Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Household food insecurity, nutrient intakes and BMI in New Zealand infants(Cambridge University Press on behalf of The Nutrition Society, 2025-11-03) Katiforis I; Smith C; Haszard JJ; Styles SE; Leong C; Fleming EA; Taylor RW; Conlon CA; Beck KL; Von Hurst PR; Te Morenga LA; Daniels L; Rowan M; Casale M; McLean NH; Cox AM; Jones EA; Brown KJ; Bruckner BR; Jupiterwala R; Wei A; Heath A-LMObjective: The first year of life is a critical period when nutrient intakes can affect long-term health outcomes. Although household food insecurity may result in inadequate nutrient intakes or a higher risk of obesity, no studies have comprehensively assessed nutrient intakes of infants from food insecure households. This study aimed to investigate how infant nutrient intakes and body mass index (BMI) differ by household food security. Design: Cross-sectional analysis of the First Foods New Zealand study of infants aged 7–10 months. Two 24-hour diet recalls assessed nutrient intakes. “Usual” intakes were calculated using the Multiple Source Method. BMI z-scores were calculated using World Health Organization Child Growth Standards. Setting: Dunedin and Auckland, New Zealand. Participants: Households with infants (n=604) classified as: severely food insecure, moderately food insecure, or food secure. Results: Nutrient intakes of food insecure and food secure infants were similar, aside from slightly higher free and added sugars intakes in food insecure infants. Energy intakes were adequate, and intakes of most nutrients investigated were likely to be adequate. Severely food insecure infants had a higher mean BMI z-score than food secure infants, although no significant differences in weight categories (underweight; healthy weight; overweight) were observed between groups. Conclusions: Household food insecurity, in the short term, does not appear to adversely impact the nutrient intakes and weight status of infants. However, mothers may be protecting their infants from potential nutritional impacts of food insecurity. Future research should investigate how food insecurity affects nutrient intakes of the entire household.Item Gestational diabetes detection thresholds and infant growth, nutrition, and neurodevelopment at 12-18 months: a prospective cohort study within a randomized trial(Springer Nature Limited, 2025-09-05) Amitrano F; Manerkar K; Alsweiler JM; Conlon CA; Crowther CA; Edlin R; Harding JE; McCowan LME; Meyer MP; Rowan JA; Rush EC; McKinlay CJDObjective To assess the impact of gestational diabetes(GDM) detection thresholds on infant growth, nutrition, and neurodevelopment at 12-18 months. Design Prospective cohort study within the GEMS trial(ACTRN12615000290594), which randomized pregnant women to detection of GDM using lower or higher glycemic criteria. The main outcomes were overweight/rapid weight gain; food approach appetitive score; energy intake; cognitive z-score. Result Compared to control infants, those exposed to GDM detected and treated by higher criteria or by lower but not higher criteria that was untreated, were less likely to have increased overweight/rapid weight gain, possibly with lower energy intake. There were no important differences in appetite and cognition. Infants exposed to GDM by lower but not higher criteria that was treated were similar to controls. Conclusion Exposure to treated GDM or untreated GDM detected by lower but not higher criteria, was not associated with increased infant risk factors for obesity or adverse cognitive outcomes.Item Household food insecurity and novel complementary feeding methods in New Zealand families.(John Wiley and Sons Ltd, 2024-09-02) Katiforis I; Smith C; Haszard JJ; Styles SE; Leong C; Taylor RW; Conlon CA; Beck KL; von Hurst PR; Te Morenga LA; Daniels L; Brown KJ; Rowan M; Casale M; McLean NH; Cox AM; Jones EA; Bruckner BR; Jupiterwala R; Wei A; Heath A-LMOptimal nutrition during infancy is critical given its influence on lifelong health and wellbeing. Two novel methods of infant complementary feeding, commercial baby food pouch use and baby-led weaning (BLW), are becoming increasingly popular worldwide. Household food insecurity may influence complementary feeding practices adopted by families, but no studies have investigated the use of BLW and baby food pouches in families experiencing food insecurity. The First Foods New Zealand study was a multicentre, observational study in infants 7.0-9.9 months of age. Households (n = 604) were classified into one of three categories of food insecurity (severely food insecure, moderately food insecure, and food secure). The use of complementary feeding practices was assessed via a self-administered questionnaire, both at the current age (mean 8.4 months) and retrospectively at 6 months. Mothers experiencing severe food insecurity had 5.70 times