Innovations in dietary interventions : Use of a photographic food diary method and telephone linked computerized care in chronic disease

Access to dietetic care is important in chronic disease management and innovative technologies assists in this purpose. Photographic dietary records (PhDR) using mobile phones or cameras are valid and convenient for patients. Innovations in providing dietary interventions via telephone and computer can also inform dietetic practice. Three studies are presented. A mobile phone method was validated by comparing energy intake (EI) to a weighed food record and a measure of energy expenditure (EE) obtained using the doubly labelled water technique in 10 adults with T2 diabetes. The level of agreement between mean (±sd) energy intake mobile phone (8.2±1.7 MJ) and weighed record (8.5±1.6 MJ) was high (p=0.392), however EI/EE for both methods gave similar levels of under-reporting (0.69 and 0.72). All subjects preferred using the mobile phone vs. weighed record. Nineteen individuals with Parkinsons disease kept 3-day PhDRs on three occasions using point-and-shoot digital cameras over a 12 week period. The camera was rated as easy to use by 89%, keeping a PhDR was considered acceptable by 94% and none would rather use a “pen and paper” method. Eighty-three percent felt confident to use the camera again to record intake. An interactive, automated telephone system designed to coach people with T2 diabetes to adopt and maintain diabetes self-care behaviours, including nutrition, showed trends for improvements in total fat, saturated fat and vegetable intake of the intervention group compared to control participants over 6 months. Innovative technologies are acceptable to patients with chronic conditions and can be incorporated into dietetic care.

Food literacy : what is it and does it influence what we eat?

"Food literacy" has emerged as a term to describe the everyday practicalities needed for healthy eating. It is increasingly used in policy, practice, research and in the public arena. This thesis empirically defined the term, identified its components, and developed models of its relationship to nutrition and health. Food literacy was examined from two perspectives; that of food experts and that of individuals using the case study of young people experiencing disadvantage. The research provides a common language and conceptualisation of food literacy which is being used by governments, policy-makers and practitioners to guide investment and practice.

Reported consumption of takeaway food and its contribution to socioeconomic inequalities in body mass index

The aim of this study was to examine whether takeaway food consumption mediated (explained) the association between socioeconomic position and body mass index (BMI). A postal-survey was conducted among 1500 randomly selected adults aged between 25 and 64 years in Brisbane, Australia during 2009 (response rate 63.7%, N=903). BMI was calculated using self-reported weight and height. Participants reported usual takeaway food consumption, and these takeaway items were categorised into "healthy" and "less healthy" choices. Socioeconomic position was ascertained by education, household income, and occupation. The mean BMI was 27.1kg/m(2) for men and 25.7kg/m(2) for women. Among men, none of the socioeconomic measures were associated with BMI. In contrast, women with diploma/vocational education (β=2.12) and high school only (β=2.60), and those who were white-collar (β=1.55) and blue-collar employees (β=2.83) had significantly greater BMI compared with their more advantaged counterparts. However, household income was not associated with BMI. Among women, the consumption of "less healthy" takeaway food mediated BMI differences between the least and most educated, and between those employed in blue collar occupations and their higher status counterparts. Decreasing the consumption of "less healthy" takeaway options may reduce socioeconomic inequalities in overweight and obesity among women but not men.

Brief guided imagery and body scanning interventions reduce food cravings

Elaborated Intrusion (EI) Theory proposes that cravings occur when involuntary thoughts about food are elaborated; a key part of elaboration is affectively-charged imagery. Craving can be weakened by working memory tasks that block imagery. EI Theory predicts that cravings should also be reduced by preventing involuntary thoughts being elaborated in the first place. Research has found that imagery techniques such as body scanning and guided imagery can reduce the occurrence of food thoughts. This study tested the prediction that these techniques also reduce craving. We asked participants to abstain from food overnight, and then to carry out 10 min of body scanning, guided imagery, or a control mind wandering task. They rated their craving at 10 points during the task on a single item measure, and before and after the task using the Craving Experience Questionnaire. While craving rose during the task for the mind wandering group, neither the guided imagery nor body scanning group showed an increase. These effects were not detected by the CEQ, suggesting that they are only present during the competing task. As they require no devices or materials and are unobtrusive, brief guided imagery strategies might form useful components of weight loss programmes that attempt to address cravings.

Defining food literacy and its components

Food literacy has emerged as a term to describe the everyday practicalities associated with healthy eating. The term is increasingly used in policy, practice, research and by the public; however, there is no shared understanding of its meaning. The purpose of this research was to develop a definition of food literacy which was informed by the identification of its components. This was considered from two perspectives: that of food experts which aimed to reflect the intention of existing policy and investment, and that of individuals, who could be considered experts in the everyday practicalities of food provisioning and consumption. Given that food literacy is likely to be highly contextual, this second study focused on disadvantaged young people living in an urban area who were responsible for feeding themselves. The Expert Study used a Delphi methodology (round one n = 43). The Young People’s Study used semi-structured, life-course interviews (n = 37). Constructivist Grounded Theory was used to analyse results. This included constant comparison of data within and between studies. From this, eleven components of food literacy were identified which fell into the domains of: planning and management; selection; preparation; and eating. These were used to develop a definition for the term “food literacy”.

