Explaining the intention-behaviour gap in gluten-free diet adherence: the moderating roles of habit and perceived behavioural control

Adherence to a strict gluten-free diet is the only treatment for coeliac disease. Nonetheless, many individuals with the disease struggle to achieve and maintain strict adherence. While the theory of planned behaviour is useful for predicting gluten-free diet adherence, an intention-behaviour gap remains. The aim of this study was to investigate the roles of habit and perceived behavioural control in moderating the intention-behaviour relationship in gluten-free diet adherence. A significant three-way interaction was found such that the association between intention and adherence was dependent on both perceived behavioural control and habit. Implications for both theory and intervention design are discussed.

Functional extruded snack products based on chickpea (Cicer arietinum L.) and fenugreek (Trigonella foenum-graecum) flours

Background – Chickpea and fenugreek are both legumes that confer several nutritional and functional virtues, especially to diabetes and associated metabolic syndrome conditions. They are high in protein and fibre, low in fat and prove to be low glycaemic. They also provide a gluten-free alternative to those suffering from celiac disease. Though these seeds are locally available, hardly any products appear on the supermarket shelves.
Objectives – The aim was to utilise the health and nutritional benefits of chickpea and fenugreek and develop acceptable snack products by extrusion technology.
Design – Preliminary trials were conducted with different proportions of rice and chickpea at a range of extruder conditions to optimise the raw material and processing conditions. Studies were then conducted at optimum processing conditions using a 7:3 chickpea and rice combination replacing with 2% fenugreek or 5, 10, 15 and 20% FenuLifeÒ (deodorized fenugreek powder). Products were evaluated for their physical (expansion, crunchiness and colour) and sensory ( texture, colour, flavour and overall acceptability) characteristics in order to identify their suitability as snack products.
Outcomes – Addition of chickpea up to 70% with rice showed increased expansion and stable product characteristics. Addition of fenugreek and FenuLifeÒ, indicated slight reduction in product expansion (radial) and crunchiness. However, the product made with 20% FenuLifeÒ had significant changes in expansion, crunchiness and colour values. The median scores of sensory evaluation indicated that all products were within the acceptable range. Inclusion of fenugreek showed lower ratings for flavour due to the strong bitter taste of fenugreek. There were no significant differences between products containing FenuLifeÒ (5-15%) in their colour, flavour, texture and overall quality.
Conclusion – This study demonstrates an opportunity for using chickpea and fenugreek in functional product development. Fenugreek in the form of deodorize powder (fenulifeÒ) could be incorporated up to 15% in a mixture of chickpea and rice to develop snack products of acceptable physical and sensory properties.

Phytochemicals and biofunctional properties of buckwheat: a review

A growing trend for nutraceutical and gluten-free cereal-based products highlights the need for development of new products. Buckwheat is one of the potential candidates for such products and the present paper reviews the functional and nutraceutical compounds present in common buckwheat (Fagopyrum esculentum) and tartary buckwheat (Fagopyrum tataricum). The vital functional substances in buckwheat are flavonoids, phytosterols, fagopyrins, fagopyritols, phenolic compounds, resistant starch, dietary fibre, lignans, vitamins, minerals and antioxidants, which make it a highly active biological pseudocereal. Cholesterol-lowering effects that lessen the problems of constipation and obesity are important health benefits that can be achieved through the functional substances of buckwheat.

Blood pressure response to dietary modifications in free-living individuals 1,2

A diet rich in fruits, vegetables, and low-fat dairy foods has been shown to lower blood pressure (BP) when all foods are provided. We compared the effect on BP (measured at home) of 2 different self-selected diets: a low-sodium, high-potassium diet, rich in fruit and vegetables (LNAHK) and a high-calcium diet rich in low-fat dairy foods (HC) with a moderate-sodium, high-potassium, high-calcium DASH-type diet, high in fruits, vegetables and low-fat dairy foods (OD). Subjects were randomly allocated to 2 test diets for 4 wk, the OD and either LNAHK or HC diet, each preceded by a 2 wk control diet (CD). The changes in BP between the preceding CD period and the test diet period (LNAHK or HC) were compared with the change between the CD and the OD periods. Of the 56 men and 38 women that completed the OD period, 43 completed the LNAHK diet period and 48 the HC diet period. The mean age was 55.6 ± 9.9 (±SD) years. There was a fall in systolic pressure between and the CD and OD [-1.8 ± 0.5 mm Hg (P < 0.001)]. Compared with OD, systolic and diastolic BPs fell during the LNAHK diet period [-3.5 ± 1.0 (P < 0.001) and -1.9 ± 0.7 (P < 0.05) mmHg, respectively] and increased during the HC diet period [+3.1 ± 0.9 (P < 0.01) and +0.8 ± 0.6 (P = 0.15) mm Hg, respectively]. A self-selected low-sodium, high-potassium diet resulted in a greater fall in BP than a multifaceted OD, confirming the beneficial effect of dietary intervention on BP in a community setting.

