Browsing by Author "Beck KL"

Now showing 1 - 20 of 28
  • Thumbnail Image
    Item
    Adherence to Infant Feeding Guidelines in the First Foods New Zealand Study.
    (MDPI (Basel, Switzerland), 2023-11-02) Brown KJ; Beck KL; Von Hurst P; Heath A-L; Taylor R; Haszard J; Daniels L; Te Morenga L; McArthur J; Paul R; Jones E; Katiforis I; Rowan M; Casale M; McLean N; Cox A; Fleming E; Bruckner B; Jupiterwala R; Wei A; Conlon C; Rodríguez Martínez G
    Infant feeding guidelines provide evidence-based recommendations to support optimal infant health, growth, and development, and exploring adherence to guidelines is a useful way of assessing diet quality. The aim of this study was to determine adherence to the recently updated Ministry of Health "Healthy Eating Guidelines for New Zealand Babies and Toddlers (0-2 years old)". Data were obtained from First Foods New Zealand, a multicentre observational study of 625 infants aged 7.0-10.0 months. Caregivers completed two 24-h diet recalls and a demographic and feeding questionnaire. Nearly all caregivers (97.9%) initiated breastfeeding, 37.8% exclusively breastfed to around six months of age, and 66.2% were currently breastfeeding (mean age 8.4 months). Most caregivers met recommendations for solid food introduction, including appropriate age (75.4%), iron-rich foods (88.3%), puréed textures (80.3%), and spoon-feeding (74.1%). Infants consumed vegetables (63.2%) and fruit (53.9%) more frequently than grain foods (49.5%), milk and milk products (38.6%), and meat and protein-rich foods (31.8%). Most caregivers avoided inappropriate beverages (93.9%) and adding salt (76.5%) and sugar (90.6%). Our findings indicated that while most infants met the recommendations for the introduction of appropriate solid foods, the prevalence of exclusive breastfeeding could be improved, indicating that New Zealand families may need more support.
  • Thumbnail Image
    Item
    An Investigation of the Relationship Between Dietary Patterns in Early Pregnancy and Maternal/Infant Health Outcomes in a Chinese Cohort
    (Frontiers Media S A, 2022-04-22) de Seymour JV; Beck KL; Conlon CA; Jones MB; Colombo J; Xia Y-Y; Han T-L; Qi H-B; Zhang H; Baker PN; Juturu V
    BACKGROUND: Studies assessing links between maternal diet and pregnancy outcomes have focused predominantly on individual nutrients or foods. However, nutrients are typically consumed in combinations of foods or beverages (i.e., dietary patterns). Taking into account the diet as a whole appreciates that nutrient absorption and metabolism are influenced by other nutrients and the food matrix. OBJECTIVE: The aim of this study was to investigate the relationship between dietary pattern consumption in early pregnancy and pregnancy/infant outcomes, including gestational diabetes mellitus, gestational weight gain, preeclampsia, placental weight, gestational age at delivery, small-for-gestational-age, large-for-gestational-age, macrosomia, measures of infant body composition, and scores on two main indices of the Bayley Scales of Infant Development [Mental Development Index (MDI) and the Psychomotor Development Index (PDI)] at 12 months. DESIGN: Our study included 1,437 participants from a mother-infant cohort in Chongqing, China. Maternal diet was assessed using a 96-item food frequency questionnaire at 11-14 weeks gestation. Dietary patterns were constructed using principal component analysis. Multivariate regressions were performed to assess associations between maternal dietary pattern scores and pregnancy and infant outcomes, adjusting for confounders. RESULTS: Two dietary patterns were derived: a pattern high in pasta, sweetened beverages, and oils and condiments (PSO-based dietary pattern) and a pattern high in fish, poultry, and vegetables (FPV-based dietary pattern). Higher scores on the PSO-based dietary pattern were associated with lower infant standardized scores on the PDI of the Bayley Scales of Infant Development, β (95% confidence interval) = -1.276 (-2.392, -0.160); lower placental weight, β (95% CI) = -6.413 (-12.352g, -0.473); and higher infant's tricep skinfold thickness at 6 weeks of age. β (95% CI) = 0.279 (0.033, 0.526). Higher scores on the FPV-based dietary pattern were associated with higher gestational weight gain between visit 1 (11-14 week's gestation) and 3 (32-34 week's gestation). β (95% CI) = 25.612 (13.255, 37.969). No significant associations were observed between dietary pattern scores and the remaining pregnancy/infant outcomes investigated or MDI scores on the Bayley Scales of Infant Development. This was the first study to investigate the association between dietary patterns in early pregnancy and infant neurocognition in a Chinese cohort.
  • Thumbnail Image
    Item
    Associations of protein intake, sources and distribution on muscle strength in community-dwelling older adults living in Auckland, New Zealand.
