Philippa Lyons-Wall - Academia.edu (original) (raw)

Papers by Philippa Lyons-Wall

Research paper thumbnail of Compliance, Palatability and Feasibility of PALEOLITHIC and Australian Guide to Healthy Eating Diets in Healthy Women: A 4-Week Dietary Intervention

Nutrients, 2016

(1) BACKGROUND/OBJECTIVES: The Paleolithic diet has been receiving media coverage in Australia an... more (1) BACKGROUND/OBJECTIVES: The Paleolithic diet has been receiving media coverage in Australia and claims to improve overall health. The diet removes grains and dairy, whilst encouraging consumption of fruits, vegetables, meat, eggs and nuts. Our aim was to compare the diet to the Australian Guide to Healthy Eating (AGHE) in terms of compliance, palatability and feasibility; (2) SUBJECTS/METHODS: 39 healthy women (age 47 ± 13 years, BMI 27 ± 4 kg/m²) were randomised to an ad-libitum Paleolithic (n = 22) or AGHE diet (n = 17) for 4-weeks. A food checklist was completed daily, with mean discretionary consumption (serves/day) calculated to assess compliance. A 12-item questionnaire was administered post intervention to assess palatability and feasibility; (3) RESULTS: The AGHE group reported greater daily consumption of discretionary items (1.0 + 0.6 vs. 0.57 + 0.6 serves/day, p = 0.03). Compared to the AGHE group, the Paleolithic group reported a significantly greater number of events of diarrhoea (23%, 0%, p = 0.046), costs associated with grocery shopping (69%, 6% p < 0.01) and belief that the diet was not healthy (43%, 0% p < 0.01); (4) CONCLUSIONS: Compliance to both diets was high but the potential side effects and increased cost suggest that the Paleolithic diet may not be practical in clinical/public health settings. Further studies are required to assess longer term feasibility.

Research paper thumbnail of Effects of Vegetable Consumption on Weight Loss: A Review of the Evidence with Implications for Design of Randomized Controlled Trials

Critical Reviews in Food Science and Nutrition, 2014

Vegetable consumption is a key strategy in many weight loss programs but establishing the evidenc... more Vegetable consumption is a key strategy in many weight loss programs but establishing the evidence that vegetable consumption per se assists with weight loss may be difficult. Creating a dietary energy deficit involves the whole diet, so research on the effects of vegetables may need to consider the whole-dietary model. The aims of this review were to examine the evidence on whether a higher vegetable consumption resulted in greater weight loss in overweight adults (compared to lower intakes) in view of a critique study designs with respect to their potential impact on outcomes. Using the PubMed search engine, a systematic review of randomized controlled trials (RCTs) published in the period 1988 to 2011 was conducted. Of the 16 RCTs scrutinized, five reported greater weight loss, nine no difference, one showed weight gain, and one reported a positive association between weight loss and high vegetable consumption. Trials which showed beneficial effects compared a healthy high vegetable diet with a control diet based on usual consumption patterns, and/or included behavioral support and counseling. On face value, the evidence reviewed appeared inconclusive but closer examination of study designs exposed important implications for RCTs that examine effects of foods on weight loss.

Research paper thumbnail of Evaluation of a Mobile Phone Image-Based Dietary Assessment Method in Adults with Type 2 Diabetes

Nutrients, 2015

Image-based dietary records have limited evidence evaluating their performance and use among adul... more Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM), in adults with type 2 diabetes mellitus (T2DM). Criterion validity was determined by comparing energy intake (EI) with total energy expenditure (TEE) measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR). Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m2) participated. Compared to TEE, mean EI (MJ/day) was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57), carbohydrate (g/day) (r = 0.63, p < 0.05), protein (g/day) (r = 0.78, p < 0.01) and alcohol (g/day) (rs = 0.85, p < 0.01), with a weaker relationship for fat (g/day) (r = 0.24). Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC) = 0.77-0.99) was lower when compared with the 3-day WFR (ICC = 0.82-0.99). These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required.

