Food frequency questionnaire for assessment of n-3 LCPUFA intake in Australian children

Development and validation of a food frequency questionnaire to assess omega-3 long chain polyunsaturated fatty acid intake in Australian children aged 9–13 years

Rahmawaty et al., JHND Early View


The present study aimed to develop a food frequency questionnaire (FFQ) assessing dietary omega-3 long chain polyunsaturated fatty acid (n-3 LCPUFA) intake in Australian children and to validate the FFQ against a 7-day food diary.


The investigation comprised a cross-sectional and validation study. The study setting was two private primary schools in the in the Illawarra region of New South Wales. Twenty-two Australian children, aged 9–13 years, who were not on a special diet or receiving medical care that limited their food choice in the 3 months prior to recruitment, were recruited into the study.


A total of 131 items, classified according to seven food group categories, was included in the n-3 LCPUFA FFQ, as identified from published dietary surveys and a supermarket survey. Good correlations between the FFQ and the 7-day food diary were observed for eicosapentaenoic acid (EPA) [r = 0.691, 95% confidence interval (CI) = 0.51–0.83, P < 0.001], docosahexaenoic acid (DHA) (r = 0.684, 95% CI = 0.45–0.84, P < 0.001) and total n-3 LCPUFA (r = 0.687, 95% CI = 0.48–0.85, P < 0.001). Bland–Altman plots showed an acceptable limit of agreement between the FFQ and the average 7-day food diary. However, the mean EPA, DHA and total n-3 LCPUFA intakes estimated from the FFQ were significantly higher than those from the average 7-day food diary estimates (P < 0.001).


A novel n-3 LCPUFA FFQ that has been developed to estimate dietary n-3 LCPUFA intakes in Australian children has been shown to have relative validity. The FFQ provides a useful contribution to dietary assessment methodology in this age group; however, reproducibility remains to be demonstrated.

Fortifying cows milk may be an effective approach to improve vitamin D status in preschool infants.

Dietary strategies for achieving adequate vitamin D and iron intakes in young children in Ireland

Kehoe et al., JHND Early View


Inadequate intakes of vitamin D and iron have been reported in young children in Ireland. The present study aimed to identify the main foods determining vitamin D and iron intakes and to model the impact of dietary strategies to improve adequacy of these micronutrients in young children.


The present study is based on the Irish National Pre-School Nutrition Survey (NPNS), which estimated food and nutrient intakes in a representative sample (= 500) of children (aged 1–4 years) using a 4-day weighed food record. Dietary strategies were modelled using DaDiet© software (Dazult Ltd, Co. Kildare, Republic of Ireland) and the usual intake distribution, prevalence of inadequate intakes and risk of excessive intakes were estimated using the National Cancer Institute method.


Fortified foods and nutritional supplements were the key foods influencing the intakes of vitamin D and iron. Adding a 5 μg day−1 vitamin D supplement, fortifying cow’s milk (CM) with vitamin D or replacing CM with growing-up milk (GUM) would modestly increase intakes of vitamin D. A combined strategy of fortifying CM with vitamin D or replacing CM with GUM plus a 5 μg day−1 vitamin D supplement would increase mean intakes of vitamin D (from 3.5 μg day−1 at baseline to ≥11 μg day−1) and substantially reduce the prevalence of inadequate intakes (from >95% to 12–36%). Fortifying CM with iron or replacing CM with GUM would increase mean intakes of iron (from 7.3 mg day−1 to >10 mg day−1), achieving adequate intakes across all ages.


Based on real food consumption data in a representative sample of Irish children, we have shown that through targeted dietary strategies adequate intakes of iron are achievable and intakes of vitamin D could be greatly improved.


Oral nutrition supplements reduce inflammatory cytokine concentrations in community-dwelling elderly

Supplementation with nutrients modulating insulin-like growth factor-1 negatively correlated with changes in the levels of pro-inflammatory cytokines in community-dwelling elderly people at risk of undernutrition

Kim et al., JHND Early View


Suboptimal nutrition accompanied by chronic low-grade increases in circulating cytokine levels is more common in elderly people. We explored the improvement in nutritional status, especially in the level of insulin-like growth factor-1 (IGF-1) and its relationship with changes in circulating cytokine levels, after providing extra protein and energy content to community-dwelling older adults at risk of undernutrition.


