Arts and Humanities Commons^™

Partial Replacement Of Nacl Can Be Achieved With Potassium, Magnesium And Calcium Salts In Brown Bread, Karen Charlton, Naomi Levitt, Krisela Steyn, Elizabeth Macgregor, Nonnie Vorster

Karen E. Charlton

Objectives: To develop a reduced sodium bread in which salt (NaCl) is partially replaced with K, Mg, and Ca salts. Methods: Experimental bread was compared against standard brown bread, after a drop test (to assess whether bread quality deteriorates with abuse) and after usual baking practices for baking properties (volume, crust colour, crumb colour and cell structure), sensory properties and nutritional composition. Plant production feasibility was evaluated in an industrial plant. Breads produced there were subjected to sensory evaluation using triangulation tests in a panel of 122 consumers. Twenty-four samples of both standard and experimental bread were laboratory-analysed for Na, …

Strategies To Address Iodine Deficiency In Australia Require Ongoing Monitoring And Surveillance, Heather Yeatman, Karen E. Charlton

Karen E. Charlton

No abstract provided.

Improved Iodine Status In Breastfeeding Women Following Mandatory Fortification, Samantha Axford, Karen Charlton, Heather Yeatman, Gary Ma

Karen E. Charlton

Mandatory iodine fortification of salt used in the bread-making process was introduced in Australia in October 2009 at levels to meet the iodine needs of the general Australian population. An iodine supplement of 150 μg each day is recommended to meet the additional needs of pregnancy and lactation.1,2 As the iodine status of pregnant women in Australia has been found to be inadequate,3–5 it can be anticipated that many women commence lactation in an iodine-depleted state. Thus, it is important to determine the iodine status of breastfeeding mothers.

Defining The Functional Properties Of Dietary Protein And Protein-Rich Foods In Human Energy Expenditure, Sze Yen Tan, Linda Tapsell, Marijka Batterham, Karen Charlton

Karen E. Charlton

Food has a number of functional properties that can support the balance between energy intake and energy expenditure and, theoretically, one of these is the thermic effect of food. Including high-protein foods in meals may be advantageous in contributing to energy expenditure but, in practice, the evidence needs to relate to specific foods and normal dietary conditions. Using the human whole room calorimeter facility, we conducted three studies to examine the effects of: (i) higher and lower levels of protein on energy expenditure; (ii) high-protein meals using different foods to deliver the protein; and (iii) omnivorous and vegetarian cuisines in …

A Food-Based Dietary Strategy Lowers Blood Pressure In A Low Socio-Economic Setting: A Randomised Study In South Africa, Karen E. Charlton, Naomi Levitt, Krisela Steyn, Deborah Jonathan, Nomonde Gwebushe, Nasheeta Peer, Katja Rossouw, Theresa Gogela, Carl J. Lombard

Karen E. Charlton

Objective To assess the impact of a food-based intervention on blood pressure (BP) in free-living South African men and women aged 50–75 years, with drug-treated mild-to-moderate hypertension. Methods A double-blind controlled trial was undertaken in eighty drug-treated mild-to-moderate hypertensive subjects randomised to an intervention (n 40) or control (n 40) arm. The intervention was 8-week provision of six food items with a modified cation content (salt replacement (SOLO™), bread, margarine, stock cubes, soup mix and a flavour enhancer) and 500 ml of maas (fermented milk)/d. The control diet provided the same quantities of the targeted foods but of standard commercial …

Dietary Methodology In Clinical Trials: Changing Dietary Fat Profiles, Linda Tapsell, Jane O'Shea, Marijka Batterham, Karen Charlton

Karen E. Charlton

No abstract provided.

