Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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Policy Versus Practice: School Food Practices Do Not Reflect Healthy Food Guidance in New Zealand Primary Schools
(Cambridge University Press on behalf of The Nutrition Society, 2025-10-20) Pillay D; Ali A; Wham C; Evans C
Objective: To examine how school food policies and perceived barriers influence food provision in New Zealand primary school canteens, using the ‘Healthy Food and Drink Guidance for Schools.’ Design: Cross-sectional analyses of school food menus, and school food policy and practices surveys completed by school leaders/principals. Setting: New Zealand primary schools. Participants: 239 primary schools completed the school food policies and practices survey, and 80 schools provided canteen menus. Results: Most schools reported having a healthy food and drink policy in their school (76.2%) and promoted healthy eating during school hours (87.4%). Two-thirds (69.5%) identified barriers to healthy food and drink provision, most commonly the convenience of ready-made foods (39.3%), and resistance from parents (34.3%). The number of reported barriers was not a significant predictor for the presence of a school food policy (OR-1.034, p=0.841). School menus (n=80) consisted of 16.4% ‘green’ items, 34.7% ‘amber’ items, and 36.8% ‘red’ items. There was no relationship between the percentage of ‘green’, ‘amber’, and ‘red’ items and the presence of a school food policy or reported barriers. More than a third (38.9%) of menus from schools that reported they had a ‘Plain Milk and Water’ only policy still contained sugar-sweetened beverages. Conclusions: Although most New Zealand primary schools had healthy food policies, this was not consistently reflected in healthy food items on canteen menus. Further research is needed to understand how systemic barriers, such as cost, convenience, and parental influence, affect policy implementation and school food provision.
Effects of carbohydrate, caffeine, and combined mouth rinses on physiological and perceptual responses during high-intensity interval exercise following a pre-exercise meal: a double-blinded, placebo-controlled, randomized crossover trial
(Taylor and Francis Group, 2025-12-31) Suen MW-K; Sun F; Ali A; Poon ET-C
Background Mouth rinsing with carbohydrate (CHO), caffeine (CAF), and their combined (CHO+CAF) solutions has been shown to enhance exercise performance. However, most previous studies were conducted under fasted conditions, which may not accurately reflect the typical practices of athletes who generally consume food before intense exercise or competition. This study examined the effects of CHO, CAF, and CHO+CAF mouth rinses on physiological and perceptual responses during high-intensity interval exercise (HIIE) following a pre-exercise meal. Methods Twelve recreationally active males (age: 23.4 ± 3.2 years) completed four HIIE trials involving 8 bouts of 1-min cycling at 85% of peak power output (PPO), separated by 1-min active recovery at 20% of PPO. Using a double-blinded randomized crossover design, participants rinsed with either 10% maltodextrin (CHO), 1.2% caffeine (CAF), 10% maltodextrin + 1.2% caffeine (CHO+CAF), or water (PLA) twice in each trial (after warm-up and interval 4). All solutions were taste-matched using the artificial sweetener sucralose. A standardized CHO-rich (1 g·kg−1 body weight) breakfast was provided an hour before testing. Results Ratings of perceived exertion were significantly different between conditions after interval 4 (CHO: 12.3 ± 1.6; CAF: 13.5 ± 2.2; CHO+CAF: 12.7 ± 1.7; PLA: 13.7 ± 2.4; 𝑝 = 0.049, 𝜂2 𝑝 = 0.21), but no significant effects of the mouth rinse conditions were observed on heart rate, blood glucose, blood lactate, affective valence, perceived activation, or affective responses (pleasure, arousal, and dominance) (all p > 0.05). Conclusion These findings suggest a limited ergogenic benefit of CHO and/or CAF mouth rinse through physiological and perceptual responses following sufficient food intake.
The Effect of Gymnema Sylvestre on Motivation to Consume Sweet Foods—A Qualitative Investigation
(MDPI (Basel, Switzerland), 2025-09-01) Nelson I; Kruger R; Hsiao D; Stice E; Ali A; Min K-J
Background/Objectives: Excessive intake of sugar-sweetened food (SSF) increases obesity risk. Various psychological, physiological, and environmental factors may drive high consumption of SSF. Due to blocking sweet tastes, the herb Gymnema sylvestre (GS) has been shown to reduce SSF consumption, but its impact on motivation to eat SSF is unknown. This research aimed to qualitatively investigate adults’ perceptions regarding effects of GS on their motivation to eat SSF when administered systematically (three times/day in-between meals, i.e., GS-SYS treatment) or ad libitum (up to six times/day at participants’ discretion, i.e., GS-ADLIB) over 14 days, compared to placebo (taste-matched mint; PLAC-SYS). Methods: This study represents the qualitative investigation of a placebo-controlled randomised cross-over trial, conducted as three 14-day phases. The qualitative investigation included interviews at baseline and three post-testing phases. Seven participants (mean age 34.7 ± 13.8 years; two males, five females) agreed to participate. Twenty-eight interviews (across phases) were thematically analysed using NVivo software, identifying themes and highlighting changes in motivation to eat SSFs across the study. Results: The GS-SYS and GS-ADLIB treatments made SSFs unpleasant to eat and increased mindful eating, subsequently increasing motivation to avoid SSFs. External factors could increase or decrease motivation, depending on individual circumstances. Participants preferred GS-SYS and GS-ADLIB over PLAC-SYS, feeling it was more effective at changing behaviours related to SSF intake. Self-control over SSF intake changed during the study, mostly due to external factors, and in part GS-ADLIB. Conclusions: Participants found both GS administrations successful as motivation to avoid SSF; GS-ADLIB was considered most effective.
