Massey Research Online - Browsing by Author "Te Morenga L"

Browsing by Author "Te Morenga L"

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2021 Assessment of New Zealand district health boards' institutional healthy food and drink policies: the HealthY Policy Evaluation (HYPE) study
(Pasifika Medical Association Group (PMAG), 2022-08-19) Gerritsen S; Kidd B; Rosin M; Shen S; Mackay S; Te Morenga L; Mhurchu CN
AIM: To assess adoption of the voluntary National Healthy Food and Drink Policy (NHFDP) and the alignment of individual institutional healthy food and drink policies with the NHFDP. METHOD: All 20 district health boards (DHBs) and two national government agencies participated. Policies of those organisations that had not fully adopted the NHFDP were assessed across three domains: nutrition standards; promotion of a healthy food and beverages environment; and policy communication, implementation and evaluation. Three weighted domain scores out of 10, and a total score out of 30 were calculated. RESULTS: Nine of the 22 organisations reported adopting the NHFDP in full. Of the remaining 13, six referred to the NHFDP when developing their institutional policy and three were working toward full adoption of the NHFDP. Mean scores (SD) were 8.7 (1.0), 6.1 (2.6) and 3.8 (2.2) for the three domains, and 18.6 (4.8) in total. Most individual institutional policies were not as comprehensive as the NHFDP. However, some contained stricter/additional clauses that would be useful to incorporate into the NHFDP. CONCLUSION: Since a similar policy analysis in 2018, most DHBs have adopted the NHFDP and/or strengthened their own nutrition policies. Regional inconsistency remains and a uniform mandatory NHFDP should be implemented that incorporates improvements identified in individual institutional policies.
A Casual Video Game With Psychological Well-being Concepts for Young Adolescents: Protocol for an Acceptability and Feasibility Study
(JMIR Publications, 2021-08-12) Pine R; Mbinta J; Te Morenga L; Fleming T
BACKGROUND: Many face-to-face and digital therapeutic supports are designed for adolescents experiencing high levels of psychological distress. However, promoting psychological well-being among adolescents is often neglected despite significant short-term and long-term benefits. OBJECTIVE: This research has 3 main objectives: (1) to assess the acceptability of Match Emoji, a casual video game with psychological well-being concepts among 13-15-year-old students in a New Zealand secondary school; (2) to identify the feasibility of the research process; and (3) to explore the preliminary well-being and therapeutic potential of Match Emoji. METHODS: Approximately 40 participants aged 13-15 years from a local secondary college in Wellington, New Zealand, will be invited to download and play Match Emoji 3-4 times a week for 5-15 minutes over a 2-week period. Participants will complete 4 assessments at baseline, postintervention, and 3 weeks later to assess psychological well-being and therapeutic changes. Statistical analysis will be used to synthesize data from interviews and triangulated with assessment changes and game analytics. This synthesis will help to assess the acceptability and feasibility of the Match Emoji. RESULTS: The key outputs from the project will include the acceptability, feasibility, and therapeutic potential of Match Emoji. It is anticipated that participants will have finished playing the recommended game play regimen by August 2021 with analysis of results completed by October 2021. CONCLUSIONS: Data from the study are expected to inform future research on Match Emoji including a randomized controlled trial and further adjustments to the design and development of the game. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/31588.