Research paper thumbnail of Trial of a mobile phone method for recording dietary intake in adults with type 2 diabetes: evaluation and implications for future applications

Journal of telemedicine and telecare, 2011

We evaluated a mobile phone application (Nutricam) for recording dietary intake. It allowed users... more We evaluated a mobile phone application (Nutricam) for recording dietary intake. It allowed users to capture a photograph of food items before consumption and store a voice recording to explain the contents of the photograph. This information was then sent to a website where it was analysed by a dietitian. Ten adults with type 2 diabetes (BMI 24.1-47.9 kg/m(2)) recorded their intake over a three-day period using both Nutricam and a written food diary. Compared to the food diary, energy intake was under-recorded by 649 kJ (SD 810) using the mobile phone method. However, there was no trend in the difference between dietary assessment methods at levels of low or high energy intake. All subjects reported that the mobile phone system was easy to use. Six subjects found that the time taken to record using Nutricam was shorter than recording using the written diary, while two reported that it was about the same. The level of detail provided in the voice recording and food items obscured in...

Research paper thumbnail of Salt Appetite in Pregnancy

Hypertension in Pregnancy, 1996

ABSTRACT Objective: Pregnancy is a state of sodium retention, needed to provide additional sodium... more ABSTRACT Objective: Pregnancy is a state of sodium retention, needed to provide additional sodium to the fetus and for expansion of maternal plasma volume. Hypertension in pregnancy may be accompanied by further sodium retention, particularly when due to preeclampsia. The aim of this study was to compare salt appetite in normotensive and hypertensive pregnant women with nonpregnant normal controls. The hypothesis was that salt appetite would be increased in pregnant, compared to nonpregnant women, and further increased in hypertensive pregnancy. Methods: Salt appetite was assessed by measuring (i) salt sensitivity, determined by taste detection threshold, preference, and tolerance data; and (ii) salt intake, assessed by food frequency questionnaire and 24-h urinary sodium. Subjects were 18 normotensive pregnant and 14 hypertensive pregnant women recruited from a hospital clinic; and 15 normal, age-matched nonpregnant controls recruited from hospital staff. Results: Median salt detection threshold in the hypertensive pregnant women (1.44 mmol/L) was 2.6-fold higher than in nonpregnant women (0.56 mmol/L) (P = 0.003) and 1.8-fold higher than in normotensive pregnant women (0.81 mmol/L) (P = 0.027). There were no significant differences in salt preference or tolerance. Normotensive pregnant women reported greater use of discretionary salt, with less frequent consumption of low-salt products (P = 0.004). There were no group differences in sodium excretion. Conclusion: Changes of salt appetite in pregnancy are very small. Within the limits of present methodology available to assess salt appetite, it appears unlikely that such changes contribute to the sodium retention observed in normal and hypertensive pregnancies.

Research paper thumbnail of Intake of isoflavone and lignan phytoestrogens and associated demographic and lifestyle factors in older Australian women

Asia Pacific Journal of Clinical Nutrition

The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and ... more The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and to investigate associated lifestyle factors. Subjects were an age-stratified sample of 511 women aged 40-80 y, randomly selected from the electoral roll and participating in the Longitudinal Assessment of Ageing in Women at the Royal Brisbane and Women's Hospital. A cross-sectional study was conducted to assess isoflavone and lignan intake over the past month from food and supplements using a 112-item phytoestrogen frequency questionnaire. Data were also collected on nutrient intakes, physical activity, smoking, alcohol, non-prescription supplements, hormone therapy, education and occupation. Logistic regression was used to evaluate associations between demographic and lifestyle variables and soy/linseed consumption while controlling for age. Isoflavone intakes were significantly higher in the younger compared to older age groups (p<0.001); there were no age-related differences in...

Research paper thumbnail of Intake of Selected Phytochemicals and Prevention of Coronary Heart Disease: Practical Implications

Research paper thumbnail of Supplement Usage in Women Entering the Menopausal Transition in Brisbane

Research paper thumbnail of Meetings of Interest

Research paper thumbnail of Intake of isoflavone and lignan phytoestrogens and associated demographic and lifestyle factors in older Australian women

Asia Pacific journal of clinical nutrition, 2010

The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and ... more The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and to investigate associated lifestyle factors. Subjects were an age-stratified sample of 511 women aged 40-80 y, randomly selected from the electoral roll and participating in the Longitudinal Assessment of Ageing in Women at the Royal Brisbane and Women's Hospital. A cross-sectional study was conducted to assess isoflavone and lignan intake over the past month from food and supplements using a 112-item phytoestrogen frequency questionnaire. Data were also collected on nutrient intakes, physical activity, smoking, alcohol, non-prescription supplements, hormone therapy, education and occupation. Logistic regression was used to evaluate associations between demographic and lifestyle variables and soy/linseed consumption while controlling for age. Isoflavone intakes were significantly higher in the younger compared to older age groups (p<0.001); there were no age-related differences in...

