Papers by Colleen O'Connor
British Journal of Nutrition, 2009
Evidence from observational, animal and human studies supports a role for soya protein and its is... more Evidence from observational, animal and human studies supports a role for soya protein and its isoflavones in the improvement of glycaemic control in type 2 diabetes. The objective of the present study was to determine the effect of isoflavone-rich soya protein on markers of glycaemic control in adults with type 2 diabetes. Using a randomised, crossover, double-blind, placebo-controlled design, adults with diet-controlled type 2 diabetes (n 29) consumed soya protein isolate (SPI) and milk protein isolate (MPI) for 57 d each separated by a 4-week washout. Blood was collected on days 1 and 57 of each treatment period for analysis of fasting HbA1C, and fasting and postprandial glucose, insulin and calculated indices of insulin sensitivity and resistance. Urine samples of 24 h were collected at the end of each treatment period for analysis of isoflavones. Urinary isoflavone excretion was significantly greater following consumption of SPI compared with MPI, and 20·7 % of the subjects (n ...
Quality Assessment Tool for Genetic Interventions [11]. Legend for Additional file 5. *CD, cannot... more Quality Assessment Tool for Genetic Interventions [11]. Legend for Additional file 5. *CD, cannot determine; NR, not reported; NA, not applicable (DOCX 13 kb)
Sample Report for Personalized Lifestyle Intervention. Sample genetic-based lifestyle recommendat... more Sample Report for Personalized Lifestyle Intervention. Sample genetic-based lifestyle recommendations and information provided to the lifestyle genomics intervention group (DOCX 14 kb)
Sample Report for Standard Lifestyle Intervention (Control Group). Sample population-based lifest... more Sample Report for Standard Lifestyle Intervention (Control Group). Sample population-based lifestyle recommendations and information provided to the control group (DOCX 13 kb)
Proposed Extended CONSORT Checklist of Items for Reporting Pragmatic Trials [42]. Checklist of it... more Proposed Extended CONSORT Checklist of Items for Reporting Pragmatic Trials [42]. Checklist of items to include in a pragmatic RCT (DOCX 18 kb)
Nutrients, 2021
Food literacy is a set of skills and knowledge that are integral to diet. It is common among teen... more Food literacy is a set of skills and knowledge that are integral to diet. It is common among teenagers to not have basic food literacy skills needed to consume a healthy diet. This study examined: (1) the current state of food and nutrition knowledge among adolescents 13–19 years of age in the census metropolitan area of London, ON, Canada; and (2) correlates of food knowledge and nutrition knowledge among adolescents. Data for this study were drawn from baseline youth and parent survey data collected from a larger population health intervention study. Statistical analysis of the survey data indicates that higher parental education and higher median neighbourhood family income, the use of mobile health applications, liking to cook, as well as confidence in reading and understanding food labels were all consistently associated with increased food and nutrition knowledge. Findings may help guide future research towards optimal methods for delivering food literacy interventions to effe...
Lifestyle Genomics, 2020
Background: Lifestyle genomics (LGx) is a science that explores interactions between genetic vari... more Background: Lifestyle genomics (LGx) is a science that explores interactions between genetic variation, lifestyle components such as physical activity (PA), and subsequent health- and performance-related outcomes. The objective of this study was to determine whether an LGx intervention could motivate enhanced engagement in PA to a greater extent than a population-based intervention. Methods: In this pragmatic randomized controlled trial, participants received either the standard, population-based Group Lifestyle BalanceTM (GLB) program intervention or the GLB program in addition to the provision of LGx information and advice (GLB + LGx). Participants (n = 140) completed a 7-day PA recall at baseline, 3, 6, and 12 months. Data from the PA recalls were used to calculate metabolic equivalents (METs), a measure of energy expenditure. Statistical analyses included split plot analyses of covariance and binary logistic regression (generalized linear models). Differences in leisure time PA ...
