietary data and reported in terms of how they were consumed, primary composition, and contribution to total daily energy and selected macro- and micronutrient intakes. Most participants (85.1%) reported consuming at least one SCS on the day of the recall (median [interquartile range], 2 [1-4]). SCS were predominantly consumed within main meals (breakfast, lunch, dinner) (73.9%), and were predominantly sugar/sugar products (e.g., white sugar) (35.0%), or fats and oils (e.g., butter) (25.9%). SCS contributed a median (interquartile range) of 3.8% (1.1-7.9) of total energy, 5.3% (0.0-15.5) of fat, 2.3% (0.1-6.6) of carbohydrate and 0.2% (0.01-1.2) of protein intake. SCS made the largest contribution towards vitamin E (females median 3.6%; males median 3.4%) and sodium intakes (females median 3.0%; males median 2.9%). Although SCS contribute a small proportion of total energy and nutrient intakes in the Australian population, the contribution is more substantial for some nutrients and population groups.

Interactivity, Quality, and Content of Websites Promoting Health Behaviors During Infancy: 6-Year Update of the Systematic Assessment.

BackgroundAs of 2021, 89% of the Australian population are active internet users. Although the internet is widely used, there are concerns about the quality, accuracy, and credibility of health-related websites. A 2015 systematic assessment of infant feeding websites and apps available in Australia found that 61% of websites were of poor quality and readability, with minimal coverage of infant feeding topics and lack of author credibility.ObjectiveWe aimed to systematically assess the quality, interactivity, readability, and comprehensibility of information targeting infant health behaviors on websites globally and provide an update of the 2015 systematic assessment.MethodsKeywords related to infant milk feeding behaviors, solid feeding behaviors, active play, screen time, and sleep were used to identify websites targeting infant health behaviors on the Google search engine on Safari. The websites were assessed by a subset of the authors using predetermined criteria between July 2021 and February 2022 and assessed for information content based on the Australian Infant Feeding Guidelines and National Physical Activity Recommendations. The Suitability Assessment of Materials, Quality Component Scoring System, the Health-Related Website Evaluation Form, and the adherence to the Health on the Net code were used to evaluate the suitability and quality of information. Readability was assessed using 3 web-based readability tools.ResultsOf the 450 websites screened, 66 were included based on the selection criteria and evaluated. Overall, the quality of websites was mostly adequate. Media-related sources, nongovernmental organizations, hospitals, and privately owned websites had the highest median quality scores, whereas university websites received the lowest median score (35%). The information covered within the websites was predominantly poor: 91% (60/66) of the websites received an overall score of ≤74% (mean 53%, SD 18%). The suitability of health information was mostly rated adequate for literacy demand, layout, and learning and motivation of readers. The median readability score for the websites was grade 8.5, which is higher than the government recommendations (<grade 8). Overall, 74% (49/66) of the websites obtained a poor rating for interactivity, measuring active control, 2-way communication, and synchronicity. The most common features found on websites were social media links (61/66, 92%), frequently asked questions (48/66, 73%), and videos (44/66, 67%). Only 14% (9/66) of websites presented culturally responsive information.ConclusionsQuality, content, readability, and interactivity of websites promoting health behaviors during infancy ranged between poor and adequate. Since the 2015 systematic assessment, there was a slight improvement in the quality of websites but no difference in the Suitability Assessment of Materials rating and readability of information. There is a need for researchers and health care providers to leverage innovative web-based platforms to provide culturally competent evidence-based information based on government guidelines that are accessible to those with limited English proficiency.

The Diet Quality of Food-Insecure Australian Adults-A Nationally Representative Cross-Sectional Analysis.

Poor diet quality exacerbates risks for acute and chronic conditions. People experiencing food insecurity have an increased likelihood of lower diet quality; however, this has not been investigated in the Australian context. The aim of this cross-sectional study was to examine whether the diet quality of Australian adults differed according to their household food security status. Data were analysed from a nationally representative sample (≥19 years; n = 9115) collected as part of the National Nutrition and Physical Activity Survey 2011-12. Household food security status and socio-demographic and health characteristics were assessed using data from an 18-module health interview. A 24 h dietary recall was used to estimate food and nutrient intakes and to calculate the Dietary Guidelines Index (DGI). DGI is a food-based score (0 to 130) that assesses adherence to the 2013 Australian Dietary Guidelines. Survey-weighted linear regression models, adjusted for age and sex, were used to examine diet quality (total DGI and component scores), and total energy and nutrient intake by food security status. Adults from food-insecure households had a mean total DGI score 3.5 points lower (95% CI −5.57, −1.46) than food-secure adults (p = 0.001). Adults from households experiencing food insecurity, when compared to those who were food-secure, had several lower DGI component scores including for dietary variety (1.6 vs. 2.3, p = 0.009), fruit (3.8 vs. 5.0, p = 0.001) and vegetables (3.7 vs. 4.4, p = 0.010). Adults from food-insecure households consumed on average more carbohydrates (45.6 vs. 43.3, p = 0.004) and total sugar (21.8 vs. 19.0, p = 0.003) as a percentage of daily energy and less protein (18.5 vs. 17.2, p = 0.004), mono-unsaturated fats (11.2 vs. 11.8, p = 0.026) as a percentage of daily energy, and fibre (20.1 vs. 23.0, p = 0.003), than food-secure adults. Sub-optimal diet may be one of the contributing factors to, or outcomes of, poorer health in food-insecure populations. Food security interventions are required to better address nutrition in food-insecure households and should be tailored to the health and socio-demographic characteristics of this population.