    (Cambridge University Press, 2023-08-23) Hiol AN; von Hurst PR; Conlon CA; Beck KL
    Protein intake, sources and distribution impact on muscle protein synthesis and muscle mass in older adults. However, it is less clear whether dietary protein influences muscle strength. Data were obtained from the Researching Eating Activity and Cognitive Health (REACH) study, a cross-sectional study aimed at investigating dietary patterns, cognitive function and metabolic syndrome in older adults aged 65-74 years. Dietary intake was assessed using a 4-d food record and muscle strength using a handgrip strength dynamometer. After adjusting for confounders, in female older adults (n 212), total protein intake (β = 0⋅22, P < 0⋅01); protein from dairy and eggs (β = 0⋅21, P = 0⋅03) and plant food sources (β = 0⋅60, P < 0⋅01); and frequently consuming at least 0⋅4 g/kg BW per meal (β = 0⋅08, P < 0⋅01) were associated with higher BMI-adjusted muscle strength. However, protein from meat and fish intake and the coefficient of variance of protein intake were not related to BMI-muscle strength in female older adults. No statistically significant associations were observed in male participants (n = 113). There may be sex differences when investigating associations between protein intake and muscle strength in older adults. Further research is needed to investigate these sex differences.
  • Thumbnail Image
    Item
    Athlete Preferences for Nutrition Education: Development of and Findings from a Quantitative Survey.
    (MDPI (Basel, Switzerland), 2023-05-29) Solly H; Badenhorst CE; McCauley M; Slater GJ; Gifford JA; Erueti B; Beck KL; Nieman DC
    Nutrition education (NE) is one of several strategies aimed at enhancing the dietary intake of athletes. This study investigated NE preferences of New Zealand and Australian athletes competing nationally and internationally. Athletes (n = 124, 22 (18, 27) years, female 54.8%) from 22 sports completed an online survey, with responses analysed using descriptive statistics. Teaching techniques considered 'extremely effective' were life examples (47.6% of athletes), hands-on activities (30.6%), and discussions with a facilitator (30.6%). Setting personal nutrition goals was important to most athletes (83.9%), along with two-way feedback with a facilitator (75.0%). General nutrition topics considered 'essential' were energy requirements (52.9%), hydration (52.9%), and nutrient deficiencies (43.3%). Performance topics considered 'essential' were recovery (58.1%), pre-exercise nutrition (51.6%), nutrition during exercise (50.0%), and energy requirements for training (49.2%). Athletes preferred a 'combination of in-person group and one-on-one sessions' (25% of athletes), 'one-on one sessions' (19.2%) and 'in-person group sessions' (18.3%), with only 13.3% interested in 'exclusively online delivery'. Sessions of 31-60 min (61.3% of athletes) held monthly (37.5%) and undertaken with athletes of the same sporting calibre (61.3%) were favoured by the participants. The preferred facilitator was a performance dietitian or nutritionist (82.1% of athletes), who had knowledge of the sport (85.5%), experience in sports nutrition (76.6%), and credibility (73.4%). This research provides novel insights into the factors that need to be considered when designing and implementing nutrition education for athletes.
  • Thumbnail Image
    Item
    Baby food pouches and Baby-Led Weaning: Associations with energy intake, eating behaviour and infant weight status.
    (Elsevier B.V., 2024-01-01) Cox AM; Taylor RW; Haszard JJ; Beck KL; von Hurst PR; Conlon CA; Te Morenga LA; Daniels L; McArthur J; Paul R; McLean NH; Jones EA; Katiforis I; Brown KJ; Gash M; Rowan M; Fleming EA; Jupiterwala R; Bruckner BR; Heath A-LM
    Although concern is frequently expressed regarding the potential impact of baby food pouch use and Baby-Led Weaning (BLW) on infant health, research is scarce. Data on pouch use, BLW, energy intake, eating behaviour and body mass index (BMI) were obtained for 625 infants aged 7-10 months in the First Foods New Zealand study. Frequent pouch use was defined as ≥5 times/week during the past month. Traditional spoon-feeding (TSF), "partial" BLW and "full" BLW referred to the relative proportions of spoon-feeding versus infant self-feeding, assessed at 6 months (retrospectively) and current age. Daily energy intake was determined using two 24-h dietary recalls, and caregivers reported on a variety of eating behaviours. Researchers measured infant length and weight, and BMI z-scores were calculated (World Health Organization Child Growth Standards). In total, 28% of infants consumed food from pouches frequently. Frequent pouch use was not significantly related to BMI z-score (mean difference, 0.09; 95% CI -0.09, 0.27) or energy intake (92 kJ/day; -19, 202), but was associated with greater food responsiveness (standardised mean difference, 0.3; 95% CI 0.1, 0.4), food fussiness (0.3; 0.1, 0.4) and selective/restrictive eating (0.3; 0.2, 0.5). Compared to TSF, full BLW was associated with greater daily energy intake (BLW at 6 months: mean difference 150 kJ/day; 95% CI 4, 297; BLW at current age: 180 kJ/day; 62, 299) and with a range of eating behaviours, including greater satiety responsiveness, but not BMI z-score (6 months: 0.06 (-0.18, 0.30); current age: 0.06 (-0.13, 0.26)). In conclusion, neither feeding approach was associated with weight in infants, despite BLW being associated with greater energy intake compared with TSF. However, infants who consumed pouches frequently displayed higher food fussiness and more selective eating.
