Exploring the determinants of food choice in Chinese immigrants living in Australia and Chinese people living in mainland China: A qualitative study
Journal of Human Nutrition and Dietetics, Feb 19, 2023
BackgroundThe present study aimed to qualitatively explore the food choice determinants of both C... more BackgroundThe present study aimed to qualitatively explore the food choice determinants of both Chinese immigrants living in Australia and Chinese people living in mainland China.MethodsEight Chinese Australian participants (female, n = 5; male, n = 3) and ten mainland Chinese participants (female, n = 5; male, n = 5) were recruited from Australia (primarily in Melbourne, Victoria) and China (predominantly in Zhengzhou, Henan province) between June 2021 and March 2022. Participants were diverse in age, socio‐economic background, occupation and health status. Semi‐structured in‐depth interviews were conducted in Mandarin either face‐to‐face or using online video/voice calls. Interviews were audio‐recorded and transcribed verbatim. Investigator triangulation was used to enhance scientific rigour.ResultsFour themes were identified: (1) food choice determinants were shaped by traditional and modern nutrition perceptions and personal food philosophy; (2) physiological responses to food provide direct feedback that impacts future food choices; (3) consideration of convenience was a predominant influencer of food choice; and (4) the differences in food environments between China and Australia promoted distinctive food choice determinants for Chinese people.ConclusionsChinese Australian and mainland Chinese participants' food choices are shaped by traditional Chinese nutrition philosophy, modern Western nutrition science and the contemporary food environment. There are clear cultural characteristics in their food choice determinants that should be considered by health educators, nutrition professionals and nutrition policymakers when developing culturally appropriate health interventions for Chinese people.
Chinese immigrants living in Western countries are at increased risk for cardiometabolic diseases... more Chinese immigrants living in Western countries are at increased risk for cardiometabolic diseases. Dietary acculturation has been implicated as a potential contributor, but little is known about why diets change post-migration. The purpose of this qualitative research study was to explore how and why diets change post-migration for Chinese immigrants living in Australia. Eleven participants undertook semi-structured interviews exploring and comparing their diets when they lived in China to their post-migration diets. Thematic analysis revealed that participants exhibited changed social structures of meal preparation, and made unacknowledged dietary changes, such as recipe modification, to maintain their traditional Chinese diet post-migration. Implications of both deliberate and unrecognized dietary changes post-migration include connections to increased risk for metabolic disease post-migration.
East Asian immigrants face multiple challenges upon arrival in their destination country, includi... more East Asian immigrants face multiple challenges upon arrival in their destination country, including an increased risk of future diabetes and cardiovascular disease development. The adoption of food and eating patterns of their host country (i.e., dietary acculturation) may contribute to this increased disease risk. To effectively examine the dietary acculturation–disease risk relationship in East Asian immigrants, sensitive tools are necessary; however, there has been no systematic review of the methods used to assess dietary acculturation in this population. A systematic scoping review of the literature was undertaken to address this gap. A systematic search was conducted in December 2019 and returned a total of 6140 papers. Manuscripts were screened independently by 2 reviewers, resulting in the final inclusion of 30 papers reporting on 27 studies. Robust measures of dietary acculturation were lacking, with only 6 studies using validated tools. Most studies used self-reported cros...