Lupin kernel fibre-enriched foods beneficially modify serum lipids in men

Objective: To examine the effect of a diet containing a novel legume food ingredient, Australian sweet lupin (Lupinus angustifolius) kernel fibre (LKFibre), compared to a control diet without the addition of LKFibre, on serum lipids in men.

Design: Randomized crossover dietary intervention study.

Setting: Melbourne, Australia — Free-living men.

Subjects: A total of 38 healthy males between the ages of 24 and 64 y completed the intervention.

Intervention: Subjects consumed an LKFibre and a control diet for 1 month each. Both diets had the same background menus with seven additional experimental foods that either contained LKFibre or did not. Depending on energy intake, the LKFibre diet was designed to contain an additional 17 to 30 g/day fibre beyond that of the control diet.

Results: Compared to the control diet, the LKFibre diet reduced total cholesterol (TC) (meanplusminuss.e.m.; 4.5plusminus1.7%; P=0.001), low-density lipoprotein cholesterol (LDL-C) (5.4plusminus2.2%; P=0.001), TC: high-density lipoprotein cholesterol (HDL-C) (3.0plusminus2.0%; P=0.006) and LDL-C:HDL-C (3.8plusminus2.6%; P=0.003). No effects on HDL-C, triacylglycerols, glucose or insulin were observed.

Conclusions: Addition of LKFibre to the diet provided favourable changes to some serum lipid measures in men, which, combined with its high palatability, suggest this novel ingredient may be useful in the dietary reduction of coronary heart disease risk.

Lupin kernel fibre foods improve bowel function and beneficially modify some putative faecal risk factors for colon cancer in men.

Consumption of some dietary fibres may benefit bowel health; however, the effect of Australian sweet lupin (Lupinus angustifolius) kernel fibre (LKFibre) is unknown. The present study examined the effect of a high-fibre diet containing LKFibre on bowel function and faecal putative risk factors for colon cancer compared to a control diet without LKFibre. Thirty-eight free-living, healthy men consumed an LKFibre and a control diet for 1 month each in a single-blind, randomized, crossover study. Depending on subject energy intake, the LKFibre diet was designed to provide 17–30 g/d fibre (in experimental foods) above that of the control diet. Bowel function self-perception, frequency of defecation, transit time, faecal output, pH and moisture, faecal levels of SCFA and ammonia, and faecal bacterial [ß]-glucuronidase activity were assessed. In comparison to the control diet, the LKFibre diet increased frequency of defecation by 0·13 events/d (P = 0·047), increased faecal output by 21 % (P = 0·020) and increased faecal moisture content by 1·6 % units (P = 0·027), whilst decreasing transit time by 17 % (P = 0·012) and decreasing faecal pH by 0·26 units (P < 0·001). Faecal butyrate concentration was increased by 16 % (P = 0·006), butyrate output was increased by 40 % (P = 0·002) and [ß]-glucuronidase activity was lowered by 1·4 µmol/h per g wet faeces compared to the control diet (P < 0·001). Addition of LKFibre to the diet incorporated into food products improved some markers of healthy bowel function and colon cancer risk in men.

Dietary counseling to increase natural folate intake: a ransomized placebo-controlled trial in free-living subjects to assess effects on serum folate and plasma total homocysteine.