the odds of currently using commercial baby food pouches frequently (≥5 times/week) compared to food secure mothers (95% CI [1.54, 21.01]), reporting that pouches were 'easy to use' (89%) and made it 'easy to get fruits and vegetables in' (64%). In contrast, no evidence of a difference in the prevalence of current BLW was observed among mothers experiencing moderate food insecurity (adjusted OR; 1.28, 95% CI [0.73, 2.24]) or severe food insecurity (adjusted OR; 1.03, 95% CI [0.44, 2.43]) compared to food secure mothers. The high prevalence of frequent commercial baby food pouch use in food insecure households underscores the need for research to determine whether frequent pouch use impacts infant health.Item Parent-reported offering of allergen foods to infants during complementary feeding: An observational study of New Zealand infants(Elsevier Ltd, 2024-12-01) Medemblik JM; Conlon CA; Haszard JJ; Heath A-LM; Taylor RW; Von Hurst P; Beck KL; Te Morenga L; Daniels L; Keller KThe prevalence of food allergies in New Zealand infants is uncertain but is believed to be similar to Australia, exceeding 10%. Current recommendations for reducing food allergy risk are to offer all major food allergens to infants from as early as six months of age (start of complementary feeding), and before 12 months of age. However, little is known regarding parental practices around introducing major food allergens. This study aimed to explore parental offering of major food allergens to infants during complementary feeding, and parent-reported food allergies. The cross-sectional study is a secondary analysis of the multi-centre (Auckland and Dunedin) First Foods New Zealand study of 625 parent-infant dyads. Participants were recruited in 2020-2022 when infants were 7-10 months of age. Questionnaires assessed sociodemographic characteristics, complementary feeding approach, infant pouch use and parental responses to five food allergy questions. All major food allergens had been offered to only 17% of infants by 9-10 months of age. Having offered egg, peanut, tree nuts, sesame, soy and seafood was more commonly associated with using a baby-led complementary feeding approach than a parent-led approach (p < 0.001). Frequent baby food pouch use was associated with a lower likelihood of offering egg and peanut (both p < 0.001). Overall, 12.6% of infants had a reported food allergy, with symptomatic response after exposure being the most common diagnostic tool. Most infants are not offered all major food allergens during early complementary feeding, with some parents actively avoiding major food allergens in the first year of life. These results provide up-to-date knowledge of parental practices, highlighting the need for more targeted advice and strategies to improve parental engagement with allergy prevention and diagnosis.Item Frequent Use of Baby Food Pouches in Infants and Young Children and Associations with Energy Intake and BMI: An Observational Study.(MDPI (Basel, Switzerland), 2024-09-19) McLean NH; Bruckner BR; Heath A-LM; Haszard JJ; Daniels L; Conlon CA; von Hurst PR; Beck KL; Te Morenga LA; Firestone R; McArthur J; Paul R; Cox AM; Jones EA; Katiforis I; Brown KJ; Casale M; Jupiterwala RM; Rowan MM; Wei A; Fangupo LJ; Healey M; Pulu V; Neha T; Taylor RW; Fernandez M-LOBJECTIVE: Most wet commercial infant foods are now sold in squeezable 'pouches'. While multiple expert groups have expressed concern about their use, it is not known how commonly they are consumed and whether they impact energy intake or body mass index (BMI). The objectives were to describe pouch use, and determine associations with energy intake and BMI, in infants and young children. METHODS: In this observational cross-sectional study of 933 young New Zealand children (6.0 months-3.9 years), pouch use was assessed by a questionnaire ('frequent' use was consuming food from a baby food pouch ≥5 times/week in the past month), usual energy intake using two 24-h recalls, and BMI z-score calculated using World Health Organization standards. RESULTS: The sample broadly represented the wider population (27.1% high socioeconomic deprivation, 22.5% Māori). Frequent pouch use declined with age (infants 27%, toddlers 16%, preschoolers 8%). Few children were both frequent pouch users and regularly used the nozzle (infants 5%, toddlers 13%, preschoolers 8%). Preschoolers who were frequent pouch users consumed significantly less energy than non-users (-580 kJ [-1094, -67]), but infants (115 [-35, 265]) and toddlers (-206 [-789, 378]) did not appear to have a different energy intake than non-users. There were no statistically significant differences in the BMI z-score by pouch use. CONCLUSIONS: These results do not support the strong concerns expressed about their use, particularly given the lack of evidence for higher energy intake or BMI.Item Vitamin B and One-Carbon Metabolite Profiles Show Divergent Associations with Cardiometabolic Risk Markers but not Cognitive Function in Older New Zealand Adults: A Secondary Analysis of the REACH Study.