Consumers' Salient Beliefs Regarding Dairy Products In The Functional Food Era: A Qualitative Study Using Concepts From The Theory Of Planned Behaviour, Deborah Nolan, Elizabeth Neale, Yasmine Probst, Karen E. Charlton, Linda C. Tapsell

Karen E. Charlton

Background Inadequate consumption of dairy products without appropriate dietary substitution may have deleterious health consequences. Social research reveals the factors that may impede compliance with dietary recommendations. This is particularly important given the recent introduction of functional dairy products. One of the challenges for public health professionals is to demonstrate the efficacy of nutrition education in improving attitudes toward nutrient rich foods. The aim of this study was to explore the salient beliefs of adult weight loss trial participants regarding both traditional and functional dairy products and to compare these with a control group not exposed to nutrition education Methods …

Iodine Fortification: Why, When, What, How, And Who?, Karen Charlton, Sheila Skeaff

Karen E. Charlton

Purpose of review: To highlight current issues regarding the role of iodine fortification in correcting and preventing iodine deficiency. Universal salt iodization (USI) is recommended, wherein all salt is iodized; however, a more graduated approach may be warranted.Recent findings: Iodine deficiency is widespread and has re-emerged in countries such as Australia, New Zealand and the UK. As well as supplementation in groups such as pregnant and lactating women who have increased iodine requirements, public health strategies to improve iodine intakes include voluntary or mandatory fortification of the food supply. A key player in the process of fortification is the food …

Two Apples And Five Carrots A Day Keep The Doctor Away: Strategies To Increase Fruit And Vegetable Consumption, Karen Charlton

Karen E. Charlton

No abstract provided.

Poor Knowledge And Practices Related To Iodine Nutrition During Pregnancy And Lactation In Australian Women: Pre-And Post-Iodine Fortification, Karen Charlton, Heather Yeatman, Catherine Lucas, Samantha Axford, Luke Gemming, Fiona Houweling, Alison Goodfellow, Gary Ma

Karen E. Charlton

A before-after review was undertaken to assess whether knowledge and practices related to iodine nutrition, supplementation and fortification has improved in Australian women since the introduction of mandatory iodine fortification in 2009. Surveys of pregnant (n = 139) and non-pregnant (n = 75) women in 2007-2008 are compared with surveys of pregnant (n = 147) and lactating women (n = 60) one to two years post-fortification in a regional area of New South Wales, Australia. A self-administered questionnaire was completed and dietary intake of iodine was assessed using a validated food frequency questionnaire. A generally poor knowledge about the role …

Poor Nutritional Status Of Older Subacute Patients Predicts Clinical Outcomes And Mortality At 18 Months Of Follow-Up, K Charlton, C Nichols, S Bowden, Marianna Milosavljevic, K Lambert, L Barone, M Mason, M Batterham

Karen E. Charlton

Background/Objectives: Older malnourished patients experience increased surgical complications and greater morbidity compared with their well-nourished counterparts. This study aimed to assess whether nutritional status at hospital admission predicted clinical outcomes at 18 months follow-up. Subjects/Methods: A retrospective analysis of N=2076 patient admissions (65+ years) from two subacute hospitals, New South Wales, Australia. Analysis of outcomes at 18 months, according to nutritional status at index admission, was performed in a subsample of n=476. Nutritional status was determined within 72 h of admission using the Mini Nutritional Assessment (MNA). Outcomes, obtained from electronic patient records, included hospital readmission rate, total Length of …

Poor Iodine Status And Knowledge Related To Iodine On The Eve Of Mandatory Iodine Fortification In Australia, Heather Yeatman, Karen E. Charlton, Fiona Houweling

Karen E. Charlton

Background: Mandatory fortification of bread with iodised salt is proposed to address the re-emergence of iodine deficiency in Australia and New Zealand. The impacts of fortification require baseline data of iodine status among vulnerable sectors of the population. Objective: To assess the iodine status of healthy women and to investigate consumer understanding and attitudes related to the proposed mandatory iodine fortification programme. Design: Cross-sectional sample of 78 non-pregnant women aged 20-55 y was conveniently sampled in Wollongong, NSW. A single 24-hr urine sample was collected for urinary iodine concentration (UIC). A selfadministered questionnaire assessed consumer understanding, perceptions and attitudes related …

Fibre: Male Participants Not Getting Enough, Rebecca Thorne, Jane O'Shea, Qingsheng Zhang, Linda Tapsell, Marijka Batterham, Karen Charlton