Investigation of Advertising and Food Environment Surrounding Primary Schools in New Zealand
(John Wiley and Sons Australia Ltd on behalf of Australian Health Promotion Association, 2025-10-01) Nicholls K; Ali A; Wham C
Objective: The objective of this study is to examine food and beverage advertising and stores around New Zealand (NZ) primary schools. Methods: Food and beverage advertising and stores within 800 m of 18 primary schools in NZ were collected in August 2023. Food and beverage advertising and store characteristics were compared across low (1–3), medium (4–7) and high (8–10) decile schools, reflecting socioeconomic status. Results: ‘Non-core’ food and beverage advertisements (n = 426, 89%) outnumbered ‘core’ (n = 53, 11%) with sugar-sweetened beverages (n = 192, 40.1%) the most common category, and Coca-Cola the most common brand (n = 158, 33%, p = 0.033). Food stores were the most common location for food and beverage advertisements (97.1%, p ≤ 0.001). More food and beverage advertisements surrounded low (n = 406, 43%) and medium (n = 208, 43.4%) decile schools, with low-decile schools having more nearby advertisements (0–400 m) (n = 111, 57.5%). The most common food and beverage stores near schools were local fast-food (44.7%) and convenience stores (24.2%). Store type varied by school decile, with more convenience stores (51.9%) and fast-food chains (81.3%) near low-decile schools. Conclusions: ‘Non-core’ food and beverage advertising, local fast-food, fast-food chains and convenience stores were prevalent surrounding primary schools, particularly low and medium-decile schools. So What? These findings highlight high levels of exposure to unhealthy food and beverage advertising and food stores, especially surrounding schools within low and medium socioeconomic areas.
Dietary Nitrate Supplementation and Exercise Performance: An Umbrella Review of 20 Published Systematic Reviews with Meta-analyses
(Springer Nature Switzerland AG, 2025-03-14) Poon ET-C; Iu JC-K; Sum WM-K; Wong P-S; Lo KK-H; Ali A; Burns SF; Trexler ET; McMillan S; Olney R
Background: Dietary nitrate (NO3−) supplementation is purported to benefit exercise performance. However, previous studies have evaluated this nutritional strategy with various performance outcomes, exercise tasks, and dosing regimens, often yielding inconsistent results that limit the generalizability of the findings. Objective: We aimed to synthesize the available evidence regarding the effect of NO3− supplementation on 11 domains of exercise performance. Methods: An umbrella review was reported in accordance with the Preferred Reporting Items for Overviews of Reviews guideline. Seven databases (MEDLINE, EMBASE, Cochrane Database, CINAHL, Scopus, SPORTDiscus, and Web of Science) were searched from inception until July 2024. Systematic reviews with meta-analyses comparing NO3− supplementation and placebo-controlled conditions were included. Literature search, data extraction, and methodological quality assessment (A Measurement Tool to Assess Systematic Reviews Assessing the Methodological quality of SysTemAtic Review [AMSTAR-2]) were conducted independently by two reviewers. Results: Twenty systematic reviews with meta-analyses, representing 180 primary studies and 2672 unique participants, met the inclusion criteria. Our meta-analyses revealed mixed effects of NO3− supplementation. It improved time-to-exhaustion tasks [standardized mean difference (SMD): 0.33; 95% confidence interval (CI) 0.19–0.47] with subgroup analyses indicating more pronounced improvements when a minimum dose of 6 mmoL/day (372 mg/day) and chronic (> 3 days) supplementation protocol was implemented. Additionally, ergogenic effects of NO3− supplementation were observed for total distance covered (SMD: 0.42; 95% CI 0.09–0.76), muscular endurance (SMD: 0.48; 95% CI 0.23–0.74), peak power output (PPO; SMD: 0.25; 95% CI 0.10 to 0.39), and time to PPO (SMD: − 0.76; 95% CI − 1.18, − 0.33). However, no significant improvements were found for other performance outcomes (all p > 0.05). The AMSTAR-2 ratings of most included reviews ranged from low to critically low. Conclusions: This novel umbrella review with a large-scale meta-analysis provides an updated synthesis of evidence on the effects of NO3− supplementation across various aspects of exercise performance. Our review also highlights significant methodological quality issues that future systematic reviews in this field should address to enhance the reliability of evidence. Clinical Trial Registration: This study was registered in the International Prospective Register of Systematic Review (PROSPERO) database (registration number: CRD42024577461).
