The Select Committee Report on Obesity (2004): The significant omission of parental views of their children's eating

Many studies have reported increasing levels of obesity and overweight in children. Recent policy developments have examined a range of influences on children's eating habits but have left largely unexamined the role of parents in general and mothers in particular. In this study we examined mothers’ understandings of healthy eating and of their influence on their children's eating patterns. Semi-structured interviews were conducted with nine mothers of children aged between 4 and 12 years of age. Interviewees displayed knowledge of recommended eating practices for their children but distinguished this knowledge from actual eating practices. Avoidance of negative social perceptions, pleasure in eating and opportunities for fast food were regarded as more important than eating in accordance with recommended nutritional guidelines. Moreover, the food choices made were viewed as positive alternatives to eating based on nutritional balance. These views pose a challenge for policy initiatives to address obesity and excess weight in children. Future initiatives should have increased regard for the everyday contexts within which children's eating patterns are understood and justified.

A critical analysis of crisis escalation models : understanding stages and severity in infrastructure disturbance

A range of authors from the risk management, crisis management, and crisis communications literature have proposed different models as a means of understanding components of crisis. A generic component of these sources has focused on preparedness practices before disturbance events and response practices during events. This paper provides a critical analysis of three key explanatory models of how crises escalate highlighting the strengths and limitations of each approach. The paper introduces an optimised conceptual model utilising components from the previous work under the four phases of pre-event, response, recovery, and post-event. Within these four phases, a ten step process is introduced that can enhance understanding of the progression of distinct stages of disturbance for different types of events. This crisis evolution framework is examined as a means to provide clarity and applicability to a range of infrastructure failure contexts and provide a path for further empirical investigation in this area.

Anthropometry and body composition of Indonesian adults : an evaluation of body image, eating behaviours, and physical activity

This thesis examines the characteristics of anthropometry and body composition in Indonesian adults and some of the risk factors including body image, eating behaviours, and physical activity. Examination on body image, eating behaviours, and physical activity demonstrates significant correlations with anthropometry and body composition in Indonesian adults. The study also identified body image distortion in some of the participants and provides suggestions for intervention development addressed to the groups of participants which have been identified as having a distorted body image.

The role of intensity of interval training on fat oxidation and eating behaviour in overweight/obese men

