Does high-intensity resistance training maintain bone mass during moderate weight loss in older overweight adults with type 2 diabetes?

The aim was to investigate whether the addition of supervised high intensity progressive resistance training to a moderate weight loss program (RT+WLoss) could maintain bone mineral density (BMD) and lean mass compared to moderate weight loss (WLoss) alone in older overweight adults with type 2 diabetes. We also investigated whether any benefits derived from a supervised RT program could be sustained through an additional home-based program. This was a 12-month trial in which 36 sedentary, overweight adults aged 60 to 80 years with type 2 diabetes were randomized to either a supervised gymnasium-based RT+WLoss or WLoss program for 6 months (phase 1). Thereafter, all participants completed an additional 6-month home-based training without further dietary modification (phase 2). Total body and regional BMD and bone mineral content (BMC), fat mass (FM) and lean mass (LM) were assessed by DXA every 6 months. Diet, muscle strength (1-RM) and serum total testosterone, estradiol, SHBG, insulin and IGF-1 were measured every 3 months. No between group differences were detected for changes in any of the hormonal parameters at any measurement point. In phase 1, after 6 months of gymnasium-based training, weight and FM decreased similarly in both groups (P<0.01), but LM tended to increase in the RT+WLoss (n=16) relative to the WLoss (n=13) group [net difference (95% CI), 1.8% (0.2, 3.5), P<0.05]. Total body BMD and BMC remained unchanged in the RT+WLoss group, but decreased by 0.9 and 1.5%, respectively, in the WLoss group (interaction, P<0.05). Similar, though non-significant, changes were detected at the femoral neck and lumbar spine (L2-L4). In phase 2, after a further 6 months of home-based training, weight and FM increased significantly in both the RT+WLoss (n=14) and WLoss (n=12) group, but there were no significant changes in LM or total body or regional BMD or BMC in either group from 6 to 12 months. These results indicate that in older, overweight adults with type 2 diabetes, dietary modification should be combined with progressive resistance training to optimize the effects on body composition without having a negative effect on bone health.

Consumers' readiness to eat a plant-based diet

Objective: The aim of this study was to examine consumers' readiness to change to a plant-based diet. Design: Mail survey that included questions on readiness to change, eating habits and perceived benefits and barriers to the consumption of a plant-based diet. Setting: Victoria, Australia. Subjects: A total of 415 randomly selected adults. Results: In terms of their readiness to eat a plant-based diet, the majority (58%) of participants were in the precontemplation stage of change, while 14% were in contemplation/preparation, and 28% in action/maintenance. Those in the action/maintenance stage ate more fruit, vegetables, nuts, seeds, whole-meal bread, and cooked cereals than those in earlier stages. There were statistically significant differences in age and vegetarian status between the stages of change, but not for other demographic variables. There were strong differences across the stages of change with regard to perceived benefits and barriers to plant-based diets. For example, those in action/maintenance scored highest for benefit factors associated with well-being, weight, health, convenience and finances, whereas those in the precontemplation stage did not recognise such benefits. Conclusions: These findings can be utilised to help provide appropriate nutrition education and advertising, targeted at specific stages of change. For example, education about how it is possible to obtain iron and protein from a plant-based diet and on the benefits of change, in addition to tips on how to make a gradual, easy transition to a plant-based diet, could help progress precontemplators to later stages.

Food, health, the environment and consumers' dietary choices

The aim of this paper is to examine some of the issues that surround food and the environment, particularly conventional and organic agriculture and food distribution, and to look at some of the health implications. It is argued that the links between food, health and the environment are strong. Consumers have the power to have an impact positively or negatively on the environment via their dietary choices. By providing information and advice about the environmental as well as the health impact of food choices, health and nutrition professionals could increase consumers' awareness of such issues.

Food industry awareness of consumers` plant food beliefs

Abstract: Purpose – The aims of this study were to examine farmers' and food processors' alignment with consumers' views about plant foods and their intentions to produce plant foods. Design/methodology/approach – Data on plant food beliefs were collected from mail surveys of farmers, food processing businesses and random population samples of adults in Victoria, Australia. Findings – There were strong differences between consumers' beliefs and farmers' and food processors' perceptions of consumers' beliefs. For example, a higher proportion of farmers and processors believed that consumers would eat more plant foods if more convenience-oriented plant-based meals were available than consumers themselves agreed. Farmers appeared to be more aware of or aligned with consumers' beliefs than were processors. One- and two-thirds of farmers and processors respectively were planning to grow or process more plant foods, which bodes well for the availability of plant and plant-based foods. Research limitations/implications – Study limitations include the small food industry sample sizes and possible response bias, although analysis suggests the latter was low. Future research could survey a larger sample of food industry representatives, including those from other sectors (e.g. retailers). Practical implications – Education of consumers and industry groups on plant foods and better lines of communication from consumer to processor to farmer, are required. Originality/value – To the authors' knowledge, this is the first study to examine farmers' and food processors' awareness of consumers' beliefs about plant foods. This issue is important for those involved with the production and marketing of plant foods or with food, farming and health policy.

