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Open AccessReview A Review of Recruitment, Adherence and Drop-Out Rates in Omega-3 Polyunsaturated Fatty Acid Supplementation Trials in Children and Adolescents
Nutrients 2017, 9(5), 474; doi:10.3390/nu9050474
Received: 30 January 2017 / Revised: 26 April 2017 / Accepted: 2 May 2017 / Published: 10 May 2017
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Abstract
Introduction: The influence of n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation on health outcomes has been studied extensively with randomized controlled trials (RCT). In many research fields, difficulties with recruitment, adherence and high drop-out rates have been reported. However,
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Introduction: The influence of n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation on health outcomes has been studied extensively with randomized controlled trials (RCT). In many research fields, difficulties with recruitment, adherence and high drop-out rates have been reported. However, what is unknown is how common these problems are in n-3 LCPUFA supplementation studies in children and adolescents. Therefore, this paper will review n-3 LCPUFA supplementation studies in children and adolescents with regard to recruitment, adherence and drop-out rates. Methods: The Web of Science, PubMed and Ovid databases were searched for papers reporting on RCT supplementing children and adolescents (2–18 years) with a form of n-3 LCPUFA (or placebo) for at least four weeks. As a proxy for abiding to CONSORT guidelines, we noted whether manuscripts provided a flow-chart and provided dates defining the period of recruitment and follow-up. Results: Ninety manuscripts (reporting on 75 studies) met the inclusion criteria. The majority of the studies did not abide by the CONSORT guidelines: 55% did not provide a flow-chart, while 70% did not provide dates. The majority of studies provided minimal details about the recruitment process. Only 25 of the 75 studies reported an adherence rate which was on average 85%. Sixty-five of the 75 studies included drop-out rates which were on average 17%. Conclusion: Less than half of the included studies abided by the CONSORT guidelines (45% included a flow chart, while 30% reported dates). Problems with recruitment and drop-out seem to be common in n-3 LCPUFA supplementation trials in children and adolescents. However, reporting about recruitment, adherence and dropout rates was very heterogeneous and minimal in the included studies. Some techniques to improve recruitment, adherence and dropout rates were identified from the literature, however these techniques may need to be tailored to n-3 LCPUFA supplementation studies in children and adolescents. Full article
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Open AccessArticle Australians are not Meeting the Recommended Intakes for Omega-3 Long Chain Polyunsaturated Fatty Acids: Results of an Analysis from the 2011–2012 National Nutrition and Physical Activity Survey
Nutrients 2016, 8(3), 111; doi:10.3390/nu8030111
Received: 18 December 2015 / Revised: 3 February 2016 / Accepted: 14 February 2016 / Published: 24 February 2016
Cited by 2 | Viewed by 1589 | PDF Full-text (1490 KB) | HTML Full-text | XML Full-text
Abstract
Health benefits have been attributed to omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). Therefore it is important to know if Australians are currently meeting the recommended intake for n-3 LCPUFA and if they have increased since the last National
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Health benefits have been attributed to omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). Therefore it is important to know if Australians are currently meeting the recommended intake for n-3 LCPUFA and if they have increased since the last National Nutrition Survey in 1995 (NNS 1995). Dietary intake data was obtained from the recent 2011–2012 National Nutrition and Physical Activity Survey (2011–2012 NNPAS). Linoleic acid (LA) intakes have decreased whilst alpha-linolenic acid (LNA) and n-3 LCPUFA intakes have increased primarily due to n-3 LCPUFA supplements. The median n-3 LCPUFA intakes are less than 50% of the mean n-3 LCPUFA intakes which highlights the highly-skewed n-3 LCPUFA intakes, which shows that there are some people consuming high amounts of n-3 LCPUFA, but the vast majority of the population are consuming much lower amounts. Only 20% of the population meets the recommended n-3 LCPUFA intakes and only 10% of women of childbearing age meet the recommended docosahexaenoic acid (DHA) intake. Fish and seafood is by far the richest source of n-3 LCPUFA including DHA. Full article
(This article belongs to the Special Issue DHA for Optimal Health)
Open AccessArticle Four Models Including Fish, Seafood, Red Meat and Enriched Foods to Achieve Australian Dietary Recommendations for n-3 LCPUFA for All Life-Stages
Nutrients 2015, 7(10), 8602-8614; doi:10.3390/nu7105413
Received: 31 August 2015 / Revised: 25 September 2015 / Accepted: 8 October 2015 / Published: 19 October 2015
