Michelle Blumfield - Academia.edu (original) (raw)

Papers by Michelle Blumfield

The FASEB Journal, Apr 1, 2017

Sleep, 2021

Maternal sleep disturbance is common during pregnancy and postpartum periods. This study evaluate... more Maternal sleep disturbance is common during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods. This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous women without major medical/psychiatric conditions were randomised 1:1 to CBT or active control of equal frequency/duration. All participants received a 1-hr telephone session and automated multimedia emails from the 3rd trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12, and 24. 163 eligible participants (age M +/- SD = 33.35 +/- 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that compared to active control, receiving CBT was...

Psychological Medicine, 2021

Background Sleep disturbance is common in gestational parents during pregnancy and postpartum per... more Background Sleep disturbance is common in gestational parents during pregnancy and postpartum periods. This study evaluated the feasibility and efficacy of a scalable cognitive behavioural therapy (CBT) sleep intervention tailored for these periods. Methods This is a two-arm, parallel-group, single-blind, superiority randomised controlled trial. Nulliparous females without severe medical/psychiatric conditions were randomised 1:1 to CBT or attention- and time-matched control. All participants received a 1 h telephone session and automated multimedia emails from the third trimester until 6 months postpartum. Outcomes were assessed with validated instruments at gestation weeks 30 (baseline) and 35 (pregnancy endpoint), and postpartum months 1.5, 3, 6 (postpartum endpoint), 12 and 24. Results In total, 163 eligible participants (age M ± s.d. = 33.35 ± 3.42) were randomised. The CBT intervention was well accepted, with no reported adverse effect. Intention-to-treat analyses showed that ...

SSRN Electronic Journal, 2020

Nutrients, 2020

The internet is the fastest growing source of nutrition information for consumers. Massive Open O... more The internet is the fastest growing source of nutrition information for consumers. Massive Open Online Courses (MOOCs) provide and avenue for nutrition professionals’ urgent need to respond to consumer demand for low-cost, accessible and engaging information. This research aimed to evaluate learner participation and perceptions in an evidence-based nutrition MOOC and provide recommendations for engaging international online lay audiences. Learners completed pre and post course surveys including quantitative and open-ended questions. Pre-course surveys collected demographic data, prior nutrition knowledge and motivations for doing the course. Post-course surveys evaluated their preferred learning modes and learners’ opinions of the course. Quantitative were analyzed using descriptive statistics. Conventional content analysis was conducted on learners’ responses to open-ended survey questions using an inductive approach. Learners represented 158 countries from a range of educational b...

Midwifery, 2019

Objective: To investigate the relationship between sleeping behaviour and macronutrient intake of... more Objective: To investigate the relationship between sleeping behaviour and macronutrient intake of pregnant women. Design: Cross-sectional analysis of data collected in 2009 as part of the Australian Longitudinal Study on Women's Health. Setting: Australia Participants: Australian pregnant women (n = 437, aged 31-36) enrolled in the Australian Longitudinal Study on Women's Health who completed Survey 5 in 2009. Measurements: Pregnant women self-reported sleep and dietary data. Latent class analysis derived sleep patterns. Relationships between sleep and diet were investigated through multivariate linear regression controlling for confounders including: area of residence, body mass index, depression, difficulty managing on income, education level and parity. Findings: Latent class analysis identified three sleeping behaviour patterns: (LC1) average sleep (∼7.8 h) with no adverse sleep-related symptoms (n = 167); (LC2) average sleep (∼8.3 h) with adverse sleep symptoms (n = 193); and (LC3) short sleep (∼6.6 h) with adverse sleep symptoms (n = 97). After adjusting for potential confounders, LC2 was associated lower percentage energy (%E) total fat (b = −0.032, p = 0.039) and%E monounsaturated fat (b = −0.050, p = 0.005) and higher intake of%E carbohydrate (b = 0.031, p = 0.020), compared to LC1. No differences were found between LC1 and LC3. Key conclusions: Higher monounsaturated fat intake, at the expense of carbohydrate intake, may prove protective against poor sleep quality in pregnancy. Implications for practice: Antenatal support provided by health professionals should consider the important relationship between dietary intake and sleeping behaviour. Encouraging pregnant women to improve their sleep quality may prove an important strategy to optimise dietary intake during pregnancy and consequently improve the health outcomes for both mother and child.

