Rejection without review- reprise

Sad to say, we are currently rejecting a lot of papers without going out to external peer review. As the journal raises standards this is inevitable, but there seem to be a lot of misplaced papers that would be better suited to food science journals coming our way, along with a lot of small scale, cross-sectional studies which unfortunately add little to the already existing evidence-base. I blogged about this last year and it is perhaps timely to bring it to your attention again

Parents help with childhood obesity

Parents as the start of the solution: a social marketing approach to understanding triggers and barriers to entering a childhood weight management service

Gillespie et al., JHND Early View

Background

Childhood obesity is a sensitive subject and barriers exist with respect to accessing weight management programmes. Social marketing insight gathering provides an opportunity to understand behaviours and address these challenges. This project gained insight into the views of parents/carers on triggers and barriers to entering a childhood weight management service.

Methods

Participants were identified from the public using marketing recruitment. Four focus groups were conducted with parents of school aged children (n = 27) by an experienced interviewer. Twenty two mothers, three fathers and two grandmothers participated, with half describing their child as overweight. Groups discussed health behaviours; attitudes to health messages and weight issues; and motivations, benefits and barriers with respect to accessing weight management services. Discussions were taped and transcribed. Themes were identified using framework analysis of content matrix data analysis.

Results

Participants were aware of healthy lifestyle messages, although the ability to implement these was variable. Triggers to seeking help included bullying, health concerns and inability to participate in school activities. Barriers included feeling a lack of control, desire to avoid conflict and no proven case that weight was a problem. Parents wished to be given information regarding their child’s weight by a trusted person. The Internet and word of mouth were identified as methods of recruitment into a weight management service, with a focus on fitness, fun and friendliness and being free-of-charge.

Conclusions

Insight gathering can be used to establish parental/carer opinion regarding engaging in childhood weight management services. A fun, friendly programme that is free of charge appealed to parents. Local community involvement around normalising child weight issues may boost referrals into child healthy weight interventions.

When peer review hits the news

I came across this article via Twitter earlier today. It reports a story that an eminent climate scientist claimed his paper was rejected by a journal editor on the grounds of political expediency rather than on the basis of the scientific merit of the study. It isn’t this aspect of the story that caught my imagination (it is covered nicely in the link anyway). I was rather more fascinated that the issue of a paper being rejected should be reported in a national newspaper and how that might play with the general public. This is particularly pertinent in the UK where the papers and other media are in the middle of a feeding frenzy about a whole range of nutrition related stories. Having gone through the ‘sugar is the new tobacco’ debate, stirred up by Action on Sugar, we moved on to the ‘saturated fats aren’t really bad for you’ story, followed by the ‘5-a-day isn’t enough, eat 10-a-day’ shambles. Lots of column inches and airtime later I would suspect that the public are more confused than ever about what they should be eating.
More importantly there is no understanding among lay people of the process of peer-review and the basis of academic publication. Stories are presented by the press, often on a whim it seems, without any explanation that a) a single study in isolation almost certainly doesn’t mean anything, b) that the work that has been published has been subject to the scrutiny of experts in the field and c) that even following that scrutiny the work will have flaws and limitations.
It may be that understanding the process of peer review and all of the various perils and pitfalls (discussed elsewhere on this blog) is not a high priority for the man or woman on the street. The climate change story does, however, flag up the fact that journalists don’t understand it either. As health professionals, scientists or public health nutritionists we are hugely dependent upon journalists presenting a balanced account of scientific evidence as a means of influencing dietary choices and behaviour. If the hacks can’t grasp the fact that the work of anyone from the lowliest student to the Nobel prize winning professor has to go through peer review to quality check, then we can’t possibly expect the public to understand nutritional science. Even more importantly, the notion that the scientific (i.e. published) evidence base has been peer-reviewed by experts is critical when we go up against the quacks (no qualifications or evidence-base necessary) spruiking garbage.
I certainly wouldn’t want the editorial team at JHND, or our reviewers, to be tailoring their comments on papers to ensure that they are acceptable to readers of the Daily Tat. However, I am confident that if they were ever paraded through the press, we have in place the quality control, expertise, independence of thought and integrity to stand by them.

Traditional diets improve nutritional quality

Traditional food patterns are associated with better diet quality and improved dietary adequacy in Aboriginal peoples in the Northwest Territories, Canada

Sheehy et al., JHND Early View

Background

Traditionally, the Arctic diet has been derived entirely from locally harvested animal and plant species; however, in recent decades, imported foods purchased from grocery stores have become widely available. The present study aimed to examine Inuvialuit, traditional or nontraditional dietary patterns; nutrient density of the diet; dietary adequacy; and main food sources of energy and selected nutrient intakes.