The role of food regulation in promoting health

Food regulations are a series of laws and guidelines that focus on food that can be bought and sold in Australia. This system includes laws and regulations that address, food safety, food handling, what ingredients can go in a food, what a food can be called, what information needs to be included on a label, how a food can be advertised and promoted and developing a food industry that is both economically strong and supports the health of Australia's people and it's environment.

The influence of food literacy on the everyday practicalities of meeting nutrition recommendations

Contemporary nutrition policies and plans call for focussing efforts to improve nutrition through a closer connection with food and the everyday practicalities of how people live and eat. Various words have been used to articulate what this might mean in practice. More recently, the term “food literacy” has emerged to explain this gap between the policy aims the (in)ability of people to know, understand and use food to meet nutrition recommendations. Despite its increasing use, there is no common understanding of this term or its components. Once established, food literacy could be measured in order to examine its association with nutritional outcomes. A Delphi study of 43 Australian food experts from diverse sectors and settings explored their understanding of the term “food literacy”, the likely components and possible relationship with nutrition. The three round Delphi study began with a semi-structured telephone interview and was followed by two online surveys. Constructivist grounded theory was used to analyse data, from which a conceptual model of the relationship between food literacy and nutrition was developed. The model was then tested and refined following a phenomenological study of 37 young people aged 16-25 years who were responsible for feeding themselves. They were interviewed about their food intake, day-to-day food decision making, the knowledge and skills used and their perceptions of someone who is “good with food”. Analysis from the Delphi study identified, eighty components of food literacy and these were grouped into eight domains: 1)access, 2)planning and management, 3)selection, 4)knowing where food comes from, 5)preparation, 6)eating, 7)nutrition and 8)food related language. When these were compared to results of the Young People’s study it was found that while specific components of food literacy were largely contextual, the importance of all eight domains continued to be relevant. The results of these qualitative studies have set the boundaries and scope of meaning of food literacy and will be used to inform the development of measurable variables to be tested in a quantitative cross-sectional study. This prospective study will examine the relationship between food literacy and nutrition. This research is useful in guiding government strategy and investment, and informing the planning, implementation and evaluation of interventions by practitioners.

Linking food literacy to nutrition

“Food literacy” is an emerging term used to describe the relative ability to understand the nature of food and how it is important. It also describes the ability to gather, process, analyse and act upon information about food and to apply it in individual settings. A Delphi study of 43 Australian food experts from diverse sectors and settings in all states and territories explored the meaning of food literacy, its constitutive components and how they relate to nutrition. The three-round Delphi began with a semi-structured telephone interview and was followed by two online surveys. Grounded theory was used to develop a conceptual model of the relationship between food literacy and nutrition. It is proposed that food literacy influences nutrition through three related mechanisms of security, choice and pleasure. These mechanisms will be mediated by the local food supply and individual values. The relative importance of components of food literacy will depend upon these mediators. The level of nutrition outcome being sought (for example, dietary guidelines versus food group serves) will also influence the relative importance of these components. This model will be useful in informing program planning and evaluation and will be tested and refined following a phenomenological study of consumers.

Urban Food Security, Urban Resilience and Climate Change

The growing importance of logistics in increasingly globalised production and consumption systems strengthens the case for explicit consideration of the climate risks that may impact on the operation of ports in the future, as well as the formulation of adaptation responses that act to enhance their resilience. Within a logistics chain, seaports are functional nodes of significant strategic importance, and are considered as critical gateways linking local and national supply chains to global markets. However, they are more likely to be exposed to vagaries of climate-related extreme events due to their coastal locations. As such, they need to be adaptive and respond to the projected impacts of climate change, in particular extreme weather events. These impacts are especially important in the logistics context as they could result in varying degrees of business interruption; including business closure in the worst case scenario. Since trans-shipment of freight for both the import and export of goods and raw materials has a significant impact on Australia’s sustained economic growth it was considered important to undertake a study of port functional assets, to assess their vulnerability to climate change, to model the potential impacts of climate-related extreme events, and to highlight possible adaptation responses.

