As the population ages it is increasingly important to understand the factors influencing dietary habits of older people. Social, biological and psychological factors influence food intake and affect nutrition risk among older people living in the community. The purpose of this study was to identify food-related behaviours that place older people at nutrition risk and to evaluate older peoples’ perceptions and experiences of various nutrition support options. Fifty-one community living people aged between 80 and 85 years were recruited in North Shore City. Food-related behaviours were explored with the use of three quantitative tools. Practitioner Assessment of Network Type (PANT) was used to evaluate social networks. Elderly Assessment System (EASY-Care) was used to evaluate physical and mental wellbeing. Seniors in the Community: Risk Evaluation for Eating and Nutrition Version II (SCREEN II) assessed nutrition risk. Five people participated in a qualitative interview about nutrition support they had received. A third of the participants (31 percent) were found to be at nutrition risk. Twothirds (67 percent) showed some evidence of disability and needed assistance with everyday tasks. Nearly half (47 percent) of these older people had supportive social networks including close relationships with local family, friends and neighbours. There was an inverse linear relationship between participants’ self-rated health and nutrition risk (p<.001). Those who perceived their health to be fair or poor were more likely to be at nutrition risk. The importance of social contact, a sense of gratitude, ‘getting a meal’, and ‘meeting the need’ were common themes that emerged from interviews with participants who received nutrition support. These findings indicate that nutrition risk may be prevalent among community living older people in New Zealand. Strategies and initiatives are needed to encourage independent living and to help older people with the procurement, preparation, cooking and sharing of enjoyable meals.

New Zealand’s population, like the global population, is ageing. An important element of successful ageing is the maintenance of optimal nutritional status, which is linked to general health and quality of life. The purpose of this mixed methods study, guided by qualitative descriptive methods, was to identify barriers to healthy eating in a group of older single-living New Zealand men. Understanding the men’s perspectives on meal procurement and preparation, in essence walking in their shoes, was a key part of identifying barriers to healthy eating. A cohort of 12 men participated, each completing a semi-structured interview as well as a nutrition knowledge and nutritional risk assessment questionnaire. Data from the semi-structured interviews was analysed using a general inductive approach. The results of the questionnaire were used to enrich description in this mixed methods study. Three core themes emerged from the data which were ‘Individual Circumstances’; ‘Nutrition Knowledge and Skills’; and ‘Food-Related Values’. Potential barriers to healthy eating, in terms of individual circumstances, were limited finances, limited mobility and a lack of personal transport. These barriers were partially ameliorated by effective, reliable social and support networks. A diverse range of shopping, cooking and gardening skills, as well as nutrition knowledge, existed amongst the men. Poor nutrition knowledge and limited cooking skills were possible barriers to healthy eating. Strong beliefs the men held about how food procurement and preparation should occur, termed food-related values, were also potential barriers to healthy eating. Values identified were ‘the importance of healthy eating’; ‘structure in food-related activities’; ‘convenience’; and ‘like it or not, it has to be done – shopping and cooking’. Depending on the prioritisation of values by the individual, they could develop into barriers. For example, prioritising ‘convenience’ over ‘the importance of healthy eating’ led to decisions that negatively impacted dietary intake. This study highlighted the diversity of experiences, circumstances, skills and priorities of older single-living men. Interventions aimed at improving the dietary behaviours of older single-living New Zealand men must recognise the heterogeneity of this population and support the values they hold in regards to food-related activities.

Osteoporosis is a serious public health issue, which is growing in significance because of our aging population. It is estimated that one in three New Zealand women over the age of 50 years will suffer from an osteoporotic-related fracture. The risk of osteoporosis among South Asian women living in New Zealand is unknown. However, this is an important and growing population group. The purpose of this study was to determine osteoporosis knowledge, health beliefs and dietary calcium intake in a sample of South Asian women living in Auckland, New Zealand. Relationships between these variables and the predictors of dietary calcium intake were examined. A sample of 102 South Asian women (mean age of 41.6 years) completed an online questionnaire to assess osteoporosis knowledge and health beliefs using the validated Osteoporosis Knowledge Test (OKT) and Osteoporosis Health Belief Scale (OHBS), respectively. A four day food diary was used to assess dietary calcium and energy intake. In general, these South Asian women were lacking in osteoporosis knowledge, they did not perceive themselves to be susceptible to osteoporosis and did not consider osteoporosis to be a serious disease. They perceived many benefits of consuming a high calcium diet for the prevention of osteoporosis and did not identify many barriers to dietary calcium intake. In addition, these South Asian women were highly health motivated. Perceived barriers to dietary calcium intake (R=-0.32; P<0.01) and health motivation (R=0.30; P<0.01) were significantly correlated to dietary calcium intake. Health motivation, perceived barriers to dietary calcium intake and the use of a dietary supplement were significant predictors of dietary calcium intake and together explained 27% of the variance. These findings suggest that osteoporosis prevention interventions may need to increase awareness, overcome perceived barriers to dietary calcium intake as well as maintain health motivation among these South Asian women to achieve sufficient dietary calcium intake.

