Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
Browse
11 results
Search Results
Item Adherence to Dietary and Lifestyle Guidelines Among Women With a History of Gestational Diabetes Mellitus and the Influence of a Student-Led Dietetic Clinics(Wiley Periodicals LLC, Hoboken, USA, 2025-02-23) Illenberger K; Sekula J; Lawrence RWomen with a history of gestational diabetes mellitus have an increased risk of developing type 2 diabetes. Healthy diet and lifestyle habits may contribute to reducing this risk. This study aimed to describe dietary intake and lifestyle habits of women with a history of gestational diabetes mellitus and determine the impact of nutrition and lifestyle counseling on dietary intake and lifestyle goals. This retrospective cohort study included 32 women with a history of gestational diabetes mellitus 6 months postpartum who attended the student-led nutrition clinic between 01 June 2021 and 31 August 2022. Dietary intake, lifestyle, and physical activity habits were extracted from student dietitians' notes. The mid-p-value McNemar's test was used to determine whether attendance at the student-led dietetic clinic was associated with a change in the proportion of women meeting the guidelines. Fifteen percent (n = 5) of women did not meet any food group recommendations prior to any interventions. Most women (46.8%) engaged in less than the recommended level of physical activity and more than a quarter (28.1%) did not engage in any physical activity at their initial consultation. After attending at least one consultation, a greater proportion of women met recommendations for at least one food group (41.1% vs. 18.7%, p = 0.256) and a greater proportion of women met physical activity guidelines (60% vs. 25%, p = 0.125). In this cohort of postpartum women with a history of gestational diabetes mellitus, adherence to the Ministry of Health Eating and Activity guidelines was poor. Positive changes towards adherence are possible after attendance at a student-led nutrition and dietetic clinic.Item Proposing a unified Mediterranean diet score to address the current conceptual and methodological challenges in examining adherence to the Mediterranean diet(Frontiers Media S.A., 2025-09-12) Hwalla N; Trichopoulou A; Delarue J; Adinolfi F; Brighenti F; Burlingame B; Capone R; Dernini S; El Moujabber M; González-Gross M; Vecchio Y; Massouh N; Naja F; Pederiva CA plethora of studies has documented the benefits of the Mediterranean diet (MedDiet) for both human and environmental health. At the core of these investigations lies the assessment of adherence to it. In this manuscript, we aim to examine existing original scores used to assess adherence to the MedDiet and propose a framework for a unified score to address current challenges and complement the existing scores. A literature search was conducted to identify original MED scores, excluding those derived from earlier scores. A total of nineteen original scores were identified and examined. At the conceptual level, across existing scores, the following issues were identified: inconsistencies in food items, lack of holistic lifestyle approaches with focus on food-based components, limited cultural specificity, absence of sustainability evaluations, and regional focus solely on economically developed countries. At the methodological level, the majority of scores were based on cutoffs set by the population-specific distributions of dietary intake. Such cutoffs may be in discordance with the dietary recommendations of the different food groups considered. In addition, the definition of “adherence” is inconsistent across the scores, making the interpretation and comparability of the prevalence of adherence another methodological challenge. As a result, a framework for a Unified Mediterranean diet Score (UMEDS) is proposed. This framework consists of 10 food groups (whole grains, fruits, vegetables, dairy products, fish, legumes, olive oil, nuts and seeds, poultry, and red meat). These food groups are the common denominators of a traditional Mediterranean diet. In addition to the food-related components, the UMEDS also addresses physical activity, sleep, conviviality, and culture-specific food consumption (mainly composite dishes based on olive oil). For each of these items, evidence-based cut-offs were proposed. The total score for the UMEDS ranges from 0 to 22 with higher scores indicating a higher adherence (≤12 poor adherence, 13–17 moderate adherence, ≥18 good adherence). By integrating key components of dietary intake, lifestyle habits, and cultural practices, the UMEDS provides a comprehensive unified approach that aligns with global health guidelines and reflects the true spirit of the Mediterranean diet, rooted in food, lifestyle, culture, lifestyle, and traditional knowledge and practices.Item The Role of Lifestyle and Dietary Factors in the Development of Premature Ovarian Insufficiency(MDPI (Basel, Switzerland), 2023-08-11) Shelling AN; Ahmed Nasef N; Dimitriadis, F; Sofikitis N; Sulyok EPremature ovarian insufficiency (POI) is a condition that arises from dysfunction or early depletion of the ovarian follicle pool accompanied by an earlier-than-normal loss of fertility in young women. Oxidative stress has been suggested as an important factor in the decline of fertility in women and POI. In this review, we discuss the mechanisms of oxidative stress implicated in ovarian ageing and dysfunction in relation to POI, in particular mitochondrial dysfunction, apoptosis and inflammation. Genetic defects, autoimmunity and chemotherapy, are some of the reviewed hallmarks of POI that can lead to increased oxidative stress. Additionally, we highlight lifestyle factors, including diet, low energy availability and BMI, that can increase the risk of POI. The final section of this review discusses dietary factors associated with POI, including consumption of oily fish, mitochondria nutrient therapy, melatonin, dairy and vitamins that can be targeted as potential interventions, especially for at-risk women and in combination with personalised nutrition. Understanding the impact of lifestyle and its implications for POI and oxidative stress holds great promise in reducing the burden of this condition.Item Lifestyle and incident dementia: A COSMIC individual participant data meta-analysis(Wiley Periodicals LLC on behalf of Alzheimer's Association, 2024-06-16) Van Asbroeck S; Köhler S; van Boxtel MPJ; Lipnicki DM; Crawford JD; Castro-Costa E; Lima-Costa MF; Blay SL; Shifu X; Wang T; Yue L; Lipton RB; Katz MJ; Derby CA; Guerchet M; Preux P-M; Mbelesso P; Norton J; Ritchie K; Skoog I; Najar J; Sterner TR; Scarmeas N; Yannakoulia M; Dardiotis T; Rolandi E; Davin A; Rossi M; Gureje O; Ojagbemi A; Bello T; Kim KW; Han JW; Oh DJ; Trompet S; Gussekloo J; Riedel-Heller SG; Röhr S; Pabst A; Shahar S; Rivan NFM; Singh DKA; Jacobsen E; Ganguli M; Hughes T; Haan M; Aiello AE; Ding D; Zhao Q; Xiao Z; Narazaki K; Chen T; Chen S; Ng TP; Gwee X; Gao Q; Brodaty H; Trollor J; Kochan N; Lobo A; Santabárbara J; Gracia-Garcia P; Sachdev PS; Deckers K; for Cohort Studies of Memory in an International Consortium (COSMIC)INTRODUCTION: The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics. METHODS: We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis. RESULTS: A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed. DISCUSSION: Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups. HIGHLIGHTS: - A two-step individual participant data meta-analysis was conducted. - This was done at a global scale using data from 21 ethno-regionally diverse cohorts. - The association between a modifiable dementia risk score and dementia was examined. - The association was modified by geographical region and age at baseline. - Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.Item Lifestyle for brain health and cognitive functioning in midlife to early late-life New Zealanders: Utility of the LIBRA index.(John Wiley and Sons, Inc., 2024-05-01) Röhr S; Stephens C; Alpass FOBJECTIVES: There is enormous potential to improve brain health and reduce the risk of cognitive decline and dementia based on modifiable risk factors. The Lifestyle for Brain Health (LIBRA) index was developed to quantify modifiable dementia risk or room for brain health improvement. The objective of the study was to investigate the utility of the LIBRA index in relation to cognitive functioning in a midlife to early late-life sample of New Zealanders. METHODS: A subsample (n = 1001) of the longitudinal New Zealand Health, Work and Retirement (NZHWR) study completed face-to-face cognitive assessments using the 'Kiwi' Addenbrooke's Cognitive Examination-Revised (ACE-R) in 2010 and again in 2012, in addition to completing biennial NZHWR surveys on socioeconomic, health and wellbeing aspects. The LIBRA index was calculated incorporating information on 8 out of 12 modifiable health and lifestyle factors for dementia. Unadjusted and adjusted regression models and mixed effects models were used to inspect associations of LIBRA with cognitive functioning, cognitive impairment, and cognitive decline. RESULTS: The analytical sample (n = 881 [88.0%], after considering exclusion criteria and missing data) had a mean age of 63.1 (SD = 6.5) years, 53.3% were female, 26.2% were Māori, and 61.7% were highly educated. Higher LIBRA scores (indicating higher modifiable dementia risk) were associated with lower cognitive functioning (B = -0.33, 95% CI = -0.52;-0.15, p < 0.001) and a higher likelihood of cognitive impairment (OR = 1.22, 95% CI = 1.04; 1.42, p = 0.013), but did not predict cognitive decline over 2 years (B = -0.03, 95% CI = -0.22; 0.16, p = 0.766), adjusted for age, age2, gender, education, and ethnicity. CONCLUSIONS: The LIBRA index indicated promising utility for quantifying modifiable dementia risk in midlife and early late-life New Zealanders. For local use, refinement of the LIBRA index should consider cultural differences in health and lifestyle risk factors, and further investigate its utility with a wider range of modifiable factors over a longer observation period.Item A multidomain intervention against cognitive decline in an at-risk-population in Germany: Results from the cluster-randomized AgeWell.de trial.