  • Thumbnail Image
    Item
    Baby Food Pouches, Baby-Led Weaning, and Iron Status in New Zealand Infants: An Observational Study.
    (MDPI (Basel, Switzerland), 2024-05-15) McLean NH; Haszard JJ; Daniels L; Taylor RW; Wheeler BJ; Conlon CA; Beck KL; von Hurst PR; Te Morenga LA; McArthur J; Paul R; Katiforis I; Brown KJ; Gash MC; Rowan MM; Casale M; Cox AM; Jones EA; Jupiterwala RM; Bruckner B; Fleming L; Heath A-LM; Chen Y; Tran PV; Felt BT
    Iron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at "around 6 months of age": "frequent" baby food pouch use (five+ times per week) and "full baby-led weaning" (the infant primarily self-feeds). Iron status was assessed using a venepuncture blood sample. The estimated prevalence of suboptimal iron status was 23%, but neither feeding method significantly predicted body iron concentrations nor the odds of iron sufficiency after controlling for potential confounding factors including infant formula intake. Adjusted ORs for iron sufficiency were 1.50 (95% CI: 0.67-3.39) for frequent pouch users compared to non-pouch users and 0.91 (95% CI: 0.45-1.87) for baby-led weaning compared to traditional spoon-feeding. Contrary to concerns, there was no evidence that baby food pouch use or baby-led weaning, as currently practiced in New Zealand, were associated with poorer iron status in this age group. However, notable levels of suboptimal iron status, regardless of the feeding method, emphasise the ongoing need for paying attention to infant iron nutrition.
  • Thumbnail Image
    Item
    Blood donation, being Asian, and a history of iron deficiency are stronger predictors of iron deficiency than dietary patterns in premenopausal women
    (Hindawi Publishing Corporation, 2014) Beck KL; Conlon CA; Kruger R; Heath A-LM; Matthys C; Coad J; Jones B; Stonehouse W
    This study investigated dietary patterns and nondietary determinants of suboptimal iron status (serum ferritin < 20 μg/L) in 375 premenopausal women. Using multiple logistic regression analysis, determinants were blood donation in the past year [OR: 6.00 (95% CI: 2.81, 12.82); P < 0.001], being Asian [OR: 4.84 (95% CI: 2.29, 10.20); P < 0.001], previous iron deficiency [OR: 2.19 (95% CI: 1.16, 4.13); P = 0.016], a "milk and yoghurt" dietary pattern [one SD higher score, OR: 1.44 (95% CI: 1.08, 1.93); P = 0.012], and longer duration of menstruation [days, OR: 1.38 (95% CI: 1.12, 1.68); P = 0.002]. A one SD change in the factor score above the mean for a "meat and vegetable" dietary pattern reduced the odds of suboptimal iron status by 79.0% [OR: 0.21 (95% CI: 0.08, 0.50); P = 0.001] in women with children. Blood donation, Asian ethnicity, and previous iron deficiency were the strongest predictors, substantially increasing the odds of suboptimal iron status. Following a "milk and yoghurt" dietary pattern and a longer duration of menstruation moderately increased the odds of suboptimal iron status, while a "meat and vegetable" dietary pattern reduced the odds of suboptimal iron status in women with children.
  • Thumbnail Image
    Item
    Body composition associations with muscle strength in older adults living in Auckland, New Zealand
    (PLOS, 2021-05-28) Hiol AN; von Hurst PR; Conlon CA; Mugridge O; Beck KL; Coin A
    BACKGROUND: Aging is associated with decreases in muscle strength and simultaneous changes in body composition, including decreases in muscle mass, muscle quality and increases in adiposity. METHODS: Adults (n = 369; 236 females) aged 65-74 years living independently were recruited from the cross-sectional Researching Eating Activity and Cognitive Health (REACH) study. Body fat percentage and appendicular skeletal muscle mass (ASM) (sum of lean mass in the arms and legs) were assessed using Dual-energy X-ray Absorptiometry (Hologic, QDR Discovery A). The ASM index was calculated by ASM (kilograms) divided by height (meters) squared. Isometric grip strength was measured using a hand grip strength dynamometer (JAMAR HAND). RESULTS: Linear regression analyses revealed that muscle strength was positively associated with the ASM index (R2 = 0.431, p < 0.001). When exploring associations between muscle strength and muscle mass according to obesity classifications (obesity ≥30% males; ≥40% females), muscle mass was a significant predictor of muscle strength in non-obese participants. However, in participants with obesity, muscle mass was no longer a significant predictor of muscle strength. CONCLUSIONS: Body fat percentage should be considered when measuring associations between muscle mass and muscle strength in older adults.