The increasing prevalence of obesity in society has been associated with a number of atherogenic risk factors such as insulin resistance. Aerobic training is often recommended as a strategy to induce weight loss, with a greater impact of high-intensity levels on cardiovascular function and insulin sensitivity, and a greater impact of moderate-intensity levels on fat oxidation. Anaerobic high-intensity (supramaximal) interval training has been advocated to improve cardiovascular function, insulin sensitivity and fat oxidation. However, obese individuals tend to have a lower tolerance of high-intensity exercise due to discomfort. Furthermore, some obese individuals may compensate for the increased energy expenditure by eating more and/or becoming less active. Recently, both moderate- and high-intensity aerobic interval training have been advocated as alternative approaches. However, it is still uncertain as to which approach is more effective in terms of increasing fat oxidation given the issues with levels of fitness and motivation, and compensatory behaviours. Accordingly, the objectives of this thesis were to compare the influence of moderate- and high-intensity interval training on fat oxidation and eating behaviour in overweight/obese men. Two exercise interventions were undertaken by 10-12 overweight/obese men to compare their responses to study variables, including fat oxidation and eating behaviour during moderate- and high-intensity interval training (MIIT and HIIT). The acute training intervention was a methodological study designed to examine the validity of using exercise intensity from the graded exercise test (GXT) - which measured the intensity that elicits maximal fat oxidation (FATmax) - to prescribe interval training during 30-min MIIT. The 30-min MIIT session involved 5-min repetitions of workloads 20% below and 20% above the FATmax. The acute intervention was extended to involve HIIT in a cross-over design to compare the influence of MIIT and HIIT on eating behaviour using subjective appetite sensation and food preference through the liking and wanting test. The HIIT consisted of 15-sec interval training at 85 %VO2peak interspersed by 15-sec unloaded recovery, with a total mechanical work equal to MIIT. The medium term training intervention was a cross-over 4-week (12 sessions) MIIT and HIIT exercise training with a 6-week detraining washout period. The MIIT sessions consisted of 5-min cycling stages at ±20% of mechanical work at 45 %VO2peak, and the HIIT sessions consisted of repetitive 30-sec work at 90 %VO2peak and 30-sec interval rests, during identical exercise sessions of between 30 and 45 mins. Assessments included a constant-load test (45 %VO2peak for 45 mins) followed by 60-min recovery at baseline and the end of 4-week training, to determine fat oxidation rate. Participants’ responses to exercise were measured using blood lactate (BLa), heart rate (HR) and rating of perceived exertion (RPE) and were measured during the constant-load test and in the first intervention training session of every week during training. Eating behaviour responses were assessed by measuring subjective appetite sensations, liking and wanting and ad libitum energy intake. Results of the acute intervention showed that FATmax is a valid method to estimate VO2 and BLa, but is not valid to estimate HR and RPE in the MIIT session. While the average rate of fat oxidation during 30-min MIIT was comparable with the rate of fat oxidation at FATmax (0.16 ±0.09 and 0.14 ±0.08 g/min, respectively), fat oxidation was significantly higher at minute 25 of MIIT (P≤0.01). In addition, there was no significant difference between MIIT and HIIT in the rate of appetite sensations after exercise, but there was a tendency towards a lower rate of hunger after HIIT. Different intensities of interval exercise also did not affect explicit liking or implicit wanting. Results of the medium-term intervention indicated that current interval training levels did not affect body composition, fasting insulin and fasting glucose. Maximal aerobic capacity significantly increased (P≤0.01) (2.8 and 7.0% after MIIT and HIIT respectively) during GXT, and fat oxidation significantly increased (P≤0.01) (96 and 43% after MIIT and HIIT respectively) during the acute constant-load exercise test. RPE significantly decreased after HIIT greater than MIIT (P≤0.05), and the decrease in BLa was greater during the constant-load test after HIIT than MIIT, but this difference did not reach statistical significance (P=0.09). In addition, following constant-load exercise, exercise-induced hunger and desire to eat decreased after HIIT greater than MIIT but were not significant (p value for desire to eat was 0.07). Exercise-induced liking of high-fat sweet (HFSW) and high-fat non-sweet (HFNS) foods increased after MIIT and decreased after HIIT (p value for HFNS was 0.09). The intervention explained 12.4% of the change in fat intake (p = 0.07). This research is significant in that it confirmed two points in the acute study. While the rate of fat oxidation increased during MIIT, the average rate of fat oxidation during 30-min MIIT was comparable with the rate of fat oxidation at FATmax. In addition, manipulating the intensity of acute interval exercise did not affect appetite sensations and liking and wanting. In the medium-term intervention, constant-load exercise-induced fat oxidation significantly increased after interval training, independent of exercise intensity. In addition, desire to eat, explicit liking for HFNS and fat intake collectively confirmed that MIIT is accompanied by a greater compensation of eating behaviour than HIIT. Findings from this research will assist in developing exercise strategies to provide obese men with various training options. In addition, the finding that overweight/obese men expressed a lower RPE and decreased BLa after HIIT compared with MIIT is contrary to the view that obese individuals may not tolerate high-intensity interval training. Therefore, high-intensity interval training can be advocated among the obese adult male population. Future studies may extend this work by using a longer-term intervention.

Prevalence and correlates of sleep disturbance in post-menopausal Australian women : the Healthy Aging of Women (HOW) study

Background: Sleep disturbance in midlife women has been studied extensively, although less is known about sleep after menopause. This study examined the relative impact of socio-demographics, modifiable lifestyle factors, and health status on sleep disturbance in post-menopausal women from Queensland, Australia. Methods: The longitudinal Healthy Aging of Women (HOW) study examines health-related quality of life (HRQOL measured by SF-12©), chronic illness, modifiable lifestyle factors such as physical activity, alcohol consumption, smoking, and sleep disturbance (General Sleep Disturbance Scale, GSDS ≥ 43 represent poor sleep) in midlife and older women from low and high socio-economic, rural and urban areas of South-East Queensland, Australia. This paper presents cross-sectional data from the 322 women, aged 60-70 years, participating in the HOW study in 2011. Results: For women in this study, sleep disturbance was relatively common, with 23% (n = 83) reporting poor sleeping (GSDS ≥ 43). Sleep disturbance scores were strongly correlated with being unemployed or on a disability support pension (β = 18.69, P < 0.01), sedentary lifestyle (β = 23.84, P < 0.01), and lower mental (β = -0.60, P <0.01) and physical health-related quality of life scores (β = -0.32, P = 0.01), and these variables explained almost one third of variance in sleep disturbance scores (ηρ² = 29%). Conclusions: Multivariable analysis revealed that sleep disturbance was correlated with physical and mental health-related quality of life, disability, and sedentary lifestyle, but not other lifestyle and socio-demographic characteristics. It may be however, that modifiable lifestyle factors may indirectly impact on sleep by influencing health status.