A Co-Designed, Culturally-Tailored mHealth Tool to Support Healthy Lifestyles in Māori and Pasifika Communities in New Zealand: Protocol for a Cluster Randomized Controlled Trial
(JMIR Publications, 22/08/2018) Verbiest M; Borrell S; Dalhousie S; Tupa'i-Firestone R; Funaki T; Goodwin D; Grey J; Henry A; Hughes E; Humphrey G; Jiang Y; Jull A; Pekepo C; Schumacher J; Te Morenga L; Tunks M; Vano M; Whittaker R; Ni Mhurchu C
BACKGROUND: New Zealand urgently requires scalable, effective, behavior change programs to support healthy lifestyles that are tailored to the needs and lived contexts of Māori and Pasifika communities. OBJECTIVE: The primary objective of this study is to determine the effects of a co-designed, culturally tailored, lifestyle support mHealth tool (the OL@-OR@ mobile phone app and website) on key risk factors and behaviors associated with an increased risk of noncommunicable disease (diet, physical activity, smoking, and alcohol consumption) compared with a control condition. METHODS: A 12-week, community-based, two-arm, cluster-randomized controlled trial will be conducted across New Zealand from January to December 2018. Participants (target N=1280; 64 clusters: 32 Māori, 32 Pasifika; 32 clusters per arm; 20 participants per cluster) will be individuals aged ≥18 years who identify with either Māori or Pasifika ethnicity, live in New Zealand, are interested in improving their health and wellbeing or making lifestyle changes, and have regular access to a mobile phone, tablet, laptop, or computer and to the internet. Clusters will be identified by community coordinators and randomly assigned (1:1 ratio) to either the full OL@-OR@ tool or a control version of the app (data collection only plus a weekly notification), stratified by geographic location (Auckland or Waikato) for Pasifika clusters and by region (rural, urban, or provincial) for Māori clusters. All participants will provide self-reported data at baseline and at 4- and 12-weeks postrandomization. The primary outcome is adherence to healthy lifestyle behaviors measured using a self-reported composite health behavior score at 12 weeks that assesses smoking behavior, fruit and vegetable intake, alcohol intake, and physical activity. Secondary outcomes include self-reported body weight, holistic health and wellbeing status, medication use, and recorded engagement with the OL@-OR@ tool. RESULTS: Trial recruitment opened in January 2018 and will close in July 2018. Trial findings are expected to be available early in 2019. CONCLUSIONS: Currently, there are no scalable, evidence-based tools to support Māori or Pasifika individuals who want to improve their eating habits, lose weight, or be more active. This wait-list controlled, cluster-randomized trial will assess the effectiveness of a co-designed, culturally tailored mHealth tool in supporting healthy lifestyles. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Register ACTRN12617001484336; http://www.ANZCTR.org.au/ACTRN12617001484336.aspx (Archived by WebCite at http://www.webcitation.org/71DX9BsJb). REGISTERED REPORT IDENTIFIER: RR1-10.2196/10789.
A Novel Casual Video Game With Simple Mental Health and Well-Being Concepts (Match Emoji): Mixed Methods Feasibility Study.
(JMIR Publications, 2024-02-12) Pine R; Mbinta J; Te Morenga L; Fleming T; Leung TI
BACKGROUND: Adolescence is a crucial phase for early intervention and prevention of mental health problems. Casual video games are popular and have promise as a novel mechanism for reaching young people, but this potential has seldom been explored. OBJECTIVE: This study aimed to explore the acceptability, feasibility, and possible indicators of therapeutic changes after playing a purpose-built novel casual video game (Match Emoji) with simple mental health and well-being content among young adolescents. METHODS: We conducted a single-arm, nonrandomized trial of Match Emoji with 12- to 14-year-old school students (N=45; 26 [57%] New Zealand European, 12 [26%] Māori; 7 [15%] Asian or Pacific; 27 [60%] boys, 3 [6%] non-binary). Participants were invited to play Match Emoji for 15 minutes, 2-3 times a week over 2 weeks (a total of 60 minutes). Acceptability was assessed through the frequency and duration of use (analytics analyzed at the end of the 2-week intervention period and at weeks 4 and 6) and through participant reports. The Child and Adolescent Mindfulness Measure (CAMM), General Help-Seeking Questionnaire (GHSQ), Flourishing Scale (FS), and Revised Children's Anxiety and Depression Scale (RCADS) were assessed at baseline and week 2 to indicate possible effects. Focus groups were held in week 4. RESULTS: Most participants (n=39, 87%) used Match Emoji for at least 60 minutes over the 2-week intervention, with 80% (36/45) continuing to play the game after the intervention period. Mean change (from baseline to 2 weeks) on each measure was 1.38 (95% CI -0.03 to 2.79; P=.06) for CAMM; 0.8 (95% CI -2.71 to 4.31; P=.64) for GHSQ; -1.09 (95% CI -2.83 to 0.66; P=.21) for FS; and -3.42 (95% CI -6.84 to -0.001; P=0.49) for RCADS. Focus group feedback suggested that Match Emoji was enjoyable and helpful. CONCLUSIONS: The casual video game with mental health content appeared to be acceptable and provided a promising indication of possible therapeutic effects. This approach is worthy of further investigation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/31588.