The Impacts of Climate Change on Australia’s Food Production and Export

The global food system is undergoing unprecedented change. With population increases, demands for food globally will continue to rise at the same time that agricultural environments are compromised through urban encroachment, climate change and environmental degradation. Australia has long identified itself as an agricultural exporting nation—but what will its capacity be in feeding an increasing global population as it also comes to terms with extreme climatic events such as the floods, fires and droughts, and reduced water availability, experienced in recent decades? This chapter traces the history of Australian agricultural exports and evaluates its food production and export capacity against scientific predictions of climate change impacts. With the federal government forecasting declines in the production of wheat, beef, dairy and sugar, Australia’s key export commodities may well be compromised. Calls to produce more food using new technologies are likely to generate significant environmental problems. Yet, a radical reconfiguration of Australian agriculture which incorporates alternative approaches, such as agro-ecology, is rarely considered by government and industry.

Climate Change and the Resilience of Commodity Food Production in Australia

The current view of Australian state and national governments about the effects of climate change on agriculture is that farmers – through the adoption of mitigation and adaptation strategies – will remain resilient, and agricultural production will continue to expand. The assumption is that neoliberalism will provide the best ‘free market’ options for climate change mitigation and adaptation in farming. In contrast, we argue that neoliberalism will increase the move towards productivis (‘high-tech’) agriculture – the very system that has caused major environmental damage to the Australian continent. High-tech farming is highly dependent upon access to water and fossil fuels, both of which would appear to be the main limits to production in future decades. Productivist agriculture is a system highly reliant upon fertilizers and fuels that are derived from the petrochemical industry, and are currently increasing in cost as the price of oil increases.

Food security in Australia in an era of neoliberalism, productivism and climate change

For over 150 years Australia has exported bulk, undifferentiated, commodities such as wool, wheat, meat and sugar to the UK and more recently to Japan, Korea, and the Middle East. It is estimated that, each year, Australia's farming system feeds a domestic population of some 22 million people, while exporting enough food to feed another 40 million. With the Australian population expected to double in the next 40 years, and with the anticipated growth in the world's population to reach a level of some 9 billion (from its present level of 7 billion) in the same period, there are strong incentives for an expansion of food production in Australia. Neoliberal settings are encouraging this expansion at the same time as they are facilitating importation of foods, higher levels of foreign direct investment and the commoditisation of resources (such as water). Yet, expansion in food production – and in an era of climate change – will continue to compromise the environment. After discussing Australia's neoliberal framework and its relation to farming, this paper outlines how Australia is attempting to address the issue of food security. It argues that productivist farming approaches that are favoured by both industry and government are proving incapable of bringing about long-term production outcomes that will guarantee national food security.

Food in the city : urban food movements and the (re)imagining of urban spaces

Ethical food movements are growing in number throughout Australia. Amongst these diverse movements are urban agriculture initiatives, which articulate a multitude of social and environmental values. Yet, despite the long history of production and exchange of food in urban areas, planners (and others) often overlook its significance. To assist in addressing this oversight, we take the case study of Melbourne to examine the ways in which participants in urban agriculture are re-imagining urban spaces and the future of agriculture and food systems in Australia. We demonstrate that urban food advocates' politics and practices both challenge and resist the enclosure of urban spaces. This creates new frontiers that transgress social, political, ecological and economic boundaries and edges. These transgressions or counter-enclosures articulate new visions for secure and just food systems and, in so doing, offer insights to assist planners in ensuring Australian cities support socially just and environmentally responsible food systems.

Supermarkets’ governance of the agri-food supply chain : is the ‘corporate-environmental’ food regime evident in Australia?

This article investigates the extent to which the purported greening of food retailing and consumption in Australia is consistent with the development of a corporate-environmental food regime. Recent developments in food regime theory, particularly the concept of an emerging third food regime (the so-called ‘corporate-environmental food regime’), provide a useful organizing framework for understanding recent agri-restructuring trends. We find that, while a globally based, third food regime is becoming more apparent, the attributes that relate to corporate retail-driven greening of the supply chain are less evident within Australia’s domestic market than in its EU counterparts. However, there is some evidence that Australia’s export market is subject to some degree of ‘greening at a distance’ due to private regulations imposed by supermarkets overseas. We argue that while broader agri-restructuring trends may be evident at an international level, elements of greening specific to national contexts are important for determining the trajectory of any third food regime.

Food reward sensitivity predicts overconsumption of high-fat snack food

Overconsumption of snack foods has been linked to rising rates of obesity, with our ‘obesogenic’ environment and its abundance of palatable, high-calorie foods and associated cues especially implicated. However, it is clear that some individuals are particularly susceptible to overconsumption and weight gain. It was hypothesised that individuals sensitive to the rewarding properties of palatable foods, and associated stimuli, would show elevated consumption. Snack food intake was measured in 50 adults (mean age 34.5 years, BMI 23.9 kg/m2, 56% female) in a repeated measures design, both with and without a ‘food cue’. Trait (BIS/BAS scales), behavioural (computerised CARROT) and food reward were assessed. Sensitivity to food reward, but not generalised reward, was positively associated with snack food intake. This relationship was not affected by the presence of a food cue. Findings are discussed in the context of implications for weight management.