Sixty nondiabetic subjects, aged ≥65 years and living independently in a community for elderly people, with a serum pre-albumin level ≤30 mg dL−1 and a body mass index <25 kg m−2, were recruited. The subjects were followed for a 2-week pre-intervention period, during which they maintained routine dietary habits. This was followed by an intervention period, during which they received oral nutritional supplementation for 2 weeks.


Following 2 weeks of intervention, there were significant increases in total lymphocyte count (TLC) and insulin-like growth factor (IGF)-1, pre-albumin and transferrin compared to baseline. Body weight and mid-arm circumference significantly increased without alteration of tricep skinfold thickness at the end of the intervention. There was a significant reduction in interleukin (IL)-6 levels and a trend toward a decrease in the tumor necrosis factor (TNF)-α levels. At baseline, age was negatively correlated with IGF-1 levels and positively correlated with IL-6 and TNF-α levels. The change (▵, from baseline) in IGF-1 level was positively correlated with age and negatively correlated with ▵IL-6 and ▵TNF-α.


A 2-week intervention with oral nutritional supplementation improved nutritional status and decreased circulating cytokine levels. Specifically, ▵IGF-1 was negatively correlated with changes in pro-inflammatory cytokine levels in community-dwelling elderly people at risk of undernutrition. ( NCT02656186).

November/December issue


The year 2016 is moving steadily onwards and here in the UK the temperatures are plummeting. The latest issue of the Journal of Human Nutrition and Dietetics is available online now and we have a great series of articles.

JHND Volume 29Issue 6

Weight and Health

Outcomes of a community-based weight management programme for morbidly obese populations (pages 669–676) L. Nield and S. Kelly

Implementing healthier foodservice guidelines in hospital and federal worksite cafeterias: barriers, facilitators and keys to success (pages 677–686) S. B. Jilcott Pitts, J. Graham, A. Mojica, L. Stewart, M. Walter, C. Schille, J. McGinty, M. Pearsall, O. Whitt, P. Mihas, A. Bradley and C. Simon

Setting targets leads to greater long-term weight losses and ‘unrealistic’ targets increase the effect in a large community-based commercial weight management group (pages 687–696) A. Avery, S. C. Langley-Evans, M. Harrington and J. A. Swift (Open Access)

Nutritional Assessment and Screening

Implementation of nutrition risk screening using the Malnutrition Universal Screening Tool across a large metropolitan health service (pages 697–703) P. L. Cooper, R. Raja, J. Golder, A. J. Stewart, R. F. Shaikh, M. Apostolides, J. Savva, J. L. Sequeira and M. A. Silver

Evaluation of the nutritional status of older hospitalised geriatric patients: a comparative analysis of a Mini Nutritional Assessment (MNA) version and the Nutritional Risk Screening (NRS 2002) (pages 704–713) S. Christner, M. Ritt, D. Volkert, R. Wirth, C. C. Sieber and K.-G. Gaßmann

Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques (pages 714–732) S. Smith and A. M. Madden


Nutritional intervention as part of functional rehabilitation in older people with reduced functional ability: a systematic review and meta-analysis of randomised controlled studies (pages 733–745) A. M. Beck, E. Dent and C. Baldwin


Meats, milk and fat consumption in colorectal cancer (pages 746–756) R. F. Tayyem, H. A. Bawadi, I. Shehadah, S. S. AbuMweis, L. M. Agraib, T. Al-Jaberi, M. Al-Nusairr, D. D. Heath and K. E. Bani-Hani

Dietary patterns and risk of colorectal adenoma: a systematic review and meta-analysis of observational studies (pages 757–767) J. Godos, F. Bella, A. Torrisi, S. Sciacca, F. Galvano and G. Grosso

A prospective study comparing prophylactic gastrostomy to nutritional counselling with a therapeutic feeding tube if required in head and neck cancer patients undergoing chemoradiotherapy in Thai real-world practice (pages 768–776) P. Pramyothin, S. Manyanont, A. Trakarnsanga, J. Petsuksiri and S. Ithimakin


The accuracy of dietary recall of infant feeding and food allergen data (pages 777–785) Z. van Zyl, K. Maslin, T. Dean, R. Blaauw and C. Venter