Cited by 2 | Viewed by 1463 | PDF Full-text (508 KB) | HTML Full-text | XML Full-text
Abstract
Populations are not meeting recommended intakes of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). The aim was (i) to develop a database on n-3 LCPUFA enriched products; (ii) to undertake dietary modelling exercise using four dietary approaches to meet
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Populations are not meeting recommended intakes of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA). The aim was (i) to develop a database on n-3 LCPUFA enriched products; (ii) to undertake dietary modelling exercise using four dietary approaches to meet the recommendations and (iii) to determine the cost of the models. Six n-3 LCPUFA enriched foods were identified. Fish was categorised by n-3 LCPUFA content (mg/100 g categories as “excellent” “good” and “moderate”). The four models to meet recommended n-3 LCPUFA intakes were (i) fish only; (ii) moderate fish (with red meat and enriched foods); (iii) fish avoiders (red meat and enriched foods only); and (iv) lacto-ovo vegetarian diet (enriched foods only). Diets were modelled using the NUTTAB2010 database and n-3 LCPUFA were calculated and compared to the Suggested Dietary Targets (SDT). The cost of meeting these recommendations was calculated per 100 mg n-3 LCPUFA. The SDT were achieved for all life-stages with all four models. The weekly food intake in number of serves to meet the n-3 LCPUFA SDT for all life-stages for each dietary model were: (i) 2 “excellent” fish; (ii) 1 “excellent” and 1 “good” fish, and depending on life-stage, 3–4 lean red meat, 0–2 eggs and 3–26 enriched foods; (iii) 4 lean red meat, and 20–59 enriched foods; (iv) 37–66 enriched foods. Recommended intakes of n-3 LCPUFA were easily met by the consumption of fish, which was the cheapest source of n-3 LCPUFA. Other strategies may be required to achieve the recommendations including modifying the current food supply through feeding practices, novel plant sources and more enriched foods. Full article
(This article belongs to the Special Issue DHA for Optimal Health)
Open AccessArticle A High-Dose Shiitake Mushroom Increases Hepatic Accumulation of Triacylglycerol in Rats Fed a High-Fat Diet: Underlying Mechanism
Nutrients 2014, 6(2), 650-662; doi:10.3390/nu6020650
Received: 13 December 2013 / Revised: 7 January 2014 / Accepted: 22 January 2014 / Published: 12 February 2014
Cited by 4 | Viewed by 2944 | PDF Full-text (1422 KB) | HTML Full-text | XML Full-text
Abstract
Shiitake mushroom have been shown to have health benefits including lowering plasma lipids and preventing body weight gain. However, their underlying mechanisms are largely unknown. The study aim was to assess the potential underlying mechanism of Shiitake mushrooms in lowering plasma triacylglycerol (TAG)
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Shiitake mushroom have been shown to have health benefits including lowering plasma lipids and preventing body weight gain. However, their underlying mechanisms are largely unknown. The study aim was to assess the potential underlying mechanism of Shiitake mushrooms in lowering plasma triacylglycerol (TAG) in rats fed a high fat diet (HFD). Forty Wistar rats were divided into control group were given HFD and treatment group were fed HFD, enriched with Shiitake mushroom powder at a low dose (LD-M): 0.7%, medium dose (MD-M): 2%, or high dose (HD-M): 6% (wt:wt) for six weeks. Diets were isocaloric containing ~50% energy from fat. After six weeks’ dietary intervention, the rats were sacrificed, and blood and tissue samples were collected. The HD-M group showed a significantly higher ratio of liver weight to 100 g body weight (p < 0.05), a more severe hepatic steatosis marker, such as hepatocyte ballooning (p < 0.0001), and more liver triacylglycerol content than LD-M and MD-M (p < 0.05). HD-M also showed a significantly decreased ratio of phosphatidylcholine (PC) to phosphatidylethanolamine (PE) compared to HFD (p < 0.05), however, there were no differences compared to HD-M and MD-M. Our results also showed a positive association between the dosage, liver TAG, and liver ballooning histology. A negative association was found between the mushroom dosage and the ratio of liver PC to PE. This study showed the mechanism of how high-dose Shiitake mushroom (HD-M) prevents obesity by increasing TAG accumulation in the liver, rather than adipose tissue. Full article
Open AccessArticle Expanding Awareness of Docosahexaenoic Acid during Pregnancy
Nutrients 2013, 5(4), 1098-1109; doi:10.3390/nu5041098
Received: 7 February 2013 / Revised: 22 March 2013 / Accepted: 25 March 2013 / Published: 2 April 2013
Cited by 6 | Viewed by 2256 | PDF Full-text (236 KB) | HTML Full-text | XML Full-text
Abstract
Pregnant women do not currently meet the consensus recommendation for docosahexaenoic acid (DHA) (≥200 mg/day). Pregnant women in Australia are not receiving information on the importance of DHA during pregnancy. DHA pregnancy education materials were developed using current scientific literature, and tested for
[...] Read more.