Australian adult consumers' beliefs about plant foods: a qualitative study

This exploratory qualitative study examined consumers’ perceived barriers and benefits of plant food (fruits, vegetables, grains, legumes, nuts, seeds) consumption and views on the promotion of these foods. Ten focus groups were conducted in Melbourne, Australia. Groups consisted of employees of various workplaces, community group members, university students, and inner-city residents. Health-related benefits predominated, particularly relating to the properties of plant foods (e.g., vitamins). Taste, variety, versatility, and environmental benefits were also considered important. The main barriers to eating plant foods were lack of knowledge and skills and length of preparation time. The poor quality of plant foods was also an issue for consumers. Awareness of the promotion of plant foods was generally high. Participants noted that promotions require a stronger practical emphasis with a focus on quick, easy-to-prepare foods and meals. These findings provide insight into effective ways to promote a higher consumption of plant foods

Lifetime sport and leisure activity participation is associated with greater bone size, quality and strength in older men

Introduction: It remains uncertain whether long-term participation in regular weight-bearing exercise confers an advantage to bone structure and strength in old age. The aim of this study was to investigate the relationship between lifetime sport and leisure activity participation on bone material and structural properties at the axial and appendicular skeleton in older men (>50 years).

Methods: We used dual-energy X-ray absorptiometry (DXA) to assess hip, spine and ultradistal (UD) radius areal bone mineral density (aBMD) (n=161), quantitative ultrasound (QUS) to measure heel bone quality (n=161), and quantitative computed tomography (QCT) to assess volumetric BMD, bone geometry and strength at the spine (L₁–L₃) and mid-femur (n=111). Current (>50+ years) and past hours of sport and leisure activity participation during adolescence (13–18 years) and adulthood (19–50 years) were assessed by questionnaire. This information was used to calculate the total time (min) spent participating in sport and leisure activities and an osteogenic index (OI) score for each participant, which provides a measure of participation in weight-bearing activities.

Results: Regression analysis revealed that a greater lifetime (13–50+ years) and mid-adulthood (19–50 years) OI, but not total time (min), was associated with a greater mid-femur total and cortical area, cortical bone mineral content (BMC), and the polar moment of inertia (I _p) and heel VOS (p ranging from <0.05 to <0.01). These results were independent of age, height (or femoral length) and weight (or muscle cross-sectional area). Adolescent OI scores were not found to be significant predictors of bone structure or strength. Furthermore, no significant relationships were detected with areal or volumetric BMD at any site. Subjects were then categorized into either a high (H) or low/non-impact (L) group during adolescence (13–18 years) and adulthood (19–50+ years) according to their OI scores during each of these periods. Three groups were subsequently formed to reflect weight-bearing impact categories during adolescence and then adulthood: LL, HL and HH. Compared to the LL group, mid-femur total and cortical area, cortical BMC and I _p were 6.5–14.2% higher in the HH group. No differences were detected between the LL and HL groups.

Conclusions: In conclusion, these findings indicate that long-term regular participation in sport and leisure activities categorized according to an osteogenic index [but not the total time (min) spent participating in all sport and leisure activities] was an important determinant of bone size, quality and strength, but not BMD, at loaded sites in older men. Furthermore, continued participation in weight-bearing exercise in early to mid-adulthood appears to be important for reducing the risk of low bone strength in old age.

Long-term effects of calcium-vitamin-D3-fortified milk on bone geometry and strength in older men

The long-term effects of calcium and vitamin D supplementation on bone material and structural properties in older men are not known. The aim of this study was to examine the effects of high calcium (1000 mg/day)- and vitamin-D3 (800 IU/day)-fortified milk on cortical and trabecular volumetric BMD (vBMD) and bone geometry at the axial and appendicular skeleton in men aged over 50 years. One hundred and eleven men who were part of a larger 2-year randomized controlled trial had QCT scans of the mid-femur and lumbar spine (L1–L3) to assess vBMD, bone geometry and indices of bone strength [polar moment of inertia (Ipolar)]. After 2 years, there were no significant differences between the milk supplementation and control group for the change in any mid-femur or L1–L3 bone parameters for all men aged over 50 years. However, the mid-femur skeletal responses to the fortified milk varied according to age, with a split of ≤62 versus >62 years being the most significant for discriminating the changes between the two groups. Subsequent analysis revealed that, in the older men (>62 years), the expansion in mid-femur medullary area was 2.8% (P < 0.01) less in the milk supplementation compared to control group, which helped to preserve cortical area in the milk supplementation group (between group difference 1.1%, P < 0.01). Similarly, for mid-femur cortical vBMD and Ipolar, the net loss was 2.3 and 2.8% less in the milk supplementation compared to control group (P < 0.01 and <0.001, respectively). In conclusion, calcium–vitamin-D3-fortified milk may represent an effective strategy to maintain bone strength by preventing endocortical bone loss and slowing the loss in cortical vBMD in elderly men.