Research paper thumbnail of Development and Validation of a Short Questionnaire for Estimating the Intake of Zinc

Biological Trace Element Research, 2009

Research paper thumbnail of Minor Dietary Factors in Relation to Coronary Heart Disease. Flavonoids, Isoflavones and Boron

Journal of Clinical Biochemistry and Nutrition, 1996

ABSTRACT Flavonoids are potent inhibitors of the oxidative modification of low-density lipoprotei... more ABSTRACT Flavonoids are potent inhibitors of the oxidative modification of low-density lipoprotein (LDL), and foods containing these compounds have been shown to be negatively associated with coronary heart disease (CHD). Flavonoids reduce the formation of free radicals and protect or regenerate other antioxidants; or alternatively, they chelate divalent metal ions. Isoflavones may act in a manner similar to estrogen in that they lower LDL and in this way confer protection against CHD. Less is known about other minor dietary constituents, such as boron, which is widespread in fruits and vegetables. Boron may have an impact on CHD by inducing small increases in the concentration of plasma estrogen.

Research paper thumbnail of Isoflavones and Plasma Lipids in Young Women - Potential Effects on HDL

Natural Antioxidants and Anticarcinogens in Nutrition, Health and Disease, 1999

Research paper thumbnail of The use of complementary and alternative medications by menopausal women in South East Queensland

Women’s Health Issues, 2004

This study aimed to identify the prevalence and types of complementary and alternative medication... more This study aimed to identify the prevalence and types of complementary and alternative medications (CAMs) used by women during menopause and explore potential associations between CAM use and menopausal symptoms. Analysis was undertaken with 886 randomly selected menopausal women aged 47-67 years who participated in a postal questionnaire on the menopause experience. The prevalence of CAM use was relatively high (82.5%), with nutrition most commonly cited (67%), followed by phytoestrogens (56%), herbal therapies (41%), and CAM medications (25%). Multivariate analysis adjusted for confounders revealed that women who consumed CAM medications were 17-23% more likely to report anxiety (p _ .019) or vasomotor symptoms (p _ .013). Women who used herbal therapies (p _ .009) or phytoestrogens (p _ .030) were 13-16% more likely to experience vasomotor symptoms. Women who used nutrition were 18% more likely to experience anxiety (p _ .049). These results highlight the importance for health professionals to incorporate CAMs into their practice to better inform menopausal women of their treatment choices.

Research paper thumbnail of Effects of supplementation with purified red clover (Trifolium pratense) isoflavones on plasma lipids and insulin resistance in healthy premenopausal women

British Journal of Nutrition, 2003

Consumption of isoflavone-rich soyabean protein is reported to reduce total and LDL-cholesterol, ... more Consumption of isoflavone-rich soyabean protein is reported to reduce total and LDL-cholesterol, but the specific components responsible are undetermined. In a previous crossover trial we showed that purified isoflavones, derived from red clover (Trifolium pratense ), raised HDL 3cholesterol in premenopausal women; however, these findings were inconclusive due to period and carryover effects. In an attempt to overcome this problem, we utilised a parallel study designed to re-examine the effects of purified isoflavones on plasma lipoproteins and markers of insulin resistance in premenopausal women. Twenty-five healthy premenopausal women participated in a double-blind, randomised, parallel study. The treatment group (n 12) consumed a placebo for the first menstrual cycle and an isoflavone supplement (86 mg/d, derived from red clover) for three cycles, while the placebo group (n 13) consumed a placebo supplement for four menstrual cycles. Blood samples were collected weekly during cycles 1, 3 and 4. Supplementation with isoflavones resulted in a 15-fold increase in urinary isoflavone excretion (P, 0·0001). There were no significant effects on total cholesterol, LDL-and HDL-cholesterol, HDL subfractions, triacylglycerol, lipoprotein(a), glucose or insulin concentrations. Our present results indicate that purified isoflavones derived from red clover have no effect on cholesterol homeostasis or insulin resistance in premenopausal women, a group which is at low risk of CHD.