Impacts on social, economic and health systems that result from global ageing have been well docu... more Impacts on social, economic and health systems that result from global ageing have been well documented (1,2). It is important that evidence for total energy expenditure (TEE) in this older population is synthesised, interpreted, and applied to improve nutrition and health outcomes at a population, community and individual level. Doubly-labelled water (DLW) is recognised as the gold standard method for measuring TEE. In the first stage of a multi-phase study, we aimed to establish the extent of TEE data measured by DLW in the population of older adults aged ⩾65 years, and to make recommendations for data sharing (3). Participant level TEE data measured by DLW were identified using systematic review principles; the protocol was registered (PROSPERO registration CRD42016047549). Studies were eligible where all participants were aged ⩾65 years, or where participantlevel data could be obtained for those ⩾65 years. No restrictions were placed on date, language or study designs of original research; review and conference abstracts were ineligible. The search strategy was devised in consultation with a medical librarian. Four databases (MEDLINE complete, EMBASE, CINAHL Plus, and Cochrane Central) were searched from inception to July 2016, complemented by hand searching. Title and abstract screening then full text review was undertaken independently and in duplicate. Where participant level data were not publicly accessible, attempts were made to contact the corresponding author by email to request access to data. The database search yielded 1491 records with another 5 identified through other sources. Following removal of duplicates and the title/abstract screen, 317 full text papers were reviewed. The final library included 45 publications of 28 studies; many were ineligible due to the wrong population (e.g. age <65years) and the wrong outcome (e.g. DLW not used to measure energy expenditure). Data were reported in fifteen publications and data were contributed directly from authors of 30 publications with the final library including 45 publications of 28 studies. In total, participant level data were accessible for 890 participants aged ⩾65 years. Approximately 67 % of TEE data measured by DLW for the population of interest were unable to be obtained. Figure 1 describes several approaches that should be considered to increase DLW data access. In conclusion, the systematic approach used to establish the extent of TEE data has identified the need for international data repositories that aim to minimise the loss of access to data over time. Greater transparency in reporting primary data would support the international research effort.
Background Contemporary energy expenditure data are crucial to inform and guide nutrition policy ... more Background Contemporary energy expenditure data are crucial to inform and guide nutrition policy in older adults to optimize nutrition and health. Objective The aim was to determine the optimal method of estimating total energy expenditure (TEE) in adults (aged ≥65 y) through 1) establishing which published predictive equations have the closest agreement between measured resting metabolic rate (RMR) and predicted RMR and 2) utilizing the RMR equations with the best agreement to predict TEE against the reference method of doubly labeled water (DLW). Methods A database consisting of international participant-level TEE data from DLW studies was developed to enable comparison with energy requirements estimated by 17 commonly used predictive equations. This database included 31 studies comprising 988 participant-level RMR data and 1488 participant-level TEE data. Mean physical activity level (PAL) was determined for men (PAL = 1.69, n = 320) and women (PAL = 1.66, n = 668). Bland–Altman ...
Advanced glycation endproducts (AGEs) are formed naturally inside the body, and within processed ... more Advanced glycation endproducts (AGEs) are formed naturally inside the body, and within processed foods which we absorb from our diet. Elevated AGE levels in the body may contribute to the development of chronic diseases. A cross-sectional study found that a variety of lifestyle factors are associated with increased levels of AGE accumulation in skin. A clinical trial was conducted to determine whether a dietary fibre supplement could reduce circulating AGE levels in adults at risk of type 2 diabetes. While there were no changes in AGE levels, fibre consumption reduced waist circumference, urine protein levels and increased HDL(good) cholesterol levels.
The nutritional status of reproductive-aged couples can have a significant impact on fertility st... more The nutritional status of reproductive-aged couples can have a significant impact on fertility status, but the effect of dietary patterns on pregnancy outcomes in people using assisted reproductive technologies (ARTs) is currently unknown. This review aimed to synthesize the published research investigating the relation between preconception dietary patterns and clinical pregnancy or live birth in men and women of reproductive age undergoing ART. Six electronic databases were systematically searched for original research published between January 1978 and June 2021. Original research reporting on the effect of predefined dietary patterns on either clinical pregnancy and/or live birth rates following in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in men and women aged 18–49 y was eligible for inclusion. Studies were assessed for risk of bias according to the Cochrane guidelines. Included studies underwent qualitative and quantitative synthesis using random-ef...
