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Authors = Michelle Blumfield ORCID = 0000-0002-6502-4121

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26 pages, 1664 KiB  
Review
Should We ‘Eat a Rainbow’? An Umbrella Review of the Health Effects of Colorful Bioactive Pigments in Fruits and Vegetables
by Michelle Blumfield, Hannah Mayr, Nienke De Vlieger, Kylie Abbott, Carlene Starck, Flavia Fayet-Moore and Skye Marshall
Molecules 2022, 27(13), 4061; https://doi.org/10.3390/molecules27134061 - 24 Jun 2022
Cited by 34 | Viewed by 23334
Abstract
Health promotion campaigns have advocated for individuals to ‘eat a rainbow’ of fruits and vegetables (FV). However, the literature has only focused on individual color pigments or individual health outcomes. This umbrella review synthesized the evidence on the health effects of a variety [...] Read more.
Health promotion campaigns have advocated for individuals to ‘eat a rainbow’ of fruits and vegetables (FV). However, the literature has only focused on individual color pigments or individual health outcomes. This umbrella review synthesized the evidence on the health effects of a variety of color-associated bioactive pigments found in FV (carotenoids, flavonoids, betalains and chlorophylls), compared to placebo or low intakes. A systematic search of PubMed, EMBASE, CINAHL and CENTRAL was conducted on 20 October 2021, without date limits. Meta-analyzed outcomes were evaluated for certainty via the GRADE system. Risk of bias was assessed using the Centre for Evidence-Based Medicine critical appraisal tools. A total of 86 studies were included, 449 meta-analyzed health outcomes, and data from over 37 million participants were identified. A total of 42% of health outcomes were improved by color-associated pigments (91% GRADE rating very low to low). Unique health effects were identified: n = 6 red, n = 10 orange, n = 3 yellow, n = 6 pale yellow, n = 3 white, n = 8 purple/blue and n = 1 green. Health outcomes associated with multiple color pigments were body weight, lipid profile, inflammation, cardiovascular disease, mortality, type 2 diabetes and cancer. Findings show that color-associated FV variety may confer additional benefits to population health beyond total FV intake. Full article
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22 pages, 1402 KiB  
Article
Nutrient Dense, Low-Cost Foods Can Improve the Affordability and Quality of the New Zealand Diet—A Substitution Modeling Study
by Carlene S. Starck, Michelle Blumfield, Tim Keighley, Skye Marshall, Peter Petocz, Elif Inan-Eroglu, Kylie Abbott, Tim Cassettari, Ajmol Ali, Carol Wham, Rozanne Kruger, Geoff Kira and Flavia Fayet-Moore
Int. J. Environ. Res. Public Health 2021, 18(15), 7950; https://doi.org/10.3390/ijerph18157950 - 27 Jul 2021
Cited by 8 | Viewed by 5850
Abstract
The high prevalence of non-communicable disease in New Zealand (NZ) is driven in part by unhealthy diet selections, with food costs contributing to an increased risk for vulnerable population groups. This study aimed to: (i) identify the nutrient density-to-cost ratio of NZ foods; [...] Read more.
The high prevalence of non-communicable disease in New Zealand (NZ) is driven in part by unhealthy diet selections, with food costs contributing to an increased risk for vulnerable population groups. This study aimed to: (i) identify the nutrient density-to-cost ratio of NZ foods; (ii) model the impact of substituting foods with a lower nutrient density-to-cost ratio with those with a higher nutrient density-to-cost ratio on diet quality and affordability in representative NZ population samples for low and medium socioeconomic status (SES) households by ethnicity; and (iii) evaluate food processing level. Foods were categorized, coded for processing level and discretionary status, analyzed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods were 56% unprocessed (vegetables, fruit, porridge, pasta, rice, nuts/seeds), 31% ultra-processed (vegetable dishes, fortified bread, breakfast cereals unfortified <15 g sugars/100 g and fortified 15–30 g sugars/100 g), 6% processed (fruit juice), and 6% culinary processed (oils). Using substitution modeling, diet quality improved by 59% and 71% for adults and children, respectively, and affordability increased by 20–24%, depending on ethnicity and SES. The NZ diet can be made healthier and more affordable when nutritious, low-cost foods are selected. Processing levels in the healthier, modeled diet suggest that some non-discretionary ultra-processed foods may provide a valuable source of low-cost nutrition for food insecure populations. Full article
(This article belongs to the Special Issue Health and Economic Impacts of Healthier Lifestyles)
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18 pages, 1766 KiB  
Article
Diet and Economic Modelling to Improve the Quality and Affordability of the Australian Diet for Low and Medium Socioeconomic Households
by Michelle Blumfield, Carlene Starck, Tim Keighley, Peter Petocz, Anna Roesler, Kylie Abbott, Tim Cassettari, Skye Marshall and Flavia Fayet-Moore
Int. J. Environ. Res. Public Health 2021, 18(11), 5771; https://doi.org/10.3390/ijerph18115771 - 27 May 2021
Cited by 8 | Viewed by 4745
Abstract
Food costs are a barrier to healthier diet selections, particularly for low socioeconomic households who regularly choose processed foods containing refined grains, added sugars, and added fats. In this study, the objectives were to: (i) identify the nutrient density-to-cost ratio of Australian foods; [...] Read more.