  • Thumbnail Image
    Item
    Body Fat Percentage and Blood Donation are the Strongest Determinants of Iron Stores in Premenopausal Women Joining the New Zealand Army.
    (Oxford University Press, 2023-02-16) Martin NM; von Hurst PR; Conlon CA; Smeele RJM; Mugridge OAR; Beck KL
    INTRODUCTION: Suboptimal iron status is an issue for women joining the military because of its association with impaired aerobic performance, yet no studies have investigated dietary and non-dietary determinants of iron status simultaneously in this population. The purpose of this study was to explore associations between iron stores, dietary patterns (DPs), and potential non-dietary determinants of iron status in premenopausal women at the commencement of basic military training (BMT) in the New Zealand Army. METHODS: During week 1 of BMT, demographic, body composition, lifestyle, medical history, and dietary data were measured as potential determinants of serum ferritin (SF) in 101 participants. Following univariate analysis, age, body fat percentage, previous blood donation, at least 6 h of exercise per week that raised the heart rate, and a vegetarian DP were analyzed using a multiple linear regression model. RESULTS: An increase in body fat percentage was associated with increased SF (P < .009), although blood donation in the past year decreased SF (P < .011) compared to those participants who did not donate blood. There was no association between SF and a vegetarian DP or hours of exercise per week. The model explained 17.5% of the variance in SF at the commencement of BMT. CONCLUSION: Body fat percentage and blood donation in the past year were the strongest determinants of iron stores in healthy premenopausal women commencing BMT. It is recommended that women joining the New Zealand Army are provided information to maintain or improve their iron status based on these findings. This includes clinical screening of iron status, advice for women considering blood donation, and dietary advice regarding total energy requirements and iron bioavailability.
  • Thumbnail Image
    Item
    Evaluating a novel dietary diversity questionnaire to assess dietary diversity and adequacy of New Zealand women.
    (Elsevier Inc, 2021) Kruger R; Hepburn AJ; Beck KL; McNaughton S; Stonehouse W
    Objectives We sought to develop and evaluate the relative validity of a dietary diversity questionnaire (DDQ) that reflects food-group diversity, food variety, and micronutrient adequacy among New Zealand women. Methods A cross-sectional study included New Zealand women (Auckland based; ages 16–45 y, n = 101), completing a 7-d DDQ and 4-d weighed food record (reference method). The relative validity of the DDQ was evaluated by correlating nutritious and discretionary dietary diversity scores (DDSs; number of food groups) and food-variety scores (number of foods), calculated from both methods. The dietary mean adequacy ratio (MAR; micronutrient intakes relative to estimated average requirements) was calculated from the weighed food record and correlated to dietary diversity and food-variety scores from the DDQ to assess construct validity. Cross-tabulation was used to explore dietary diversity measures versus adequacy ratios. Significance was set at P < 0.05. Results The median (interquartile range) DDSs (maximum 25) from the DDQ—23 (21–23)—and the weighed food record—18 (17–19)—were significantly correlated (rs = 0.33, P < 0.001), as were the food-variety scores (maximum 237)—respectively, 75 (61–87) and 45 (37–52) (rs = 0.22, P < 0.03). A mean (± SD) MAR of 0.94 ± 0.04 suggested a near-adequate diet, but one-third of foods consumed were from discretionary sources. Nutritious DDS was significantly correlated with MAR for micronutrients (rs = 0.20, P ≤ 0.05). An inverse trend was observed between discretionary DDS and MAR. Conclusions The DDQ is a quick, low-burden tool for describing nutritious and discretionary dietary diversity reflecting micronutrient adequacy in high-income settings. It requires further validation across different time frames, population groups, and settings.
  • Thumbnail Image
    Item
    Frequent Use of Baby Food Pouches in Infants and Young Children and Associations with Energy Intake and BMI: An Observational Study.