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.
Awareness, support, and opinions of healthy food and drink policies: a survey of staff and visitors in New Zealand healthcare organisations.
(BioMed Central Ltd, 2024-08-12) Gerritsen S; Rosin M; Te Morenga L; Jiang Y; Kidd B; Shen S; Umali E; Mackay S; Ni Mhurchu C
Background In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, “the Policy”) was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors’ awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy. Methods Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants. Results Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that “Hospitals should be good role models.” Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options. Conclusions The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces.
Barriers and facilitators to implementation of healthy food and drink policies in public sector workplaces: a systematic literature review.
(19/06/2023) Rosin M; Mackay S; Gerritsen S; Te Morenga L; Terry G; Ni Mhurchu C
CONTEXT: Many countries and institutions have adopted policies to promote healthier food and drink availability in various settings, including public sector workplaces. OBJECTIVE: The objective of this review was to systematically synthesize evidence on barriers and facilitators to implementation of and compliance with healthy food and drink policies aimed at the general adult population in public sector workplaces. DATA SOURCES: Nine scientific databases, 9 grey literature sources, and government websites in key English-speaking countries along with reference lists. DATA EXTRACTION: All identified records (N = 8559) were assessed for eligibility. Studies reporting on barriers and facilitators were included irrespective of study design and methods used but were excluded if they were published before 2000 or in a non-English language. DATA ANALYSIS: Forty-one studies were eligible for inclusion, mainly from Australia, the United States, and Canada. The most common workplace settings were healthcare facilities, sports and recreation centers, and government agencies. Interviews and surveys were the predominant methods of data collection. Methodological aspects were assessed with the Critical Appraisal Skills Program Qualitative Studies Checklist. Generally, there was poor reporting of data collection and analysis methods. Thematic synthesis identified 4 themes: (1) a ratified policy as the foundation of a successful implementation plan; (2) food providers' acceptance of implementation is rooted in positive stakeholder relationships, recognizing opportunities, and taking ownership; (3) creating customer demand for healthier options may relieve tension between policy objectives and business goals; and (4) food supply may limit the ability of food providers to implement the policy. CONCLUSIONS: Findings suggest that although vendors encounter challenges, there are also factors that support healthy food and drink policy implementation in public sector workplaces. Understanding barriers and facilitators to successful policy implementation will significantly benefit stakeholders interested or engaging in healthy food and drink policy development and implementation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021246340.
Co-design of mhealth delivered interventions: A systematic review to assess key methods and processes
(Springer, 4/07/2016) Eyles H; Jull A; Dobson R; Firestone RT; Whittaker R; Te Morenga L; Goodwin D; Ni Mhurchu C
Most mobile health (mHealth) programmes are designed with minimal input from target end users and are not truly personalised or adaptive to their specific and evolving needs. This review describes the methods and processes used in the co-design of mHealth interventions. Nine relevant studies of varying design were identified following searches of six academic databases. All employed co-design or participatory methods for the development of a health intervention delivered via a mobile device, with three focusing on health behaviour change (one on nutrition) and six on management of a health condition. Overall, six key phases of design and 17 different methods were used. Sufficiency of reporting was poor, and no study undertook a robust assessment of efficacy; these factors should be a focus for future studies. An opportunity exists to use co-design methods to develop acceptable and feasible mHealth interventions, especially to support improved nutrition and for minority and indigenous groups.
Development of a casual video game (Match Emoji) with psychological well-being concepts for young adolescents
(SAGE Publications, 2021-10-04) Pine R; Te Morenga L; Olson M; Fleming T
Digital interventions for mental health and well-being have been shown to be effective in trials, yet uptake and retention in real-world settings are often disappointing. A more significant impact may be achieved by building interventions that are closer to how target groups use technology to support their own psychological well-being. Casual video games may be poised to offer an opportunity in this area as they are a highly popular activity among young people. We propose that mental health content can be integrated into the explicit content and the implicit processes used in casual video games. In this paper, we describe the design and core processes of Match Emoji, a casual video game designed to support the development of psychological well-being via gameplay and micro-messages. The iterative development of Match Emoji involved various phases, including a systematic review of the literature, consultation with target users, clinicians, game developers, and close reading of the literature. Expert collaboration was sought throughout the process to ensure gameplay and messages matched behaviour change and learning theories. An acceptability and feasibility study of Match Emoji will inform a randomised controlled trial in the future.