Food costs are a barrier to healthier diet selections, particularly for low socioeconomic households who regularly choose processed foods containing refined grains, added sugars, and added fats. In this study, the objectives were to: (i) identify the nutrient density-to-cost ratio of Australian foods; (ii) model the impact of substituting foods with lower nutrient density-to-cost ratio with those with the highest nutrient density-to-cost ratio for diet quality and affordability in low and medium socioeconomic households; and (iii) evaluate food processing levels. Foods were categorized, coded for processing level, analysed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods included 54% unprocessed (vegetables and reduced fat dairy), 33% ultra-processed (fortified wholegrain bread and breakfast cereals <20 g sugars/100 g), and 13% processed (fruit juice and canned legumes). Using substitution modelling, diet quality improved by 52% for adults and 71% for children across all households, while diet affordability improved by 25% and 27% for low and medium socioeconomic households, respectively. The results indicate that the quality and affordability of the Australian diet can be improved when nutritious, low-cost foods are selected. Processing levels in the healthier modelled diets suggest that some ultra-processed foods may provide a beneficial source of nutrition when consumed within national food group recommendations. Full article
(This article belongs to the Special Issue Health and Economic Impacts of Healthier Lifestyles)
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17 pages, 685 KiB  
Article
Macronutrient Intake in Pregnancy and Child Cognitive and Behavioural Outcomes
by Rachael M. Taylor, Michelle L. Blumfield, Lee M. Ashton, Alexis J. Hure, Roger Smith, Nick Buckley, Karen Drysdale and Clare E. Collins
Children 2021, 8(5), 425; https://doi.org/10.3390/children8050425 - 20 May 2021
Cited by 6 | Viewed by 4189
Abstract
Prenatal nutrient exposures can impact on brain development and disease susceptibility across the lifespan. It is well established that maternal macronutrient intake during pregnancy influences foetal and infant development. Therefore, we hypothesise that macronutrient intakes during pregnancy are correlated with cognitive development during [...] Read more.
Prenatal nutrient exposures can impact on brain development and disease susceptibility across the lifespan. It is well established that maternal macronutrient intake during pregnancy influences foetal and infant development. Therefore, we hypothesise that macronutrient intakes during pregnancy are correlated with cognitive development during early childhood. The current study aimed to investigate the relationship between maternal macronutrient intake during pregnancy and child cognitive and behavioural outcomes at age 4 years. We analysed prospective data from a cohort of 64 Australian mother–child dyads. Maternal macronutrient intake was assessed using a validated 74-item food frequency questionnaire at 2 timepoints during pregnancy. Child cognition and behaviour were measured at age 4 years using the validated Wechsler Preschool and Primary Scale of Intelligence, 3rd version (WPPSI-III) and the Child Behaviour Checklist (CBC). Linear regression models were used to quantify statistical relationships and were adjusted for maternal age, education, pre-pregnancy BMI, breastfeeding duration and birthweight. Child Performance IQ was inversely associated with maternal starch intake (b = −11.02, p = 0.03). However, no other associations were found. Further research is needed to explore the association between different types of starch consumed during pregnancy and child cognitive development. Full article
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15 pages, 293 KiB  
Article
An Analysis of the Mineral Composition of Pink Salt Available in Australia
by Flavia Fayet-Moore, Cinthya Wibisono, Prudence Carr, Emily Duve, Peter Petocz, Graham Lancaster, Joanna McMillan, Skye Marshall and Michelle Blumfield
Foods 2020, 9(10), 1490; https://doi.org/10.3390/foods9101490 - 19 Oct 2020
Cited by 20 | Viewed by 24651
Abstract
Little is known about the mineral composition of pink salt. The aim of this study was to evaluate for the first time the mineral composition of pink salt available for purchase in Australia and its implications for public health. Pink salt samples were [...] Read more.