Public views of the benefits and barriers to the consumption of a plant-based diet

Objective: The aim of this study was to examine consumers' perceived benefits and barriers to the consumption of a plant-based diet. Design: Mail survey that included questions on perceived benefits and barriers to the consumption of a plant-based diet. Setting: Victoria, Australia. Subjects: Four hundred and fifteen randomly selected Victorian adults. Results: The main perceived barrier to adoption of a plant-based diet was a lack of information about plant-based diets (42% agreement). Sex, age and education differences were present in over a quarter of the barrier items. For example, non-university-educated respondents and older people were less willing to change their current eating pattern than were university educated and younger respondents. The main benefits associated with plant-based diets were health benefits, particularly decreased saturated fat intake (79% agreement), increased fibre intake (76%), and disease prevention (70%). Age, sex and education differences with regard to benefits were apparent, although sex differences were more important than age or education differences. Conclusions: The majority of respondents perceived there to be health benefits associated with the consumption of a plant-based diet. Compared with the proportion of respondents who agreed that there were particular benefits of eating a plant-based diet, perceived barriers were relatively low. An understanding of the perceived benefits and barriers of consuming a plant-based diet will help formulate strategies that aim to influence beliefs about plant foods, plant food consumption, and, ultimately, public health.

Automated Negotiation Between Publishers And Consumers Of Grid Notifications

Notification Services mediate between information publishers and consumers that wish to subscribe to periodic updates. In many cases, however, there is a mismatch between the dissemination of these updates and the delivery preferences of the consumer, often in terms of frequency of delivery, quality, etc. In this paper, we present an automated negotiation engine that identifies mutually acceptable terms; we study its performance, and discuss its application to a Grid Notification Service. We also demonstrate how the negotiation engine enables users to control the Quality of Service levels they require.

A clinical nursing leadership model for enhancing continence care for older adults in a subacute inpatient care setting

This article describes the application and evaluation of a clinical nursing leadership model to enhance continence care in an inpatient rehabilitation setting for older adults. Multiple strategies were employed to optimize the uptake and sustainability of 3 practice initiatives: (1)  establishment of an enhanced role for wardbased nurses to provide clinical support to patients and other staff for the management of incontinence, (2) a new method for nursing assessment and management of bowel elimination, and (3) a framework for improved discharge care of patients with incontinence. Evaluation data indicated a high level of acceptance of the role of the ward-based continence resource nurses, improved assessment and management of bowel elimination, and enhanced discharge care for patients with incontinence. These initiatives were sustainable during a 2-year period after their introduction, despite the gradual withdrawal of the clinical leader.

Older Australians : involvement in civil society in the 1990s

As Australia’s population continues to age, questions about how older individuals use their time holds increasing interest and significance for scholars and policy makers. As individuals near the end of their paid working life, and family roles and responsibilities diminish, the type of activities that will fill this time void have important implications for the health and wellbeing of older Australians and for the strength of civil society. In Australia, there have been sustained moves at all levels of government to encourage the more active engagement in community services of this group of citizens, given the size and significant amount of human capital of this cohort. However, international research suggests that this enthusiasm has not translated into increased volunteer activity for seniors, and that older citizens tend to spend their expanding discretionary time pursuing leisure activities, such as watching television or listening to the radio (Robinson & Godbey 1997; Wilson & Musick 1997; Thoits & Hewitt 2001). This study builds on a broader interest in how people choose to utilise time across the life course and how the experience of ageing shapes such decisions. This aim of this paper is twofold – first, to investigate how older Australians allocated their time in the 1990s, and how these time use patterns changed over a 5-year period, using nationally representative, longitudinal data from two waves of the Australian Time Use Survey. Second, the time use characteristics of those individuals who devote more time to social participation activities are examined, to investigate trends in volunteering across age cohorts, with a focus on those above the age of fifty.

Consumers as partners in inclusive assistive technology research

While there is a general favorable predisposition to the involvement of consumers in rehabilitation and assistive technology research, it remains the case that few research studies are conducted using a participatory approach (participatory action research, inclusive research, emancipatory research). Advantages as well as barriers to the conduct of participatory research are discussed with an emphasis on two research frameworks that have particular relevance to assistive technology and have the potential to make participatory research more viable.

Adding value to online privacy for consumers: remedying deficiences in online privacy policies with an holistic approach

We present findings from a longitudinal, empirical study of online privacy policies. Our research found that although online privacy policies have improved in quality and effectiveness since 2000, they still fall well short of the level of privacy assurance desired by consumers. This study has identified broad areas of deficiency in existing online privacy policies, and offers a solution in the form of an holistic framework for the development, factors and content of online privacy policies for organizations. Our study adds to existing theory in this area and, more immediately, will assist businesses concerned about the effect of privacy issues on consumer Web usage.