Karen E. Charlton

A regular intake of dietary fibre has been associated with a number of health benefits. Consuming a high fibre diet may significantly lower the risk of developing heart disease, stroke, hypertension, diabetes and obesity (Anderson et al, 2009). Foods high in fibre such as fruit, vegetables, legumes and wholegrains are regularly included in diets targeting weight loss as they are low in fat, sugar and salt and contain a number of vitamins and minerals. Participants in trials using healthy background diets may increase their fibre intake in addition to the study variables. The aim of this study was to report …

Managing Undernutrition In The Elderly: Prevention Is Better Than Cure, Damian Flanagan, Therese Fisher, Micheal Murray, Renuka Visvanathan, Karen Charlton, Cathy Thesing, Gerald Quigley, Kerstin Walther

Karen E. Charlton

Background: Undernutrition in the elderly is common and can be associated with adverse medical consequences, contributing to frailty, morbidity, hospitalisation and mortality.Objective: This article provides guidelines for screening for undernutrition in general practice, and suggests strategies to address undernutrition in older patients.Discussion: Screening for undernutrition in general practice helps focus time and resources on people at greatest risk. Early identification and management of people at risk of undernutritionis important because it is difficult to reverse its adverse effects,once established.

Urinary Sodium Excretion, Dietary Sources Of Sodium Intake And Knowledge And Practices Around Salt Use In A Group Of Healthy Australian Women, Karen Charlton, Heather Yeatman, Fiona Houweling, Sophie Guenon

Karen E. Charlton

Objective: Strategies that aim to facilitate reduction of the salt content of foods in Australia are hampered by sparse and outdated data on habitual salt intakes. This study assessed habitual sodium intake through urinary excretion analyses, and identified food sources of dietary sodium, as well as knowledge and practices related to salt use in healthy women. Methods: Cross-sectional, convenient sample of 76 women aged 20 to 55 years, Wollongong, NSW. Data included a 24 hour urine sample, three-day food diary and a self-administered questionnaire. Results: Mean Na excretion equated to a NaCl (salt) intake of 6.41 (SD=2.61) g/day; 43% had …

Start Date May Predict Attrition 6 Months Into A 12mth Dietary Intervention Weight Loss Trial, Jane O'Shea, Linda Tapsell, Marijka Batterham, Karen Charlton, Yasmine Probst, Rebecca Thorne, Qingsheng Zhang, Holley Jones

Karen E. Charlton

Participant recruitment is a difficult and time consuming aspect of clinical trials, often resulting in delays and budget overruns. Having reached recruitment targets the next challenge is participant retention. Some weight-loss studies have attrition rates around 60% which may introduce bias in the results. It may be possible to reduce attrition rates if known predictors can be found but to date few studies produced consistent results. The aim of this exploratory study was to determine whether start date could be a predictor of attrition for participants involved in the SMART weight loss clinical trial (ACTRN12608000425392). Recruitment for the trial occurred …

Associations Between Baseline Erythrocyte N-3 Polyunsaturated Fatty Acids And Weight Indices In Volunteers For A Weight Loss Dietary Intervention, Linda Tapsell, J O'Shea, M Batterham, K Charlton, E Warensjo, R Thorne, K Zhang

Karen E. Charlton

No abstract provided.

Short Term Effects Of Energy Restriction And Dietary Fat Sub-Type On Weight Loss And Disease Risk Factors, Linda C. Tapsell, Marijka Batterham, Xu-Feng Huang, Sze Yen Tan, Grigorijs Teuss, Karen E. Charlton, Jane E. O'Shea, Eva M. Warensjo

Karen E. Charlton

Background and aims: Decreasing energy intake relative to energy expenditure is the indisputable tenet of weight loss. In addition to caloric restriction modification of the type of dietary fat may provide further benefits. The aim of the present study was to examine the effect of energy restriction alone and with dietary fat modification on weight loss and adiposity, as well as on risk factors for obesity related disease. Methods and results: One-hundred and fifty overweight men and women were randomized into a 3 month controlled trial with four low fat (30% energy) dietary arms: (1) isocaloric (LF); (2) isocaloric with …

