Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Supporting the mental health of dietetics students: Perspectives from work placement supervisors(New Zealand Association for Cooperative Education, 2024-11-29) Soniassy R; Martin AJ; Kruger RThis study explores workplace supervisors’ perceptions of student mental health during their work-integrated learning (WIL) programme and their role in supporting these students. Research methods involved analyzing online survey (n = 80) results and semi-structured recorded interviews (n = 11) with supervisors from the MSc WIL programme (Nutrition and Dietetics) at Massey University, New Zealand. Supervisors noted student’s mental health being influenced across individual-, relationship- and organizational areas. However, most supervisors (69%) only felt ‘somewhat confident’ or ‘not confident at all’ in recognizing signs of anxiety and depression, and almost all (92%) had no formal mental health training. Supervisors supported student mental health during WIL by creating a sense of belonging for students within the workplace, using appropriate supervisory styles which align with mentoring and coaching techniques, and adopting culturally responsive supervision. Potential strategies identified to support workplace supervisors in their role were mental health first aid and resilience training.Item 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-JBackground/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.Item 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 AGymnema 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.Item Dietary Fibre Intake, Adiposity, and Metabolic Disease Risk in Pacific and New Zealand European Women(MDPI (Basel, Switzerland), 2024-10-07) Renall N; Merz B; Douwes J; Corbin M; Slater J; Tannock GW; Firestone R; Kruger R; Te Morenga L; Brownlee IA; Feraco A; Armani ABACKGROUND/OBJECTIVES: To assess associations between dietary fibre intake, adiposity, and odds of metabolic syndrome in Pacific and New Zealand European women. METHODS: Pacific (n = 126) and New Zealand European (NZ European; n = 161) women (18-45 years) were recruited based on normal (18-24.9 kg/m2) and obese (≥30 kg/m2) BMIs. Body fat percentage (BF%), measured using whole body DXA, was subsequently used to stratify participants into low (<35%) or high (≥35%) BF% groups. Habitual dietary intake was calculated using the National Cancer Institute (NCI) method, involving a five-day food record and semi-quantitative food frequency questionnaire. Fasting blood was analysed for glucose and lipid profile. Metabolic syndrome was assessed with a harmonized definition. RESULTS: NZ European women in both the low- and high-BF% groups were older, less socioeconomically deprived, and consumed more dietary fibre (low-BF%: median 23.7 g/day [25-75-percentile, 20.1, 29.9]; high-BF%: 20.9 [19.4, 24.9]) than Pacific women (18.8 [15.6, 22.1]; and 17.8 [15.0, 20.8]; both p < 0.001). The main source of fibre was discretionary fast foods for Pacific women and whole grain breads and cereals for NZ European women. A regression analysis controlling for age, socioeconomic deprivation, ethnicity, energy intake, protein, fat, and total carbohydrate intake showed an inverse association between higher fibre intake and BF% (β= -0.47, 95% CI = -0.62, -0.31, p < 0.001), and odds of metabolic syndrome (OR = 0.91, 95% CI = 0.84, 0.98, p = 0.010) among both Pacific and NZ European women (results shown for both groups combined). CONCLUSIONS: Low dietary fibre intake was associated with increased metabolic disease risk. Pacific women had lower fibre intakes than NZ European women.Item The fecal microbiotas of women of Pacific and New Zealand European ethnicities are characterized by distinctive enterotypes that reflect dietary intakes and fecal water content.(Taylor and Francis Groups, 2023-02-17) Renall N; Lawley B; Vatanen T; Merz B; Douwes J; Corbin M; Te Morenga L; Kruger R; Breier BH; Tannock GWObesity is a complex, multifactorial condition that is an important risk factor for noncommunicable diseases including cardiovascular disease and type 2 diabetes. While prevention and management require a healthy and energy balanced diet and adequate physical activity, the taxonomic composition and functional attributes of the colonic microbiota may have a supplementary role in the development of obesity. The taxonomic composition and metabolic capacity of the fecal microbiota of 286 women, resident in Auckland New Zealand, was determined by metagenomic analysis. Associations with BMI (obese, nonobese), body fat composition, and ethnicity (Pacific, n = 125; NZ European women [NZE], n = 161) were assessed using regression analyses. The fecal microbiotas were characterized by the presence of three distinctive enterotypes, with enterotype 1 represented in both Pacific and NZE women (39 and 61%, respectively), enterotype 2 mainly in Pacific women (84 and 16%) and enterotype 3 mainly in NZE women (13 and 87%). Enterotype 1 was characterized mainly by the relative abundances of butyrate producing species, Eubacterium rectale and Faecalibacterium prausnitzii, enterotype 2 by the relative abundances of lactic acid producing species, Bifidobacterium adolescentis, Bifidobacterium bifidum, and Lactobacillus ruminis, and enterotype 3 by the relative abundances of Subdoligranulum sp., Akkermansia muciniphila, Ruminococcus bromii, and Methanobrevibacter