    (MDPI (Basel, Switzerland), 2024-09-19) McLean NH; Bruckner BR; Heath A-LM; Haszard JJ; Daniels L; Conlon CA; von Hurst PR; Beck KL; Te Morenga LA; Firestone R; McArthur J; Paul R; Cox AM; Jones EA; Katiforis I; Brown KJ; Casale M; Jupiterwala RM; Rowan MM; Wei A; Fangupo LJ; Healey M; Pulu V; Neha T; Taylor RW; Fernandez M-L
    OBJECTIVE: Most wet commercial infant foods are now sold in squeezable 'pouches'. While multiple expert groups have expressed concern about their use, it is not known how commonly they are consumed and whether they impact energy intake or body mass index (BMI). The objectives were to describe pouch use, and determine associations with energy intake and BMI, in infants and young children. METHODS: In this observational cross-sectional study of 933 young New Zealand children (6.0 months-3.9 years), pouch use was assessed by a questionnaire ('frequent' use was consuming food from a baby food pouch ≥5 times/week in the past month), usual energy intake using two 24-h recalls, and BMI z-score calculated using World Health Organization standards. RESULTS: The sample broadly represented the wider population (27.1% high socioeconomic deprivation, 22.5% Māori). Frequent pouch use declined with age (infants 27%, toddlers 16%, preschoolers 8%). Few children were both frequent pouch users and regularly used the nozzle (infants 5%, toddlers 13%, preschoolers 8%). Preschoolers who were frequent pouch users consumed significantly less energy than non-users (-580 kJ [-1094, -67]), but infants (115 [-35, 265]) and toddlers (-206 [-789, 378]) did not appear to have a different energy intake than non-users. There were no statistically significant differences in the BMI z-score by pouch use. CONCLUSIONS: These results do not support the strong concerns expressed about their use, particularly given the lack of evidence for higher energy intake or BMI.
  • Thumbnail Image
    Item
    Hair and cord blood element levels and their relationship with air pollution, dietary intake, gestational diabetes mellitus, and infant neurodevelopment.
    (Elsevier B.V., 2023-08-23) Xia Y-Y; de Seymour JV; Yang X-J; Zhou L-W; Liu Y; Yang Y; Beck KL; Conlon CA; Mansell T; Novakovic B; Saffery R; Han T-L; Zhang H; Baker PN
    BACKGROUND & AIMS: Exposure to a range of elements, air pollution, and specific dietary components in pregnancy has variously been associated with gestational diabetes mellitus (GDM) risk or infant neurodevelopmental problems. We measured a range of pregnancy exposures in maternal hair and/or infant cord serum and tested their relationship to GDM and infant neurodevelopment. METHODS: A total of 843 pregnant women (GDM = 224, Non-GDM = 619) were selected from the Complex Lipids in Mothers and Babies cohort study. Forty-eight elements in hair and cord serum were quantified using inductively coupled plasma-mass spectrometry analysis. Binary logistic regression was used to estimate the associations between hair element concentrations and GDM risk, while multiple linear regression was performed to analyze the relationship between hair/cord serum elements and air pollutants, diet exposures, and Bayley Scales of infant neurodevelopment at 12 months of age. RESULTS: After adjusting for maternal age, BMI, and primiparity, we observed that fourteen elements in maternal hair were associated with a significantly increased risk of GDM, particularly Ta (OR = 9.49, 95% CI: 6.71, 13.42), Re (OR = 5.21, 95% CI: 3.84, 7.07), and Se (OR = 5.37, 95% CI: 3.48, 8.28). In the adjusted linear regression model, three elements (Rb, Er, and Tm) in maternal hair and infant cord serum were negatively associated with Mental Development Index scores. For dietary exposures, elements were positively associated with noodles (Nb), sweetened beverages (Rb), poultry (Cs), oils and condiments (Ca), and other seafood (Gd). In addition, air pollutants PM2.5 (LUR) and PM10 were negatively associated with Ta and Re in maternal hair. CONCLUSIONS: Our findings highlight the potential influence of maternal element exposure on GDM risk and infant neurodevelopment. We identified links between levels of these elements in both maternal hair and infant cord serum related to air pollutants and dietary factors.
  • Thumbnail Image
    Item
    Household food insecurity and novel complementary feeding methods in New Zealand families.
