Browsing by Author "McLean R"

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    Effectiveness of a Sodium-Reduction Smartphone App and Reduced-Sodium Salt to Lower Sodium Intake in Adults With Hypertension: Findings From the Salt Alternatives Randomized Controlled Trial.
    (JMIR Publications, 2023-03-09) Eyles H; Grey J; Jiang Y; Umali E; McLean R; Te Morenga L; Neal B; Rodgers A; Doughty RN; Ni Mhurchu C; Buis LR; Eysenbach G
    BACKGROUND: Even modest reductions in blood pressure (BP) can have an important impact on population-level morbidity and mortality from cardiovascular disease. There are 2 promising approaches: the SaltSwitch smartphone app, which enables users to scan the bar code of a packaged food using their smartphone camera and receive an immediate, interpretive traffic light nutrition label on-screen alongside a list of healthier, lower-salt options in the same food category; and reduced-sodium salts (RSSs), which are an alternative to regular table salt that are lower in sodium and higher in potassium but have a similar mouthfeel, taste, and flavor. OBJECTIVE: Our aim was to determine whether a 12-week intervention with a sodium-reduction package comprising the SaltSwitch smartphone app and an RSS could reduce urinary sodium excretion in adults with high BP. METHODS: A 2-arm parallel randomized controlled trial was conducted in New Zealand (target n=326). Following a 2-week baseline period, adults who owned a smartphone and had high BP (≥140/85 mm Hg) were randomized in a 1:1 ratio to the intervention (SaltSwitch smartphone app + RSS) or control (generic heart-healthy eating information from The Heart Foundation of New Zealand). The primary outcome was 24-hour urinary sodium excretion at 12 weeks estimated via spot urine. Secondary outcomes were urinary potassium excretion, BP, sodium content of food purchases, and intervention use and acceptability. Intervention effects were assessed blinded using intention-to-treat analyses with generalized linear regression adjusting for baseline outcome measures, age, and ethnicity. RESULTS: A total of 168 adults were randomized (n=84, 50% per group) between June 2019 and February 2020. Challenges associated with the COVID-19 pandemic and smartphone technology detrimentally affected recruitment. The adjusted mean difference between groups was 547 (95% CI -331 to 1424) mg for estimated 24-hour urinary sodium excretion, 132 (95% CI -1083 to 1347) mg for urinary potassium excretion, -0.66 (95% CI -3.48 to 2.16) mm Hg for systolic BP, and 73 (95% CI -21 to 168) mg per 100 g for the sodium content of food purchases. Most intervention participants reported using the SaltSwitch app (48/64, 75%) and RSS (60/64, 94%). SaltSwitch was used on 6 shopping occasions, and approximately 1/2 tsp per week of RSS was consumed per household during the intervention. CONCLUSIONS: In this randomized controlled trial of a salt-reduction package, we found no evidence that dietary sodium intake was reduced in adults with high BP. These negative findings may be owing to lower-than-anticipated engagement with the trial intervention package. However, implementation and COVID-19-related challenges meant that the trial was underpowered, and it is possible that a real effect may have been missed. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12619000352101; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377044 and Universal Trial U1111-1225-4471.
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    Erratum: Estimating Free and Added Sugar Intakes in New Zealand; Nutrients 2017, 9, 1292
    (MDPI (Basel, Switzerland), 2018-05-18) Kibblewhite R; Nettleton A; McLean R; Haszard J; Fleming E; Kruimer D; Te Morenga L
    The authors have requested that the following changes be made to their paper. In Figure 1, the caption was changed to “Figure 1. 10–step method for estimating free sugars content (adapted from Louie et al. 2015 [14])”. In Appendix A, “This appendix details how we used and adapted the 10-step methodology for estimating added sugars described by Louie et al. 2015 [14] to calculate free sugars in the New Zealand food composition database, based on analytical data on total sugars and ingredients in food products. We used the unmodified Louie method to estimate added sugars in the New Zealand food composition database as reported in this paper” [2] was inserted in front of the Appendix A title. Further, “adapted from Louie et al., 2015 [14]” [2] was added after the title. “as per Step 1 of Louie et al., 2015 [14]” [2] was added in Step 1. “as per Step 2 of Louie et al., 2015 [14]” [2] was added in Step 2. “adapted from Step 3 of Louie et al., 2015 [14]” [2] was added in Step 3. “as per Step 4 of Louie et al., 2015 [14]” [2] was added in Step 4a; “adapted from Step 4 of Louie et al.2015 [14]” [2] was added in Step 4b. “as per Step 5 of Louie et al., 2015 [14]” [2] was added in Step 5. “as per Step 6 of Louie et al., 2015 [14]” [2] was added in Step 6. “adapted from Step 7 of Louie et al., 2015 [14]” [2] was added in Step 7. “as per from Step 9 of Louie et al., 2015 [14]” [2] was added as the last sentence of Step 9. “adapted from Step 10 of Louie et al., 2015 [14]” [2] was added as the last sentence of Step 10.
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    Food, nutrition and cancer: perspectives and experiences of New Zealand cancer survivors
    (New Zealand Medical Association, 2021-11-12) Peniamina R; Davies C; Moata'ane L; Signal L; Tavite H; Te Morenga L; McLean R
    AIM: This research sought to understand and describe cancer survivors' perspectives and post-diagnosis experiences of food and nutrition, with a particular focus on barriers to healthy eating, health equity, and Māori and Pacific perspectives. METHOD: Data were collected using semi-structured interviews with cancer survivors from three different ethnic groups (Māori, Pacific Peoples, and New Zealand European). Thematic analysis was undertaken to identify both similar and contrasting experiences and perspectives in relation to topics of interest. Data analysis also sought to identify any trends indicating differences between ethnic groups. RESULTS: Limited awareness of the role nutrition has in cancer recovery or prevention, combined with little or no access to nutrition advice/support, meant that healthy dietary change was not a focus for some cancer survivors in this study, whereas others invested considerable time and money accessing nutrition information and support outside of cancer care services. Financial limitations (eg, cost of healthy food and low income) and lack of practical support were also important barriers to post-diagnosis healthy eating. CONCLUSION: There is a need for more widely available cancer-specific nutrition advice and support in New Zealand. Interventions to address financial barriers and increase access to cancer-related nutrition advice and support have the potential to improve cancer outcomes and reduce inequities in cancer outcomes.
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    How Does Driving Anxiety Relate to the Health and Quality of Life of Older Drivers?
    (2022-05) Taylor JE; McLean R; Samaranayaka A; Connolly MJ
    OBJECTIVES: 11% of drivers aged 65+ report moderate to extreme driving anxiety, with associated reduction in driving. Knowledge about the relationships of driving anxiety with health and quality of life for older people is minimal. The present study examined these relationships. METHOD: 1170 community dwelling drivers aged 65+ in New Zealand completed a population survey. RESULTS: After adjusting for socio-demographic variables, higher driving anxiety was associated with lower quality of life and lower odds of 'very good' self-reported health, but no difference in odds of multi-comorbidity. DISCUSSION: Further research is needed to examine the influence of driving anxiety on health and quality of life outcomes with a broader range of older people who experience more challenges to their health and wellbeing, especially to mental health.