Papers by Pamela Von Hurst
European journal of nutrition, Jan 24, 2022
The global population is ageing. Evidence show dietary patterns may be associated with cognitive ... more The global population is ageing. Evidence show dietary patterns may be associated with cognitive status in older adults. This cross-sectional study investigated associations between dietary patterns and cognitive function in older adults in New Zealand. The REACH study (Researching Eating, Activity, and Cognitive Health) included 371 participants (65–74 years, 36% male) living independently in Auckland, New Zealand. Valid and reproducible dietary patterns were derived, using principal component analysis, from dietary data collected by a 109-item validated food frequency questionnaire. Six cognitive domains (global cognition, attention and vigilance, executive function, episodic memory, working memory, and spatial memory) were tested using COMPASS (Computerised Mental Performance Assessment System). Associations between dietary patterns and cognitive scores, adjusted for age, sex, education, physical activity, energy, and Apolipoprotein E-ε4 status were analysed using multiple linear regression analysis. Three dietary patterns explained 18% of dietary intake variation—‘Mediterranean style’ (comprising: salad vegetables, leafy cruciferous vegetables, other vegetables, avocados and olives, alliums, nuts and seeds, white fish and shellfish, oily fish, and berries); ‘Western’ (comprising: processed meats, sauces and condiments, cakes, biscuits and puddings, meat pies and chips, and processed fish); and ‘Prudent’ (comprising: dried legumes, soy-based foods, fresh and frozen legumes, whole grains, and carrots). No associations between any cognitive domain and dietary pattern scores were observed. Global cognitive function was associated with being younger and having a university education. In this cohort of community-dwelling, older adults in New Zealand, current dietary patterns were not associated with cognitive function.
The Journal of Steroid Biochemistry and Molecular Biology, Jun 1, 2020
Factures are common during childhood. There are limited data available regarding relationships be... more Factures are common during childhood. There are limited data available regarding relationships between bone fracture history and calcium intake, sugar sweetened beverages (SSBs) intake, vitamin D status, physical activity (PA), ethnicity, and body composition in New Zealand (NZ) children. Identifying groups of NZ children at risk of fracture and associated predictors may help to improve bone quality during childhood and decrease the risk of fractures throughout life. The aim of this study was to investigate fracture history and associated risk factors in New Zealand children. Children aged 8-12 years were recruited. Capillary blood spots collected from a finger prick were as analyzed for 25(OH)D concentrations. Bioelectrical impedance analysis (InBody720, Seoul, Korea) was used to measure body fat percentage (%BF). Information about fracture history, siblings' history of fractures, family osteoporosis history, PA, ethnicity, and intake of calcium containing foods, and SSBs was collected using questionnaires. Children (n = 647, 354 girls), mean ± SD age 9.8 ± 0.7 years were recruited from six Auckland primary schools. NZ European (n = 252) (NZE) and South Asian (n = 68) children reported the lowest (20.2 %) and highest (44.1 %) fracture incidence, respectively. NZE compared to South Asian children, had higher 25(OH) D concentrations (74.6 ± 19.8 vs. 48.4 ± 19.3 nmol/L, P < 0.001), higher total calcium intake (764.0 ± 394.4 vs. 592.7 ± 266.3 mg/d, P < 0.018), and lower %BF (19.5 ± 6.6 vs. 23.4 ± 8.4, P < 0.003). Māori children had the next highest fracture rate (32.5 %). This group had adequate 25(OH)D (64.2 ± 18.9 nmol/L), but high %BF (23.9 %) and most participated in vigorous PA. After stratifying by sex, binary logistic regression analysis revealed the main determinants of fracture history for boys were high %BF, low 25(OH)D, low calcium intake, high SSBs consumption, siblings' fracture history, family osteoporosis history, and being South Asian; and in girls, high SSBs consumption, siblings' fracture history, and family osteoporosis history. We found South Asian ethnicity was a significant risk factor for boys. Some children were at high risk of vitamin D deficiency and for whom supplementation may be necessary in winter. Good nutrition (especially good sources of calcium and reducing SSBs intakes) should be recommended to children during growth and development to reduce their risk of fractures.