Research paper thumbnail of Comparison of multiple and novel measures of dietary glycemic carbohydrate with insulin resistant status in older women

Nutrition & Metabolism, 2010

Background: Previous epidemiological investigations of associations between dietary glycemic inta... more Background: Previous epidemiological investigations of associations between dietary glycemic intake and insulin resistance have used average daily measures of glycemic index (GI) and glycemic load (GL). We explored multiple and novel measures of dietary glycemic intake to determine which was most predictive of an association with insulin resistance. Methods: Usual dietary intakes were assessed by diet history interview in women aged 42-81 years participating in the Longitudinal Assessment of Ageing in Women. Daily measures of dietary glycemic intake (n = 329) were carbohydrate, GI, GL, and GL per megacalorie (GL/Mcal), while meal based measures (n = 200) were breakfast, lunch and dinner GL; and a new measure, GL peak score, to represent meal peaks. Insulin resistant status was defined as a homeostasis model assessment (HOMA) value of >3.99; HOMA as a continuous variable was also investigated. Results: GL, GL/Mcal, carbohydrate (all P < 0.01), GL peak score (P = 0.04) and lunch GL (P = 0.04) were positively and independently associated with insulin resistant status. Daily measures were more predictive than meal-based measures, with minimal difference between GL/Mcal, GL and carbohydrate. No significant associations were observed with HOMA as a continuous variable. Conclusion: A dietary pattern with high peaks of GL above the individual's average intake was a significant independent predictor of insulin resistance in this population, however the contribution was less than daily GL and carbohydrate variables. Accounting for energy intake slightly increased the predictive ability of GL, which is potentially important when examining disease risk in more diverse populations with wider variations in energy requirements.

Research paper thumbnail of Trends in purchasing patterns of sugar-sweetened water-based beverages in a remote Aboriginal community store following the implementation of a community-developed store nutrition policy

Nutrition & Dietetics, 2011

Research paper thumbnail of Glycaemic index and glycaemic load intake patterns in older Australian women

Nutrition & Dietetics, 2009

Aims: Dietary glycemic index (GI) and glycemic load (GL) have been associated with risk of 2 chro... more Aims: Dietary glycemic index (GI) and glycemic load (GL) have been associated with risk of 2 chronic diseases, yet limited research exists on patterns of consumption in Australia. Our aims 3 were to investigate glycemic carbohydrate in a population of older women, identify major 4 contributing food sources, and determine low, moderate and high ranges. 5

Research paper thumbnail of Does scientific evidence support the use of non-prescription supplements for treatment of acute menopausal symptoms such as hot flushes?

Nutrition <html_ent glyph="@amp;" ascii="&"/> Dietetics, 2005

Nutr Diet 2005;62:138-151)

Research paper thumbnail of Factors that influence consumption of fish and omega-3-enriched foods: A survey of Australian families with young children

Nutrition & Dietetics, 2013

Aim: The present study aimed to identify factors that influence the consumption of fish and foods... more Aim: The present study aimed to identify factors that influence the consumption of fish and foods that are enriched with omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA), in order to inform the development of effective nutrition education strategies. Methods: A cross-sectional, 10-item self-administered survey was conducted to 262 parents of children aged 9-13 years from a regional centre in New South Wales. Parents were asked questions related to frequency of consumption, and to identify factors that either encouraged or prevented the provision of fish/seafood and/or n-3 LCPUFAenriched foods for their families. Results: Salmon, canned tuna, prawn and take-away fish were the most commonly eaten variants of fish/ seafood, at approximately once a month. Perceived health benefits and the influence of media and health professionals in health promotion were identified as the primary motivators for consumption of fish/seafood and foods enriched with n-3 LCPUFA. Among families who consume fish, taste was valued as having a major positive influence, as well as preferences of individual family members, but the latter was perceived as an obstacle in non-fish consumers. Price was the main barrier to consumption of fresh, but not canned, fish and n-3-enriched foods, in both those that do and do not consume these foods. Conclusion: Despite Australian parents' knowledge of the health benefits n-3 LCPUFA, only a fifth of households meet the recommended two serves of fish per week, hence nutrition education strategies are warranted.