Nutrition in Clinical Practice, 2021
BACKGROUND Patients with interstitial lung disease (ILD) are known to have diminished exercise ab... more BACKGROUND Patients with interstitial lung disease (ILD) are known to have diminished exercise ability. This study aimed to explore the relationship between nutrition status and body composition parameters with exercise capacity in ILD patients. A second aim focused on assessing the appropriateness of surrogate markers of nutrition status in ILD patients. METHODS Disease severity was determined by the percentage of predicted forced vital capacity. Exercise capacity was determined using 6-minute walk distance. Nutrition status was assessed using the subjective global assessment (SGA), standardized phase angle (SPhA), and impedance ratio z-score (z-IR). Bioelectrical impedance analysis estimated body composition parameters. RESULTS 45 of 79 participants (57%) were malnourished according to the SGA. FFM index z-score (z-FFMI) (r = 0.42, P = .02) and SGA (r = 0.49, P < .01) were significant predictors of exercise capacity independent of disease severity. Age (odds ratio [OR] = 1.1; 95% CI, 1.01-1.25; P = .04), low body mass index (OR = 0.73; 95% CI, 0.57-0.92; P = .01), z-FFMI (OR = 0.34; 95% CI, 0.17-0.68; P < .01), and body fat mass index z-score (OR = 0.39; 95% CI, 0.17-0.91; P = .03) were significantly associated with severe malnutrition. There was no significant difference in SPhA across SGA groups; however, a higher z-IR (poorer cell health) significantly increased the odds of severe malnutrition (OR = 2.75; 95% CI, 1.27-6.03; P = .02). CONCLUSION In ILD patients, malnutrition and loss of FFM negatively impact the ability to perform activities of daily living.
Healthcare Policy | Politiques de Santé, 2020
Background: Current Ontario healthcare policy permits anyone to use the title "nutritionist" and ... more Background: Current Ontario healthcare policy permits anyone to use the title "nutritionist" and practice as a clinician regardless of education and training. The title "dietitian," on the other hand, is protected under the Dietetics Act (1991) for use exclusively by individuals who undergo rigorous education and training in evidence-based nutrition. Objectives: The objectives of this study were to: identify whether the Ontario general public understands the difference between a registered dietitian (RD) and an unregulated "nutritionist;" understand experiences with RDs and "nutritionists;" and determine if the current nutrition landscape arising from gaps in healthcare policy has the potential to harm the public. Methods: A cross-sectional mixed methods survey study was carried out using inductive content analysis, descriptive statistics and chi-square tests. Results: Respondents (n = 402) did not understand the difference between RDs and "nutritionists." Overall, public experiences have been significantly more positive when nutrition information/advice stemmed from an RD. Implications: This study provides justification for proposed legislative amendments to the Dietetics Act (1991) and the Regulated Health Professions Act (1991). These proposed amendments have been detailed in the full-text manuscript. Résumé Contexte : La politique de santé actuelle en Ontario permet à quiconque d' utiliser le titre de « nutritionniste » et d' exercer en tant que clinicien, et ce, indépendamment de son éducation et de sa formation. Le titre de « diététiste », quant à lui, est protégé en vertu de la Loi de 1991 sur les diététistes et ne peut être utilisé que par des personnes qui ont reçu une éducation et une formation rigoureuses en nutrition. Objectifs : L' objectif de cette étude était de déterminer si la population ontarienne comprend la différence entre un diététiste et un « nutritionniste » non réglementé, afin de mieux comprendre l'interaction avec les diététistes et les « nutritionnistes ». L'étude cherchait aussi à déterminer si le paysage nutritionnel actuel, résultant de lacunes dans les politiques de santé, peut être nuisible pour la population. Méthode : Une étude transversale mixte a été réalisée au moyen d' une analyse inductive de contenu, de statistiques descriptives et de tests du chi carré. Résultats : Les répondants (n = 402) ne comprennent pas la différence entre diététiste et « nutritionniste ». Dans l' ensemble, l' expérience de la population est nettement plus positive lorsque les informations et conseils nutritionnels proviennent d'un diététiste. Répercussions : Cette étude justifie les modifications législatives proposées à la Loi de 1991 sur les diététistes et à la Loi de 1991 sur les professions de la santé réglementées. The Ontario Public Does Not Understand the Difference Between Registered Dietitians and Unregulated "Nutritionists" Longwoods Breakfast Series is an educational session that provides invited chief executives the opportunity to share new ideas, policies and/or best practices with colleagues.