Maternal and Child Nutrition, Feb 17, 2019
This study aimed to examine the validity and reliability of the Dietary Index for a Child's Eatin... more This study aimed to examine the validity and reliability of the Dietary Index for a Child's Eating (DICE) in children living in New Zealand (NZ). Caregivers of healthy children aged 2-8 years completed a 4-day estimated food record (4DFR) for their child and completed the DICE online on two separate occasions, 8 weeks apart. Relative validity was assessed by comparing the DICE and 4DFR total score and component subscores using the Wilcoxon test, Spearman rank correlation coefficients, crossclassification, and weighted kappa (ĸ) statistic. For evaluating construct validity, the DICE total score was compared with energy and nutrient intake from the 4DFR using linear contrast analysis. Intraclass correlation coefficients (Cronbach's α) and Bland-Altman plots were used to assess the reliability of DICE. From a possible score of 100, the mean ± standard deviation of DICE was 78.2 ± 11.5 and from the 4DFR, was 73.8 ± 10.8, with a positive correlation (r = 0.72; p < 0.001) and moderate agreement (ĸ = 0.49). Cross-classification showed 61.9% were correctly categorised into the same tertile group from DICE and the 4DFR. Participants in the highest tertile of DICE had higher intakes of fibre, vitamin C, vitamin A, vitamin D, folate, and calcium. Good agreement (α = 0.87) was found for reliability. DICE is a valid and reliable tool for the assessment of children's adherence to a healthy diet, as recommended by the NZ Ministry of Health Food and Nutrition guidelines.
British Journal of Nutrition, Mar 13, 2019
Decreases in Fe status have been reported in military women during initial training periods of 8-... more Decreases in Fe status have been reported in military women during initial training periods of 8-10 weeks. The present study aimed to characterise Fe status and associations with physical performance in female New Zealand Army recruits during a 16-week basic combat training (BCT) course. Fe status indicators-Hb, serum ferritin (sFer), soluble transferrin receptor (sTfR), transferrin saturation (TS) and erythrocyte distribution width (RDW)were assessed at the beginning (baseline) and end of BCT in seventy-six volunteers without Fedeficiency non-anaemia (sFer <12 µg/l; Hb ≥120 g/l) or Fe-deficiency anaemia (sFer <12 µg/l; Hb <120 g/l) at baseline or a C-reactive protein >10 mg/l at baseline or end. A timed 2•4 km run followed by maximum press-ups were performed at baseline and midpoint (week 8) to assess physical performance. Changes in Fe status were investigated using paired t tests and associations between Fe status and physical performance evaluated using Pearson correlation coefficients. sFer (56•6 (SD 33•7) v. 38•4 (SD 23•8) µg/l) and TS (38•8 (SD 13•9) v. 34•4 (SD 11•5) %) decreased (P < 0•001 and P = 0•014, respectively), while sTfR (1•21 (SD 0•27) v. 1•39 (SD 0•35) mg/l) and RDW (12•8 (SD 0•6) v. 13•2 (SD 0•7) %) increased (P < 0•001) from baseline to end. Hb (140•6 (SD 7•5) v. 142•9 (SD 7•9) g/l) increased (P = 0•009) during BCT. At end, sTfR was positively (r 0•29, P = 0•012) and TS inversely associated (r-0•32, P = 0•005) with midpoint run time. There were no significant correlations between Fe status and press-ups. Storage and functional Fe parameters indicated a decline in Fe status in female recruits during BCT. Correlations between tissue-Fe indicators and run times suggest impaired aerobic fitness. Optimal Fe status appears paramount for enabling success in female recruits during military training.
European Journal of Clinical Nutrition, Aug 19, 2020
Nutrients, Feb 28, 2020
Background: The role of vitamin D and omega-3 long chain polyunsaturated fatty acids (omega-3 LCP... more Background: The role of vitamin D and omega-3 long chain polyunsaturated fatty acids (omega-3 LCPUFA) in improving core symptoms of autism spectrum disorder (ASD) in children has been investigated by a few randomised controlled trials and the results are mixed and inconclusive. The response to treatment with these nutrients is heterogenous and may be influenced by inflammatory state. As an exploratory analysis, we investigated whether inflammatory state would modulate the effect of these nutrients on core symptoms of ASD. Methods: Seventy-three New Zealand children with ASD (2.5-8.0 years) completed a 12-month randomised, double-blind, placebo-controlled trial of vitamin D (VID, 2000 IU/day), omega-3 LCPUFA; (OM, 722 mg/day docosahexaenoic acid), or both (VIDOM). Non-fasting baseline plasma interleukin-1β (IL-1β) was available for 67 children (VID = 15, OM = 21, VIDOM = 15, placebo = 16). Children were categorised as having undetectable/normal IL-1β (<3.2 pg/ml, n = 15) or elevated IL-1β (≥3.2 pg/mL, n = 52). The Social Responsiveness Scale (SRS) questionnaire was used to assess core symptoms of ASD (baseline, 12-month). Mixed model repeated measure analyses (including all children or only children with elevated IL-1β) were used. Results: We found evidence for an interaction between baseline IL-1β and treatment response for SRS-total, SRS-social communicative functioning, SRS-awareness and SRS-communication (all P interaction < 0.10). When all children were included in the analysis, two outcome comparisons (treatments vs. placebo) showed greater improvements: VID, no effect (all P > 0.10); OM and VIDOM (P = 0.01) for SRS-awareness. When only children with elevated IL-1β were included, five outcomes showed greater improvements: OM (P = 0.01) for SRS-total; OM (P = 0.03) for SRS-social communicative