Research paper thumbnail of Compliance, Palatability and Feasibility of PALEOLITHIC and Australian Guide to Healthy Eating Diets in Healthy Women: A 4-Week Dietary Intervention

Nutrients, 2016

(1) BACKGROUND/OBJECTIVES: The Paleolithic diet has been receiving media coverage in Australia an... more (1) BACKGROUND/OBJECTIVES: The Paleolithic diet has been receiving media coverage in Australia and claims to improve overall health. The diet removes grains and dairy, whilst encouraging consumption of fruits, vegetables, meat, eggs and nuts. Our aim was to compare the diet to the Australian Guide to Healthy Eating (AGHE) in terms of compliance, palatability and feasibility; (2) SUBJECTS/METHODS: 39 healthy women (age 47 ± 13 years, BMI 27 ± 4 kg/m²) were randomised to an ad-libitum Paleolithic (n = 22) or AGHE diet (n = 17) for 4-weeks. A food checklist was completed daily, with mean discretionary consumption (serves/day) calculated to assess compliance. A 12-item questionnaire was administered post intervention to assess palatability and feasibility; (3) RESULTS: The AGHE group reported greater daily consumption of discretionary items (1.0 + 0.6 vs. 0.57 + 0.6 serves/day, p = 0.03). Compared to the AGHE group, the Paleolithic group reported a significantly greater number of events of diarrhoea (23%, 0%, p = 0.046), costs associated with grocery shopping (69%, 6% p &amp;amp;lt; 0.01) and belief that the diet was not healthy (43%, 0% p &amp;amp;lt; 0.01); (4) CONCLUSIONS: Compliance to both diets was high but the potential side effects and increased cost suggest that the Paleolithic diet may not be practical in clinical/public health settings. Further studies are required to assess longer term feasibility.

Research paper thumbnail of Effects of Vegetable Consumption on Weight Loss: A Review of the Evidence with Implications for Design of Randomized Controlled Trials

Critical Reviews in Food Science and Nutrition, 2014

Vegetable consumption is a key strategy in many weight loss programs but establishing the evidenc... more Vegetable consumption is a key strategy in many weight loss programs but establishing the evidence that vegetable consumption per se assists with weight loss may be difficult. Creating a dietary energy deficit involves the whole diet, so research on the effects of vegetables may need to consider the whole-dietary model. The aims of this review were to examine the evidence on whether a higher vegetable consumption resulted in greater weight loss in overweight adults (compared to lower intakes) in view of a critique study designs with respect to their potential impact on outcomes. Using the PubMed search engine, a systematic review of randomized controlled trials (RCTs) published in the period 1988 to 2011 was conducted. Of the 16 RCTs scrutinized, five reported greater weight loss, nine no difference, one showed weight gain, and one reported a positive association between weight loss and high vegetable consumption. Trials which showed beneficial effects compared a healthy high vegetable diet with a control diet based on usual consumption patterns, and/or included behavioral support and counseling. On face value, the evidence reviewed appeared inconclusive but closer examination of study designs exposed important implications for RCTs that examine effects of foods on weight loss.

Research paper thumbnail of Evaluation of a Mobile Phone Image-Based Dietary Assessment Method in Adults with Type 2 Diabetes

Nutrients, 2015

Image-based dietary records have limited evidence evaluating their performance and use among adul... more Image-based dietary records have limited evidence evaluating their performance and use among adults with a chronic disease. This study evaluated the performance of a 3-day mobile phone image-based dietary record, the Nutricam Dietary Assessment Method (NuDAM), in adults with type 2 diabetes mellitus (T2DM). Criterion validity was determined by comparing energy intake (EI) with total energy expenditure (TEE) measured by the doubly-labelled water technique. Relative validity was established by comparison to a weighed food record (WFR). Inter-rater reliability was assessed by comparing estimates of intake from three dietitians. Ten adults (6 males, age: 61.2 ± 6.9 years old, BMI: 31.0 ± 4.5 kg/m2) participated. Compared to TEE, mean EI (MJ/day) was significantly under-reported using both methods, with a mean ratio of EI:TEE 0.76 ± 0.20 for the NuDAM and 0.76 ± 0.17 for the WFR. Correlations between the NuDAM and WFR were mostly moderate for energy (r = 0.57), carbohydrate (g/day) (r = 0.63, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), protein (g/day) (r = 0.78, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) and alcohol (g/day) (rs = 0.85, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01), with a weaker relationship for fat (g/day) (r = 0.24). Agreement between dietitians for nutrient intake for the 3-day NuDAM (Intra-class Correlation Coefficient (ICC) = 0.77-0.99) was lower when compared with the 3-day WFR (ICC = 0.82-0.99). These findings demonstrate the performance and feasibility of the NuDAM to assess energy and macronutrient intake in a small sample. Some modifications to the NuDAM could improve efficiency and an evaluation in a larger group of adults with T2DM is required.