    (John Wiley and Sons Ltd, 2024-09-02) Katiforis I; Smith C; Haszard JJ; Styles SE; Leong C; Taylor RW; Conlon CA; Beck KL; von Hurst PR; Te Morenga LA; Daniels L; Brown KJ; Rowan M; Casale M; McLean NH; Cox AM; Jones EA; Bruckner BR; Jupiterwala R; Wei A; Heath A-LM
    Optimal nutrition during infancy is critical given its influence on lifelong health and wellbeing. Two novel methods of infant complementary feeding, commercial baby food pouch use and baby-led weaning (BLW), are becoming increasingly popular worldwide. Household food insecurity may influence complementary feeding practices adopted by families, but no studies have investigated the use of BLW and baby food pouches in families experiencing food insecurity. The First Foods New Zealand study was a multicentre, observational study in infants 7.0-9.9 months of age. Households (n = 604) were classified into one of three categories of food insecurity (severely food insecure, moderately food insecure, and food secure). The use of complementary feeding practices was assessed via a self-administered questionnaire, both at the current age (mean 8.4 months) and retrospectively at 6 months. Mothers experiencing severe food insecurity had 5.70 times the odds of currently using commercial baby food pouches frequently (≥5 times/week) compared to food secure mothers (95% CI [1.54, 21.01]), reporting that pouches were 'easy to use' (89%) and made it 'easy to get fruits and vegetables in' (64%). In contrast, no evidence of a difference in the prevalence of current BLW was observed among mothers experiencing moderate food insecurity (adjusted OR; 1.28, 95% CI [0.73, 2.24]) or severe food insecurity (adjusted OR; 1.03, 95% CI [0.44, 2.43]) compared to food secure mothers. The high prevalence of frequent commercial baby food pouch use in food insecure households underscores the need for research to determine whether frequent pouch use impacts infant health.
  • Thumbnail Image
    Item
    Nutritional Implications of Baby-Led Weaning and Baby Food Pouches as Novel Methods of Infant Feeding: Protocol for an Observational Study
    (JMIR Publications, 2021-04-21) Taylor RW; Conlon CA; Beck KL; von Hurst PR; Te Morenga LA; Daniels L; Haszard JJ; Meldrum AM; McLean NH; Cox AM; Tukuafu L; Casale M; Brown KJ; Jones EA; Katiforis I; Rowan M; McArthur J; Fleming EA; Wheeler BJ; Houghton LA; Diana A; Heath A-LM
    BACKGROUND: The complementary feeding period is a time of unparalleled dietary change for every human, during which the diet changes from one that is 100% milk to one that resembles the usual diet of the wider family in less than a year. Despite this major dietary shift, we know relatively little about food and nutrient intake in infants worldwide and virtually nothing about the impact of baby food "pouches" and "baby-led weaning" (BLW), which are infant feeding approaches that are becoming increasingly popular. Pouches are squeezable containers with a plastic spout that have great appeal for parents, as evidenced by their extraordinary market share worldwide. BLW is an alternative approach to introducing solids that promotes infant self-feeding of whole foods rather than being fed purées, and is popular and widely advocated on social media. The nutritional and health impacts of these novel methods of infant feeding have not yet been determined. OBJECTIVE: The aim of the First Foods New Zealand study is to determine the iron status, growth, food and nutrient intakes, breast milk intake, eating and feeding behaviors, dental health, oral motor skills, and choking risk of New Zealand infants in general and those who are using pouches or BLW compared with those who are not. METHODS: Dietary intake (two 24-hour recalls supplemented with food photographs), iron status (hemoglobin, plasma ferritin, and soluble transferrin receptor), weight status (BMI), food pouch use and extent of BLW (questionnaire), breast milk intake (deuterium oxide "dose-to-mother" technique), eating and feeding behaviors (questionnaires and video recording of an evening meal), dental health (photographs of upper and lower teeth for counting of caries and developmental defects of enamel), oral motor skills (questionnaires), and choking risk (questionnaire) will be assessed in 625 infants aged 7.0 to 9.9 months. Propensity score matching will be used to address bias caused by differences in demographics between groups so that the results more closely represent a potential causal effect. RESULTS: This observational study has full ethical approval from the Health and Disability Ethics Committees New Zealand (19/STH/151) and was funded in May 2019 by the Health Research Council (HRC) of New Zealand (grant 19/172). Data collection commenced in July 2020, and the first results are expected to be submitted for publication in 2022. CONCLUSIONS: This large study will provide much needed data on the implications for nutritional intake and health with the use of baby food pouches and BLW in infancy. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12620000459921; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379436. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/29048.
  • Thumbnail Image
    Item
    Parent-reported offering of allergen foods to infants during complementary feeding: An observational study of New Zealand infants
    (Elsevier Ltd, 2024-12-01) Medemblik JM; Conlon CA; Haszard JJ; Heath A-LM; Taylor RW; Von Hurst P; Beck KL; Te Morenga L; Daniels L; Keller K
    The prevalence of food allergies in New Zealand infants is uncertain but is believed to be similar to Australia, exceeding 10%. Current recommendations for reducing food allergy risk are to offer all major food allergens to infants from as early as six months of age (start of complementary feeding), and before 12 months of age. However, little is known regarding parental practices around introducing major food allergens. This study aimed to explore parental offering of major food allergens to infants during complementary feeding, and parent-reported food allergies. The cross-sectional study is a secondary analysis of the multi-centre (Auckland and Dunedin) First Foods New Zealand study of 625 parent-infant dyads. Participants were recruited in 2020-2022 when infants were 7-10 months of age. Questionnaires assessed sociodemographic characteristics, complementary feeding approach, infant pouch use and parental responses to five food allergy questions. All major food allergens had been offered to only 17% of infants by 9-10 months of age. Having offered egg, peanut, tree nuts, sesame, soy and seafood was more commonly associated with using a baby-led complementary feeding approach than a parent-led approach (p < 0.001). Frequent baby food pouch use was associated with a lower likelihood of offering egg and peanut (both p < 0.001). Overall, 12.6% of infants had a reported food allergy, with symptomatic response after exposure being the most common diagnostic tool. Most infants are not offered all major food allergens during early complementary feeding, with some parents actively avoiding major food allergens in the first year of life. These results provide up-to-date knowledge of parental practices, highlighting the need for more targeted advice and strategies to improve parental engagement with allergy prevention and diagnosis.