Background Hypovitaminosis D is becoming recognised as an emerging threat to health, even in countries like New Zealand which enjoy plentiful sunshine. The evidence for a role for vitamin D deficiency in the aetiology of a plethora of diseases continues to accumulate, including type 2 diabetes, and the preceding insulin resistance. Objectives The primary objective of the Surya Study was to investigate the effect of improved vitamin D status (through supplementation) on insulin resistance. The secondary objectives were to investigate the vitamin D status and bone mineral density of South Asian women living in New Zealand, and to investigate the effect of vitamin D supplementation on bone turnover as measured by biochemical markers of bone resorption and formation. Method Women of South Asian origin, ≥20 years old, living in Auckland (n = 235) were recruited for the study. All were asked to complete a 4-day food diary, invited to have a bone scan, and were screened for entry into the intervention phase which required insulin resistance (HOMA-IR >1.93) and serum 25(OH)D < 50 nmol/L. Eighty-one completed a 6-month randomised controlled trial with 4000 IU vitamin D3 (n = 42) or placebo (n = 39). Primary endpoint measures included insulin resistance, insulin sensitivity (HOMA2%S), fasting C-peptide and markers of bone turnover, osteocalcin (OC) and collagen C-telopeptide (CTX). Ninety-one of the 239 had a bone scan and bone mineral density (BMD) was measured in the proximal femur and lumbar spine. Results Adequate serum 25(OH)D concentrations (>50 nmol/L) were observed in only 16% of subjects screened. Median (25th, 75th percentile) serum 25(OH)D increased significantly from 21 (11,40) to 75 (55,84) nmol/L with supplementation. Significant improvements were seen in insulin sensitivity and insulin resistance (P = 0·003, P = 0·02 respectively), and circulating serum insulin decreased (P = 0·02) with supplementation compared to placebo. There was no change in C-peptide with supplementation. Insulin resistance was most improved when endpoint serum 25(OH)D =80 nmol/L. In post-menopausal women OC and CTX levels increased in the placebo arm but CTX decreased from 0.39±0.15 to 0.36±0.17 (P = 0.012) with supplementation. Osteoporosis (T score <-2.5) was present in 32% of postmenopausal, and 3% of premenopausal women. Women 20 – 29 years (n=10) had very low BMD, calcium intake and serum 25(OH)D Conclusions Improving vitamin D status in insulin resistant women resulted in improved insulin resistance and sensitivity but no change in insulin secretion. Optimal 25(OH)D concentrations for reducing insulin resistance were shown to be ≥80 nmol/L. The prevalence of low 25(OH)D concentrations in this population was alarmingly high, especially in younger women. In post-menopausal women, vitamin D supplementation appeared to ameliorate increased bone turnover attributed to oestrogen deficiency.

