Effect of fat replacement by insulin or lupin-kernal fibre on sausage patty acceptability, post-meal perceptions of satiety and food intake in men

The present study examined whether replacing fat with inulin or lupin-kernel fibre influenced palatability, perceptions of satiety, and food intake in thirty-three healthy men (mean age 52 years, BMI 27·4 kg/m²), using a within-subject design. On separate occasions, after fasting overnight, the participants consumed a breakfast consisting primarily of either a full-fat sausage patty (FFP) or a reduced-fat patty containing inulin (INP) or lupin-kernel fibre (LKP). Breakfast variants were alike in mass, protein and carbohydrate content; however the INP and LKP breakfasts were 36 and 37 % lower in fat and 15 and 17 % lower in energy density respectively compared with the FFP breakfast. The participants rated their satiety before breakfast then evaluated patty acceptability. Satiety was rated immediately after consuming the breakfast, then over the subsequent 4·5 h whilst fasting. Food consumed until the end of the following day was recorded. All patties were rated above ‘neither acceptable or unacceptable’, however the INP rated lower for general acceptability (P=0·039) and the LKP lower for flavour (P=0·023) than the FFP. The LKP breakfast rated more satiating than the INP (P=0·010) and FFP (P=0·016) breakfasts. Total fat intake was 18 g lower on the day of the INP (P=0·035) and 26 g lower on the day of the LKP breakfast (P=0·013) than the FFP breakfast day. Energy intake was lower (1521 kJ) only on the day of the INP breakfast (P=0·039). Both inulin and lupin-kernel fibre appear to have potential as fat replacers in meat products and for reducing fat and energy intake in men.

Sensory acceptability of foods containing Australian sweet lupin (Lupinus angustifolius) flour

Foods containing Australian sweet lupin (Lupinus angustifolius) flour (ASLF) were assessed by consumer panelists (n= 54) in comparison to wheat flour (control) and defatted soy flour (DFSF) products. All ASLF products were rated in the acceptable half of the evaluation scale. General acceptability of ASLF chocolate chip cookies and breakfast bars was rated similarly to the control and DFSF variants (P > 0.05). ASLF pasta was rated lower than control but higher than DFSF pasta (P < 0.05), whereas ASLF addition reduced the general acceptability of muffins and bread (P < 0.05) compared with the other variants. Some ASLF products appeared palatable whereas ASLF incorporation rate in others requires reduction.

Consumer acceptability of low fat foods containing inulin and oligofructose

Inulin and oligofructose were used as fat replacers in Anzac cookies, blueberry muffins, carrot cake, chocolate cake, lemon cheesecake, ice cream, and beef sausages at levels ranging from 4 to 13g/100g, achieving a significant reduction in fat content (20% to 80% relative). These foods were rated as acceptable by an untrained taste panel, but scored consistently lower than their full-fat counterparts (controls). Regression analysis showed that, unlike the controls, texture was more important than flavor in determining overall acceptability of the low-fat foods. Inulin and oligofructose are readily incorporated into bakery and meat formulations, but their use might be limited by adverse physiological effects when consumed at high levels.

Exploring the feasibility and acceptability of using internet technology to promote physical activity within a defined community

ISSUE ADDRESSED: To explore the feasibility of using the Internet and e-mail to promote physical activity in a defined community.

METHODS: An online survey was conducted through a community-based Internet Service Provider (ISP). ISP clients were recruited via electronic newsletter and direct e-mail. Data were collected on preferred sources of assistance for physical activity advice and stage of motivational readiness for physical activity.

RESULTS: Valid surveys were completed by 797 (9% response rate). Participants were: 55% men; 56% aged >45 years; 57% worked full time; mean BMI was 28+/-8. Thirty-six per cent were in the early stages of motivational readiness for physical activity. More than 70% were somewhat to extremely interested in having access to a physical activity website.

CONCLUSION: Promoting physical activity via the Internet and e-mail is feasible and appealing to some people. Expanding the reach, appeal and use of this technology to deliver physical activity programs will be a challenge.

Extruded products with Fenugreek (Trigonella foenum-graecium) chickpea and rice: Physical properties, sensory acceptability and glycaemic index

The present study investigated the effects of fenugreek flour (Trigonella foenum-graecum) and debittered fenugreek polysaccharide (FenuLife^®) inclusion on the physical and sensory quality characteristics, and glycaemic index (GI) of chickpea–rice based extruded products. Based on preliminary evaluation with different proportions of chick pea and rice, a blend of 70:30 chickpea and rice was chosen as the control for further studies. The control blend, replaced with fenugreek flour at 2%, 5% and 10%, or fenugreek polysaccharide at 5%, 10%, 15% and 20%, was extruded at the optimum processing conditions as specified in the detailed study. The extruded products were evaluated for their physical (moisture retention, expansion, hardness, water solubility index (WSI) and water absorption index (WAI)), sensory (flavor, texture, color and overall acceptability) characteristics and in vitro GI to evaluate their suitability as extruded snack products.

