Library Bulletin – Journal Articles – August 2007
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NUTRITION
CARAHER, Martin and DOWLER, Elizabeth. Food projects in London : lessons for policy and practice - A hidden sector and the need for 'more unhealthy puddings ... sometimes'. Health Education Journal Vol 66, No 2 - June 2007: 188-205
Abstract: Background and Objective: Successive governments have promoted local action to address food components of public health. This article presents findings from research commissioned by the (then) London NHS Office, scoping the range of food projects in the London area, and the potential challenges to public health practice. Methods: Research followed four overlapping phases with a London focus: (1) a systemized review of the literature, (2) analysis of health authority Health Improvement Plans (HImPs) and Coronary Heart Disease (CHD) local implementation plans and Health Action Zone reports, (3) a scoping exercise of`food projects' and community-based participatory projects with a food focus using food databases and directories, and (4) 29 in-depth interviews with individuals responsible for commissioning and running projects. Results: There were, in 2001/2, a variety of food projects in the London area, ranging from small-scale social enterprises to those whose turnover marked them out as small businesses. There was a significant human resource cost in maintaining and setting up such projects both from NHS staff and in terms of volunteer and paid labour. The lack of an overall or area-based approach to food policy development in London was apparent, and little thought seemed to have been given to creating a supportive policy environment. Food projects often existed as isolated entities in a borough or health authority area, with short-term funding and little systemic long-term supportThe majority employed what might best be called health education approaches. This is now partially addressed by the draft London Food Strategy. Conclusions: Food projects run by local professionals and/or volunteers operated within an isolated policy and suffered from a lack of support both from financial and human resources perspectives. The potential for long-term delivery of improved health was unrealized, as was their potential contribution to a London-wide food economy and to London food policy.
De BOURDEAUDHUIJ, Ilse and STEVENS, Veerle and others. Evaluation of an interactive computer-tailored nutrition intervention in a real-life setting. Annals of Behavioral Medicine Volume 33, No 1 - February 2007: 39-48
Abstract: Background: Studies testing Web-based computer-tailored education in real-life settings are now needed. Purpose: The aim of this study is to examine the effectiveness and applicability of an interactive computer-tailored fat reduction intervention, which was previously tested as efficacious in a controlled setting, delivered to a broader population by local health promotion services. The impact of the computer-tailored intervention is compared with a generic intervention and with a no-intervention control group. Methods: A quasi-experimental design was used assigning 6 companies randomly to (a) the computer-tailored intervention condition, (b) the generic intervention condition, and (c) the no-intervention control condition. Participants (N = 337) completed validated baseline and posttest questionnaires and received the personal feedback immediately through the company's intranet. A structured interview with the project coordinators assessed the process that the companies had passed through to disseminate the fat intake intervention. Results: Six months postbaseline, the results showed that the computer-tailored intervention to reduce fat intake implemented through worksites was more effective in decreasing employees' fat intake compared with a generic intervention, F = 23.5, p < .001, or no intervention, F = 28.1, p < .001. Moreover, the dissemination strategy used is feasible for local health promotion services. Conclusions: This study can be regarded as an effective "real-life" trial with an implementation strategy that can be used for large scale dissemination.
de la HUNTY, A and ASHWELL, M. Are people who regularly eat breakfast cereals slimmer than those who don't? A systematic review of the evidence. Nutrition Bulletin Vol 32, No 2 - June 2007: 118-128
Abstract: Summary: There is growing evidence that people who eat breakfast regularly tend to be slimmer than those who skip breakfast. However, this is not a consistent finding and it is not true for all types of breakfast. Also the relationship with breakfast can disappear in studies when adjusted for breakfast cereal consumption, suggesting it is breakfast cereal that is driving the association. This systematic review, therefore, looked specifically at the relationship between breakfast cereal consumption and weight. A systematic search of the literature identified nine references looking at the relationship between the consumption of breakfast cereals and BMI as an outcome measure. Five of the nine included studies were in adults. These studies consistently showed that people who eat breakfast cereals regularly tend to have a lower BMI and are less likely to be overweight than those who do not eat breakfast cereals regularly. Although not all of the results were statistically significant, they all point in the same direction. There was no evidence that regular breakfast cereal consumers have lower daily energy intakes than infrequent consumers. Four of the nine included studies were in children. As for adults, the evidence from the included studies is consistent that children who eat breakfast cereals regularly tend to have a lower BMI and are less likely to be overweight than those who eat breakfast cereals infrequently. There was no evidence that children who consume breakfast cereals regularly have lower energy intakes than infrequent cereal consumers. This systematic review considered whether the relationship between breakfast cereal consumption and weight is likely to be mediated either through lower energy intakes or higher energy expenditures. We found no clear evidence for this or for any other proposed mechanism. The relationship could arise out of confounding by lifestyle factors. There is consistent evidence of an association between breakfast cereal consumption and a healthy weight, but limited evidence for any proposed mechanism that would point to it being a causal relationship.