Dietary Fibre Intake, Adiposity, and Metabolic Disease Risk in Pacific and New Zealand European Women
(MDPI (Basel, Switzerland), 2024-10-07) Renall N; Merz B; Douwes J; Corbin M; Slater J; Tannock GW; Firestone R; Kruger R; Te Morenga L; Brownlee IA; Feraco A; Armani A
BACKGROUND/OBJECTIVES: To assess associations between dietary fibre intake, adiposity, and odds of metabolic syndrome in Pacific and New Zealand European women. METHODS: Pacific (n = 126) and New Zealand European (NZ European; n = 161) women (18-45 years) were recruited based on normal (18-24.9 kg/m2) and obese (≥30 kg/m2) BMIs. Body fat percentage (BF%), measured using whole body DXA, was subsequently used to stratify participants into low (<35%) or high (≥35%) BF% groups. Habitual dietary intake was calculated using the National Cancer Institute (NCI) method, involving a five-day food record and semi-quantitative food frequency questionnaire. Fasting blood was analysed for glucose and lipid profile. Metabolic syndrome was assessed with a harmonized definition. RESULTS: NZ European women in both the low- and high-BF% groups were older, less socioeconomically deprived, and consumed more dietary fibre (low-BF%: median 23.7 g/day [25-75-percentile, 20.1, 29.9]; high-BF%: 20.9 [19.4, 24.9]) than Pacific women (18.8 [15.6, 22.1]; and 17.8 [15.0, 20.8]; both p < 0.001). The main source of fibre was discretionary fast foods for Pacific women and whole grain breads and cereals for NZ European women. A regression analysis controlling for age, socioeconomic deprivation, ethnicity, energy intake, protein, fat, and total carbohydrate intake showed an inverse association between higher fibre intake and BF% (β= -0.47, 95% CI = -0.62, -0.31, p < 0.001), and odds of metabolic syndrome (OR = 0.91, 95% CI = 0.84, 0.98, p = 0.010) among both Pacific and NZ European women (results shown for both groups combined). CONCLUSIONS: Low dietary fibre intake was associated with increased metabolic disease risk. Pacific women had lower fibre intakes than NZ European women.
Dietary patterns associated with meeting the WHO free sugars intake guidelines
(Cambridge University Press, 2020-06) Steele C; Eyles H; Te Morenga L; Ni Mhurchu C; Cleghorn C
OBJECTIVE: Emerging evidence suggests that free sugars intake in many countries exceeds that recommended by the WHO. However, information regarding real-world dietary patterns associated with meeting the WHO free sugars guidelines is lacking. The current study aimed to determine dietary patterns associated with meeting the guidelines to inform effective free sugars reduction interventions in New Zealand (NZ) and similar high-income countries. DESIGN: Dietary patterns were derived using principal component analysis on repeat 24-h NZ Adult Nutrition Survey dietary recall data. Associations between dietary patterns and the WHO guidelines (<5 and <10 % total energy intake) were determined using logistic regression analyses. SETTING: New Zealand. PARTICIPANTS: NZ adults (n 4721) over 15 years old. RESULTS: Eight dietary patterns were identified: 'takeaway foods and alcohol' was associated with meeting both WHO guidelines; 'contemporary' was associated with meeting the <10 % guideline (males only); 'fast foods, sugar-sweetened beverages and dessert', 'traditional' and 'breakfast foods' were negatively associated with meeting both guidelines; 'sandwich' and 'snack foods' were negatively associated with the <5 % guideline; and 'saturated fats and sugar' was negatively associated with the <10 % guideline. CONCLUSIONS: The majority of NZ dietary patterns were not consistent with WHO free sugars guidelines. It is possible to meet the WHO guidelines while consuming a healthier ('contemporary') or energy-dense, nutrient-poor ('takeaway foods and alcohol') diet. However, the majority of energy-dense patterns were not associated with meeting the guidelines. Future nutrition interventions would benefit from focusing on establishing healthier overall diets and reducing consumption and free sugars content of key foods.