Due to the distinct bitter taste, inclusion of fenugreek flour was not acceptable at levels more than 2% in extruded chickpea based products. Addition of fenugreek polysaccharide resulted in slight reduction in radial expansion (P < 0.05), while longitudinal expansion increased. WAI increased while WSI decreased compared to the control (P < 0.05). The mean scores of sensory evaluation indicated that all products containing fenugreek polysaccharide up to 15% were within the acceptable range. There were no significant differences (P > 0.05) between products containing 5–15% fenugreek polysaccharide in their color, flavor, texture and overall quality.

Fenugreek, in the form of debittered polysaccharide (FenuLife^®) could be incorporated up to a level of 15% in a chickpea–rice blend to develop snack products of acceptable physical and sensory properties with low GI Index.

Chemical modification of timber decking : assessing the parameters of acceptability

The criteria for accepting or rejecting a technology extend beyond the intrinsic properties of the finished product such as physical performance. There are also extrinsic factors such as the history of the product and trust in the manufacturers and suppliers, as well as the perceptions and risk management strategies of various stakeholder groups. A methodology was trialled to take into account the extended supply chain of the product, while simultaneously engaging stakeholders to determine and to understand their perceptual frameworks. Three pine decking products manufactured using different amounts and types of chemical modification were compared using life cycle assessment and the comments of 114 respondents from six stakeholder groups in New Zealand. The results of the perceptual research include a quadrant diagram which allows a visual comparison of the responses of different stakeholders to actual or hypothetical products, aiding the identification of when and why certain technologies may be disqualified from acceptability or become the topic of public debate.

Acceptability, impact and sustainability of the national pilot quality assurance system for self management programs

Chronic condition self-management education and training interventions such as the Stanford Self Management Programs (SMP) have the capacity to improve health and quality of life of people with chronic conditions whilst reducing the use of health services. This is in line with the outcomes from the recent Council of Australian Governments’ meeting where it was indicated that self-management will be a centrepiece in forthcoming chronic disease initiatives.
Aim: report on a large national pilot quality assurance program involving the implementation and of an evaluation and quality monitoring system for SMPs including the provision of structured feedback to courses course leaders and service providers. During 2005/06 the quality assurance program was implemented at 11 diverse organisations across Australia. The program involved assisting organisations apply the 42-item Health Education Impact Questionnaire (HEIQ), a chronic disease health education outcome measure, and then observe and evaluate the value and impact of the quality program. Interviews with course leaders (n=60) and course participants (n=35) have elicited views about course quality and feedback processes.
Results: The evaluation revealed enablers and barriers to effective implementation and sustainability. Important enablers were:
- Course Leaders and organisations valued an Australia-wide system that provided feedback on course
quality and the impact on participants.
- Course Leaders were strongly personally motivated to respond appropriately to HEI-Q course
report feedback.
- Completing the questionnaire provided participants with the opportunity to reflect on issues that
emerge in the course content and reflect on their progression at the end of the SSMP.
Sustainability issues included:
- Organisations and course leaders require support, training and flexibility on how to administer and
manage the use of the HEI-Q.
- Availability of administrative resources in organisations to support the quality assurance activities.
- The requirement that course leaders are trained in interpreting HEI-Q course report data.
A quality improvement framework was developed which identified the actions required of key stakeholders to
support effective implementation.
Discussion: With the increasing endorsement of SMP across sectors it is important that course quality is known, is acceptable, and is communicated to stakeholders to inform and engender confidence in the SSMP. To effectively implement and sustain a quality improvement program for SMP, the processes and tools for measuring outcomes need to be responsive, flexible and easily integrated into the organisation and delivery of programs.

Evaluating the feasibility, effectiveness and acceptability of an active play intervention for disadvantaged preschool children : a pilot study

Australian children from disadvantaged families are at increased risk of delays in acquiring fundamental movement skills, with physical inactivity and increased risk of the potential consequences of obesity. The aims of this pilot study were to: 1) assess the fundamental movement skills of disadvantaged children; 2) evaluate the feasibility and effectiveness of adapting an existing parenting and child development program to incorporate additional weekly play activities (the intervention); and 3) examine the acceptability of the intervention. Children aged 1.5-5 years were assessed pre-intervention (n = 26) and postintervention (n = 16) over a period of 22 weeks using the gross motor component of the Peabody Developmental Motor Scales - 2nd Edition (PDMS-2) (Folio & Fewell, 2000). Parents completed a demographic and environmental survey and those implementing the intervention were interviewed to assess the feasibility and acceptability of the intervention. Pre-intervention the children from disadvantaged families had locomotion, object manipulation and Gross Motor Quotient (GMQ) scores significantly below the norm-referenced standards of the PDMS-2 (p < 0.05). The intervention was associated with improvements in the locomotion (8.35 to 9.5; p = 0.009), and object manipulation (8.6 to 9.6; p = 0.04) subtest scores and the GMQ scores (92.6 to 99.3; p < 0.01). The intervention was deemed feasible and acceptable by those implementing the program. Low levels of physical activity in disadvantaged communities may be related to delayed acquisition of fundamental movement skills in childhood. This pilot study raises the possibility of correcting this deficit in early childhood, and improving the potential for all children to lead an active life.