Study protocol for the Shifting Weight using Intermittent Fasting in night shift workers (SWIFt) study: a three-arm randomised controlled trial comparing three weight loss strategies in night shift workers with obesity
BMJ Open, Apr 26, 2022
Introduction: Shift workers are at an increased risk of developing obesity and type 2 diabetes. E... more Introduction: Shift workers are at an increased risk of developing obesity and type 2 diabetes. Eating and sleeping out of synchronisation with endogenous circadian rhythms causes weight gain, hyperglycaemia and insulin resistance. Interventions that promote weight loss and reduce the metabolic consequences of eating at night are needed for night shift workers. The aim of this study is to examine the effects of three weight loss strategies on weight loss and insulin resistance (HOMA-IR) in night shift workers. Methods and analysis: A multisite 18-month, three-arm randomised controlled trial comparing three weight loss strategies; continuous energy restriction; and two intermittent fasting strategies whereby participants will fast for 2 days per week (5:2); either during the day (5:2D) or during the night shift (5:2N). Participants will be randomised to a weight loss strategy for 24 weeks (weight loss phase) and followed up 12 months later (maintenance phase). The primary outcomes are weight loss and a change in HOMA-IR. Secondary outcomes include changes in glucose, insulin, blood lipids, body composition, waist circumference, physical activity and quality of life. Assessments will be conducted at baseline, 24 weeks (primary endpoint) and 18 months (12-month follow-up). The intervention will be delivered by research dietitians via a combination of face-to-face and telehealth consultations. Mixed-effect models will be used to identify changes in dependent outcomes (weight and HOMA-IR) with predictor variables of outcomes of group, time and group-time interaction, following an intention-to-treat approach. Ethics and dissemination: The study protocol was approved by Monash Health Human Research Ethics Committee (RES 19-0000-462A) and registered with Monash University Human Research Ethics Committee. Ethical approval has also been obtained from the University of South Australia (HREC ID: 202379) and Ambulance Victoria Research Committee (R19-037). Results from this trial will be disseminated via conference presentations, peer-reviewed journals and student theses. Trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN-12619001035112).
Determinants of food choice in Chinese populations have not been systematically synthesised using... more Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, ProQuest, and China National Knowledge Infrastructure database (CNKI) were searched from database inception to 1 April 2021. Studies were included if they involved qualitative research methods, were written in English or Chinese, investigated the factors influencing food choices, and targeted Chinese mainlanders or Chinese immigrants living in Western countries. Twenty-five studies (24 in English, 1 in Chinese) were included, involving 2048 participants. Four themes were identified; (1) the principles of traditional Chinese medicine (TCM), (2) perceptions of a healthy diet in Chinese culture (e.g., regular eating, eating in moderation, and emphasis on food freshness), (3) the...
STUDY PROTOCOL Open Access Effect of dietary prebiotic supplementation on
Full list of author information is available at the end of the articlebetween 40–60 years will be... more Full list of author information is available at the end of the articlebetween 40–60 years will be randomly assigned to receive either 10 grams of prebiotic (inulin/oligofructose) daily or 10 grams placebo (maltodextrin) daily for 12 weeks. After a 2-week washout period, study subjects will crossover to receive the alternative dietary treatment for 12 weeks. The primary outcome is the difference in markers of the advanced glycation pathway carboxymethyllysine (CML) and methylglyoxal (MG) between experimental and control treatments. Secondary outcomes include HbA1c, insulin sensitivity, lipid levels, blood pressure, serum glutathione, adiponectin, IL-6, E-selectin, myeloperoxidase, C-reactive protein, Toll-like Receptor 4 (TLR4), soluble receptor for AGE (sRAGE), urinary 8-isoprostanes, faecal bacterial composition and short chain fatty acid profile. Anthropometric measures including BMI and waist circumference will be collected in addition to comprehensive dietary and lifestyle data....
A Single High Fat Meal Adversely Affects Postprandial Endothelial Function: A Systematic Review and Meta-Analysis
High-fat diets are associated with endothelial dysfunction, the first step in the progression to ... more High-fat diets are associated with endothelial dysfunction, the first step in the progression to atherosclerosis and cardiovascular disease. We aimed to determine the postprandial endothelial response (flow-mediated dilation (FMD)) to a high-fat meal in various populations and define how the response varies by conducting a systematic review of the literature. Six electronic databases were systematically searched for original research published from database inception to May 2020. Eligible studies measured both fasting and postprandial FMD following consumption of a meal containing ≥ 30 g fat or ≥ 40% energy from fat. A random-effects model was used to analyse the pooled effect size change from the fasting FMD, presented as mean difference. Moderator variables were analysed by meta-regression. One-hundred and twenty articles reporting on 3821 adults were included in the review. High fat meal consumption significantly attenuated FMD at 2 hours (MD: −1.61; 95% CI −2.02 −1.19, p < 0....