Effect of Wholegrain Flour Particle Size in Bread on Glycaemic and Insulinaemic Response among People with Risk Factors for Type 2 Diabetes: A Randomised Crossover Trial
(MDPI (Basel, Switzerland), 2021-08) Mete E; Haszard J; Perry T; Oey I; Mann J; Te Morenga L
Wholegrain flour produced by roller-milling is predominantly comprised of fine particles, while stoneground flour tends to have a comparatively smaller proportion of fine particles. Differences in flour particle size distribution can affect postprandial glycaemia in people with type 2 diabetes and postprandial insulinaemia in people with and without type 2 diabetes. No prior studies have investigated the effect of wholegrain flour particle size distribution on glycaemic or insulinaemic response among people with impaired glucose tolerance or risk factors for type 2 diabetes. In a randomised crossover study, we tested the 180-min acute glycaemic and insulinaemic responses to three wholegrain breads differing in flour particle size and milling method: (1) fine roller-milled flour, (2) fine stoneground flour, and (3) coarse stoneground flour. Participants (n = 23) were males and females with risk factors for type 2 diabetes (age 55-75 y, BMI >28 kg/m2, completing less than 150 min moderate to vigorous intensity activity per week). Each test meal provided 50 g available carbohydrate, and test foods were matched for energy and macronutrients. There was no significant difference in blood glucose iAUC (incremental area under the curve) between the coarse stoneground flour bread and the fine stoneground flour bread (mean difference -20.8 (95% CI: -51.5, 10.0) mmol·min/L) and between the coarse stoneground flour bread and the fine roller-milled flour bread (mean difference -23.3 (95% CI: -57.6, 11.0) mmol·min/L). The mean difference in insulin iAUC for fine stoneground flour bread compared with the fine roller-milled flour bread was -6.9% (95% CI: -20.5%, 9.2%) and compared with the coarse stoneground flour bread was 9.9% (95% CI: -2.6%, 23.9%). There was no evidence of an effect of flour particle size on postprandial glycaemia and insulinaemia among older people with risk factors for type 2 diabetes, most of whom were normoglycaemic.
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.
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.
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.
Impact of a Modified Version of Baby-Led Weaning on Infant Food and Nutrient Intakes: The BLISS Randomized Controlled Trial
(MDPI (Basel, Switzerland), 2018-06-07) Williams Erickson L; Taylor RW; Haszard JJ; Fleming EA; Daniels L; Morison BJ; Leong C; Fangupo LJ; Wheeler BJ; Taylor BJ; Te Morenga L; McLean RM; Heath A-LM
Despite growing international interest in Baby-Led Weaning (BLW), we know almost nothing about food and nutrient intake in infants following baby-led approaches to infant feeding. The aim of this paper was to determine the impact of modified BLW (i.e., Baby-Led Introduction to SolidS; BLISS) on food and nutrient intake at 7⁻24 months of age. Two hundred and six women recruited in late pregnancy were randomized to Control (n = 101) or BLISS (n = 105) groups. All participants received standard well-child care. BLISS participants also received lactation consultant support to six months, and educational sessions about BLISS (5.5, 7, and 9 months). Three-day weighed diet records were collected for the infants (7, 12, and 24 months). Compared to the Control group, BLISS infants consumed more sodium (percent difference, 95% CI: 35%, 19% to 54%) and fat (6%, 1% to 11%) at 7 months, and less saturated fat (-7%, -14% to -0.4%) at 12 months. No differences were apparent at 24 months of age but the majority of infants from both groups had excessive intakes of sodium (68% of children) and added sugars (75% of children). Overall, BLISS appears to result in a diet that is as nutritionally adequate as traditional spoon-feeding, and may address some concerns about the nutritional adequacy of unmodified BLW. However, BLISS and Control infants both had high intakes of sodium and added sugars by 24 months that are concerning.
Implementing healthy food environment policies in Aotearoa
(Public Health Communication Centre, 2023-07-27) McKay S; Te Morenga L
Food-EPI (Healthy Food Environment Policy Index) was recently conducted for the fourth time in Aotearoa New Zealand to benchmark government policies influencing food environments against international best practice. Some policies were comparable with international best practice, but New Zealand falls short in many areas including for healthy food and drinks in all schools, fiscal policies influencing food costs, and restricting marketing of unhealthy foods that children see. Sixty experts prioritised the need for a comprehensive multi-sector food systems strategy and for people to have sufficient income to make healthy food choices with autonomy. Five policy actions and five infrastructure support actions were prioritised for immediate action. A mandatory approach needs to be adopted in many policy areas, such as marketing of unhealthy food to children and healthy food policies in schools, and a new national nutrition survey is urgently needed.