Validation Of The Mini Nutritional Assessment Short-Form (Mna-Sf): A Practical Tool For Identification Of Nutritional Status, Matthius Kaiser, J. Bauer, C. Ramsch, W. Uter, Yves Guigoz, Tommy Cederholm, D. Thomas, Patricia Anthony, Karen Charlton, M. Maggio, Alan Tsai, D. Grathwohl, Bruno Vellas, C. Sieber

Karen E. Charlton

Objective: To validate a revision of the Mini Nutritional Assessment short-form (MNA®-SF) against the full MNA, a standard tool for nutritional evaluation. Methods: A literature search identified studies that used the MNA for nutritional screening in geriatric patients. The contacted authors submitted original datasets that were merged into a single database. Various combinations of the questions on the current MNA-SF were tested using this database through combination analysis and ROC based derivation of classification thresholds. Results: Twenty-seven datasets (n=6257 participants) were initially processed from which twelve were used in the current analysis on a sample of 2032 study participants (mean …

Baseline Characteristics Of Volunteers In The Smart Clinical Trial: Associations Between Habitual Physical Activity And Lifestyle Disease Risk Factors, Qingsheng Zhang, Jane E. O'Shea, Rebecca L. Thorne, Linda C. Tapsell, Marijka Batterham, Karen E. Charlton

Karen E. Charlton

Physical Activity has been suggested to have favorable effects on various cardiovascular risk factors, and may serve as an intervening variable in life-style intervention studies. We aimed to examine the relationship between habitual physical activity and selected cardiovascular markers at baseline in a sample of overweight women who participated in the SMART clinical trial [ACTRN12608000425392]. A sub-sample of eighty-six overweight/obese women (mean age ± S.D.: 45 ± 7.9 years) were included in this analysis. Anthropometric and fasting blood data was collected at baseline (t = 0). Habitual physical activity was assessed by a validated questionnaire (Baecke questionnaire). Associations were examined …

The Mna, But Not The Determine, Screening Tool Is A Valid Indicator Of Nutritional Status In Elderly Africans, Karen Charlton, Tracy Kolbe-Alexander, Johanna Nel

Karen E. Charlton

Objectives: To compare the validity of existing nutrition screening tools for use in older South Africans. Design: A cross-sectional study in 283 free-living and institutionalized black South Africans aged 60+ years.Methods: Trained fieldworkers administered a 24-hour recall, the DETERMINE and Mini Nutritional Assessment (MNA) screening tools and performed anthropometrical measurements and physical function tests. Biochemical indicators assessed included serum albumin; haemoglobin, ferritin, vitamin B12, RBC folate, cholesterol and vitamin C. The 6-item Cognitive Impairment Test was used to assess cognitive function.Results: MNA score was positively and significantly associated with anthropometrical measurements, cognitive function, IADL and, in women only, % body …

Frequency Of Malnutrition In Older Adults: A Multinational Perspective Using The Mini Nutritional Assessment, Matthias Kaiser, J. Bauer, C. Ramsch, W. Uter, Yves Guigoz, Tommy Cederholm, D. Thomas, Patricia Anthony, Karen Charlton, M. Maggio, Alan Tsai, Bruno Vellas, C. Sieber

Karen E. Charlton

OBJECTIVES: To provide pooled data on the prevalence of malnutrition in elderly people as evaluated using the Mini Nutritional Assessment (MNA).

DESIGN: Retrospective pooled analysis of previously published datasets.

SETTING: Hospital, rehabilitation, nursing home, community.

PARTICIPANTS: Four thousand five hundred seven people (75.2% female) with a mean age of 82.3.

MEASUREMENTS: The prevalence of malnutrition in the combined database and in the four settings was examined.