  • Thumbnail Image
    Item
    Plasma nervonic acid levels were negatively associated with attention levels in community-living older adults in New Zealand
    (Springer Nature, 2022-08) de Seymour JV; Beck KL; Conlon CA; Von Hurst PR; Mumme KD; Haskell-Ramsay CF; Jones MB
    The global population is aging. Preserving function and independence of our aging population is paramount. A key component to maintaining independence is the preservation of cognitive function. Metabolomics can be used to identify biomarkers of cognition before noticeable deterioration. Our study investigated the plasma metabolome of 332 community-living New Zealanders between 65 and 74 years of age, using gas chromatography-mass spectrometry. Six cognitive domains were assessed. Of the 123 metabolites identified using an in-house mass spectral libraries of standards, nervonic acid had a significant, inverse association with the attention domain (P-value = 1.52E− 4; FDR = 0.019), after adjusting for covariates (apolipoprotein E -ε4 genotype, sex, body fat percentage (standardised by sex), age, education, deprivation index, physical activity, metabolic syndrome, polypharmacy, smoking status, and alcohol intake) and multiple testing. Attention is defined as the ability to concentrate on selected aspects of the environment while ignoring other stimuli. This is the first study to identify nervonic acid as a potential biomarker of attention in older adults. Future research should confirm this association in a longitudinal study.
  • Thumbnail Image
    Item
    Predictors and risks of body fat profiles in young New Zealand European, Māori and Pacific women: study protocol for the women’s EXPLORE study
    (SpringerOpen, 1/12/2015) Kruger R; Shultz SP; McNaughton SA; Russell AP; Firestone RT; George L; Beck KL; Conlon CA; von Hurst PR; Breier B; Jayasinghe SN; O Brien WJ; Jones B; Stonehouse W
    Background: Body mass index (BMI) (kg/m2) is used internationally to assess body mass or adiposity. However, BMI does not discriminate body fat content or distribution and may vary among ethnicities. Many women with normal BMI are considered healthy, but may have an unidentified “hidden fat” profile associated with higher metabolic disease risk. If only BMI is used to indicate healthy body size, it may fail to predict underlying risks of diseases of lifestyle among population subgroups with normal BMI and different adiposity levels or distributions. Higher body fat levels are often attributed to excessive dietary intake and/or inadequate physical activity. These environmental influences regulate genes and proteins that alter energy expenditure/storage. Micro ribonucleic acid (miRNAs) can influence these genes and proteins, are sensitive to diet and exercise and may influence the varied metabolic responses observed between individuals. The study aims are to investigate associations between different body fat profiles and metabolic disease risk; dietary and physical activity patterns as predictors of body fat profiles; and whether these risk factors are associated with the expression of microRNAs related to energy expenditure or fat storage in young New Zealand women. Given the rising prevalence of obesity globally, this research will address a unique gap of knowledge in obesity research. Methods/Design: A cross-sectional design to investigate 675 NZ European, Māori, and Pacific women aged 16–45 years. Women are classified into three main body fat profiles (n = 225 per ethnicity; n = 75 per body fat profile): 1) normal BMI, normal body fat percentage (BF%); 2) normal BMI, high BF%; 3) high BMI, high BF%. Regional body composition, biomarkers of metabolic disease risk (i.e. fasting insulin, glucose, HbA1c, lipids), inflammation (i.e. IL-6, TNF-alpha, hs-CRP), associations between lifestyle factors (i.e. dietary intake, physical activity, taste perceptions) and microRNA expression will be investigated. Discussion: This research targets post-menarcheal, premenopausal women, potentially exhibiting lifestyle behaviours resulting in excess body fat affecting metabolic health. These behaviours may be characterised by specific patterns of microRNA expression that will be explored in terms of tailored solutions specific to body fat profile groups and ethnicities. Trial registration: ACTRN12613000714785
  • Thumbnail Image
    Item
    Protein intake, distribution, and sources in community-dwelling older adults living in Auckland, New Zealand
    (IOS Press, 2023-10-13) Hiol AN; Von Hurst PR; Conlon CA; Mumme KD; Beck KL