BMC Public Health, May 10, 2019
Background: Loss of cognitive function is a significant issue as the world's population ages. Pre... more Background: Loss of cognitive function is a significant issue as the world's population ages. Preserving cognitive function maintains independence in older adults bringing major societal and financial benefits. Lifestyle factors such as diet are modifiable risk factors, which may help preserve cognitive function. Most nutrition research aimed at preserving cognitive function and metabolic health has focussed on individual nutrients and foods, not allowing for food combinations and interactions. A dietary pattern approach considers the entire diet including its complexity. Previous research investigating dietary patterns and cognitive function has not always considered relevant covariates such as physical activity and the Apolipoprotein E genotype, which are known to have associations with cognitive function. The aim of the REACH (Researching Eating, Activity and Cognitive Health) study is to investigate associations between dietary patterns, cognitive function and metabolic syndrome, accounting for a range of covariates. Methods: This cross-sectional study design will recruit older, community-living adults (65-74 years) from Auckland, New Zealand. Dietary data will be collected via a 109-item food frequency questionnaire validated using a 4-day food record. Cognitive function will be assessed using the Montreal Cognitive Assessment (paper based) and the Computerised Mental Performance Assessment System (COMPASS)-a testing suite covering six domains. Additional data will include genetic (Apolipoprotein E ε4) and biochemical markers (fasting glucose, HbA1c, lipids profile), anthropometric measurements (weight, height, waist and hip circumference, body composition using dual X-ray absorptiometry), blood pressure, physical activity (International Physical Activity Questionnaireshort form) and health and demographics (questionnaire). Dietary patterns will be derived by principal component analysis. Associations between cognitive function and dietary patterns will be examined using multiple regression analysis. Covariates and interaction factors will include age, education, socioeconomic status, physical activity, Apolipoprotein E ε4 genotype, family history of dementia or cognitive impairment, and lifestyle factors. Differences between participants with and without metabolic syndrome will also be examined.
The Journal of Steroid Biochemistry and Molecular Biology, Mar 1, 2019
A randomised controlled trial of vitamin D and omega-3 long chain polyunsaturated fatty acids in ... more A randomised controlled trial of vitamin D and omega-3 long chain polyunsaturated fatty acids in the treatment of irritability and hyperactivity among children with Autism Spectrum Disorder
Proceedings, Dec 17, 2019
Nutrition and Healthy Aging
BACKGROUND: To maximally stimulate muscle protein synthesis (MPS), older adults should consume≥1.... more BACKGROUND: To maximally stimulate muscle protein synthesis (MPS), older adults should consume≥1.2 g/kg body weight (BW) of high-quality protein, evenly distributed across the day ( 0.4 g/kg BW per meal). OBJECTIVES: To investigate protein intake, distribution, and sources in community-dwelling older adults. METHODS: Data (including a 4-day food record) were obtained from the Researching Eating, Activity, and Cognitive Health (REACH) study, a cross-sectional study in adults aged 65 to 74 years. RESULTS: Participants (n = 327, 65.4% female) had a median daily protein intake of 1.16 g/kg BW (males) and 1.09 g/kg BW (females). Over half of participants consumed less than 1.2 g protein/kg BW/day (62% females, 57% males). Protein intake was unevenly distributed throughout the day (CV = 0.48 for males and females) and was inadequate for reaching 0.4 g/kg BW/meal at breakfast and at the mid-day meal (males only). The main sources of protein at breakfast were milk (28%), breakfast cereals (...
Current Developments in Nutrition
Current Developments in Nutrition
NSNZ 2022
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
NSNZ 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
BMC Public Health
Background The benefit of reducing sugar-sweetened beverage (SSB) consumption is widely accepted,... more Background The benefit of reducing sugar-sweetened beverage (SSB) consumption is widely accepted, but updated and in-depth data on New Zealand (NZ) children’s SSB consumption is lacking. The aims of this study were to describe beverage consumption, focusing on SSBs in primary school age children living in Auckland; to examine the association of selected socio-demographic, home, community and school factors and children’s beverage knowledge/attitudes with regards to beverage consumption; to explore the relationship between SSBs consumption and adiposity in children. Methods A cross-sectional, Auckland-wide survey of 578 school age children (8-12 years) was conducted using questionnaires to collect data on beverage consumption, beverage knowledge/attitudes, and selected socio-demographic and home, community, school factors. Body fat percentage (BF%) was assessed using bioelectrical impedance (BIA). Results Ninety-six percent of children consumed ≥1 serving of SSBs a week; with ≥5 serv...