Arabinoxylans are hemicellulose dietary fibres abundant in the bran of many cereal grains includi... more Arabinoxylans are hemicellulose dietary fibres abundant in the bran of many cereal grains including wheat and rice. They pass undigested through the human intestine until they reach the colon where they provide substrates for bacterial fermentation, generating beneficial short-chain fatty acids including acetate, butyrate and propionate. As viscous fibres, arabinoxylans help suppress appetite, delay gastric emptying and slow post-prandial glucose and insulin responses as well as promote laxation. Their beneficial effects on post-prandial glucose responses have been recognised by the European Food Safety Authority, and the European Union has authorised a health claim that ‘consumption of arabinoxylan as part of a meal contributes to a reduction of the blood glucose rise after that meal’. Eight substantiating research trials are reviewed, four in healthy adults, three in people with metabolic disturbance and one in people with type 2 diabetes. Results indicate that arabinoxylans added...
There is evidence to indicate that the central biological clock (i.e., our endogenous circadian s... more There is evidence to indicate that the central biological clock (i.e., our endogenous circadian system) plays a role in physiological processes in the body that impact energy regulation and metabolism. Cross-sectional data suggest that energy consumption later in the day and during the night is associated with weight gain. These findings have led to speculation that when, as well as what, we eat may be important for maintaining energy balance. Emerging literature suggests that prioritising energy intake to earlier during the day may help with body weight maintenance. Evidence from tightly controlled acute experimental studies indicates a disparity in the body’s ability to utilise (expend) energy equally across the day and night. Energy expenditure both at rest (resting metabolic rate) and after eating (thermic effect of food) is typically more efficient earlier during the day. In this review, we discuss the key evidence for a circadian pattern in energy utilisation and balance, whic...
Complex relationships exist between the gut microflora and their human hosts. Emerging evidence s... more Complex relationships exist between the gut microflora and their human hosts. Emerging evidence suggests that bacterial dysbiosis within the colon may be involved in the pathogenesis of the metabolic syndrome, type 2 diabetes and CVD. The use of dietary prebiotic supplements to restore an optimal balance of intestinal flora may positively affect host metabolism, representing a potential treatment strategy for individuals with cardiometabolic disorders. The present review aimed to examine the current evidence supporting that dietary prebiotic supplementation in adults has beneficial effects on biochemical parameters associated with the development of metabolic abnormalities including obesity, glucose intolerance, dyslipidaemia, hepatic steatosis and low-grade chronic inflammation. Between January 2000 and September 2013, eight computer databases were searched for randomised controlled trials published in English. Human trials were included if at least one group received a dietary pre...
This study aimed to describe the prevalence, severity and socio-demographic predictors of food in... more This study aimed to describe the prevalence, severity and socio-demographic predictors of food insecurity in Australian households during the COVID-19 pandemic in 2020, from the perspective of women. A cross-sectional online survey of Australian (18–50 years) women was conducted. The survey collected demographic information and utilised the 18-item US Department of Agriculture Household Food Security Survey Module and the Kessler Psychological Distress Scale (K10). A multivariable regression was used to identify predictors of food security status. In this cohort (n = 1005), 19.6% were living in households experiencing food insecurity; with 11.8% experiencing low food-security and 7.8% very low food-security. A further 13.7% of households reported marginal food-security. Poor mental health status (K10 score ≥ 20) predicted household food insecurity at all levels. The presence of more than three children in the household was associated with low food-security (OR 6.24, 95% CI: 2.59–15....
How and Why Diets Change Post Migration for Chinese Immigrants
Cardiovascular disease (CVD) risk is disproportionally greater in Chinese immigrants in Australia... more Cardiovascular disease (CVD) risk is disproportionally greater in Chinese immigrants in Australia compared with in China. Dietary acculturation is implicated as a CVD risk factor. This study aimed to explored Chinese immigrants’ perspectives on how and why their diets change post migration. An exploratory qualitative interview study was undertaken with adult Chinese migrants who had been living in Australia for less than 10 years. Semi-structured interview questions were designed to draw out participants’ experience, emotions and thoughts of dietary change. Interviews were conducted via Zoom in participants’ preferred language (Mandarin or English). Interviews were transcribed verbatim and translated into English for analysis. A constructivist approach was adopted to thematically analyse the interviews. A total of 11 participants were interviewed (n = 3 males and n = 8 females) and ranged in age from 22–68 years old with length of residence in Australia ranging from 1–8 years. Key t...