Less Food Wasted? Changes to New Zealanders' Household Food Waste and Related Behaviours Due to the 2020 COVID-19 Lockdown
(MDPI (Basel, Switzerland), 2021-09-07) Sharp EL; Haszard J; Egli V; Roy R; Te Morenga L; Teunissen L; Decorte P; Cuykx I; De Backer C; Gerritsen S
Food waste is a crisis of our time, yet it remains a data gap in Aotearoa New Zealand’s (NZ’s) environmental reporting. This research contributes to threshold values on NZ’s food waste and seeks to understand the impact of the 2020 COVID-19 lockdown on household food waste in NZ. The data presented here form part of the ‘Covid Kai Survey’, an online questionnaire that assessed cooking and food planning behaviours during the 2020 lockdown and retrospectively before lockdown. Of the 3028 respondents, 62.5% threw out food ‘never’/‘rarely’ before lockdown, and this number increased to 79.0% during lockdown. Participants who wasted food less frequently during lockdown were more likely to be older, work less than full-time, and have no children. During lockdown, 30% and 29% of those who ‘frequently’ or ‘sometimes’ struggled to have money for food threw out food ‘sometimes or more’; compared with 20% of those who rarely struggled to have money for food (p < 0.001). We found that lower levels of food waste correlated with higher levels of cooking confidence (p < 0.001), perceived time (p < 0.001), and meal planning behaviours (p < 0.001). Understanding why food waste was generally considerably lower during lockdown may inform future initiatives to reduce food waste, considering socio-economic and demographic disparities.
Māori first foods: a Māori centred approach to understanding infant complementary feeding practices within Māori whānau
(Taylor and Francis Group on behalf of the Royal Society of New Zealand, 2022) Rapata H; Heath A-LM; Wall C; Taylor R; Te Morenga L
This study sought to explore infant complementary feeding practices among Māori whānau and the extent to which they may be informed by traditional and culturally specific practices, knowledge, personal beliefs and values. This study also endeavoured to explore how these practices, values and beliefs may have changed across time and between generations. Māori-centred qualitative methods were used within a theoretical framework of Kaupapa Māori and socioecological theories. Semi-structured interviews were conducted and analysed using Braun & Clarke’s method of thematic analysis to uncover key themes and a new theory for understanding infant feeding among Māori whānau. The themes and theories identified through this project suggest that infant complementary feeding is believed to be a natural and instinctive process for Māori whānau, one that is undergoing a process of decolonisation across generations. These theories indicate that Te Ao Māori centred living, grounded in mātauranga Māori is integral to infant feeding values and practices within Māori whānau. It is also clear that many Māori parents desire more culturally relevant infant nutrition information and support. Our findings should inform future updates to infant complementary feeding guidelines within Aotearoa New Zealand, as well as developments in infant nutrition information and support.
Moe Kitenga: a qualitative study of perceptions of infant and child sleep practices among Māori whānau
(SAGE Publications, 2020-06-21) George M; Theodore R; Richards R; Galland B; Taylor R; Matahaere M; Te Morenga L
Insufficient sleep is a strong risk factor for unhealthy weight gain in children. Māori (the indigenous population of Aotearoa (New Zealand)) children have an increased risk of unhealthy weight gain compared to New Zealand European children. Interventions around sleep could provide an avenue for improving health and limiting excessive weight gain with other meaningful benefits for whānau (extended family) well-being. However, current messages promoting good sleep may not be realistic for many Māori whānau. Using qualitative methods, the Moe Kitenga project explored the diverse realities of sleep in 14 Māori whānau. We conclude that for infant sleep interventions to prevent obesity and improve health outcomes for Māori children, they must take into account the often pressing social circumstances of many Māori whānau that are a barrier to adopting infant sleep recommendations, otherwise sleep interventions could create yet another oppressive standard that whānau fail to live up to.

Browsing by Author "Te Morenga L"

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