Individual variability in compensatory eating following acute exercise in overweight and obese women

Background While compensatory eating following acute aerobic exercise is highly variable, little is known about the underling mechanisms that contribute to alterations in exercise-induced eating behaviour. Methods Overweight and obese women (BMI = 29.6 ± 4.0kg.m2) performed a bout of cycling individually tailored to expend 400kcal (EX), or a time-matched no exercise control condition in a randomised, counter-balanced order. Sixty minutes after the cessation of exercise, an ad libitum test meal was provided. Substrate oxidation and subjective appetite ratings were measured during exercise/time-matched rest, and during the period between the cessation of exercise and food consumption. Results While ad libitum EI did not differ between EX and the control condition (666.0 ± 203.9kcal vs. 664.6 ± 174.4kcal, respectively; ns), there was marked individual variability in compensatory energy intake (EI). The difference in EI between EX and the control condition ranged from -234.3 to +278.5kcal. Carbohydrate oxidation during exercise was positively associated with post-exercise EI, accounting for 37% of the variance in EI (r = 0.57; p = 0.02). Conclusions These data indicate that capacity of acute exercise to create a short-term energy deficit in overweight and obese women is highly variable. Furthermore, exercise-induced CHO oxidation can explain part of the variability in acute exercise-induced compensatory eating. Post-exercise compensatory eating could serve as an adaptive response to facilitate the restoration of carbohydrate balance.

Hush-a-by mummy : interactions between co-sleeping and maternal sleep disturbance

Childbirth is an extraordinary, everyday experience; in 2011, 301 617 infants were born in Australia [1], resulting in countless potential occurrences of sleep disturbance and subsequent daytime sleepiness. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, comparatively postpartum women have been overlooked. Previous research has reported slower reaction times to the Psychomotor Vigilance Task [2] and shorter sleep onset in the multiple sleep latency test [3] in new mothers compared with control women. However little is known about change in sleep and sleepiness over time or potential interactions with infant care behaviour choices, such as co-sleeping (mother and infant sharing a bed). This study aims to investigate change in new mothers sleep quantity, sleep quality and resulting daytime sleepiness over postpartum weeks 6, 12 and 18, while evaluating the impact of co-sleeping.

Child eating behaviour outcomes of an early feeding intervention to reduce risk indicators for child obesity : the NOURISH RCT

Objective Describe parent-reported child eating behaviour and maternal parenting impact outcomes of an infant feeding intervention to reduce child obesity risk. Design and Methods An assessor masked Randomised Controlled Trial (RCT) with concealed allocation of individual mother-infant dyads. The NOURISH RCT enrolled 698 first-time mothers (mean age 30.1 years, SD=5.3) with healthy term infants (51% female) aged 4.3 months (SD=1.0) at baseline. Outcomes were assessed six months post-intervention when the children were 2-years old. Mothers reported on child eating behaviours using the Child Eating Behaviour Questionnaire (CEBQ), food preferences and dietary intake using a 24-hour telephone recall. Parenting was assessed using five scales validated for use in Australia. Results Intervention effects were evident on the CEBQ overall (MANOVA P=.002) and 4/8 subscales: child satiety responsiveness (P=.03), fussiness (P=.01), emotional overeating (P<.01), and food responsiveness (P=.06). Intervention children ‘liked’ more fruits (P<.01) and fewer non-core foods and beverages (Ps=.06, .03). The intervention mothers reported greater ‘autonomy encouragement’ (P=.002) Conclusions Anticipatory guidance on protective feeding practices appears to have modest positive impacts on child eating behaviours that are postulated to reduce future obesity risk.

Thinking about internal states, a qualitative investigation into metacognitions in women with eating disorders

Background There is a need for qualitative research to help develop case conceptualisations to guide the development of Metacognitive Therapy interventions for Eating Disorders. Method A qualitative study informed by grounded theory methodology was conducted involving open-ended interviews with 27 women aged 18–55 years, who were seeking or receiving treatment for a diagnosed ED. Results The categories identified in this study appeared to be consistent with a metacognitive model including constructs of a Cognitive Attentional Syndrome and metacognitive beliefs. These categories appear to be transdiagnostic, and the interaction between the categories is proposed to explain the maintenance of EDs. Conclusions The transdiagnostic model proposed may be useful to guide the development of future metacognitive therapy interventions for EDs with the hope that this will lead to improved outcomes for individuals with EDs.