Pregnant women do not currently meet the consensus recommendation for docosahexaenoic acid (DHA) (≥200 mg/day). Pregnant women in Australia are not receiving information on the importance of DHA during pregnancy. DHA pregnancy education materials were developed using current scientific literature, and tested for readability and design aesthetics. The study aimed to evaluate their usefulness, the desire for pregnant women to receive these materials and whether a larger separate study (using a control group) is warranted to evaluate the influence the materials may have on increasing DHA consumption in pregnant women in Australia. Pregnant women (N = 118) were recruited at antenatal clinics at two NSW hospitals. Participants completed a 16-item questionnaire and DHA educational materials (pamphlet and shopping card) were provided. Participants were contacted via phone two weeks later and completed the second questionnaire (25-item, N = 74). Statistics were conducted in SPSS and qualitative data were analysed to identify common themes. Ninety three percent of women found the materials useful, with the main reason being it expanded their knowledge of DHA food sources. Only 34% of women had received prior information on DHA, yet 68% said they would like to receive information. Due to the small sample size and lack of a control group, this small study cannot provide a cause and effect relationship between the materials and nutrition related behaviours or knowledge, however the results indicate a potential positive influence towards increased fish consumption and awareness of DHA containing foods. This suggests a larger study, with a control group is warranted to identify the impact such materials could have on Australian pregnant women. Full article
(This article belongs to the Special Issue Docosahexaenoic Acid and Human Health)
Open AccessArticle Do Pregnant Women and Those at Risk of Developing Post-Natal Depression Consume Lower Amounts of Long Chain Omega-3 Polyunsaturated Fatty Acids?
Nutrients 2010, 2(2), 198-213; doi:10.3390/nu2020198
Received: 28 January 2010 / Accepted: 11 February 2010 / Published: 21 February 2010
Cited by 12 | Viewed by 6110 | PDF Full-text (241 KB) | HTML Full-text | XML Full-text
Abstract
The aims were to compare intakes of long chain omega-3 polyunsaturated fatty acid (LC n-3 PUFA) in pregnant and non-pregnant women in Australia and to compare these intakes to the Australian National Nutrition Survey of 1995 (NNS95) [1] and to determine if the
[...] Read more.
The aims were to compare intakes of long chain omega-3 polyunsaturated fatty acid (LC n-3 PUFA) in pregnant and non-pregnant women in Australia and to compare these intakes to the Australian National Nutrition Survey of 1995 (NNS95) [1] and to determine if the LC n-3 PUFA intakes differed in women who may be ‘at risk’ compared with women ‘not at risk’ of developing post-natal depression (PND). A validated LC n-3 PUFA food frequency questionnaire and pregnant women’s Edinburgh Postnatal Depression Scale (EPDS) scores were used. LC n-3 PUFA intakes were comparable to the NNS95 but did not differ due to pregnancy or whether or not a woman is at risk of developing PND. Full article
(This article belongs to the Special Issue Omega-3 Update)

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