Exploring the determinants of food choice in Chinese immigrants living in Australia and Chinese people living in mainland China: A qualitative study
Journal of Human Nutrition and Dietetics, Feb 19, 2023
BackgroundThe present study aimed to qualitatively explore the food choice determinants of both C... more BackgroundThe present study aimed to qualitatively explore the food choice determinants of both Chinese immigrants living in Australia and Chinese people living in mainland China.MethodsEight Chinese Australian participants (female, n = 5; male, n = 3) and ten mainland Chinese participants (female, n = 5; male, n = 5) were recruited from Australia (primarily in Melbourne, Victoria) and China (predominantly in Zhengzhou, Henan province) between June 2021 and March 2022. Participants were diverse in age, socio‐economic background, occupation and health status. Semi‐structured in‐depth interviews were conducted in Mandarin either face‐to‐face or using online video/voice calls. Interviews were audio‐recorded and transcribed verbatim. Investigator triangulation was used to enhance scientific rigour.ResultsFour themes were identified: (1) food choice determinants were shaped by traditional and modern nutrition perceptions and personal food philosophy; (2) physiological responses to food provide direct feedback that impacts future food choices; (3) consideration of convenience was a predominant influencer of food choice; and (4) the differences in food environments between China and Australia promoted distinctive food choice determinants for Chinese people.ConclusionsChinese Australian and mainland Chinese participants' food choices are shaped by traditional Chinese nutrition philosophy, modern Western nutrition science and the contemporary food environment. There are clear cultural characteristics in their food choice determinants that should be considered by health educators, nutrition professionals and nutrition policymakers when developing culturally appropriate health interventions for Chinese people.
Chinese immigrants living in Western countries are at increased risk for cardiometabolic diseases... more Chinese immigrants living in Western countries are at increased risk for cardiometabolic diseases. Dietary acculturation has been implicated as a potential contributor, but little is known about why diets change post-migration. The purpose of this qualitative research study was to explore how and why diets change post-migration for Chinese immigrants living in Australia. Eleven participants undertook semi-structured interviews exploring and comparing their diets when they lived in China to their post-migration diets. Thematic analysis revealed that participants exhibited changed social structures of meal preparation, and made unacknowledged dietary changes, such as recipe modification, to maintain their traditional Chinese diet post-migration. Implications of both deliberate and unrecognized dietary changes post-migration include connections to increased risk for metabolic disease post-migration.
East Asian immigrants face multiple challenges upon arrival in their destination country, includi... more East Asian immigrants face multiple challenges upon arrival in their destination country, including an increased risk of future diabetes and cardiovascular disease development. The adoption of food and eating patterns of their host country (i.e., dietary acculturation) may contribute to this increased disease risk. To effectively examine the dietary acculturation–disease risk relationship in East Asian immigrants, sensitive tools are necessary; however, there has been no systematic review of the methods used to assess dietary acculturation in this population. A systematic scoping review of the literature was undertaken to address this gap. A systematic search was conducted in December 2019 and returned a total of 6140 papers. Manuscripts were screened independently by 2 reviewers, resulting in the final inclusion of 30 papers reporting on 27 studies. Robust measures of dietary acculturation were lacking, with only 6 studies using validated tools. Most studies used self-reported cros...