Caffeine Related Risk among Tertiary Students in New Zealand
(MDPI (Basel, Switzerland), 2019-03-11) Stachyshyn S; Rutherfurd-Markwick K; Ali A; Wham C
Background: Caffeine-related health incidents in New Zealand have escalated over the last two decades. Tertiary students may be at higher risk as they are known to seek caffeinated products to treat sleep deprivation and while studying for exams or completing major course projects. The aim of this study was to examine the caffeine consumption habits of tertiary students and their motivations for use across a broad range of caffeinated products. Method: Eligible participants were invited to complete a caffeine consumption habits questionnaire (CaffCo) via the online survey software, Qualtrics. Results: A total of 317 participants (46.7% men) completed the online CaffCo. Most (74.4%) were aged between 19 to 30 years and nearly a half were NZ European (47.5%). The majority (99.1%) consumed at least one source of caffeine in their diet. Coffee was the largest contributor (61.4%) followed by tea (14.4%), energy drinks (8%), chocolate (7.3%), kola drinks (5.3%), sports supplements (2.4%), RTDs (0.8%) and caffeine tablets (0.5%). The median estimated daily caffeine consumption was 146.73 mg·day−1 (n = 314), or 2.25 mg−kgbw−1−day−1 (n = 281). An estimated 14.3% of caffeine consumers exceeded the suggested ‘safe limit’ of 400 mg−day−1. Cigarette smokers were significantly more likely to exceed this level. Caffeine and alcohol were co-ingested by 38.5% of the participants, especially among those in paid employment or by cigarette smokers. The majority of caffeine consumers (84.7%) reported experiencing at least one adverse symptom post caffeine consumption especially to energy drinks (77.3%). Two thirds (64.2%) reported being dependent on at least one caffeine source, and 47.3% reported experiencing at least one withdrawal symptom. Conclusions: These findings provide critical information for developing caffeine-related risk-reduction strategies for NZ tertiary students. Improved labelling and consumer education which targets those who consume caffeinated products above the daily 400 mg safe limit may help ameliorate caffeine related risk.
The effect of healthy food guidance for schools on food availability, purchasing, and consumption among school children in New Zealand and Australia: An integrative review.
(Cambridge University Press on behalf of The Nutrition Society, 2024-11-27) Pillay D; Ali A; Wham CA
Modifying the food environment holds promise for instilling healthier behaviours in children and may be an effective public health strategy for preventing childhood obesity and adverse health outcomes. The school food environment is a valuable setting to influence most children's dietary behaviours from an early age, yet evidence suggests that the New Zealand and Australian school food environment is not conducive to healthy food and drink consumption. The present study aimed to investigate the level of compliance in New Zealand and Australia with government guidelines for food and drink availability within schools and the subsequent effect on food consumption and purchasing behaviours of children. A systematic review utilising three databases; 'PubMed', 'Scopus', and the 'Cochrane Library' was conducted. The research covered peer-reviewed studies from both New Zealand and Australia that met predefined inclusion criteria. Fifteen studies focussed on assessing food availability within schools based on government guidelines, and ten studies explored food purchasing and consumption by students influenced by changes to the school food environment. Results showed low compliance with government healthy food guidelines for schools, and significant socioeconomic disparities. Western Australia's clear targets as well as the mandatory monitoring systems in place stand out as being a significant enabler of greater compliance with government food policies. Interventions aimed at improving healthy food availability and promoting healthy options in the canteen may positively influence student purchasing and consumption habits. Strategies such as feedback models and incentivisation hold promise for promoting healthier school environments and influencing children's food choices.