RESULTS: Twenty-four data sets with information on full MNA classification from researchers from 12 countries were submitted. In the combined database, the prevalence of malnutrition was 22.8%, with considerable differences between the settings (rehabilitation, …

An Assessment Of The Effectiveness Of Growth Monitoring And Promotion Practices In The Lusaka District Of Zambia, Karen Charlton, Beatrice Kawana, Michael Hendricks

Karen E. Charlton

Objective: We evaluated the effectiveness of the growth monitoring and promotion (GMP) program in Zambia. Methods: A 3-mo prospective study of growth outcomes was undertaken at randomly selected health facilities and community posts within the Lusaka district. Children(n equals 698) were purposively sampled from three health facilities (n equals 459) and four community posts (n equals 77) where health workers had undergone training inGMP and three health facilities where staff had not received training (n equals 162). Qualitative data on knowledge, attitudes, and practices of GMP were collected from health facility managers (n equals 6), health workers (n equals 35), …

Nutrition Screening: Time To Address The Skeletons In The Bedroom Closet As Well As Those In Hospitals, Karen E. Charlton

Karen E. Charlton

Ever since Dr Charles Butterworth's seminal article in 19741 on the widespread prevalence of malnutrition in hospitalised patients and its detrimental effect on recovery, attempts have been made to improve the detection of malnutrition through screening initiatives. However, despite compelling evidence that those who are either malnourished at admission or become malnourished during their hospital stay experience increased surgical complications, greater morbidity and increased length of hospital stay2,3 as well as higher rates of mortality at 12 months,4,5 malnutrition often remains undetected and untreated because it is not considered to be a clinical priority. Even overt signs of malnutrition are …

G-Protein-Coupled Receptor Kinase 4 Polymorphisms Predict Blood Pressure Response To Dietary Modification In Black Patients With Mild-To-Moderate Hypertension, B Rayner, R Ramesar, K Steyn, N Levitt, C Lombard, K Charlton

Karen E. Charlton

No abstract provided.

Long-Term Effects Of Increased Dietary Polyunsaturated Fat From Walnuts On Metabolic Parameters In Type Ii Diabetes, Cassandra Quick, Marijka Batterham, Linda Tapsell, Lynda Gillen, Karen Charlton, Sze Yen Tan, Grigorijs Teuss, Sayne Mam Dalton

Karen E. Charlton

Background/Objectives: Most dietary interventions have metabolic effects in the short term, but long-term effects may require dietary fat changes to influence body composition and insulin action. This study assessed the effect of sustained high polyunsaturated fatty acids (PUFA) intake through walnut consumption on metabolic outcomes in type II diabetes.Subjects/Methods: Fifty overweight adults with non-insulin-treated diabetes (mean age 54±8.7 years) were randomized to receive low-fat dietary advice ±30 g per day walnuts targeting weight maintenance (around 2000 kcal, 30% fat) for 1 year. Differences between groups were assessed by changes in anthropometric values (body weight, body fat, visceral adipose tissue) and …

Women's Perceptions Relating To The Introduction Of Mandatory Iodine Fortification In Australia, Heather Yeatman, Karen Charlton, Chantell Player

Karen E. Charlton

Aim: In Australia, the mandatory fortification of salt used in bread with iodine has recently been approved by the regulatory authorities (Food Standards Australia New Zealand). Apart from thiamine fortification of bread that has been in place since 1991, no other mandatory fortification programs exist in the country. The aim of the present study was to explore women’s understanding of mandatory fortification as a public health strategy and their opinions regarding its appropriateness for addressing the re-emergence of iodine deficiency.

Older Rehabilitation Patients Are At High Risk Of Malnutrition: Evidence From A Large Australian Database, Karen Charlton, Clare Nichols, Steven Bowden, Kelly Lambert, Lilliana Barone, Michelle Mason, Marianna Milosavljevic

Karen E. Charlton

No abstract provided.

Blood Pressure Is Associated With Markers Of Endogenous Fat Metabolism, K Charlton, E Warensjo, Linda Tapsell, M Batterham, J O'Shea

Karen E. Charlton

No abstract provided.

Pork, Beef And Chicken Have Similar Effects On Acute Satiety And Appetite Regulatory Hormone Responses, Karen E. Charlton, Linda C. Tapsell, Marijka Batterham, Jane E. O'Shea, Rebecca L. Thorne, Qingsheng Zhang, Eleanor Beck

Karen E. Charlton

No abstract provided.