    BACKGROUND: To maximally stimulate muscle protein synthesis (MPS), older adults should consume≥1.2 g/kg body weight (BW) of high-quality protein, evenly distributed across the day ( 0.4 g/kg BW per meal). OBJECTIVES: To investigate protein intake, distribution, and sources in community-dwelling older adults. METHODS: Data (including a 4-day food record) were obtained from the Researching Eating, Activity, and Cognitive Health (REACH) study, a cross-sectional study in adults aged 65 to 74 years. RESULTS: Participants (n = 327, 65.4% female) had a median daily protein intake of 1.16 g/kg BW (males) and 1.09 g/kg BW (females). Over half of participants consumed less than 1.2 g protein/kg BW/day (62% females, 57% males). Protein intake was unevenly distributed throughout the day (CV = 0.48 for males and females) and was inadequate for reaching 0.4 g/kg BW/meal at breakfast and at the mid-day meal (males only). The main sources of protein at breakfast were milk (28%), breakfast cereals (22%), and bread (12%); at the mid-day meal, bread (18%), cheese (10%) and milk (9%); and at the evening meal, meat provided over half the protein (56%). CONCLUSIONS: Protein intake for a high proportion of older adults was less than 1.2 g/kg BW/day, and unevenly distributed through the day. Protein was obtained mainly from cereals and dairy products at breakfast and the mid-day meal, and meat sources at the evening meal.
  • Thumbnail Image
    Item
    Recent Developments in the Assessment of Nutrition Knowledge in Athletes
    (Springer Science+Business Media, LLC, 2022-06) Tam R; Gifford JA; Beck KL
    Purpose of Review Adequate nutrition knowledge may influence dietary behaviour, and the performance and health of athletes. Assessment of the nutrition knowledge of athletes can inform practice and provide a quantitative way to evaluate education interventions. This article aims to review nutrition knowledge questionnaires published in the last 5 years to identify advances, possible improvements in questionnaire development and design, and challenges that remain. Recent Findings Twelve new or modified questionnaires were identified. All had undergone validity and reliability testing. Advancements included quantitative measures of content validity and Rasch analysis. Online questionnaires were common, with at least seven using this format. Advances included use of images (n=2), automated scored feedback (n=1), and use of applied questions. Summary While advancements have been made in validation and reliability testing and electronic delivery, new questionnaires would benefit from interactive and attractive features including images, provision of electronic feedback, and applied questions.
  • Thumbnail Image
    Item
    Relationship between vitamin D, iron, and hepcidin in premenopausal females, potentially confounded by ethnicity.
    (Springer Nature, 2023-08-29) Greenwood A; Von Hurst PR; Beck KL; Mazahery H; Lim K; Badenhorst CE
    PURPOSE: To investigate the associations between vitamin D, hepcidin, and iron status in premenopausal females of different ethnic cohorts residing in Auckland, New Zealand (NZ). METHODS: A total of 160 females aged 18-45 years participated in a cross-sectional study. Demographics, body composition, serum 25(OH)D, inflammatory markers (C-reactive protein and interleukin-6, IL-6), and iron biomarkers (serum ferritin, haemoglobin, soluble transferrin receptor, and hepcidin) were measured. Comparisons between parametric, non-parametric, and categorical variables were completed by using one-way ANOVA, Kruskal-Wallis, and Chi-squared tests, respectively. ANCOVA was used to compare serum 25(OH)D across iron parameter categories. RESULTS: Of the 160 participants, 60 were NZ European, 67 were South Asian, and 33 were from the 'other' ethnic groups. South Asians had significantly higher body fat percentage (BF%) and IL-6 concentration (38.34% and 1.66 pg·mL-1, respectively), compared to NZ Europeans (27.49% and 0.63 pg·mL-1, respectively, p < 0.001). South Asians had significantly lower 25(OH)D concentrations compared to NZ Europeans (33.59 nmol·L-1 vs 74.84 nmol·L-1, p < 0.001). In NZ Europeans, higher 25(OH)D concentration was seen in those with lower (≤ 3.5 nM) hepcidin concentration, p = 0.0046. In South Asians, higher 25(OH)D concentration was seen in those with higher (> 3.5 nM) hepcidin concentrations, p = 0.038. There were no associations between serum 25(OH)D and serum ferritin. CONCLUSION: Within South Asian women, an unexpected positive relationship between 25(OH)D and hepcidin concentration was observed which may be due to significantly higher IL-6 concentrations, BF%, and lower 25(OH)D concentrations. Future research is required to confirm these observations in this ethnic cohort.