Obesity, 2020
The aim of this study was to compare changes in body fat percentage (BFP), weight, and BMI betwee... more The aim of this study was to compare changes in body fat percentage (BFP), weight, and BMI between a standard intervention and a nutrigenomics intervention. Methods: The Nutrigenomics, Overweight/Obesity and Weight Management (NOW) trial is a parallel-group, pragmatic, randomized controlled clinical trial incorporated into the Group Lifestyle Balance TM (GLB) Program. Statistical analyses included two-way ANOVA and split-plot ANOVA. Inclusion criteria consisted of: BMI ≥ 25.0 kg/m 2 , ≥18 years of age, English speaking, willing to undergo genetic testing, having internet access, and not seeing another health care provider for weight-loss advice outside of the study. Pregnancy and lactation were exclusion criteria. GLB groups were randomly assigned 1 to 1 (N = 140) so that participants received either the standard 12-month GLB program or a modified 12-month program (GLB plus nutrigenomics), which included the provision of nutrigenomics information and advice for weight management. The primary outcome was percent change in BFP. Secondary outcomes were change in weight and BMI. Results: The GLB plus nutrigenomics group experienced significantly (P < 0.05) greater reductions in percent and absolute BFP at the 3-month follow-up and percent BFP at the 6-month follow-up compared with the standard GLB group. Conclusions: The nutrigenomics intervention used in the NOW trial can optimize change in body composition up to 6 months.
BMJ Nutrition, Prevention & Health, 2020
BackgroundAdherence to nutritional guidelines for chronic disease prevention and management remai... more BackgroundAdherence to nutritional guidelines for chronic disease prevention and management remains a challenge in clinical practice. Innovative strategies are needed to help optimise dietary behaviour change.ObjectiveThe objective of this study was to determine if a nutrigenomics-guided lifestyle intervention programme could be used to motivate greater dietary adherence and change in dietary intake short-term, moderate-term and long-term compared to the gold-standard population-based weight management intervention (Group Lifestyle Balance (GLB)/Diabetes Prevention Programme (DPP)).DesignThe Nutrigenomics, Overweight/Obesity, and Weight Management (NOW) randomised controlled trial is a pragmatic, parallel-group, superiority clinical trial (n=140), which was conducted at the East Elgin Family Health Team (EEFHT). GLB weight management groups were prerandomised 1:1 to receive either the standard GLB programme or a modified GLB+nutrigenomics (GLB+NGx) programme. Three 24-hour recalls w...
BMC Public Health, 2019
Background: The nutrigenomics, overweight/obesity and weight management trial (NOW Trial) is a pr... more Background: The nutrigenomics, overweight/obesity and weight management trial (NOW Trial) is a pragmatic randomized controlled trial of community-dwelling adults recruited from the Group Lifestyle Balance™ (GLB™) Program. The GLB™ Program (formerly referred to as the Diabetes Prevention Program) is an evidence-based, intensive weight management program, which was offered to overweight/obese patients (BMI ≥ 25.0 kg/m 2) in a rural Ontario community. Methods: Patients enrolled in the GLB™ Program were invited to participate in this study. GLB™ groups were randomized 1:1 to receive either the standard GLB™ program + population-based lifestyle advice for weight management, or a modified GLB™ program + personalized, genetic-based lifestyle advice for weight management. The purpose of this study is to determine if the provision of genetic-based lifestyle guidelines is superior to the provision of population-based guidelines in a pragmatic clinical setting to promote changes in: body composition, weight, body mass index, dietary and physical activity habits, as well as attitudes, subjective norms, and behavioural control. The 12-month intervention protocol consists of 23 group-based sessions and 4 one-on-one sessions. Data collection time points include baseline in addition to 3, 6, and 12-month follow up. The comprehensive study design is described in the present manuscript, using both the extended CONSORT checklist for reporting pragmatic trials and the SPIRIT checklist as guidance during manuscript development. Discussion: Overall, this study seeks to pragmatically determine if the provision of DNA-based lifestyle advice leads to improved health and lifestyle outcomes compared to the provision of standard, population-based lifestyle advice. The results of this trial can be used to inform clinical and community nutrition practice guidelines. Trial registration: This study was registered with clinicaltrials.gov: NCT03015012 on January 9, 2017.