The effect of a 14-day Gymnema sylvestre intervention to reduce sugar intake in people self-identifying with a sweet tooth
(Elsevier Ltd, 2025-01-28) Hsiao WH; Kruger R; Diako C; Nelson I; Stice E; Ali A
Gymnema sylvestre (GS) contains gymnemic acids which can reversibly suppress sweet taste responses. This randomised crossover study aimed to investigate whether supplemental GS use can reduce sugar cravings, sweet food desire and consumption among adults that identify as high sweet food consumers (having a ‘sweet tooth’). Participants were told three different mints were trialled to avoid bias. On day zero, 32 healthy participants underwent baseline sensory testing for sweet taste perception using the placebo mint (PLAC). Participants were then randomised into the two intervention groups. On day 15 and 30, participants underwent further sensory testing using the GS mints, before embarking on each 14-day intervention using the GS mints, using either a systematic (at 3 specified times/day; SYS) or ad libitum (up to 6 mints/day at times of their choosing; AD-LIB) regimen, as assigned. On day 30, participants swapped over to the other intervention (using the other regimen), completing final data collection in day 45. At all visits participants completed questionnaires (food frequency questionnaire, beverage questionnaire and cravings questionnaire), anthropometric measures, and sensory testing. Sensory testing was not required for day 45. The AD-LIB condition reduced daily sugar-sweetened beverages (SSB) intake by 42% relative to PLAC (p = 0.015) and reduced overall sugar cravings by 28% relative to PLAC (p = 0.045). Both AD-LIB and SYS reduced pleasantness ratings (p < 0.005) and desire (p = 0.005) for more chocolate. Using GS with an ad libitum regimen reduced sugar cravings and changed sweet food desire and consumption in people identifying as having a sweet tooth.
New Zealand Early Learning Service Menus Do Not Meet Health New Zealand Guidelines for Providing Healthy Menus and Reducing Food-Related Choking in Children
(John Wiley and Sons Australia, Ltd on behalf of Australian Health Promotion Association, 2025-01-23) Hall O; Ali A; Wham C; Carmel W
Objective To assess alignment of food and drinks served to New Zealand (NZ) children in early learning services (ELS) with the Health NZ (formerly known as Ministry of Health) Healthy Food and Drink (HFD) and Reducing Food Related Choking (choking) guidance. Methods Menus (271) collected remotely from 148 ELS from November 2020–March 2021 were analysed for their nutritional quality based on a ‘traffic light’ classification of ‘green’ (most nutritious), ‘amber’ (moderately nutritious) and ‘red’ (least nutritious) based on the guidance. Results Overall, 2.6% of menus met the guidance, and alignment was greater for menus for over 2-year-olds (over-2s) than under 2-year-olds (under-2s; p < 0.01). One-fifth (18.5%) of menus met the choking guidance. Services with a Healthy Heart Award (HHA) from the Heart Foundation provided more ‘green’ items to over-2s (p = 0.039) and under-2s (p = 0.01), and less ‘red’ items to over-2s (p = 0.04). Providing more green menu items was inversely correlated with providing less high choking risk foods (p < 0.01). Menu scores did not vary by service location, neighbourhood socioeconomic deprivation or type (services operating independently versus those part of an education group chain). Conclusions Alignment with Health NZ nutritional guidance is low, particularly in ELS caring for very young children (under-2s). Service characteristics, except for HHA status, are a poor predictor of nutritional quality of menus at ELS. So What Greater uptake of the HHA scheme could assist ELS to provide healthier food and drinks. Early learning services need further support from the public health sector to implement national nutritional guidelines.
The Effect of Pre-Exercise Caffeine and Glucose Ingestion on Endurance Capacity in Hypoxia: A Double-Blind Crossover Trial.
(MDPI (Basel, Switzerland), 2024-10-25) Chiu C-H; Chen C-C; Ali A; Wu S-L; Wu C-L; Nieman DC; Schroder H
The impact of caffeine and glucose supplementation in a hypoxic environment on endurance exercise performance remains inconclusive. The current study examined the effect of pre-exercise carbohydrate and caffeine supplementation on endurance exercise performance in an acute hypoxic environment. Eight healthy active young males participated in this double-blind, within-subjects crossover study. Participants ingested the test drink 60 min before exercising at 50% Wmax for 90 min on a cycle ergometer (fatiguing preload); there followed an endurance performance test at 85% Wmax until exhaustion in a hypoxic chamber (~15%O2). Participants completed four experimental trials in a randomized order: caffeine (6 mg·kg-1; Caff), glucose (1 g·kg-1; CHO), caffeine (6 mg·kg-1) + glucose (1 g·kg-1; Caff-CHO), and taste- and color-matched placebo with no caffeine or CHO (PLA). Blood samples were collected during fasting, pre-exercise, every 30 min throughout the exercise, and immediately after exhaustion. The caffeine and glucose trials significantly enhanced endurance capacity in hypoxic conditions by Caff, 44% (68.8-31.5%, 95% confidence interval), CHO, 31% (44.7-15.6%), and Caff-CHO, 46% (79.1-13.2%). Plasma-free fatty-acid and glycerol concentrations were higher in Caff and PLA than in CHO and Caff-CHO (p < 0.05). The estimated rate of fat oxidation was higher in Caff and PLA than in CHO and Caff-CHO (p < 0.05). There were no significant differences in ratings of perceived exertion between trials. In conclusion, the ingestion of caffeine, glucose, or caffeine + glucose one hour before exercising in hypoxic conditions significantly improved 85% Wmax endurance performance after prolonged exercise.

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