Impacts on social, economic and health systems that result from global ageing have been well docu... more Impacts on social, economic and health systems that result from global ageing have been well documented (1,2). It is important that evidence for total energy expenditure (TEE) in this older population is synthesised, interpreted, and applied to improve nutrition and health outcomes at a population, community and individual level. Doubly-labelled water (DLW) is recognised as the gold standard method for measuring TEE. In the first stage of a multi-phase study, we aimed to establish the extent of TEE data measured by DLW in the population of older adults aged ⩾65 years, and to make recommendations for data sharing (3). Participant level TEE data measured by DLW were identified using systematic review principles; the protocol was registered (PROSPERO registration CRD42016047549). Studies were eligible where all participants were aged ⩾65 years, or where participantlevel data could be obtained for those ⩾65 years. No restrictions were placed on date, language or study designs of original research; review and conference abstracts were ineligible. The search strategy was devised in consultation with a medical librarian. Four databases (MEDLINE complete, EMBASE, CINAHL Plus, and Cochrane Central) were searched from inception to July 2016, complemented by hand searching. Title and abstract screening then full text review was undertaken independently and in duplicate. Where participant level data were not publicly accessible, attempts were made to contact the corresponding author by email to request access to data. The database search yielded 1491 records with another 5 identified through other sources. Following removal of duplicates and the title/abstract screen, 317 full text papers were reviewed. The final library included 45 publications of 28 studies; many were ineligible due to the wrong population (e.g. age <65years) and the wrong outcome (e.g. DLW not used to measure energy expenditure). Data were reported in fifteen publications and data were contributed directly from authors of 30 publications with the final library including 45 publications of 28 studies. In total, participant level data were accessible for 890 participants aged ⩾65 years. Approximately 67 % of TEE data measured by DLW for the population of interest were unable to be obtained. Figure 1 describes several approaches that should be considered to increase DLW data access. In conclusion, the systematic approach used to establish the extent of TEE data has identified the need for international data repositories that aim to minimise the loss of access to data over time. Greater transparency in reporting primary data would support the international research effort.
Background Contemporary energy expenditure data are crucial to inform and guide nutrition policy ... more Background Contemporary energy expenditure data are crucial to inform and guide nutrition policy in older adults to optimize nutrition and health. Objective The aim was to determine the optimal method of estimating total energy expenditure (TEE) in adults (aged ≥65 y) through 1) establishing which published predictive equations have the closest agreement between measured resting metabolic rate (RMR) and predicted RMR and 2) utilizing the RMR equations with the best agreement to predict TEE against the reference method of doubly labeled water (DLW). Methods A database consisting of international participant-level TEE data from DLW studies was developed to enable comparison with energy requirements estimated by 17 commonly used predictive equations. This database included 31 studies comprising 988 participant-level RMR data and 1488 participant-level TEE data. Mean physical activity level (PAL) was determined for men (PAL = 1.69, n = 320) and women (PAL = 1.66, n = 668). Bland–Altman ...
Advanced glycation endproducts (AGEs) are formed naturally inside the body, and within processed ... more Advanced glycation endproducts (AGEs) are formed naturally inside the body, and within processed foods which we absorb from our diet. Elevated AGE levels in the body may contribute to the development of chronic diseases. A cross-sectional study found that a variety of lifestyle factors are associated with increased levels of AGE accumulation in skin. A clinical trial was conducted to determine whether a dietary fibre supplement could reduce circulating AGE levels in adults at risk of type 2 diabetes. While there were no changes in AGE levels, fibre consumption reduced waist circumference, urine protein levels and increased HDL(good) cholesterol levels.
The nutritional status of reproductive-aged couples can have a significant impact on fertility st... more The nutritional status of reproductive-aged couples can have a significant impact on fertility status, but the effect of dietary patterns on pregnancy outcomes in people using assisted reproductive technologies (ARTs) is currently unknown. This review aimed to synthesize the published research investigating the relation between preconception dietary patterns and clinical pregnancy or live birth in men and women of reproductive age undergoing ART. Six electronic databases were systematically searched for original research published between January 1978 and June 2021. Original research reporting on the effect of predefined dietary patterns on either clinical pregnancy and/or live birth rates following in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in men and women aged 18–49 y was eligible for inclusion. Studies were assessed for risk of bias according to the Cochrane guidelines. Included studies underwent qualitative and quantitative synthesis using random-ef...