HARROD-WILD, Kate. Food and health. Does childhood nutrition matter? Journal of Family Health Care Vol 17, No 3 - 2007: 89-91
Abstract: Nutrition in childhood influences both the child's present and future health. Health professionals need to educate parents from all socioeconomic groups about good nutrition for their children from birth onwards. They should give priority to including this during consultations. All parents must be made aware of the nutritional benefits of breast-feeding. Since most babies receive formula at some stage during the first year of life, health professionals also have a responsibility to be aware of current developments in infant formulae (eg. nucleotided, long chain polyunsaturated fatty acids, prebiotics) so they can give accurate information. Weaning is an important nutritional milestone with implications for present and future health. Advice on good weaning practice should be a priority and can help avoid several nutritional problems later on, such as excessively faddy eating, faltering growth, constipation, and iron deficiency anaemia and obesity. The last two are key problems in children in the UK today. Families should be encouraged to cook, eat and enjoy food together as often as they can, which in itself has been shown to have nutritional benefits, as well as considering the quality of the food they eat.
MOORE, Graham F and TAPPER, Katy and others. Associations between deprivation, attitudes towards eating breakfast and breakfast eating behaviours in 9-11-year-olds. Public Health Nutrition Vol 10 No 6 - June 2007: 582-589
Abstract: Objectives: To examine school-level relationships between deprivation and breakfast eating behaviours (breakfast skipping and the healthfulness of foods consumed) in 9-11-year-old schoolchildren and to examine whether attitudes towards eating breakfast mediated these relationships. Design: Cross-sectional survey. Setting: One hundred and eleven primary schools in Wales. Subjects: Year 5 and 6 pupils within the 111 primary schools. Measures were completed by 4314 children. Analysis was conducted at the group (school) level, with each school representing one group. Results: Deprivation was positively associated with breakfast skipping and consumption of 'unhealthy' items (i.e. sweet snacks, crisps) for breakfast. A significant negative association was found between deprivation and consumption of 'healthy' items (i.e. fruit, bread, cereal, milk). Deprivation was significantly inversely associated with attitudes towards eating breakfast. The relationships between deprivation and (1) breakfast skipping and (2) consumption of 'healthy' items for breakfast were mediated by attitudes towards eating breakfast. The hypothesis that attitudes mediated the relationship between deprivation and consumption of 'unhealthy' breakfast items was unsupported. Conclusions: Deprivation is associated with adverse breakfast eating behaviours amongst children aged 9-11 years, in terms of breakfast skipping and the quality of breakfasts consumed. Socio-economic differences in attitudes towards eating breakfast are apparent amongst this age group, and appear to relate to social gradients in breakfast eating behaviours. Research is needed to examine the causal nature of these trends and to elucidate factors underlying the development of socio-economic differences in eating-related cognitions
OGDEN, Jane and KARIM, Lubna and others. Understanding successful behaviour change: the role of intention, attitudes to the target and motivations and the example of diet. Health Education Research Vol 22, No 3 - June 2007: 397-405
Abstract: Although many attempts to change health behaviour fail, some individuals do show successful behaviour change. This study assessed the role of behavioural intentions, motivations and attitudes to the target in explaining successful changes in diet with a particular focus on positive and negative intentions and positive and negative attitudes. Participants (n=282) completed a questionnaire describing a recent change in eating behaviour (becoming a vegetarian, cutting out a food group, eating fewer calories), their intentions, their attitudes to the food being avoided, a range of motivations and their degree of success. The results showed that the three behaviour change groups differed in terms of their cognitions with those trying to eat fewer calories reporting less success in changing their behaviour. Successful vegetarianism was associated with a lower positive attitude; successfully cutting out a food group was related to ethical motivations, a lower positive attitude and greater positive and negative intentions, and reducing calorie intake was associated with greater positive intentions and a lower positive attitude. Therefore, success was associated with different cognitions depending upon the type of change being made, although cognitions such as 'I will eat more vegetables' and 'I no longer find high fat foods palatable' were consistently most predictive of success. Suggestions for the development of more effective interventions to change health behaviours are made.
STEVENSON, Clifford and DOHERTY, Glenda and others. Adolescents' views of food and eating : identifying barriers to healthy eating. Journal of Adolescence Vol 30, No 3 - June 2007: 417-434
Abstract: Contemporary Western society has encouraged an obesogenic culture of eating amongst youth. Multiple factors may influence an adolescent's susceptibility to this eating culture, and thus act as a barrier to healthy eating. Given the increasing prevalence of obesity amongst adolescents, the need to reduce these barriers has become a necessity. Twelve focus group discussions of single-sex groups of boys or girls ranging from early to-mid adolescence (N=73) were employed to identify key perceptions of, and influences upon, healthy eating behaviour. Thematic analysis identified four key factors as barriers to healthy eating. These factors were: physical and psychological reinforcement of eating behaviour; perceptions of food and eating behaviour; perceptions of contradictory food-related social pressures; and perceptions of the concept of healthy eating itself. Overall, healthy eating as a goal in its own right is notably absent from the data and would appear to be elided by competing pressures to eat unhealthily and to lose weight. This insight should inform the development of future food-related communications to adolescents.