Clinical Nutrition ESPEN, 2018
Background & aims: Subjective Global Assessment (SGA) classifies malnutrition severity via a simp... more Background & aims: Subjective Global Assessment (SGA) classifies malnutrition severity via a simple bedside assessment. Phase angle (PhA) is an indicator of cell integrity and has been suggested to be indicator of nutritional status. Objective: To explore the relationship between PhA and SGA. Methods: Relevant studies published through October 31, 2017 were identified using 7 electronic databases. Articles were included for review if they included comparison data between SGA and PhA within adult disease populations. Evidence quality was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines and methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Results: 33 articles within four disease states (liver, hospitalization, oncology and renal) met inclusion criteria for review. Results were limited by restricting the database search to articles published in English only, and by the inherent difficulty of comparing 2 methods which are both influenced by the operator. Conclusion: Based on GRADE guidelines, evidence quality received a grade of Low. Based on QUADAS-2, 61% of studies had high risk of bias in the index test (PhA), while all other domains had low risk. It is not possible to conclude that PhA is an accurate independent indicator of malnutrition. PROSPERO no. CRD42016050876.
Lifestyle genomics, Jan 10, 2018
Studying the impact of genetic testing interventions on lifestyle behaviour change has been a pri... more Studying the impact of genetic testing interventions on lifestyle behaviour change has been a priority area of research in recent years. Substantial heterogeneity exists in the results and conclusions of this literature, which has yet to be explained using validated behaviour change theory and an assessment of the quality of genetic interventions. The theory of planned behaviour (TPB) helps to explain key contributors to behaviour change. It has been hypothesized that personalization could be added to this theory to help predict changes in health behaviours. This systematic review provides a detailed, comprehensive identification, assessment, and summary of primary research articles pertaining to lifestyle behaviour change (nutrition, physical activity, sleep, and smoking) resulting from genetic testing interventions. The present review further aims to provide in-depth analyses of studies conducted to date within the context of the TPB and the quality of genetic interventions provid...
Blood pressure, Aug 1, 2017
Canadian Journal of Diabetes, 2016
Canadian Journal of Diabetes j o u r n a l h o m e p a g e : w w w. c a n a d i a n j o u r n a l... more Canadian Journal of Diabetes j o u r n a l h o m e p a g e : w w w. c a n a d i a n j o u r n a l o f d i a b e t e s .
Applied Physiology, Nutrition, and Metabolism, 2016
The risk for impaired vitamin B12 status increases with age, as does the use of proton pump inhib... more The risk for impaired vitamin B12 status increases with age, as does the use of proton pump inhibitors (PPI). Long-term use of PPIs is associated with several nutritional deficiencies including B12. Currently, there are no recommendations for B12 screening among patients taking PPIs. Data were abstracted on B12 concentrations, B12-containing supplement use, medications, and select hematological values from a retrospective chart review of 658 adults, 391 with serum B12 concentrations, admitted to 6 different medical units at 2 regional hospitals in Southwestern Ontario between 2010 and 2012. We found no difference between PPI users and nonusers and serum B12 concentrations (404 ± 224 vs 369 ± 213 pmol/L; P = 0.0690). This may be due to use of B12 containing multivitamins in 41% of PPI users. Regression modelling found that aging increases the odds of having an impaired B12 status (<220 pmol/L) by 1.4 times and those using B12 supplements are almost 4 times more likely to have an i...