(Elsevier B.V., 2023-12-07) Gillies NA; Milan AM; Cameron-Smith D; Mumme KD; Conlon CA; von Hurst PR; Haskell-Ramsay CF; Jones B; Roy NC; Coad J; Wall CR; Beck KLBACKGROUND: Vitamin B inadequacies and elevated homocysteine status have been associated with impaired cognitive and cardiometabolic health with aging. There is, however, a scarcity of research investigating integrated profiles of one-carbon (1C) metabolites in this context, including metabolites of interconnected folate, methionine, choline oxidation, and transsulfuration pathways. OBJECTIVES: The study aimed to examine associations between vitamins B and 1C metabolites with cardiometabolic health and cognitive function in healthy older adults, including the interactive effects of Apolipoprotein E-ε4 status. METHODS: Three hundred and thirteen healthy participants (65-74 y, 65% female) were analyzed. Vitamins B were estimated according to dietary intake (4-d food records) and biochemical status (serum folate and vitamin B12). Fasting plasma 1C metabolites were quantified by liquid chromatography with tandem mass spectrometry. Measures of cardiometabolic health included biochemical (lipid panel, blood glucose) and anthropometric markers. Cognitive function was assessed by the Computerized Mental Performance Assessment System (COMPASS) and Montreal Cognitive Assessment (MoCA). Associations were analyzed using multivariate linear (COMPASS, cardiometabolic health) and Poisson (MoCA) regression modeling. RESULTS: Over 90% of participants met dietary recommendations for riboflavin and vitamins B6 and B12, but only 78% of males and 67% of females achieved adequate folate intakes. Higher serum folate and plasma betaine and glycine concentrations were associated with favorable cardiometabolic markers, whereas higher plasma choline and homocysteine concentrations were associated with greater cardiometabolic risk based on body mass index and serum lipids concentration values (P< 0.05). Vitamins B and homocysteine were not associated with cognitive performance in this cohort, though higher glycine concentrations were associated with better global cognitive performance (P = 0.017), episodic memory (P = 0.016), and spatial memory (P = 0.027) scores. Apolipoprotein E-ε4 status did not modify the relationship between vitamins B or 1C metabolites with cognitive function in linear regression analyses. CONCLUSIONS: Vitamin B and 1C metabolite profiles showed divergent associations with cardiometabolic risk markers and limited associations with cognitive performance in this cohort of healthy older adults.Item Hair and cord blood element levels and their relationship with air pollution, dietary intake, gestational diabetes mellitus, and infant neurodevelopment.(Elsevier B.V., 2023-08-23) Xia Y-Y; de Seymour JV; Yang X-J; Zhou L-W; Liu Y; Yang Y; Beck KL; Conlon CA; Mansell T; Novakovic B; Saffery R; Han T-L; Zhang H; Baker PNBACKGROUND & AIMS: Exposure to a range of elements, air pollution, and specific dietary components in pregnancy has variously been associated with gestational diabetes mellitus (GDM) risk or infant neurodevelopmental problems. We measured a range of pregnancy exposures in maternal hair and/or infant cord serum and tested their relationship to GDM and infant neurodevelopment. METHODS: A total of 843 pregnant women (GDM = 224, Non-GDM = 619) were selected from the Complex Lipids in Mothers and Babies cohort study. Forty-eight elements in hair and cord serum were quantified using inductively coupled plasma-mass spectrometry analysis. Binary logistic regression was used to estimate the associations between hair element concentrations and GDM risk, while multiple linear regression was performed to analyze the relationship between hair/cord serum elements and air pollutants, diet exposures, and Bayley Scales of infant neurodevelopment at 12 months of age. RESULTS: After adjusting for maternal age, BMI, and primiparity, we observed that fourteen elements in maternal hair were associated with a significantly increased risk of GDM, particularly Ta (OR = 9.49, 95% CI: 6.71, 13.42), Re (OR = 5.21, 95% CI: 3.84, 7.07), and Se (OR = 5.37, 95% CI: 3.48, 8.28). In the adjusted linear regression model, three elements (Rb, Er, and Tm) in maternal hair and infant cord serum were negatively associated with Mental Development Index scores. For dietary exposures, elements were positively associated with noodles (Nb), sweetened beverages (Rb), poultry (Cs), oils and condiments (Ca), and other seafood (Gd). In addition, air pollutants PM2.5 (LUR) and PM10 were negatively associated with Ta and Re in maternal hair. CONCLUSIONS: Our findings highlight the potential influence of maternal element exposure on GDM risk and infant neurodevelopment. We identified links between levels of these elements in both maternal hair and infant cord serum related to air pollutants and dietary factors.Item Baby Food Pouches, Baby-Led Weaning, and Iron Status in New Zealand Infants: An Observational Study.