The allergic disease of asthma is characterized by an infiltration of inflammatory cells to the lung, a process co-ordinated by T-helper (TH) cells. The TH2 cytokine Interleukin (IL)-4 promotes infiltration of eosinophils to sites of inflammation. Eosinophil-selective chemoattractant cytokines (eg. eotaxins) are synthesized by lung epithelial cells. Eotaxin-3 is expressed at high levels in the asthmatic lung, predominantly after IL-4 stimulation. Eotaxin-3 is therefore a marker of inappropriate airway inflammation. Polyphenolic (PP) compounds found in high concentrations in berries may have beneficial effects in inflammatory conditions. Plant and Food Research produced high-PP extracts of blackcurrant (BC) cultivars that were tested for inflammation modulating effects. Since high doses of PPs have been shown to cause cell death, we tested two BC cultivars at a range of concentrations in a cell viability (WST-1) assay. While no toxic effects were attributable to the BC extracts (1-50µg/ml), a dose-related trend in cell death was observed and therefore 10µg/ml was chosen for further experiments Ten BC cultivars were compared for efficacy by measuring eotaxin-3 production in IL-4 stimulated human lung epithelial (A549) cells in vitro. Cells were incubated with BC extracts (10µg/ml) and IL-4 (10ng/ml) for 24 hours. The supernatants were then quantified for eotaxin-3 levels by an enzyme-linked immunosorbent assay (ELISA). All ten BC extracts reduced eotaxin-3 levels after stimulation with IL-4, and six BC extracts were effective by statistically significant levels (P<0.05), (BC cultivars -01, -02, -03, -05, -09 & -10). Of those, BC extracts of four cultivars demonstrated a reduction of more than 65% from the IL-4 stimulated control. In addition, a positive trend in inflammation modulation vs. one anthocyanin (ACN) in the BC extracts was shown. This study has demonstrated the beneficial inflammation modulatory effects of polyphenolic BC extracts, which could be related to cyanidin 3-O-rutinoside content. These results may have therapeutic potential for asthma.

The allergic disease of asthma is characterized by an infiltration of inflammatory cells to the lung, a process co-ordinated by T-helper (TH) cells. The TH2 cytokine Interleukin (IL)-4 promotes infiltration of eosinophils to sites of inflammation. Eosinophil-selective chemoattractant cytokines (eg. eotaxins) are synthesized by lung epithelial cells. Eotaxin-3 is expressed at high levels in the asthmatic lung, predominantly after IL-4 stimulation. Eotaxin-3 is therefore a marker of inappropriate airway inflammation. Polyphenolic (PP) compounds found in high concentrations in berries may have beneficial effects in inflammatory conditions. Plant and Food Research produced high-PP extracts of blackcurrant (BC) cultivars that were tested for inflammation modulating effects. Since high doses of PPs have been shown to cause cell death, we tested two BC cultivars at a range of concentrations in a cell viability (WST-1) assay. While no toxic effects were attributable to the BC extracts (1-50µg/ml), a dose-related trend in cell death was observed and therefore 10µg/ml was chosen for further experiments Ten BC cultivars were compared for efficacy by measuring eotaxin-3 production in IL-4 stimulated human lung epithelial (A549) cells in vitro. Cells were incubated with BC extracts (10µg/ml) and IL-4 (10ng/ml) for 24 hours. The supernatants were then quantified for eotaxin-3 levels by an enzyme-linked immunosorbent assay (ELISA). All ten BC extracts reduced eotaxin-3 levels after stimulation with IL-4, and six BC extracts were effective by statistically significant levels (P<0.05), (BC cultivars -01, -02, -03, -05, -09 & -10). Of those, BC extracts of four cultivars demonstrated a reduction of more than 65% from the IL-4 stimulated control. In addition, a positive trend in inflammation modulation vs. one anthocyanin (ACN) in the BC extracts was shown. This study has demonstrated the beneficial inflammation modulatory effects of polyphenolic BC extracts, which could be related to cyanidin 3-O-rutinoside content. These results may have therapeutic potential for asthma.

The allergic disease of asthma is characterized by an infiltration of inflammatory cells to the lung, a process co-ordinated by T-helper (TH) cells. The TH2 cytokine Interleukin (IL)-4 promotes infiltration of eosinophils to sites of inflammation. Eosinophil-selective chemoattractant cytokines (eg. eotaxins) are synthesized by lung epithelial cells. Eotaxin-3 is expressed at high levels in the asthmatic lung, predominantly after IL-4 stimulation. Eotaxin-3 is therefore a marker of inappropriate airway inflammation. Polyphenolic (PP) compounds found in high concentrations in berries may have beneficial effects in inflammatory conditions. Plant and Food Research produced high-PP extracts of blackcurrant (BC) cultivars that were tested for inflammation modulating effects. Since high doses of PPs have been shown to cause cell death, we tested two BC cultivars at a range of concentrations in a cell viability (WST-1) assay. While no toxic effects were attributable to the BC extracts (1-50µg/ml), a dose-related trend in cell death was observed and therefore 10µg/ml was chosen for further experiments Ten BC cultivars were compared for efficacy by measuring eotaxin-3 production in IL-4 stimulated human lung epithelial (A549) cells in vitro. Cells were incubated with BC extracts (10µg/ml) and IL-4 (10ng/ml) for 24 hours. The supernatants were then quantified for eotaxin-3 levels by an enzyme-linked immunosorbent assay (ELISA). All ten BC extracts reduced eotaxin-3 levels after stimulation with IL-4, and six BC extracts were effective by statistically significant levels (P<0.05), (BC cultivars -01, -02, -03, -05, -09 & -10). Of those, BC extracts of four cultivars demonstrated a reduction of more than 65% from the IL-4 stimulated control. In addition, a positive trend in inflammation modulation vs. one anthocyanin (ACN) in the BC extracts was shown. This study has demonstrated the beneficial inflammation modulatory effects of polyphenolic BC extracts, which could be related to cyanidin 3-O-rutinoside content. These results may have therapeutic potential for asthma.