Research paper thumbnail of Trial of a mobile phone method for recording dietary intake in adults with type 2 diabetes: evaluation and implications for future applications

Journal of telemedicine and telecare, 2011

We evaluated a mobile phone application (Nutricam) for recording dietary intake. It allowed users... more We evaluated a mobile phone application (Nutricam) for recording dietary intake. It allowed users to capture a photograph of food items before consumption and store a voice recording to explain the contents of the photograph. This information was then sent to a website where it was analysed by a dietitian. Ten adults with type 2 diabetes (BMI 24.1-47.9 kg/m(2)) recorded their intake over a three-day period using both Nutricam and a written food diary. Compared to the food diary, energy intake was under-recorded by 649 kJ (SD 810) using the mobile phone method. However, there was no trend in the difference between dietary assessment methods at levels of low or high energy intake. All subjects reported that the mobile phone system was easy to use. Six subjects found that the time taken to record using Nutricam was shorter than recording using the written diary, while two reported that it was about the same. The level of detail provided in the voice recording and food items obscured in...

Research paper thumbnail of Salt Appetite in Pregnancy

Hypertension in Pregnancy, 1996

ABSTRACT Objective: Pregnancy is a state of sodium retention, needed to provide additional sodium... more ABSTRACT Objective: Pregnancy is a state of sodium retention, needed to provide additional sodium to the fetus and for expansion of maternal plasma volume. Hypertension in pregnancy may be accompanied by further sodium retention, particularly when due to preeclampsia. The aim of this study was to compare salt appetite in normotensive and hypertensive pregnant women with nonpregnant normal controls. The hypothesis was that salt appetite would be increased in pregnant, compared to nonpregnant women, and further increased in hypertensive pregnancy. Methods: Salt appetite was assessed by measuring (i) salt sensitivity, determined by taste detection threshold, preference, and tolerance data; and (ii) salt intake, assessed by food frequency questionnaire and 24-h urinary sodium. Subjects were 18 normotensive pregnant and 14 hypertensive pregnant women recruited from a hospital clinic; and 15 normal, age-matched nonpregnant controls recruited from hospital staff. Results: Median salt detection threshold in the hypertensive pregnant women (1.44 mmol/L) was 2.6-fold higher than in nonpregnant women (0.56 mmol/L) (P = 0.003) and 1.8-fold higher than in normotensive pregnant women (0.81 mmol/L) (P = 0.027). There were no significant differences in salt preference or tolerance. Normotensive pregnant women reported greater use of discretionary salt, with less frequent consumption of low-salt products (P = 0.004). There were no group differences in sodium excretion. Conclusion: Changes of salt appetite in pregnancy are very small. Within the limits of present methodology available to assess salt appetite, it appears unlikely that such changes contribute to the sodium retention observed in normal and hypertensive pregnancies.

Research paper thumbnail of Intake of isoflavone and lignan phytoestrogens and associated demographic and lifestyle factors in older Australian women

Asia Pacific Journal of Clinical Nutrition

The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and ... more The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and to investigate associated lifestyle factors. Subjects were an age-stratified sample of 511 women aged 40-80 y, randomly selected from the electoral roll and participating in the Longitudinal Assessment of Ageing in Women at the Royal Brisbane and Women's Hospital. A cross-sectional study was conducted to assess isoflavone and lignan intake over the past month from food and supplements using a 112-item phytoestrogen frequency questionnaire. Data were also collected on nutrient intakes, physical activity, smoking, alcohol, non-prescription supplements, hormone therapy, education and occupation. Logistic regression was used to evaluate associations between demographic and lifestyle variables and soy/linseed consumption while controlling for age. Isoflavone intakes were significantly higher in the younger compared to older age groups (p<0.001); there were no age-related differences in...