Methods

This cross-sectional study used a culturally appropriate quantitative food frequency questionnaire to assess diet. Traditional and nontraditional eaters were classified as those consuming more or less than 300 g of traditional food daily. Nutrient densities per 4184 kJ (1000 kcal) were determined. Dietary adequacy was determined by comparing participants’ nutrient intakes with the Dietary Reference Intakes.

Results

The diet of nontraditional eaters contained, on average, a lower density of protein, niacin, vitamin B12, iron, selenium, zinc, omega-3 fatty acids (P ≤ 0.0001), vitamin B6, potassium, thiamin, pantothenic acid (P ≤ 0.001), riboflavin and magnesium (P ≤ 0.05). Inadequate nutrient intake was more common among nontraditional eaters for calcium, folate, vitamin C, zinc, thiamin, pantothenic acid, vitamin K, magnesium, potassium and sodium. Non-nutrient-dense foods (i.e. high fat and high sugar foods) contributed to energy intake in both groups, more so among nontraditional eaters (45% versus 33%). Traditional foods accounted for 3.3% and 20.7% of total energy intake among nontraditional and traditional eaters, respectively.

Conclusions

Diet quality and dietary adequacy were better among Inuvialuit who consumed more traditional foods. The promotion of traditional foods should be incorporated in dietary interventions for this population.

Low quality diets in Canadian aboriginal youth

The diets of school-aged Aboriginal youths in Canada: a systematic review of the literature

Gates  et al., JHND Early View

Background

Most national surveys examining diet leave large segments of the Aboriginal population under-represented. The present study aimed to: (i) review primary research studies that investigated the dietary intakes of Canadian school-aged Aboriginal youths; (ii) summarise the tools and methodologies currently used to measure diet in this population; and (iii) identify knowledge gaps and suggest areas of future research.

Methods

A systematic review of research published between January 2004 and January 2014 related to the diets of Canadian school-aged (6–18 years) Aboriginal youths was undertaken, including Medline, Scopus, ERIC, Web of Science and Google Scholar databases. Studies were summarised based on purpose, year, sample population, setting, dietary assessment method and main findings.

Results

Twenty-four studies were reviewed, all of which were cross-sectional in design. Most (n = 16; 67%) were from Ontario or Quebec, investigated the diets of First Nations (n = 21; 88%) youths and took place in remote or isolated settings (n = 18; 75%). Almost all of the studies used the 24-h recall to assess intake (n = 19; 79%), of which 89% used a single recall. The findings suggest that the diets of Aboriginal youths could be improved. Of particular concern are inadequate intakes of vegetables and fruit, milk and alternatives, fibre, folate, vitamin A, vitamin C, calcium and vitamin D, concomitant with an excess consumption of sugar sweetened beverages, snacks and fast foods. Traditional foods remain important but tend to be consumed infrequently.

Conclusions

The diets of Canadian Aboriginal youths are energy-dense and nutrient-poor. The diets of Inuit and Métis youths, in particular, and perceptions of a balanced diet warrant further investigation.

New JHND feature

We have added a new feature to the JHND website- the Editor’s Pick. This will feature a key paper from the current issue, which is made available free-to-access. The first Editor’s Pick is ‘The association between dietary patterns and type 2 diabetes: a systematic review and meta-analysis of cohort studies’, by Alhazmi and colleagues.

Controlling weight gain in pregnancy

Limiting antenatal weight gain improves maternal health outcomes in severely obese pregnant women: findings of a pragmatic evaluation of a midwife-led intervention

McGiveron et al., JHND Early View.

Background

Antenatal obesity in pregnancy is associated with complications of pregnancy and poor obstetric outcomes. Although most guidance on pregnancy weight is focused on the prepregnancy period, pregnancy is widely viewed as a period where women are open to lifestyle change to optimise their health.

Methods

The hospital-based Bumps and Beyond intervention invited all pregnant women with a body mass index (BMI) >35 kg m−2 to take part in a programme of health education around diet and exercise, accompanied by one-to-one guidance and monitoring of dietary change. This service evaluation compares 89 women who completed at a programme of seven sessions with healthy lifestyle midwives and advisors (intervention) versus a group of 89 women who chose not to attend (non-intervention).

Results

Mean (SD) weight gain in the intervention group [4.5 (4.6) kg] was less than in the non-intervention group [10.3 (4.4) kg] between antenatal booking and 36 weeks of gestation (< 0.001). This was associated with a 95% reduction in the risk of gestational hypertension during pregnancy and a general reduction in pregnancy complications. There was no effect of the intervention upon gestational diabetes or complications in labour other than post-partum haemorrhage (reduced by 55%). The impact of the intervention on gestational weight gain was greater in women with BMI >40 kg m−2 at booking. There were no adverse effects of the intervention, even though 21% of the intervention group lost weight during their pregnancy.

Conclusions

Intensive, personalised weight management intervention may be an effective strategy for the prevention of hypertensive disorders during pregnancy.