Clinical Endocrinology, 2018

Sleep disturbances in women with and without polycystic ovary syndrome in an Australian National ... more Sleep disturbances in women with and without polycystic ovary syndrome in an Australian National Cohort.

Journal of Human Nutrition and Dietetics, 2018

Background: Pregnancy can motivate individuals to adopt lifestyle behaviours that protect the hea... more Background: Pregnancy can motivate individuals to adopt lifestyle behaviours that protect the health of their offspring. The aims of the present study were to explore men's and women's beliefs about lifestyle, fertility and pregnancy, as well as where they seek advice. Methods: Participants (2185 women and 221 men, six unspecified) from 104 countries completed a questionnaire that explored their beliefs about what was important for a healthy pregnancy and their advice-seeking behaviours. Recruitment was via a Massive Open Online Course entitled 'Food as Medicine', with food, nutrient and health content. Comparisons of categorical data were performed using a chi-squared test (P = 0.05). Results: Eating a variety of fruits and vegetables and not smoking (both 93.7%) were the most frequently and equally ranked in the top-five factors for a healthy pregnancy. Taking prenatal supplements (26.8%) was considered to be less important. Participants in Westernised countries ranked not smoking or drinking alcohol as being significantly more important than those in other countries. Overall, doctors (47.7%) were the most common source of fertility and pregnancy advice. Larger proportions of those aged <40 years used the Internet (<40 years 44.1%, >40 years 18.2% v 2 = 152.7, P < 0.01) and social media (<40 years 16.1%, >40 years 3.6%; v 2 = 110.18, P < 0.01) for health information. Conclusions: There is disconnection between beliefs and actions regarding the lifestyle behaviours considered to be important for a healthy pregnancy, particularly nutrition. Pregnancy advice-seeking has evolved, with younger men and women utilising the Internet and social media. Health professionals must consider new communication strategies to deliver evidence-based lifestyle advice, particularly for younger men and women and where access to healthcare is limited.

Journal of Developmental Origins of Health and Disease, 2018

Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is curren... more Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: −70.67, 95% CI −101.90 to −39.43,P<0.001), 16% (RR: 0.84, 95% CI 0.73–0.98,P=0.026) ...

Nutrients, Jan 22, 2018

Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was... more Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up to May 2018 (no date or language restrictions). Keywords and MeSH terms for diet, GWG, intervention, lifestyle, maternal, physical activity, and pregnancy were used to locate randomized-controlled trials (RCTs). The Cochrane Collaboration tool for assessing risk of bias was applied. Eighty-nine RCTs were included. Meta-analysis (60 trials) estimated that women in diet only (WMD: -3.27; 95% CI: -4.96, -1.58, < 0.01), physical activity (PA) (WMD: -1.02; 95% CI: -1.56, -0.49, < 0.01), and lifestyle interventions (combining diet and PA) (WMD: -0.84; 95% CI: -1.29, -0.39, < 0.01) gained significantly less weight than controls. The three eHealth ...

Australian journal of primary health, 2018

Pregnancy is a critical stage of life requiring urgent attention when taking a lifespan approach ... more Pregnancy is a critical stage of life requiring urgent attention when taking a lifespan approach to obesity prevention. Excessive gestational weight gain (GWG) is highly predictive of overweight and obesity later in life for women and their offspring. This discussion describes the challenges faced by health professionals (general practitioners, midwives, allied health) in primary care in Australia when addressing GWG, presents evidence that supports re-prioritising GWG and highlights strategies that can be used to address GWG. The revised National Health and Medical Research Council antenatal care guidelines (to be formally released in early 2018) indicate it will be the responsibility of health professionals in antenatal care to initiate conversations about GWG with women. Women are open to discussing this sensitive topic and health professionals in primary care have an opportunity to be proactive in addressing barriers that have hindered conversations about GWG in the past so that...