smithii. Enterotypes were also associated with BMI, visceral fat %, and blood cholesterol. Habitual food group intake was estimated using a 5 day nonconsecutive estimated food record and a 30 day, 220 item semi-quantitative Food Frequency Questionnaire. Higher intake of 'egg' and 'dairy' products was associated with enterotype 3, whereas 'non-starchy vegetables', 'nuts and seeds' and 'plant-based fats' were positively associated with enterotype 1. In contrast, these same food groups were inversely associated with enterotype 2. Fecal water content, as a proxy for stool consistency/colonic transit time, was associated with microbiota taxonomic composition and gene pools reflective of particular bacterial biochemical pathways. The fecal microbiotas of women of Pacific and New Zealand European ethnicities are characterized by distinctive enterotypes, most likely due to differential dietary intake and fecal consistency/colonic transit time. These parameters need to be considered in future analyses of human fecal microbiotas.Item Outcomes of a culturally informed weight-loss competition for New Zealand Indigenous and Pacific peoples: a quasi-experimental trial(BioMed Central Ltd part of Springer Nature., 2021-09) Glover M; Kira A; McRobbie H; Kruger R; Funaki-Tahifote M; Stephen J; Breier BH; Kira GBackground Reducing obesity prevalence among marginalised subgroups with disproportionately high obesity rates is challenging. Given the promise of incentives and group-based programmes we trialled a culturally tailored, team-based weight-loss competition with New Zealand Māori (Indigenous) and Pacific Island people. Methods A quasi-experimental 12-months trial was designed. The intervention consisted of three six-months competitions, each with seven teams of seven members. Eligible participants were aged 16 years and older, with a BMI ≥30 kg/m2 and being at risk of or already diagnosed with type-2 diabetes or cardiovascular disease. Height, weight and waist circumference were measured at baseline, 6 and 12 months. Results Recruitment of a control group (n = 29) versus the intervention (n = 132) was poor and retention rates were low (52 and 27% of intervention participants were followed-up at six and 12 months, respectively). Thus, analysis of the primary outcome of individual percentage weight loss was restricted to the 6-months follow-up data. Although not significant, the intervention group appeared to lose more weight than the control group, in both the intention to treat and complete-case analyses. Conclusions The intervention promoted some behaviour change in eating behaviours, and a resulting trend toward a reduction in waist circumference. Trial registration ACTRN12617000871347 Registered 15/6/2017 Retrospectively registered.Item Chronotype Differences in Body Composition, Dietary Intake and Eating Behavior Outcomes: A Scoping Systematic Review(Elsevier Inc, 2022-11) van der Merwe C; Münch M; Kruger RThe timing and nutritional composition of food intake are important zeitgebers for the biological clocks in humans. Thus, eating at an inappropriate time (e.g., during the night) may have a desynchronizing effect on the biological clocks and, in the long term, may result in adverse health outcomes (e.g., weight gain, obesity, and poor metabolic function). Being a very late or early chronotype not only determines preferred sleep and wake times but may also influence subsequent mealtimes, which may affect the circadian timing system. In recent years, an increased number of studies have examined the relation between chronotype and health outcomes, with a main focus on absolute food intake and metabolic markers and, to a lesser extent, on dietary intake distribution and eating behavior. Therefore, this review aimed to systematically determine whether chronotype indirectly affects eating behaviors, dietary intake (timing, choice, nutrients), and biomarkers leading to body composition outcomes in healthy adults. A systematic literature search on electronic databases (PubMed, CINAHL, MEDLINE, SCOPUS, Cochrane library) was performed (International Prospective Register of Systematic Reviews number: CRD42020219754). Only studies that included healthy adults (aged >18 y), classified according to chronotype and body composition profiles, using outcomes of dietary intake, eating behavior, and/or biomarkers, were considered. Of 4404 articles, 24 met the inclusion criteria. The results revealed that late [evening type (ET)] compared with early [morning type (MT)] chronotypes were more likely to be overweight/obese with poorer metabolic health. Both MT and ET had similar energy and macronutrient intakes, consuming food during their preferred sleep–wake timing: later for ET than MT. Most of the energy and macronutrient intakes were distributed toward nighttime for ET and exacerbated by unhealthy eating behaviors and unfavorable dietary intakes. These findings from our systematic review give further insight why higher rates of overweight/obesity and unhealthier metabolic biomarkers are more likely to occur in ET.Item Enablers and barriers to prevent weight-regain post bariatric surgery - A qualitative enquiry(Elsevier Ltd, 2022-12) Billing-Bullen G; Nielsen D; Wham C; Kruger RBackground Weight-regain is commonly experienced after bariatric surgery. This qualitative enquiry aimed to explore participants' self-reported enablers and barriers to prevent future weight-regain