Little is known about the mineral composition of pink salt. The aim of this study was to evaluate for the first time the mineral composition of pink salt available for purchase in Australia and its implications for public health. Pink salt samples were purchased from retail outlets in two metropolitan Australian cities and one regional town. Color intensity, salt form, and country of origin were coded. A mass spectrometry scan in solids was used to determine the amount of 25 nutrients and non-nutritive minerals in pink salt (n = 31) and an iodized white table salt control (n = 1). A wide variation in the type and range of nutrients and non-nutritive minerals across pink salt samples were observed. One pink salt sample contained a level of lead (>2 mg/kg) that exceeded the national maximum contaminant level set by Food Standards Australia New Zealand. Pink salt in flake form, pink salt originating from the Himalayas, and darker colored pink salt were generally found to contain higher levels of minerals (p < 0.05). Despite pink salt containing nutrients, >30 g per day (approximately 6 teaspoons) would be required to make any meaningful contribution to nutrient intake, a level that would provide excessive sodium and potential harmful effects. The risk to public health from potentially harmful non-nutritive minerals should be addressed by Australian food regulations. Pink salt consumption should not exceed the nutrient reference values for Australia and New Zealand guidelines of <5 g of salt per day. Full article
(This article belongs to the Section Food Nutrition)
12 pages, 261 KiB  
Article
Promoting Evidence Based Nutrition Education Across the World in a Competitive Space: Delivering a Massive Open Online Course
by Simone Gibson, Melissa Adamski, Michelle Blumfield, Janeane Dart, Chiara Murgia, Evelyn Volders and Helen Truby
Nutrients 2020, 12(2), 344; https://doi.org/10.3390/nu12020344 - 28 Jan 2020
Cited by 18 | Viewed by 5693
Abstract
The internet is the fastest growing source of nutrition information for consumers. Massive Open Online Courses (MOOCs) provide and avenue for nutrition professionals’ urgent need to respond to consumer demand for low-cost, accessible and engaging information. This research aimed to evaluate learner participation [...] Read more.
The internet is the fastest growing source of nutrition information for consumers. Massive Open Online Courses (MOOCs) provide and avenue for nutrition professionals’ urgent need to respond to consumer demand for low-cost, accessible and engaging information. This research aimed to evaluate learner participation and perceptions in an evidence-based nutrition MOOC and provide recommendations for engaging international online lay audiences. Learners completed pre and post course surveys including quantitative and open-ended questions. Pre-course surveys collected demographic data, prior nutrition knowledge and motivations for doing the course. Post-course surveys evaluated their preferred learning modes and learners’ opinions of the course. Quantitative were analyzed using descriptive statistics. Conventional content analysis was conducted on learners’ responses to open-ended survey questions using an inductive approach. Learners represented 158 countries from a range of educational backgrounds. There were 3799 qualitative comments related to learners’ learning and course content preferences. Qualitative analysis identified key themes related to (1) online interaction, the (2) value of the evidence presented by nutrition experts and (3) the course structure and practical aspects. Divergent opinions were expressed within these themes. Satisfying the needs of large international audiences with diverse backgrounds is challenging in promoting sound evidence-based nutrition messages. MOOCs provide a means for delivering evidence based global nutrition education in the online space crowded with food advertising and nutrition conjecture. Recommendations are made as to how to construct and engage diverse on-line audiences. Full article
(This article belongs to the Special Issue Nutrition Education in Medicine)
21 pages, 1034 KiB  
Review
Attenuating Pregnancy Weight Gain—What Works and Why: A Systematic Review and Meta-Analysis
by Ruth Walker, Christie Bennett, Michelle Blumfield, Stella Gwini, Jianhua Ma, Fenglei Wang, Yi Wan and Helen Truby
Nutrients 2018, 10(7), 944; https://doi.org/10.3390/nu10070944 - 22 Jul 2018
Cited by 61 | Viewed by 10258
Abstract
Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up [...] Read more.
