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Has files: YesSubject: search.filters.subject.451004 Te horakai me ngā kai o te Māori (Māori diet and nutrition)

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    Complementary feeding practices, nutrient intake, and iron status of Māori, Pasifika, and other infants in Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nutritional Science, Massey University, Albany, Aotearoa New Zealand
    (Massey University, 2023-09-09) Casale, Maria
    Background: The period of transition from a solely milk-based diet to sharing family foods at around 12 months of age is a critical time for infants. Complementary feeding practices, from the age of introduction to complementary foods, method of feeding (baby-led weaning vs. traditional spoon-feeding), use of the novel baby food pouches, use of traditional cultural foods and practices, and the characteristics and nutrient density of first foods offered support the healthy growth and development of the infant, as well as shape long term dietary patters and food preferences. Additionally, iron status is crucial for healthy infant growth and development, and while this is impacted by myriad maternal, genetic, and environmental factors, complementary feeding practices and the characteristics of foods offered are key modifiable practices that influence infant iron status. Aims and objectives: The overall aim of this study was to investigate and describe early infant feeding practices, key nutrient intake and density, and the iron status of Māori, Pasifika and other infants living in Aotearoa New Zealand, using an observational cross-sectional study design. The primary objective was to conduct an intra-ethnic analysis of infant complementary feeding practices, nutrient intake and density from complementary foods, and iron status between Māori, Pasifika, and ‘other’ infants. ‘Other’ refers to any infants who were not self-identified by the adult respondent as Māori or Pasifika. Methods: Infants aged 7.0–10.0 months along with their primary caregiver participated in an observational cross-sectional study, with 625 infant–caregiver dyads recruited from Auckland and Dunedin, New Zealand. Participants were recruited from a range of ethnic groups and deprivation statuses. Infants were stratified by ethnicity using total response for Māori and Pasifika, with all non-Māori, non-Pasifika infants categorised into a single ‘others’ group. Demographic and feeding practices data were collected via questionnaire. Nutrient intake from complementary food was measured using the multiple-source method from two multiple-pass 24-hour diet recalls. Nutrient density of complementary food was calculated as the concentration of selected nutrients per 418 kJ (100 kcal) of energy. For iron status, haemoglobin, plasma ferritin, soluble transferrin receptor, C-Reactive protein, and alpha-glycoprotein were obtained from a venous blood sample. Inflammation was adjusted for using the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anaemia (BRINDA) method. Body iron concentration (mg/kg body weight) was calculated using the ratio of sTfR and ferritin. Results: A total of 1424 infant-caregiver dyads were assessed for eligibility, and 625 eligible dyads were enrolled in the study, all of whom provided written consent. Data for complementary feeding practices and nutrient intake were analysed for all 625 infants, with blood samples obtained from 365 of these infants for the assessment of iron status. Within the cohort 131 infants were identified by their caregiver as Māori, and 82 as Pasifika. The remaining infants are allocated into a single ‘others’ group as the primary focus of this manuscript is Māori and Pasifika infants. The mean (SD) infant age was 8.4 (0.8) months for Māori, 8.5 (0.9) months for Pasifika, and 8.4 (0.8) months for ‘other’ infants. Over half of all ethnicities introduced CF at around six months of age (56.5% of Māori, 62.2% of Pasifika, and 80.9% of ‘others’). BLW prevalence increased from 11.5% of Māori, 3.7% of Pasifika, and 12.4% of ‘other’ infants at the time of introducing CF to 29.2% of Māori, 17.1% of Pasifika, and 27.3% of ‘others’ currently. Baby food pouches were used at least once by 89.3% of Māori, 85.4% of Pasifika, and 75.6% of ‘other’ infants. Of those who always or frequently were fed pouches, 27.1% of Māori, 25% of Pasifika, and 12% of ‘other’ infants always or mostly sucked directly from the nozzle. Vegetables and ‘pureed’ were the most common first food and texture offered, respectively, for all ethnic groups. At six months red meat was consumed by 54.6% of Māori infants, 63.4% of Pasifika infants, and 61.8% of ‘other’ infants, and approximately half had iron-fortified baby rice (Māori 57.3%, Pasifika 56.1%, ‘other’ 48.7%). Age-inappropriate drinks were currently given to 17.6% of Māori, 20.7% of Pasifika, and 3.8% of ‘other’ infants. In total, 9.1% of Māori and 20.7% of Pasifika respondents reported offering traditional cultural foods to their infants. Energy intake increased with age for all ethnic groups and was higher for boys than girls. Protein as a percentage of energy intake from CF was significantly lower for Māori compared to ‘others’. Fat as a percentage of energy intake from CF was significantly lower for both Māori and Pasifika than ‘others’, whereas carbohydrate as a percentage of energy intake from CF was significantly higher. Sugar intake in grams from CF was significantly higher for Pasifika when compared to ‘others’, and sugar as a percentage of energy intake from CF was significantly higher for Māori than ‘others’. Iron, zinc, and calcium density of the complementary diet was inadequate for all groups: Māori and ‘others’ had an iron density of 0.8 mg/418 kJ, and Pasifika 0.9 mg/418 kJ. Zinc density was 0.5 mg/418 kJ for all groups. Calcium density was 37 mg/418 kJ for Māori, 40 mg/418 kJ for Pasifika, and 38 mg/418 kJ for ‘others’. In total, 96.4% of Pasifika infants were iron sufficient, compared to 82.5% of Māori and 76% of ‘other’ infants. ‘Other’ infants had the highest prevalence of iron deficiency overall, with 3% categorised with iron-deficiency anaemia, 12% with early functional iron deficiency, and 9% with iron depletion. For Māori infants, 4.7% had iron-deficiency anaemia and early functional iron deficiency, respectively, and 8% were iron depleted. One (3.6%) Pasifika infant was iron depleted, and the remainder were iron sufficient. Mediation analysis suggested that the difference in body iron concentration between Pasifika and ‘others’ was partially explained by the frequency of their higher consumption of baby food pouches. Conclusions: The high prevalence of Māori and Pasifika infants feeding directly from baby food pouch nozzles is concerning in light of the increasing popularity and prevalence of this novel feeding device, with concerns for both the safety and impact on development of this way of feeding. The low density of iron, zinc, and calcium in the complementary diet warrants further investigation into feeding and fortification strategies, due to the key role these nutrients play in the growth and development of infants. The rate of iron deficiency was very low for Pasifika infants despite little iron intake from complementary food, indicating non-dietary factors as the likely cause for this group.