post-surgery. Methods Eligible adults were recruited at 12-months post-bariatric-surgery at Counties Manukau, Auckland. Participants were invited to attend data collection at their 18-month group nutrition-education session, and to participate in a focus group at 21-months post-surgery. Thematic analysis was used to evaluate patient experiences. Results Participants (n = 28) were mostly female (73.2 %), New Zealand European (41.5 %), and had gastric sleeve surgery (92.3 %). Five key themes emerged from the analysis: A Life Changing Health Journey - participants experienced a decrease in obesity-related comorbidities and a subsequent decrease in medications. Weight change and food intolerances impacted quality of life. Challenge of managing a New Healthy Lifestyle - financial stress, buying healthier foods and social events were new challenges, often centred on food. Changing Eating Behavior - all participants struggled managing eating behaviors. Mindset Changes - post-surgery most participants had a positive mindset, increased confidence, and feelings of happiness. However, many struggled with mindset around weight and food. A need for On-going Support - most felt under-supported and expressed a need for longer, specific follow-up care. Conclusion Post-surgery group education sessions provided participants with increased support from both health professionals and peers on the same journey, to overcome struggles such as binge eating or identifying new coping strategies. Findings provide important insights into the challenges patients with bariatric surgery face and key learnings to develop specific supports for future care practices.Item Replacing Sedentary Time with Physically Active Behaviour Predicts Improved Body Composition and Metabolic Health Outcomes(MDPI (Basel, Switzerland), 2022-07) O'Brien WJ; Rauff EL; Shultz SP; Sloughter M; Fink PW; Breier B; Kruger RBackground: Discretionary leisure time for health-promoting physical activity (PA) is limited. This study aimed to predict body composition and metabolic health marker changes from PA reallocation using isotemporal substitution analysis. Methods: Healthy New Zealand women (n = 175; 16–45 y) with high BMI (≥25 kg/m2) and high body fat percentage (≥30%) were divided into three groups by ethnicity (Māori n = 37, Pacific n = 54, and New Zealand European n = 84). PA, fat mass, lean mass, and metabolic health were assessed. Isotemporal substitution paradigms reallocated 30 min/day of sedentary behaviour to varying PA intensities. Results: Reallocating sedentary behaviour with moderate intensity, PA predicted Māori women would have improved body fat% (14.83%), android fat% (10.74%), and insulin levels (55.27%) while the model predicted Pacific women would have improved waist-to-hip (6.40%) and android-to-gynoid (19.48%) ratios. Replacing sedentary time with moderate-vigorous PA predicted Māori women to have improved BMI (15.33%), waist circumference (9.98%), body fat% (16.16%), android fat% (12.54%), gynoid fat% (10.04%), insulin (55.58%), and leptin (43.86%) levels; for Pacific women, improvement of waist-to-hip-ratio (5.30%) was predicted. Conclusions: Sedentary behaviour must be substituted with PA of at least moderate intensity to reap benefits. Māori women received the greatest benefits when reallocating PA. PA recommendations to improve health should reflect the needs and current activity levels of specific populations.Item Evaluating a novel dietary diversity questionnaire to assess dietary diversity and adequacy of New Zealand women.(Elsevier Inc, 2021) Kruger R; Hepburn AJ; Beck KL; McNaughton S; Stonehouse WObjectives We sought to develop and evaluate the relative validity of a dietary diversity questionnaire (DDQ) that reflects food-group diversity, food variety, and micronutrient adequacy among New Zealand women. Methods A cross-sectional study included New Zealand women (Auckland based; ages 16–45 y, n = 101), completing a 7-d DDQ and 4-d weighed food record (reference method). The relative validity of the DDQ was evaluated by correlating nutritious and discretionary dietary diversity scores (DDSs; number of food groups) and food-variety scores (number of foods), calculated from both methods. The dietary mean adequacy ratio (MAR; micronutrient intakes relative to estimated average requirements) was calculated from the weighed food record and correlated to dietary diversity and food-variety scores from the DDQ to assess construct validity. Cross-tabulation was used to explore dietary diversity measures versus adequacy ratios. Significance was set at P < 0.05. Results The median (interquartile range) DDSs (maximum 25) from the DDQ—23 (21–23)—and the weighed food record—18 (17–19)—were significantly correlated (rs = 0.33, P < 0.001), as were the food-variety scores (maximum 237)—respectively, 75 (61–87) and 45 (37–52) (rs = 0.22, P < 0.03). A mean (± SD) MAR of 0.94 ± 0.04 suggested a near-adequate diet, but one-third of foods consumed were from discretionary sources. Nutritious DDS was significantly correlated with MAR for micronutrients (rs = 0.20, P ≤ 0.05). An inverse trend was observed between discretionary DDS and MAR. Conclusions The DDQ is a quick, low-burden tool for describing nutritious and discretionary dietary diversity reflecting micronutrient adequacy in high-income settings. It requires further validation across different time frames, population groups, and settings.