PLOS ONE, 2021
Background Aging is associated with decreases in muscle strength and simultaneous changes in body... more Background Aging is associated with decreases in muscle strength and simultaneous changes in body composition, including decreases in muscle mass, muscle quality and increases in adiposity. Methods Adults (n = 369; 236 females) aged 65–74 years living independently were recruited from the cross-sectional Researching Eating Activity and Cognitive Health (REACH) study. Body fat percentage and appendicular skeletal muscle mass (ASM) (sum of lean mass in the arms and legs) were assessed using Dual-energy X-ray Absorptiometry (Hologic, QDR Discovery A). The ASM index was calculated by ASM (kilograms) divided by height (meters) squared. Isometric grip strength was measured using a hand grip strength dynamometer (JAMAR HAND). Results Linear regression analyses revealed that muscle strength was positively associated with the ASM index (R2 = 0.431, p < 0.001). When exploring associations between muscle strength and muscle mass according to obesity classifications (obesity ≥30% males; ≥40%...
Nutrients, 2022
Dietary intake is an important predictor of health and disease outcomes. This cross-sectional stu... more Dietary intake is an important predictor of health and disease outcomes. This cross-sectional study evaluated the relative validity and reproducibility of a semi-quantitative food frequency questionnaire (FFQ) for assessing energy and nutrient intake in older adults. Dietary data were collected 2018–2019 in Auckland, New Zealand from a convenience sample of community-dwelling adults (65–74 years, n = 294, 37% male) using a 109-item self-administered FFQ at baseline (FFQ1) and four weeks later to assess reproducibility. FFQ1 was compared to a four-day food record to determine relative validity. Agreement between dietary assessment tools was assessed for both raw and energy-adjusted nutrient intakes using paired t-tests, correlation coefficients, weighted kappa statistic, Bland–Altman plots, and linear regression analysis. Energy adjustments moderately improved the relative validity and reproducibility for most nutrients. For energy and energy-adjusted nutrient intakes, the mean corre...
British Journal of Nutrition, 2021
The metabolic syndrome is common in older adults and may be modified by the diet. The aim of this... more The metabolic syndrome is common in older adults and may be modified by the diet. The aim of this study was to examine associations between a posteriori dietary patterns and the metabolic syndrome in an older New Zealand population. The REACH study (Researching Eating, Activity, and Cognitive Health) included 366 participants (aged 65–74 years, 36 % male) living independently in Auckland, New Zealand. Dietary data were collected using a 109-item FFQ with demonstrated validity and reproducibility for assessing dietary patterns using principal component analysis. The metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III. Associations between dietary patterns and the metabolic syndrome, adjusted for age, sex, index of multiple deprivation, physical activity, and energy intake were analysed using logistic regression analysis. Three dietary patterns explained 18 % of dietary intake variation – ‘Mediterranean style’ (salad/leafy cruciferous...
Proceedings, 2019
Background: The efficacy of vitamin D and omega-3 long chain polyunsaturated [...]
The New Zealand medical journal, 2019
AIM To investigate vitamin D status and its determinants in school-aged children living in Auckla... more AIM To investigate vitamin D status and its determinants in school-aged children living in Auckland, New Zealand. METHODS Healthy children (n=507) aged 8-11 years were recruited from six primary schools to include a range of ethnicities and sociodemographic characteristics. Finger-prick blood spots were collected and analysed for capillary 25-hydroxyvitamin D (25(OH)D). Weight and percentage of body fat (%BF) were measured using the InBody 230 (Biospace Co. Ltd., Seoul, Korea). Information related to ethnicity, skin colour, physical activity and sun exposure were sought from parents through a questionnaire. RESULTS Mean±standard deviation (SD) 25(OH)D concentration were 64±21 nmol/L, with 31% of the population presenting with 25(OH)D≥75nmol/L, 41% 50-75nmol/L and 28%<50nmol/L. Capillary 25(OH)D was significantly higher in New Zealand European compared to all other ethnic groups (75±20nmol/L, P<0.001). As expected, children with dark/brown skin colour had lower 25(OH)D levels c...
Uploads
Papers by Pamela Von Hurst