BACKGROUND: The association between vascular disease and elevated plasma total homocysteine (tHcy) concentrations is caused, in part, by inadequate intakes of dietary folate. Increasing folate intake either through supplements or foods naturally rich in folates has been shown to decrease tHcy concentrations. OBJECTIVE: The aim of this study was to determine whether a similar reduction in tHcy was possible in free-living persons receiving dietary counseling. DESIGN: The study included a 4-wk placebo-controlled dietary intervention trial in which participants consumed either unfortified breakfast cereal (control group) or an extra 350 micro g folate derived from food/d (dietary group). Serum folate and tHcy concentrations in both groups were measured before and after the intervention period, and the concentrations in the dietary group were also measured 17 wk after the intervention period. RESULTS: During the 4-wk intervention, mean dietary folate intake in the dietary group increased from 263 (95% CI: 225, 307) to 618 micro g/d (535, 714), resulting in a mean increase in serum folate of 37% (15%, 63%) and a decrease in tHcy from 12.0 (10.9, 13.3) to 11.3 micro mol/L (10.2, 12.5). A further decrease in tHcy occurred in the dietary group during follow-up, with a final tHcy concentration of 9.7 micro mol/L (8.8, 10.8). CONCLUSIONS: Increasing natural folate intake improved folate status and decreased tHcy concentrations to an extent that may significantly reduce the risk of vascular disease. Dietary modification may have advantages over folic acid fortification because the altered food-consumption patterns lead to increased intakes of several vitamins and minerals and decreased intakes of saturated fatty acids.

Sydney principles for reducing the commercial promotion of foods and beverages to children

A set of seven principles (the ‘Sydney Principles’) was developed by an International Obesity Taskforce (IOTF) Working Group to guide action on changing food and beverage marketing practices that target children. The aim of the present communication is to present the Sydney Principles and report on feedback received from a global consultation (November 2006 to April 2007) on the Principles.

The Principles state that actions to reduce marketing to children should: (i) support the rights of children; (ii) afford substantial protection to children; (iii) be statutory in nature; (iv) take a wide definition of commercial promotions; (v) guarantee commercial-free childhood settings; (vi) include cross-border media; and (vii) be evaluated, monitored and enforced.

The draft principles were widely disseminated and 220 responses were received from professional and scientific associations, consumer bodies, industry bodies, health professionals and others. There was virtually universal agreement on the need to have a set of principles to guide action in this contentious area of marketing to children. Apart from industry opposition to the third principle calling for a statutory approach and several comments about the implementation challenges, there was strong support for each of the Sydney Principles. Feedback on two specific issues of contention related to the age range to which restrictions should apply (most nominating age 16 or 18 years) and the types of products to be included (31 % nominating all products, 24 % all food and beverages, and 45 % energy-dense, nutrient-poor foods and beverages).

The Sydney Principles, which took a children’s rights-based approach, should be used to benchmark action to reduce marketing to children. The age definition for a child and the types of products which should have marketing restrictions may better suit a risk-based approach at this stage. The Sydney Principles should guide the formation of an International Code on Food and Beverage Marketing to Children.

Reducing sodium in foods ; the effect on flavour and consumers' perception

As the majority of people's sodium intake is via processed foods, the effective sodium reduction strategy is to reduce the sodium levels in processed foods.  The aims of the thesis were to determine the flavor characteristics of reduced sodium foods and to investigate how food lables affect consumers' expectation and liking.

Caffeine increases sugar-sweetened beverage consumption in a free-living population: a randomised controlled trial

Excessive sugar-sweetened beverage (SSB) consumption has been associated with overweight and obesity. Caffeine is a common additive to SSB, and through dependence effects, it has the potential to promote the consumption of caffeine-containing foods. The objective of the present study was to assess the influence that caffeine has on the consumption of SSB. Participants (n 99) were blindly assigned to either a caffeinated SSB (C-SSB) or a non-caffeinated SSB (NC-SSB) group. Following randomisation, all participants completed a 9 d flavour-conditioning paradigm. They then completed a 28 d ad libitum intake intervention where they consumed as much or as little of C-SSB or NC-SSB as desired. The amount consumed (ml) was recorded daily, 4 d diet diaries were collected and liking of SSB was assessed at the start and end of the intervention. Participants (n 50) consuming the C-SSB had a daily SSB intake of 419 (sd 298) ml (785 (sd 559) kJ/d) over the 28 d intervention, significantly more than participants (n 49) consuming the NC-SSB (273 (sd 278) ml/d, 512 (sd 521) kJ/d) (P< 0·001). A trained flavour panel (n 30) found no difference in flavour between the C-SSB and NC-SSB (P>0·05). However, participants who consumed the C-SSB liked the SSB more than those who consumed the NC-SSB (6·3 v. 6·0 on a nine-point hedonic scale, P= 0·022). The addition of low concentrations of caffeine to the SSB significantly increases the consumption of the SSB. Regulating caffeine as a food additive may be an effective strategy to decrease the consumption of nutrient-poor high-energy foods and beverages.