(John Wiley and Sons, Inc., 2024-01-01) Zülke AE; Pabst A; Luppa M; Roehr S; Seidling H; Oey A; Cardona MI; Blotenberg I; Bauer A; Weise S; Zöllinger I; Sanftenberg L; Brettschneider C; Döhring J; Lunden L; Czock D; Haefeli WE; Wiese B; Hoffmann W; Frese T; Gensichen J; König H-H; Kaduszkiewicz H; Thyrian JR; Riedel-Heller SGINTRODUCTION: We investigated the effectiveness of a multidomain intervention to preserve cognitive function in older adults at risk for dementia in Germany in a cluster-randomized trial. METHODS: Individuals with a Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score ≥ 9 aged 60 to 77 years were recruited. After randomization of their general practitioner (GP), patients received a multidomain intervention (including optimization of nutrition and medication, and physical, social, and cognitive activity) or general health advice and GP treatment as usual over 24 months. Primary outcome was global cognitive performance (composite z score, based on domain-specific neuropsychological tests). RESULTS: Of 1030 participants at baseline, n = 819 completed the 24-month follow-up assessment. No differences regarding global cognitive performance (average marginal effect = 0.010, 95% confidence interval: -0.113, 0.133) were found between groups at follow-up. Perceived restrictions in intervention conduct by the COVID-19 pandemic did not impact intervention effectiveness. DISCUSSION: The intervention did not improve global cognitive performance. HIGHLIGHTS: Overall, no intervention effects on global cognitive performance were detected. The multidomain intervention improved health-related quality of life in the total sample. In women, the multidomain intervention reduced depressive symptoms. The intervention was completed during the COVID-19 pandemic.Item What are the barriers to adoption of a lifestyle associated with optimal peak bone mass acquisition? A qualitative study of young adults in New Zealand(MDPI (Basel, Switzerland), 2022-02-08) Zafar S; Denison H; Patel H; Dennison E; Longo UGObjective: This study aimed to investigate the barriers to adopting lifestyle factors other than physical activity important for optimal peak bone mass (PBM) acquisition—namely, dietary factors, avoidance of cigarette smoking, and keeping alcohol consumption within recommended limits. Materials and Methods: University students and staff aged 18–35 years were recruited. Six semi-structured, in-depth focus group interviews were conducted with a total of 28 participants. The interviews were digitally recorded and transcribed. A thematic approach for data analysis using a constant comparative method was performed using NVivo software. Results: Three major themes emerged: socio-cultural barriers (peer pressure and cultural norms); personal barriers (time, cost, and diet preferences); and other barriers (medical illness and lack of symptoms associated with low bone mass density). Conclusions: We identified several barriers to adoption of lifestyle behaviours that might be beneficial to PBM acquisition. These data might facilitate the development of public health interventions designed to help young adults embrace osteoprotective lifestyles, and hence reduce the burden of osteoporotic fracture in later life.Item Knowledge of Osteoporosis and Lifestyle Behaviours Impacting Peak Bone Mass among Young Adults(LIDSEN Publishing Inc., 2021-01-11) Patel H; Denison H; Zafar S; Teesdale-Spittle P; Dennison E; Marks ROsteoporosis is a major public health problem through its association with fragility fracture. Low peak bone mass (PBM) is a major contributor to later osteoporosis risk. Despite this, most studies concentrate on older people when the window of opportunity to impact PBM has passed. This study aimed to understand what adolescents and young adults understand about PBM, the risk of osteoporotic fracture and how lifestyle factors impact PBM. Such information may inform educational interventions to reduce future risk of fracture, and provide important public health benefits. New Zealand university students were approached to participate in this study. Nine focus groups of a total of 44 adolescents and young adults, mean age 22.9 (± 4.02) years of different ethnicities (29 female 15 male), were conducted using a semi-structured approach with open-ended questions and prompts. Transcripts were thematically coded using an inductive content analysis approach. Participants reported poor knowledge of PBM and factors impacting risk of osteoporotic fracture. There was a general awareness of the positive and negative impacts of many lifestyle behaviours such as physical activity, diet, tobacco smoking and alcohol consumption on health in general, but not specifically how these impact PBM and good bone health in later life. We conclude that in a cohort of New Zealand University students, current knowledge of osteoporosis and lifestyle factors that impact PBM is