Research paper thumbnail of Intake of Selected Phytochemicals and Prevention of Coronary Heart Disease: Practical Implications

Research paper thumbnail of Supplement Usage in Women Entering the Menopausal Transition in Brisbane

Research paper thumbnail of Meetings of Interest

Research paper thumbnail of Intake of isoflavone and lignan phytoestrogens and associated demographic and lifestyle factors in older Australian women

Asia Pacific journal of clinical nutrition, 2010

The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and ... more The purpose was to determine intake of phytoestrogens in a sample of older Australian women, and to investigate associated lifestyle factors. Subjects were an age-stratified sample of 511 women aged 40-80 y, randomly selected from the electoral roll and participating in the Longitudinal Assessment of Ageing in Women at the Royal Brisbane and Women's Hospital. A cross-sectional study was conducted to assess isoflavone and lignan intake over the past month from food and supplements using a 112-item phytoestrogen frequency questionnaire. Data were also collected on nutrient intakes, physical activity, smoking, alcohol, non-prescription supplements, hormone therapy, education and occupation. Logistic regression was used to evaluate associations between demographic and lifestyle variables and soy/linseed consumption while controlling for age. Isoflavone intakes were significantly higher in the younger compared to older age groups (p<0.001); there were no age-related differences in...

Research paper thumbnail of Development and Validation of a Short Questionnaire for Estimating the Intake of Zinc

Biological Trace Element Research, 2009

Research paper thumbnail of Minor Dietary Factors in Relation to Coronary Heart Disease. Flavonoids, Isoflavones and Boron

Journal of Clinical Biochemistry and Nutrition, 1996

ABSTRACT Flavonoids are potent inhibitors of the oxidative modification of low-density lipoprotei... more ABSTRACT Flavonoids are potent inhibitors of the oxidative modification of low-density lipoprotein (LDL), and foods containing these compounds have been shown to be negatively associated with coronary heart disease (CHD). Flavonoids reduce the formation of free radicals and protect or regenerate other antioxidants; or alternatively, they chelate divalent metal ions. Isoflavones may act in a manner similar to estrogen in that they lower LDL and in this way confer protection against CHD. Less is known about other minor dietary constituents, such as boron, which is widespread in fruits and vegetables. Boron may have an impact on CHD by inducing small increases in the concentration of plasma estrogen.

Research paper thumbnail of Isoflavones and Plasma Lipids in Young Women - Potential Effects on HDL

Natural Antioxidants and Anticarcinogens in Nutrition, Health and Disease, 1999

Research paper thumbnail of The use of complementary and alternative medications by menopausal women in South East Queensland

Women’s Health Issues, 2004

This study aimed to identify the prevalence and types of complementary and alternative medication... more This study aimed to identify the prevalence and types of complementary and alternative medications (CAMs) used by women during menopause and explore potential associations between CAM use and menopausal symptoms. Analysis was undertaken with 886 randomly selected menopausal women aged 47-67 years who participated in a postal questionnaire on the menopause experience. The prevalence of CAM use was relatively high (82.5%), with nutrition most commonly cited (67%), followed by phytoestrogens (56%), herbal therapies (41%), and CAM medications (25%). Multivariate analysis adjusted for confounders revealed that women who consumed CAM medications were 17-23% more likely to report anxiety (p _ .019) or vasomotor symptoms (p _ .013). Women who used herbal therapies (p _ .009) or phytoestrogens (p _ .030) were 13-16% more likely to experience vasomotor symptoms. Women who used nutrition were 18% more likely to experience anxiety (p _ .049). These results highlight the importance for health professionals to incorporate CAMs into their practice to better inform menopausal women of their treatment choices.

Research paper thumbnail of Effects of supplementation with purified red clover (Trifolium pratense) isoflavones on plasma lipids and insulin resistance in healthy premenopausal women

British Journal of Nutrition, 2003

Consumption of isoflavone-rich soyabean protein is reported to reduce total and LDL-cholesterol, ... more Consumption of isoflavone-rich soyabean protein is reported to reduce total and LDL-cholesterol, but the specific components responsible are undetermined. In a previous crossover trial we showed that purified isoflavones, derived from red clover (Trifolium pratense ), raised HDL 3cholesterol in premenopausal women; however, these findings were inconclusive due to period and carryover effects. In an attempt to overcome this problem, we utilised a parallel study designed to re-examine the effects of purified isoflavones on plasma lipoproteins and markers of insulin resistance in premenopausal women. Twenty-five healthy premenopausal women participated in a double-blind, randomised, parallel study. The treatment group (n 12) consumed a placebo for the first menstrual cycle and an isoflavone supplement (86 mg/d, derived from red clover) for three cycles, while the placebo group (n 13) consumed a placebo supplement for four menstrual cycles. Blood samples were collected weekly during cycles 1, 3 and 4. Supplementation with isoflavones resulted in a 15-fold increase in urinary isoflavone excretion (P, 0·0001). There were no significant effects on total cholesterol, LDL-and HDL-cholesterol, HDL subfractions, triacylglycerol, lipoprotein(a), glucose or insulin concentrations. Our present results indicate that purified isoflavones derived from red clover have no effect on cholesterol homeostasis or insulin resistance in premenopausal women, a group which is at low risk of CHD.