Developing a placebo-controlled trial in surgery : issues of design, acceptability and feasibility

Background: Surgical placebos are controversial. This in-depth study explored the design, acceptability, and feasibility issues relevant to designing a surgical placebo-controlled trial for the evaluation of the clinical and cost effectiveness of arthroscopic lavage for the management of people with osteoarthritis of the knee in the UK.
Methods: Two surgeon focus groups at a UK national meeting for orthopaedic surgeons and one regional surgeon focus group (41 surgeons); plenary discussion at a UK national meeting for orthopaedic anaesthetists (130 anaesthetists); three focus groups with anaesthetists (one national, two regional; 58 anaesthetists); two focus groups with members of the patient organisation Arthritis Care (7 participants); telephone interviews with people on consultant waiting lists from two UK regional centres (15 participants); interviews with Chairs of UK ethics committees (6 individuals); postal surveys of members of the British Association of Surgeons of the Knee (382 surgeons) and members of the British Society of Orthopaedic Anaesthetists (398 anaesthetists); two centre pilot (49 patients assessed).
Results: There was widespread acceptance that evaluation of arthroscopic lavage had to be conducted with a placebo control if scientific rigour was not to be compromised. The choice of placebo surgical procedure (three small incisions) proved easier than the method of anaesthesia (general anaesthesia). General anaesthesia, while an excellent mimic, was more intrusive and raised concerns among some stakeholders and caused extensive discussion with local decision-makers when seeking formal approval for the pilot. Patients were willing to participate in a pilot with a placebo arm; although some patients when allocated to surgery became apprehensive about the possibility of receiving placebo, and withdrew. Placebo surgery was undertaken successfully.
Conclusions: Our study illustrated the opposing and often strongly held opinions about surgical placebos, the ethical issues underpinning this controversy, and the challenges that exist even when ethics committee approval has been granted. It showed that a placebo-controlled trial could be conducted in principle, albeit with difficulty. It also highlighted that not only does a placebo-controlled trial in surgery have to be ethically and scientifically acceptable but that it also must be a feasible course of action. The place of placebo-controlled surgical trials more generally is likely to be limited and require specific circumstances to be met. Suggested criteria are presented.

Treatment acceptability and psychosocial outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents

This study explores the impact of a cognitive behavioural lifestyle program, the CHOOSE HEALTH Program, on psychosocial wellbeing in overweight and obese adolescents. The sample comprised 29 male and 34 female adolescents aged 11.5 to 18.9 years (M = 14.3, SD = 1.9) and classified as overweight (n = 15) or obese (n=48). Participantswere randomly allocated to treatment or wait-list control conditions; participants allocated the wait-list condition were offered treatment after 6 months. Adolescents and parents completed self-report measures of psychopathology, psychosocial and family functioning. Treatment did not have detrimental effects on the psychosocial factors assessed. It resulted in significant improvements in weight control behaviour, impulse regulation, social support from family and parent–adolescent problem communication (p<.05). Similar results were obtained with completer and intention-to-treat analyses. Treatment acceptability was high, with all respondents indicating that they made progress. Combined, results indicate that treatment did not have detrimental effects on psychopathology, psychosocial functioning, or family functioning. Treatment resulted in significant improvements in impulse regulation, social support from family and parent–adolescent communication. Thus, parents and professionals can be assured that a comprehensive, multifaceted, parent-supported, cognitive behavioural intervention for overweight and obese adolescents does not cause psychological harm.

Acceptability of a theory of planned behaviour email-based nutrition intervention

This study investigated feasibility and acceptability of a new email-delivered intervention promoting fruit and vegetable consumption in a university-based population of Australian young adults. The study explored whether there are differences in the reported feasibility and acceptability between demographic groups within the population of interest and at three levels of intervention intensity. The email-delivered intervention program consists of an implementation intention ‘planning task’ and between 3 and 15 short email messages over a 15-day study period. The intervention program was developed using the Theory of Planned Behaviour and was designed to modify perceived behavioural control. One hundred and ten participants (mean age = 19.21 years, 25.6% male) completed the feasibility and acceptability questionnaire at Day 15. This questionnaire contained items about all intervention components. High acceptability and feasibility scores were found for all intervention parts and at all levels of intervention intensity. There were few significant differences in the reported acceptability of items between key demographic sub-groups, and no differences in reported acceptability at different levels of intervention intensity. These results suggest that this email-delivered intervention is an acceptable and feasible tool for promoting fruit and vegetable consumption for participants in the target population.