limited. Educational interventions in young adults are now warranted to improve PBM and prevent osteoporosis in late adulthood.Item Gender-Specific Design and Effectiveness of Non-Pharmacological Interventions against Cognitive Decline — Systematic Review and Meta-Analysis of Randomized Controlled Trials(Springer Nature Switzerland AG, 2023-01) Zülke AE; Riedel-Heller SG; Wittmann F; Pabst A; Röhr S; Luppa MBackground The number of people living with dementia worldwide is increasing rapidly. Preventive approaches constitute a promising strategy to counter the dementia epidemic, and growing numbers of lifestyle interventions are conducted around the globe. Gender differences with respect to modifiable risk factors for dementia have been reported, however, little is known about gender-specific effectiveness of lifestyle trials against cognitive decline and dementia. A systematic review and meta-analysis was conducted to assess evidence on gender-specific design and effectiveness of randomized controlled trials against cognitive decline. Methods Systematic literature searches were conducted in MEDLINE, PsycINFO, Web of Science, Cochrane Central and ALOIS. Studies assessing global and/or domain-specific cognitive function in older adults free from dementia were eligible for the systematic review. We assessed between-group effect sizes using random-effects meta-analysis. Methodological quality of included studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN)-checklist. Results The systematic review and meta-analysis included 34 and 31 studies, respectively. Effects of lifestyle-interventions on global cognition were non-significant overall (g =.27; 95% CI: −.01;.56) and in male subsamples (g = −.05; 95% CI: −.55;.45), and small for female subsamples (g =.38; 95% CI:.05;.72). Small beneficial effects were found for memory (overall: g =.38; 95% CI =.17;.59). Stratified by gender, significant effects were observed only in women (g =.39; 95% CI =.13;.65; men: g =.37; 95% CI:.00;.73). Aspects of gender in study design and conduct were discussed in a small minority of studies. Comparable results were observed for executive function and verbal fluency. Methodological quality was deemed high in 17.6% of studies, acceptable and low quality in 52.9% and 29.4%, respectively. Discussion We found evidence for small differences in the effectiveness of lifestyle interventions on global cognition and memory in favor of women. However, small numbers of trials 1) targeting men and 2) reporting gender-specific results for older adults with mild cognitive impairment warrant further attention. Assessing differences in modifiable risk factors for dementia in men and women and systematically addressing aspects of gender in trial conduction and recruitment in future studies might increase knowledge on gender-specific effectiveness of lifestyle trials against cognitive decline.Item Recruitment and Baseline Characteristics of Participants in the AgeWell.de Study—A Pragmatic Cluster-Randomized Controlled Lifestyle Trial against Cognitive Decline(MDPI (Basel, Switzerland), 2021-01) Röhr S; Zülke A; Luppa M; Brettschneider C; Weißenborn M; Kühne F; Zöllinger I; Samos F-AZ; Bauer A; Döhring J; Krebs-Hein K; Oey A; Czock D; Frese T; Gensichen J; Haefeli WE; Hoffmann W; Kaduszkiewicz H; König H-H; Thyrian JR; Wiese B; Riedel-Heller SGTargeting dementia prevention, first trials addressing multiple modifiable risk factors showed promising results in at-risk populations. In Germany, AgeWell.de is the first large-scale initiative investigating the effectiveness of a multi-component lifestyle intervention against cognitive decline. We aimed to investigate the recruitment process and baseline characteristics of the AgeWell.de participants to gain an understanding of the at-risk population and who engages in the intervention. General practitioners across five study sites recruited participants (aged 60–77 years, Cardiovascular Risk Factors, Aging, and Incidence of Dementia/CAIDE dementia risk score ≥ 9). Structured face-to-face interviews were conducted with eligible participants, including neuropsychological assessments. We analyzed group differences between (1) eligible vs. non-eligible participants, (2) participants vs. non-participants, and (3) between intervention groups. Of 1176 eligible participants, 146 (12.5%) dropped out before baseline; the study population was thus 1030 individuals. Non-participants did not differ from participants in key sociodemographic factors and dementia risk. Study participants were M = 69.0 (SD = 4.9) years old, and 52.1% were women. The average Montreal Cognitive Assessment/MoCA score was 24.5 (SD = 3.1), indicating a rather mildly cognitively impaired study population; however, 39.4% scored ≥ 26, thus being cognitively unimpaired. The bandwidth of cognitive states bears the interesting potential for differential trial outcome analyses. However, trial conduction is impacted by the COVID-19 pandemic, requiring adjustments to the study protocol with yet unclear methodological consequences.