Functional foods are a growing category in the food market, but little is known about New Zealanders’ views or use of them. A study was carried out in Palmerston North over the period 2005-2006 to investigate determinants of functional food use. The study had two stages: firstly focus groups (5 focus groups, n=42) to understand more of the consumer’s perspective, and then a detailed consumer survey. The questionnaire was based on the theory of Planned Behaviour (TBP), the Health Belief Model (HBM) and information gathered from the focus groups. The results from the study showed that participants knew little about the functional food concept. There was also a strong indication of scepticism, with people concerned about adequate dosage and efficacy. Dietary supplements were seen as a way to achieve the benefit without some of the barriers associated with functional foods. Therefore, a significant proportion of the respondents (>30%) preferred to have the functional ingredients in pill form. Other respondents preferred to have functional ingredients delivered in a staple food that was consumed on a daily basis and the most preferred food vehicle was a drink. Nutrition and health were ranked highest as influencers of food choice, with taste and cost also ranked as important. Women were more likely than men to identify nutrition and health as their main influence. An ANOVA model was used to establish the relationships between socio-demographics, health condition and health behaviour and the five attitudes factors (from exploratory factor analysis). No single attitude factor was significantly correlated with all the sociodemographic variables: women had less positive attitudes towards functional foods in general, were more likely to be sceptical and had less belief in the efficacy of functional foods. While more educated respondents considered functional foods to have less personal benefit, and those with lower income had less confidence in their own ability to consume functional foods. Talking to others about functional foods was found to be significantly negatively correlated with all attitude dimensions and intentions indicating that when people talk to others that their views about functional foods become more negative. In addition, people who Prediction of peoples’ intentions and actual consumption of functional foods in Palmerston North currently used dietary supplements had less positive attitudes and lower intentions to consume functional foods in general. Those who had existing CHD or arthritis symptoms had lower intentions than others to consume functional foods directed towards these diseases. Exploratory factor analysis also identified two factors related to intention to consume functional foods; one for functional foods in general and another for disease (arthritis and CHD) functional foods. Women had less intention to consume functional foods in general, while older adults were more likely to intend to consumer disease specific functional foods. A series of models were evaluated by using structural equation modelling to see how well they could predict peoples’ intentions to purchase and their actual purchase of functional foods in general, as well as disease specific functional foods. The analysis showed that the TPB model (R2=57%) and a modified TPB (R2=61%) better predicted peoples’ intention to consume general functional foods than the theory of reasoned action model (R2=55%). However, a model that included the modified TPB model plus 2 constructs (perceived benefits, perceived barriers) from the health belief model was best of all (R2=72%) at predicting peoples’ intention to consume general functional foods. Perceived barriers were the most influential predictor of intention (barriers included uncertainty about efficacy and dose; surprisingly taste and cost were not significant predictors, but this was probably due to the fact these constructs were not explored as multi-dimensional constructs. The models were poor at predicting intentions to consume specific functional foods, but the addition of perceived susceptibility and perceived severity improved prediction of intentions towards anti-CHD functional foods (R2 = 43%). Perceived susceptibility, but not perceived severity, improved prediction of intention to consumer anti arthritis functional foods (R2=37%). The research suggests that attitudes towards the concept of functional foods are generally positive, but scepticism is evident. Functional foods are not necessarily seen as ‘healthy’, nor are they considered a way to treat existing conditions. Thus careful marketing will be required to target product and messages to relevant segments of the market.