Study protocol for the Shifting Weight using Intermittent Fasting in night shift workers (SWIFt) study: a three-arm randomised controlled trial comparing three weight loss strategies in night shift workers with obesity
BMJ Open, Apr 26, 2022
Introduction: Shift workers are at an increased risk of developing obesity and type 2 diabetes. E... more Introduction: Shift workers are at an increased risk of developing obesity and type 2 diabetes. Eating and sleeping out of synchronisation with endogenous circadian rhythms causes weight gain, hyperglycaemia and insulin resistance. Interventions that promote weight loss and reduce the metabolic consequences of eating at night are needed for night shift workers. The aim of this study is to examine the effects of three weight loss strategies on weight loss and insulin resistance (HOMA-IR) in night shift workers. Methods and analysis: A multisite 18-month, three-arm randomised controlled trial comparing three weight loss strategies; continuous energy restriction; and two intermittent fasting strategies whereby participants will fast for 2 days per week (5:2); either during the day (5:2D) or during the night shift (5:2N). Participants will be randomised to a weight loss strategy for 24 weeks (weight loss phase) and followed up 12 months later (maintenance phase). The primary outcomes are weight loss and a change in HOMA-IR. Secondary outcomes include changes in glucose, insulin, blood lipids, body composition, waist circumference, physical activity and quality of life. Assessments will be conducted at baseline, 24 weeks (primary endpoint) and 18 months (12-month follow-up). The intervention will be delivered by research dietitians via a combination of face-to-face and telehealth consultations. Mixed-effect models will be used to identify changes in dependent outcomes (weight and HOMA-IR) with predictor variables of outcomes of group, time and group-time interaction, following an intention-to-treat approach. Ethics and dissemination: The study protocol was approved by Monash Health Human Research Ethics Committee (RES 19-0000-462A) and registered with Monash University Human Research Ethics Committee. Ethical approval has also been obtained from the University of South Australia (HREC ID: 202379) and Ambulance Victoria Research Committee (R19-037). Results from this trial will be disseminated via conference presentations, peer-reviewed journals and student theses. Trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN-12619001035112).
Determinants of food choice in Chinese populations have not been systematically synthesised using... more Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, ProQuest, and China National Knowledge Infrastructure database (CNKI) were searched from database inception to 1 April 2021. Studies were included if they involved qualitative research methods, were written in English or Chinese, investigated the factors influencing food choices, and targeted Chinese mainlanders or Chinese immigrants living in Western countries. Twenty-five studies (24 in English, 1 in Chinese) were included, involving 2048 participants. Four themes were identified; (1) the principles of traditional Chinese medicine (TCM), (2) perceptions of a healthy diet in Chinese culture (e.g., regular eating, eating in moderation, and emphasis on food freshness), (3) the...
STUDY PROTOCOL Open Access Effect of dietary prebiotic supplementation on
Full list of author information is available at the end of the articlebetween 40–60 years will be... more Full list of author information is available at the end of the articlebetween 40–60 years will be randomly assigned to receive either 10 grams of prebiotic (inulin/oligofructose) daily or 10 grams placebo (maltodextrin) daily for 12 weeks. After a 2-week washout period, study subjects will crossover to receive the alternative dietary treatment for 12 weeks. The primary outcome is the difference in markers of the advanced glycation pathway carboxymethyllysine (CML) and methylglyoxal (MG) between experimental and control treatments. Secondary outcomes include HbA1c, insulin sensitivity, lipid levels, blood pressure, serum glutathione, adiponectin, IL-6, E-selectin, myeloperoxidase, C-reactive protein, Toll-like Receptor 4 (TLR4), soluble receptor for AGE (sRAGE), urinary 8-isoprostanes, faecal bacterial composition and short chain fatty acid profile. Anthropometric measures including BMI and waist circumference will be collected in addition to comprehensive dietary and lifestyle data....
A Single High Fat Meal Adversely Affects Postprandial Endothelial Function: A Systematic Review and Meta-Analysis
High-fat diets are associated with endothelial dysfunction, the first step in the progression to ... more High-fat diets are associated with endothelial dysfunction, the first step in the progression to atherosclerosis and cardiovascular disease. We aimed to determine the postprandial endothelial response (flow-mediated dilation (FMD)) to a high-fat meal in various populations and define how the response varies by conducting a systematic review of the literature. Six electronic databases were systematically searched for original research published from database inception to May 2020. Eligible studies measured both fasting and postprandial FMD following consumption of a meal containing ≥ 30 g fat or ≥ 40% energy from fat. A random-effects model was used to analyse the pooled effect size change from the fasting FMD, presented as mean difference. Moderator variables were analysed by meta-regression. One-hundred and twenty articles reporting on 3821 adults were included in the review. High fat meal consumption significantly attenuated FMD at 2 hours (MD: −1.61; 95% CI −2.02 −1.19, p < 0....