Canadian Journal of Public Health, 2016
OBJECTIVES: This study examines the influence of adolescents' exposure to unhealthy food outlets ... more OBJECTIVES: This study examines the influence of adolescents' exposure to unhealthy food outlets on junk food purchasing during trips between home and school, with particular attention to how exposure and purchasing differ according to child's biological sex, mode of transportation, and direction to or from school. METHODS: Between 2010 and 2013, students (n = 654) aged 9-13 years from 25 schools in London and Middlesex County, ON, completed a socio-demographic survey and an activity diary (to identify food purchases), and were observed via a global positioning system for 2 weeks (to track routes for trips to/from school). Spatial data on routes and purchase data were integrated with a validated food outlet database in a geographic information system, and exposure was measured as the minutes a child spent within 50 m of an unhealthy food outlet (i.e., fast food restaurants, variety stores). For trips involving junk food exposure (n = 4588), multilevel logistic regression was used to assess the relationship between exposure and purchasing. RESULTS: Multilevel analyses indicated that adolescents' duration of exposure to unhealthy food outlets between home and school had a significant effect on the likelihood of junk food purchasing. This relationship remained significant when the data were stratified by sex (female/male), trip direction (to/from school) and travel mode (active/car), with the exception of adolescents who travelled by bus. CONCLUSION: Policies and programs that mitigate the concentration of unhealthy food outlets close to schools are critical for encouraging healthy eating behaviours among children and reducing diet-related health issues such as obesity.
Canadian Journal of Clinical Nutrition, 2016
Background: Personal nutrigenomics testing (PNT) is becoming an increasingly common practice amon... more Background: Personal nutrigenomics testing (PNT) is becoming an increasingly common practice amongst registered dietitians (RDs); however, nutrigenomics education is only a minor component of a select few undergraduate dietetic programs. Objective: This study explored dietetic students' knowledge and attitudes about PNT and its value as a potential additional component to the dietetic curriculum. Subjects and Methods: A total of 23 students participated in focus groups. An educational video describing nutrigenomics was shown to the participants. A semi-structured questionnaire guided the discussion and explored several topics including ethics, knowledge, awareness, perceived legitimacy and interest in PNT. Transcriptions were qualitatively analyzed. Results: The future of dietetics was identified as the global theme, while organizing themes included: further education, advancing the profession, a holistic approach, and ethics. Participants viewed PNT as a positive contributor to advancing the field of dietetics. Overall, students' had minimal knowledge of nutrigenomics, but a strong desire to learn more. Conclusion: Results of this study indicate that potential future RDs believe that nutrigenomics is the future of dietetics and demonstrate a strong desire to learn more. With the increased use of PNT in dietetic practice, it is essential to include the science of nutrigenomics in the dietetic curriculum.
BioMed research international, 2015
Smartphone "apps" are a powerful tool for public health promotion, but unidimensional i... more Smartphone "apps" are a powerful tool for public health promotion, but unidimensional interventions have been ineffective at sustaining behavioural change. Various logistical issues exist in successful app development for health intervention programs and for sustaining behavioural change. This study reports on a smartphone application and messaging service, called "SmartAPPetite," which uses validated behaviour change techniques and a behavioural economic approach to "nudge" users into healthy dietary behaviours. To help gauge participation in and influence of the program, data were collected using an upfront food survey, message uptake tracking, experience sampling interviews, and a follow-up survey. Logistical and content-based issues in the deployment of the messaging service were subsequently addressed to strengthen the effectiveness of the app in changing dietary behaviours. Challenges included creating relevant food goal categories for participant...
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Papers by Colleen O'Connor