Research paper thumbnail of Comparison of multiple and novel measures of dietary glycemic carbohydrate with insulin resistant status in older women

Nutrition & Metabolism, 2010

Background: Previous epidemiological investigations of associations between dietary glycemic inta... more Background: Previous epidemiological investigations of associations between dietary glycemic intake and insulin resistance have used average daily measures of glycemic index (GI) and glycemic load (GL). We explored multiple and novel measures of dietary glycemic intake to determine which was most predictive of an association with insulin resistance. Methods: Usual dietary intakes were assessed by diet history interview in women aged 42-81 years participating in the Longitudinal Assessment of Ageing in Women. Daily measures of dietary glycemic intake (n = 329) were carbohydrate, GI, GL, and GL per megacalorie (GL/Mcal), while meal based measures (n = 200) were breakfast, lunch and dinner GL; and a new measure, GL peak score, to represent meal peaks. Insulin resistant status was defined as a homeostasis model assessment (HOMA) value of >3.99; HOMA as a continuous variable was also investigated. Results: GL, GL/Mcal, carbohydrate (all P < 0.01), GL peak score (P = 0.04) and lunch GL (P = 0.04) were positively and independently associated with insulin resistant status. Daily measures were more predictive than meal-based measures, with minimal difference between GL/Mcal, GL and carbohydrate. No significant associations were observed with HOMA as a continuous variable. Conclusion: A dietary pattern with high peaks of GL above the individual's average intake was a significant independent predictor of insulin resistance in this population, however the contribution was less than daily GL and carbohydrate variables. Accounting for energy intake slightly increased the predictive ability of GL, which is potentially important when examining disease risk in more diverse populations with wider variations in energy requirements.

Research paper thumbnail of Trends in purchasing patterns of sugar-sweetened water-based beverages in a remote Aboriginal community store following the implementation of a community-developed store nutrition policy

Nutrition & Dietetics, 2011

Research paper thumbnail of Glycaemic index and glycaemic load intake patterns in older Australian women

Nutrition & Dietetics, 2009

Aims: Dietary glycemic index (GI) and glycemic load (GL) have been associated with risk of 2 chro... more Aims: Dietary glycemic index (GI) and glycemic load (GL) have been associated with risk of 2 chronic diseases, yet limited research exists on patterns of consumption in Australia. Our aims 3 were to investigate glycemic carbohydrate in a population of older women, identify major 4 contributing food sources, and determine low, moderate and high ranges. 5

Research paper thumbnail of Does scientific evidence support the use of non-prescription supplements for treatment of acute menopausal symptoms such as hot flushes?

Nutrition <html_ent glyph="@amp;" ascii="&"/> Dietetics, 2005

Nutr Diet 2005;62:138-151)

Research paper thumbnail of Factors that influence consumption of fish and omega-3-enriched foods: A survey of Australian families with young children

Nutrition & Dietetics, 2013

Aim: The present study aimed to identify factors that influence the consumption of fish and foods... more Aim: The present study aimed to identify factors that influence the consumption of fish and foods that are enriched with omega-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA), in order to inform the development of effective nutrition education strategies. Methods: A cross-sectional, 10-item self-administered survey was conducted to 262 parents of children aged 9-13 years from a regional centre in New South Wales. Parents were asked questions related to frequency of consumption, and to identify factors that either encouraged or prevented the provision of fish/seafood and/or n-3 LCPUFAenriched foods for their families. Results: Salmon, canned tuna, prawn and take-away fish were the most commonly eaten variants of fish/ seafood, at approximately once a month. Perceived health benefits and the influence of media and health professionals in health promotion were identified as the primary motivators for consumption of fish/seafood and foods enriched with n-3 LCPUFA. Among families who consume fish, taste was valued as having a major positive influence, as well as preferences of individual family members, but the latter was perceived as an obstacle in non-fish consumers. Price was the main barrier to consumption of fresh, but not canned, fish and n-3-enriched foods, in both those that do and do not consume these foods. Conclusion: Despite Australian parents' knowledge of the health benefits n-3 LCPUFA, only a fifth of households meet the recommended two serves of fish per week, hence nutrition education strategies are warranted.