Coeliac disease (CD) is a disorder resulting from interactions between diet, genome and immunity. This research seeks to further our understanding of the pathology of CD in regard to its secondary effects on the diversity of enteral microflora via changes in immune tolerance. It proposes that enteral mucosal pro-inflammatory change in CD is associated with a decrease in microbial diversity whilst remission from inflammation may result in an increase in enteral microbial diversity that could contribute to the restoration of tolerance. The first study analyses whether remission from active CD is associated with change in generic enteral microbial diversity by assessing people at diagnosis and following their response to gluten exclusion. A comparison is made to people without CD consuming a ’normal diet’. DGGE profiling of faecal microflora in subjects with CD at diagnosis (confirmed by serology and by duodenal biopsy) and over three consecutive months on a gluten-free diet (GFD) was performed and profiles were compared with those of age and gender matched control subjects taken at monthly intervals. Diversity of faecal microflora (measured as Simpsons Index ) was significantly lower in people with CD than in control subjects. It was possible to distinguish the profiles of coeliac subjects at diagnosis from those obtained after three months on a GFD but it was not possible to distinguish between the samples from control subjects taken at monthly intervals. The profiles of CD subjects after three months on a GFD were more dissimilar to those of the control subjects than those obtained prior to dietary treatment, chiefly on the basis of three bands that were not found in the faeces of any control subjects. The second study analyses dietary intake to determine if a lack of nutrients at diagnosis (before institution of a GFD) and at monthly intervals for three consecutive months post diagnosis (on a GFD) exists, as it is known that CD is associated with nutrient deficiencies resulting from malabsorption due to intestinal inflammation and damage. Subjects completed a customised food questionnaire at each sampling period. Dietary intake was analysed using Foodworks Professional 2007. Significant differences were identified in gluten, starch and carbohydrate intake but not in other macronutrients. Contrary to established literature, these analyses identified few significant differences in micronutrient intake within coeliac subjects over time, however, significant differences were found in iron and sodium.

Salmon is a good source of long chain (LC) omega 3 fatty acids and selenium; these are well recognised for their health benefits. Recommendations for LC omega 3 fatty acid intakes presume equivalence between fish and fish oil. The aim of this research was to compare the effects of consuming salmon with salmon oil capsules on LC omega 3 fatty acid and selenium status. Forty four healthy subjects were randomly assigned to consume either two servings of 120 g farmed New Zealand King (FNZK) salmon/week or 2, 4 or 6 capsules of salmon oil/day for 8 weeks. Fasting blood samples, anthropometric measures, food consumption habits information and blood pressure (BP) measurements were obtained at the study commencement and ending. Each subject’s intake of LC omega 3 fatty acids and selenium was determined by analysing the fatty acid and selenium content of duplicate portions of cooked salmon and capsules. The amount of salmon consumed was then calculated by subtracting unconsumed amounts of salmon and then calculating the intake of LC omega 3 fatty acids as grams of LC omega 3 fatty acids consumed per day. Percentage of compliance to capsule intake, based on counts of unconsumed capsules, was calculated to determine the amount of LC omega 3 fatty acids consumed per day from capsules. Change in red blood cells (RBC) LC omega 3 fatty acid levels from equivalent amounts of LC omega 3 fatty acids consumed from capsules and salmon were compared using linear regression analysis predictive models fitted to the capsule data. Omega 3 index was calculated. LC omega 3 fatty acid intakes from salmon and 2, 4 and 6 capsules were 0.82, 0.24, 0.47 and 0.68 g/day, respectively. Equal amounts of LC omega 3 fatty acids consumed from salmon and capsules resulted in similar increases in RBC LC omega 3 fatty acids and omega 3 index (RBC eicosapentaenoic acid (EPA): 0.80 [0.58 – 1.02] vs. 1.00 [0.71 – 1.27] %; RBC docosahexaenoic acid (DHA): 0.93 [0.58 – 1.29] vs. 0.99 [0.68 – 1.31] %; omega 3 index: 1.92 [1.46 – 2.38] vs. 2.25 [1.65 – 2.83] %). The capsules did not contain selenium, but the salmon provided 6.84 µg selenium/day. Plasma selenium concentrations increased significantly in the salmon group compared to the capsule