Excessive maternal gestational weight gain (GWG) contributes to generational obesity. Our aim was to explore efficacy and intervention characteristics (trimester, duration, frequency, intensity, and delivery method) of interventions to prevent excessive GWG. CINAHL, Cochrane, EMBASE, LILACS, MEDLINE, PsycINFO, and Scopus were searched up to May 2018 (no date or language restrictions). Keywords and MeSH terms for diet, GWG, intervention, lifestyle, maternal, physical activity, and pregnancy were used to locate randomized-controlled trials (RCTs). The Cochrane Collaboration tool for assessing risk of bias was applied. Eighty-nine RCTs were included. Meta-analysis (60 trials) estimated that women in diet only (WMD: −3.27; 95% CI: −4.96, −1.58, p < 0.01), physical activity (PA) (WMD: −1.02; 95% CI: −1.56, −0.49, p < 0.01), and lifestyle interventions (combining diet and PA) (WMD: −0.84; 95% CI: −1.29, −0.39, p < 0.01) gained significantly less weight than controls. The three eHealth interventions favored neither intervention nor control (WMD: −1.06; 95% CI: −4.13, 2.00, p = 0.50). Meta-regression demonstrated no optimal duration, frequency, intensity, setting, or diet type. Traditional face to face delivery of weight management interventions during pregnancy can be successful. Delivery via eHealth has potential to extend its reach to younger women but needs further evaluation of its success. Full article
(This article belongs to the Special Issue Early Life Nutrition: From Nutrients to Systems)
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16 pages, 230 KiB  
Article
Lower Protein-to-Carbohydrate Ratio in Maternal Diet is Associated with Higher Childhood Systolic Blood Pressure up to Age Four Years
by Michelle L. Blumfield, Caryl Nowson, Alexis J. Hure, Roger Smith, Stephen J. Simpson, David Raubenheimer, Lesley MacDonald-Wicks and Clare E. Collins
Nutrients 2015, 7(5), 3078-3093; https://doi.org/10.3390/nu7053078 - 24 Apr 2015
Cited by 29 | Viewed by 10528
Abstract
The prenatal environment can influence development of offspring blood pressure (BP), which tracks into adulthood. This prospective longitudinal study investigated whether maternal pregnancy dietary intake is associated with the development of child BP up to age four years. Data are from 129 mother-child [...] Read more.
The prenatal environment can influence development of offspring blood pressure (BP), which tracks into adulthood. This prospective longitudinal study investigated whether maternal pregnancy dietary intake is associated with the development of child BP up to age four years. Data are from 129 mother-child dyads enrolled in the Women and Their Children’s Health study. Maternal diet was assessed using a validated 74-item food frequency questionnaire at 18 to 24 weeks and 36 to 40 weeks, with a reference period of the previous three months. Child systolic and diastolic BP were measured at 3, 6, 9, 12, 24, 36 and 48 months, using an automated BP monitor. Using mixed-model regression analyses adjusted for childhood growth indices, pregnancy intakes of percentage of energy (E%) polyunsaturated fat (β coefficient 0.73; 95% CI 0.003, 1.45; p = 0.045), E% omega-6 fatty acids (β coefficient 0.89; 95% CI 0.09, 1.69; p = 0.03) and protein-to-carbohydrate (P:C) ratio (β coefficient −14.14; 95% CI −27.68, −0.60; p = 0.04) were associated with child systolic BP trajectory up to 4 years. Child systolic BP was greatest at low proportions of dietary protein (<16% of energy) and high carbohydrate (>40% of energy) intakes. There may be an ideal maternal macronutrient ratio associated with optimal infant BP. Maternal diet, which is potentially modifiable, may play an important role in influencing offspring risk of future hypertension. Full article
(This article belongs to the Special Issue Nutrition in Pregnancy)
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19 pages, 786 KiB  
Article
The Association between the Macronutrient Content of Maternal Diet and the Adequacy of Micronutrients during Pregnancy in the Women and Their Children’s Health (WATCH) Study
by Michelle Blumfield, Alexis Hure, Lesley MacDonald-Wicks, Roger Smith, Stephen Simpson, David Raubenheimer and Clare Collins
Nutrients 2012, 4(12), 1958-1976; https://doi.org/10.3390/nu4121958 - 6 Dec 2012
Cited by 28 | Viewed by 11950
Abstract
Nutrition during pregnancy can induce alterations in offspring phenotype. Maternal ratio of protein to non-protein (P:NP) energy has been linked to variations in offspring body composition and adult risk of metabolic disease. This study describes the dietary patterns of pregnant women by tertiles [...] Read more.
Nutrition during pregnancy can induce alterations in offspring phenotype. Maternal ratio of protein to non-protein (P:NP) energy has been linked to variations in offspring body composition and adult risk of metabolic disease. This study describes the dietary patterns of pregnant women by tertiles of the P:NP ratio and compares diet to Australian recommendations. Data are from 179 Australian women enrolled in the Women and Their Children’s Health Study. Diet was assessed using a validated 74-item food frequency questionnaire. Food group servings and nutrient intakes were compared to the Australian Guide to Healthy Eating and Australian Nutrient Reference Values. Higher maternal P:NP tertile was positively associated with calcium (P = 0.003), zinc (P = 0.001) and servings of dairy (P = 0.001) and meat (P = 0.001) food groups, and inversely associated with the energy dense, nutrient poor non-core (P = 0.003) food group. Micronutrient intakes were optimized with intermediate protein (18%E–20%E), intermediate fat (28%E–30%E) and intermediate carbohydrate (50%E–54%E) intakes, as indicated in tertile two. Results suggest a moderate protein intake may support pregnant women to consume the largest variety of nutrients across all food groups. Full article
(This article belongs to the Special Issue Infant Nutrition)
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