Taste preference, food neophobia and nutritional intake in children consuming a cows’ milk exclusion diet: a prospective study (pages 786–796) K. Maslin, K. Grimshaw, E. Oliver, G. Roberts, S. H. Arshad, T. Dean, J. Grundy, G. Glasbey and C. Venter – Editor’s Pick for December

Nutrition and Metabolism

The effect of soy or isoflavones on homocysteine levels: a meta-analysis of randomised controlled trials (pages 797–804) X. Song, R. Zeng, L. Ni and C. Liu

Favourable effects of DASH diet on polycystic ovary syndrome

Effects of Dietary Approach to Stop Hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: a randomised controlled trial

Azadi-Yazdi et al., JHND Early View


Polycystic ovary syndrome (PCOS) is the most common endocrine disease in reproductive age women. The present study aimed to determine the effects of Dietary Approaches to Stop Hypertension (DASH) diet on reproductive hormones, plasma total antioxidant status and anthropometric indices in overweight and obese PCOS women.


In this randomised controlled clinical trial, 60 women with PCOS were randomly assigned to one of two diets with energy restriction: the DASH diet and a control diet. The DASH and control diets consisted of 50–55% carbohydrate, 15–20% protein and 25–30% total fat. The DASH diet was designed to be rich in vegetables, fruits, whole grains and low-fat dairy products, as well as low in saturated fats, cholesterol, refined grains and sweets. In the present study, the anthropometric indices, body composition, total testosterone, androstenedione, sex hormone binding globulin (SHBG), free androgen index and 2,2′-diphenyl-1-picryylhydrazyl (DPPH) scavenging activity were measured before and after 3 months.


The consumption of DASH diet compared to the control diet was associated with a significant reduction in weight [−5.78 (1.91) kg versus −4.34 (2.87) kg, P = 0.032], body mass index (BMI) [−2.29 (0.15) kg m–2 versus −1.69 (0.20) kg m–2, P = 0.02], fat mass [−3.23(1.66) kg versus −2.13 (1.26) kg, P = 0.008] and serum androstenedione [−1.75 (1.39) ng mL–1 versus −1.02 (0.72) ng mL–1, P-value = 0.019]. Increased concentrations of SHBG [28.80 (21.71) versus 11.66(18.82) nmol L–1, P = 0.003) and DPPH scavenging activity [30.23% (19.09) versus 12.97% (25.12) were also found in the DASH group.


The DASH diet could improve weight loss, BMI and fat mass. Furthermore, it could result in a significant reduction in serum androstenedione and a significant increase in antioxidant status and SHBG.

Variable advice from dietitians on carbohydrate

Dietitians’ practice in giving carbohydrate advice in the management of type 2 diabetes: a mixed methods study

McArdle et al., JHND Early View


Carbohydrate is accepted as the principal nutrient affecting blood glucose in diabetes; however, current guidelines are unable to specify the optimal quantity of carbohydrate for glycaemic control. No studies exist that describe current practice amongst healthcare professionals giving carbohydrate advice in type 2 diabetes. The present study aims to improve understanding of the degree of variation in the current practice of UK registered dietitians (RDs) by describing how RDs advise patients.


UK RDs were contacted through national networks and asked to complete an online survey, which was analysed using stata, version 12 (StataCorp, College Station, TX, USA). Three consultations between dietitians and patients with type 2 diabetes were observed, followed by semi-structured interviews with the dietitians.


In total, 320 complete survey responses were received. Dietitians’ advice varied according to expertise, training and confidence, and the complexity of the patient’s blood glucose treatment. Some 48% (n = 154) of respondents advised patients to restrict carbohydrate intake either occasionally or frequently, with 35.6% (n = 114) considering 30–39% of total energy from carbohydrate to be a realistic expectation. The overall theme from the interviews was ‘Conflicting Priorities’, with three sub-themes: (i) how treatment decisions are made; (ii) the difference between empowerment and advice; and (iii) contradictory advice. A disparity existed between what was observed and interview data on how dietitians rationalise the type of carbohydrate advice provided.


Dietitians’ advice varies for a number of reasons. Consensus exists in some areas (e.g. carbohydrate awareness advice); however, clear definitions of such terms are lacking. Clarification of interventions may improve the consistency of approach and improve patient outcomes.