Arabinoxylans are hemicellulose dietary fibres abundant in the bran of many cereal grains includi... more Arabinoxylans are hemicellulose dietary fibres abundant in the bran of many cereal grains including wheat and rice. They pass undigested through the human intestine until they reach the colon where they provide substrates for bacterial fermentation, generating beneficial short-chain fatty acids including acetate, butyrate and propionate. As viscous fibres, arabinoxylans help suppress appetite, delay gastric emptying and slow post-prandial glucose and insulin responses as well as promote laxation. Their beneficial effects on post-prandial glucose responses have been recognised by the European Food Safety Authority, and the European Union has authorised a health claim that ‘consumption of arabinoxylan as part of a meal contributes to a reduction of the blood glucose rise after that meal’. Eight substantiating research trials are reviewed, four in healthy adults, three in people with metabolic disturbance and one in people with type 2 diabetes. Results indicate that arabinoxylans added...
There is evidence to indicate that the central biological clock (i.e., our endogenous circadian s... more There is evidence to indicate that the central biological clock (i.e., our endogenous circadian system) plays a role in physiological processes in the body that impact energy regulation and metabolism. Cross-sectional data suggest that energy consumption later in the day and during the night is associated with weight gain. These findings have led to speculation that when, as well as what, we eat may be important for maintaining energy balance. Emerging literature suggests that prioritising energy intake to earlier during the day may help with body weight maintenance. Evidence from tightly controlled acute experimental studies indicates a disparity in the body’s ability to utilise (expend) energy equally across the day and night. Energy expenditure both at rest (resting metabolic rate) and after eating (thermic effect of food) is typically more efficient earlier during the day. In this review, we discuss the key evidence for a circadian pattern in energy utilisation and balance, whic...
Complex relationships exist between the gut microflora and their human hosts. Emerging evidence s... more Complex relationships exist between the gut microflora and their human hosts. Emerging evidence suggests that bacterial dysbiosis within the colon may be involved in the pathogenesis of the metabolic syndrome, type 2 diabetes and CVD. The use of dietary prebiotic supplements to restore an optimal balance of intestinal flora may positively affect host metabolism, representing a potential treatment strategy for individuals with cardiometabolic disorders. The present review aimed to examine the current evidence supporting that dietary prebiotic supplementation in adults has beneficial effects on biochemical parameters associated with the development of metabolic abnormalities including obesity, glucose intolerance, dyslipidaemia, hepatic steatosis and low-grade chronic inflammation. Between January 2000 and September 2013, eight computer databases were searched for randomised controlled trials published in English. Human trials were included if at least one group received a dietary pre...
This study aimed to describe the prevalence, severity and socio-demographic predictors of food in... more This study aimed to describe the prevalence, severity and socio-demographic predictors of food insecurity in Australian households during the COVID-19 pandemic in 2020, from the perspective of women. A cross-sectional online survey of Australian (18–50 years) women was conducted. The survey collected demographic information and utilised the 18-item US Department of Agriculture Household Food Security Survey Module and the Kessler Psychological Distress Scale (K10). A multivariable regression was used to identify predictors of food security status. In this cohort (n = 1005), 19.6% were living in households experiencing food insecurity; with 11.8% experiencing low food-security and 7.8% very low food-security. A further 13.7% of households reported marginal food-security. Poor mental health status (K10 score ≥ 20) predicted household food insecurity at all levels. The presence of more than three children in the household was associated with low food-security (OR 6.24, 95% CI: 2.59–15....
How and Why Diets Change Post Migration for Chinese Immigrants
Cardiovascular disease (CVD) risk is disproportionally greater in Chinese immigrants in Australia... more Cardiovascular disease (CVD) risk is disproportionally greater in Chinese immigrants in Australia compared with in China. Dietary acculturation is implicated as a CVD risk factor. This study aimed to explored Chinese immigrants’ perspectives on how and why their diets change post migration. An exploratory qualitative interview study was undertaken with adult Chinese migrants who had been living in Australia for less than 10 years. Semi-structured interview questions were designed to draw out participants’ experience, emotions and thoughts of dietary change. Interviews were conducted via Zoom in participants’ preferred language (Mandarin or English). Interviews were transcribed verbatim and translated into English for analysis. A constructivist approach was adopted to thematically analyse the interviews. A total of 11 participants were interviewed (n = 3 males and n = 8 females) and ranged in age from 22–68 years old with length of residence in Australia ranging from 1–8 years. Key t...
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Papers by Nicole Kellow