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    The feasibility of using an adapted 24-hour recall method versus skin carotenoids status to assess fruit and vegetable intake in low-income Māori households : a thesis presented for the partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
    (Massey University, 2022) Young, Dana
    Background: High fruit and vegetables (F/V) intake have been repeatedly shown to decrease risk of developing obesity and non-communicable diseases. Māori people living in deprived areas are often experiencing some degree of food insecurity, which exposes this population to a greater nutritional risk due to lower F/V intake. There is currently no validated instrument to measure F/V intake in low-income Māori households. Finding a feasible dietary assessment tool will be helpful to determine nutritional status and consumption patterns; to assess the association between F/V and diseases; and to guide evaluation for food policies and programs in eliminating barriers to healthy eating. Aim: To assess the feasibility of an adapted 24-hour (24-h) recalls versus skin carotenoids status to assess F/V intake in low-income Māori households participating in a F/V intervention. Methods: This feasibility study was conducted in 12 Māori households living in Palmerston North, New Zealand. Intake of F/V were measured by a 24-h recall and skin carotenoid via Veggie Meter © (VM) on four randomised days during baseline, followed by a washout period of five weeks. The intervention study commenced with participants receiving a weekly free box of F/V (enough to feed the entire household according to guidelines). The same measurements were repeated. Feasibility of both instruments were analysed by Pearson and Spearman correlation. Significance was set as p <0.05. Results: There was no significant difference in the mean total F/V servings across the study. Median servings and intake of fruit were significantly different between baseline and endpoint (p = 0.05). Only one (8%) participant met the MoH daily recommendations of 5 servings of vegetables and 2 servings of fruits at baseline, and four participants (50%) at endpoint. Spearman’s rho correlation showed no association between VM scores and self-reported F/V intake (p = 0.50). A significant correlation was found between those with a ≥250 VM score and intake of yellow-vitamin-A F/V and F/V at baseline (p = 0.04) and intervention (p = 0.03). Conclusion: The developed multiple-pass 24-h recall was a feasible tool to assess F/V intake in low-income Māori income. To improve quality of data collection, more training and support for the research assistants is needed. Measuring skin carotenoids as a method to measure vitamin A F/V is feasible, but may not be the best to objectively measure F/V.
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    Māma ki tama : feeding families in a food insecure environment : a qualitative study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Human Nutrition at Massey University, Albany, New Zealand
    (Massey University, 2021) Urlich, Joanne Lisa
    Background: More than one in five children in New Zealand live in food poverty, meaning that they live without access to sufficient wholesome food for good health. Evidence suggests that Māori Mothers are more likely to experience food insecurity due to inequities in income, education, employment, and housing security. To achieve and maintain optimal health, a healthy diet is vital. Understanding food security experiences and perspectives which can impact nutrition status is necessary to improve health outcomes and reduce healthcare costs. Kaitaia is a small town located in the Far North of New Zealand that serves a scattered population of around 21,000, where there is a high prevalence of socioeconomic deprivation contributing to poor health outcomes. This study aimed to explore the perspectives and experiences of Māori mothers living in Kaitaia and their strategies to meet food access needs for their whānau (family). Methodology: An inductive approach was undertaken to allow findings to emerge from the data. In-depth unstructured interviews were conducted with twenty Māori mothers living in the Kaitaia region who had at least one child aged two years or younger. Interviews investigated dietary habits and routines, methods of food procurement, nutrition knowledge, skills and perceptions towards healthy food. Demographic characteristics of the participants were collected using a questionnaire. Recorded interviews were transcribed and thematic analysis using NVivo was undertaken to identify, analyse and report themes emerging from the data. Results: Three key themes were identified. Firstly, ensuring the whānau are fed, secondly accessing food from multiple avenues is a time-consuming journey and finally the need to cope with the unexpected and unplanned. Being well-connected to whānau, community groups, support services and having online digital access was pivotal for Māori mothers to meet whānau food needs. Conclusions: Māori mothers placed priority on ensuring that their whānau are fed, with cost and taste of food the driving factors in food purchase decisions. Connections were key to navigate multiple avenues to access food and to cope with unexpected and unplanned circumstances.