(MDPI (Basel, Switzerland), 2024-05-15) McLean NH; Haszard JJ; Daniels L; Taylor RW; Wheeler BJ; Conlon CA; Beck KL; von Hurst PR; Te Morenga LA; McArthur J; Paul R; Katiforis I; Brown KJ; Gash MC; Rowan MM; Casale M; Cox AM; Jones EA; Jupiterwala RM; Bruckner B; Fleming L; Heath A-LM; Chen Y; Tran PV; Felt BTIron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at "around 6 months of age": "frequent" baby food pouch use (five+ times per week) and "full baby-led weaning" (the infant primarily self-feeds). Iron status was assessed using a venepuncture blood sample. The estimated prevalence of suboptimal iron status was 23%, but neither feeding method significantly predicted body iron concentrations nor the odds of iron sufficiency after controlling for potential confounding factors including infant formula intake. Adjusted ORs for iron sufficiency were 1.50 (95% CI: 0.67-3.39) for frequent pouch users compared to non-pouch users and 0.91 (95% CI: 0.45-1.87) for baby-led weaning compared to traditional spoon-feeding. Contrary to concerns, there was no evidence that baby food pouch use or baby-led weaning, as currently practiced in New Zealand, were associated with poorer iron status in this age group. However, notable levels of suboptimal iron status, regardless of the feeding method, emphasise the ongoing need for paying attention to infant iron nutrition.Item Protein intake, distribution, and sources in community-dwelling older adults living in Auckland, New Zealand(IOS Press, 2023-10-13) Hiol AN; Von Hurst PR; Conlon CA; Mumme KD; Beck KLBACKGROUND: To maximally stimulate muscle protein synthesis (MPS), older adults should consume≥1.2 g/kg body weight (BW) of high-quality protein, evenly distributed across the day ( 0.4 g/kg BW per meal). OBJECTIVES: To investigate protein intake, distribution, and sources in community-dwelling older adults. METHODS: Data (including a 4-day food record) were obtained from the Researching Eating, Activity, and Cognitive Health (REACH) study, a cross-sectional study in adults aged 65 to 74 years. RESULTS: Participants (n = 327, 65.4% female) had a median daily protein intake of 1.16 g/kg BW (males) and 1.09 g/kg BW (females). Over half of participants consumed less than 1.2 g protein/kg BW/day (62% females, 57% males). Protein intake was unevenly distributed throughout the day (CV = 0.48 for males and females) and was inadequate for reaching 0.4 g/kg BW/meal at breakfast and at the mid-day meal (males only). The main sources of protein at breakfast were milk (28%), breakfast cereals (22%), and bread (12%); at the mid-day meal, bread (18%), cheese (10%) and milk (9%); and at the evening meal, meat provided over half the protein (56%). CONCLUSIONS: Protein intake for a high proportion of older adults was less than 1.2 g/kg BW/day, and unevenly distributed through the day. Protein was obtained mainly from cereals and dairy products at breakfast and the mid-day meal, and meat sources at the evening meal.Item Associations of protein intake, sources and distribution on muscle strength in community-dwelling older adults living in Auckland, New Zealand.(Cambridge University Press, 2023-08-23) Hiol AN; von Hurst PR; Conlon CA; Beck KLProtein intake, sources and distribution impact on muscle protein synthesis and muscle mass in older adults. However, it is less clear whether dietary protein influences muscle strength. Data were obtained from the Researching Eating Activity and Cognitive Health (REACH) study, a cross-sectional study aimed at investigating dietary patterns, cognitive function and metabolic syndrome in older adults aged 65-74 years. Dietary intake was assessed using a 4-d food record and muscle strength using a handgrip strength dynamometer. After adjusting for confounders, in female older adults (n 212), total protein intake (β = 0⋅22, P < 0⋅01); protein from dairy and eggs (β = 0⋅21, P = 0⋅03) and plant food sources (β = 0⋅60, P < 0⋅01); and frequently consuming at least 0⋅4 g/kg BW per meal (β = 0⋅08, P < 0⋅01) were associated with higher BMI-adjusted muscle strength. However, protein from meat and fish intake and the coefficient of variance of protein intake were not related to BMI-muscle strength in female older adults. No statistically significant associations were observed in male participants (n = 113). There may be sex differences when investigating associations between protein intake and muscle strength in older adults. Further research is needed to investigate these sex differences.
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