Appetite, 2018

Inadequate sleep independently influences eating habits and weight status. However, the relations... more Inadequate sleep independently influences eating habits and weight status. However, the relationship between these three factors has not been well quantified. The objective of this study was to examine if eating behavior (i.e. dietary restraint, disinhibition and hunger) mediates the relationship between sleep and body mass index (BMI) in a large sample of American adults. Cross-sectional data from the Nathan Kline Institute Rockland sample were assessed (n = 602; 38.9 ± 14.5 years). Self-reported sleep and eating behavior were measured using the Pittsburgh Sleep Quality Index and Three Factor Eating Questionnaire, respectively. Path analysis was used to examine relationships amongst the construct, with mediation tested via bootstrapped confidence intervals. Poorer sleep quality was associated with both greater hunger (P = 0.03) and higher disinhibited eating (overeating in the presence of palatable foods or other disinhibiting stimuli like emotional stress; P < 0.001) behaviors....

European Journal of Clinical Nutrition, 2017

BACKGROUND/OBJECTIVE: Reduced sleep is a strong and independent risk factor for weight gain and o... more BACKGROUND/OBJECTIVE: Reduced sleep is a strong and independent risk factor for weight gain and obesity. Maternal obesity preconception and throughout gestation can increase the risk of adverse pregnancy outcomes and impact on offspring health in later life. This study investigated the relationship between sleeping behaviour and macronutrient intake in childbearing aged women. SUBJECTS/METHODS: We used cross-sectional data from the Australian Longitudinal Study on Women's Health 1973-78 cohort, aged 31-36 years in 2009 (n = 8200). Subjective sleeping behaviour was reported and macronutrient intake was measured using a validated food frequency questionnaire. Latent class analysis (LCA) was used to derive sleeping patterns. Multivariate regression analysis was used to investigate the relationships between sleep and macronutrient intake. RESULTS: LCA identified three sleep patterns: (LC1) average sleep (~8 h) with no adverse sleep-related symptoms (n = 3570); (LC2) average sleep (~8 h) with sleeping difficulties and severe tiredness (n = 2109); and (LC3) short sleep (~6 h) with sleeping difficulties and severe tiredness (n = 915). In fully adjusted models, LC2 was inversely associated with percentage energy as protein (b = − 0.24; P = 0.01) and the protein-to-carbohydrate ratio (b = − 0.01; P o0.05). LC3 was positively associated with percentage of energy as fat (b = 0.29; P = 0.01), saturated fat (b = 0.24; P = o0.001) and monounsaturated fat (b = 0.09; P = 0.04). CONCLUSIONS: Sleeping behaviour patterns were associated with macronutrient intake in childbearing aged women. Improved sleep patterns, together with diet and physical activity strategies, may make it easier for women to achieve a balanced diet and optimise their weight status in preparation for pregnancy.

Journal of Nutrition & Intermediary Metabolism, 2016

Journal of the Endocrine Society, 2020

Sleep disturbances in women with and without polycystic ovary syndrome (PCOS) and their associati... more Sleep disturbances in women with and without polycystic ovary syndrome (PCOS) and their association with lifestyle factors (diet, physical activity and sitting time) Bennett C1, Mansfield DR2, Mo L2, Hodge A3, Joham A4, 5, Cain SW6, Blumfield M1, Teede H4, 5, Moran LJ4 1. Be Active Sleep and Eat (BASE) Facility, Department of Nutrition and Dietetics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria 2. Monash Lung and Sleep, Monash Health, Clayton, Victoria 3. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria 4. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria 5. Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria 6. Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria Sleep disturbances are a risk factor for po...