Maternal report of young children's eating styles. Validation of the Children's Eating Behaviour Questionnaire in three ethnically diverse Australian samples

The aim of this study was to validate the Children’s Eating Behaviour Questionnaire (CEBQ) in three ethnically and culturally diverse samples of mothers in Australia. Confirmatory factor analysis utilising structural equation modelling examined whether the established 8-factor model of the CEBQ was supported in our three populations: (i) a community sample of first-time mothers allocated to the control group of the NOURISH trial (mean child age = 24 months [SD = 1]; N = 244); (ii) a sample of immigrant Indian mothers of children aged 1–5 years (mean age = 34 months [SD = 14]; N = 203), and (iii) a sample of immigrant Chinese mothers of children aged 1–4 years (mean age = 36 months [SD = 14]; N = 216). The original 8-factor model provided an acceptable fit to the data in the NOURISH sample with minor post hoc re-specifications (two error covariances on Satiety Responsiveness and an item-factor covariance to account for a cross-loading of an item (Fussiness) on Satiety Responsiveness). The re-specified model showed reasonable fit in both the Indian and Chinese samples. Cronbach’s α estimates ranged from .73 to .91 in the Australian sample and .61–.88 in the immigrant samples. This study supports the appropriateness of the CEBQ in the multicultural Australian context.

Preventing eating disorders

THE first thing to remember is that eating disorders* are seldom “caused” by one sole factor. Eating disorders arise as the result of many factors, many of which medical science has not yet identified or understood. Moreover, young people are influenced by numerous forces beside the dance class – such as family, school, society, the media – over which a dance teacher has no control.

The transdiagnostic nature of metacognitions in women with eating disorders

There is emerging evidence for the important role of metacognitions in the presentation of eating disorders (EDs); however it is unclear to what extent these metacognitions are transdiagnostic. This study used a mixed methods convergent design to explore this question by triangulating both qualitative and quantitative data from 27 women, aged 18–55 years, with diagnoses of anorexia nervosa, bulimia nervosa, or eating disorders not otherwise specified. The results indicated that metacognitions in EDs may be transdiagnostic and may in part explain temporal migration between diagnoses and the degree of comorbidity associated with EDs.

Confirmatory factor analysis of the baby eating behaviour questionnaire and associations with infant weight, gender and feeding mode in an Australian sample

The aim of this study was to evaluate the factor structure of the Baby Eating Behaviour Questionnaire (BEBQ) in an Australian community sample of mother-infant dyads. A secondary aim was to explore the relationship between the BEBQ subscales and infant gender, weight and current feeding mode. Confirmatory factor analysis (CFA) utilising structural equation modelling examined the hypothesised 4-factor model of the BEBQ. Only mothers (N=467) who completed all items on the BEBQ (infant age: M=17 weeks, SD=3 weeks) were included in the analysis. The original 4-factor model did not provide an acceptable fit to the data due to poor performance of the Satiety responsiveness factor. Removal of this factor (3 items) resulted in a well-fitting 3-factor model. Cronbach’s α was acceptable for the Enjoyment of food (α=0.73), Food responsiveness (α=0.78) and Slowness in eating (α=0.68) subscales but low for the Satiety responsiveness (α=0.56) subscale. Enjoyment of food was associated with higher infant weight whereas Slowness in eating and Satiety responsiveness were both associated with lower infant weight. Differences on all four subscales as a function of feeding mode were observed. This study is the first to use CFA to evaluate the hypothesised factor structure of the BEBQ. Findings support further development work on the Satiety responsiveness subscale in particular, but confirm the utility of the Enjoyment of food, Food responsiveness and Slowness in eating subscales.

Genotoxicity of inorganic lead salts and disturbance of microtubule function

Lead compounds are known genotoxicants, principally affecting the integrity of chromosomes. Lead chloride and lead acetate induced concentration-dependent increases in micronucleus frequency in V79 cells, starting at 1.1 μM lead chloride and 0.05 μM lead acetate. The difference between the lead salts, which was expected based on their relative abilities to form complex acetato-cations, was confirmed in an independent experiment. CREST analyses of the micronuclei verified that lead chloride and acetate were predominantly aneugenic (CREST-positive response), which was consistent with the morphology of the micronuclei (larger micronuclei, compared with micronuclei induced by a clastogenic mechanism). The effects of high concentrations of lead salts on the microtubule network of V79 cells were also examined using immunofluorescence staining. The dose effects of these responses were consistent with the cytotoxicity of lead(II), as visualized in the neutral-red uptake assay. In a cell-free system, 20-60 μM lead salts inhibited tubulin assembly dose-dependently. The no-observed-effect concentration of lead(II) in this assay was 10 μM. This inhibitory effect was interpreted as a shift of the assembly/disassembly steady-state toward disassembly, e.g., by reducing the concentration of assembly-competent tubulin dimers. The effects of lead salts on microtubule-associated motor-protein functions were studied using a kinesin-gliding assay that mimics intracellular transport processes in vitro by quantifying the movement of paclitaxel-stabilized microtubules across a kinesin-coated glass surface. There was a dose-dependent effect of lead nitrate on microtubule motility. Lead nitrate affected the gliding velocities of microtubules starting at concentrations above 10 μM and reached half-maximal inhibition of motility at about 50 μM. The processes reported here point to relevant interactions of lead with tubulin and kinesin at low dose levels.