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Biomedical subjects

J Wardle

Publications and source records attributed to J Wardle.

At least 73 records · Page 4Linked to original sources

Young children's food preferences: a comparison of three modalities of food stimuli.

Food preferences are widely agreed to be important determinants of eating behaviour in young children. Existing studies of methods of assessing preferences have suggested tasting and ranking foods can generate reliable responses with young children, but there have been few attempts to assess other methods which might provide a more convenient alternative in situations where the use of real foods could be difficult (e.g. outside the laboratory), or tasting could be undesirable (e.g. if there are large numbers of foods, or foods which children would be unwilling to taste). The present study is a comparison of the reliability of preferences measured using: (i) real foods; (ii) food photographs; and (iii) food models, in 3 to 5-year-old children. The results showed that the tasting method produced good results, replicating existing data from U.S. samples. Food photographs came a close second in reliability but food models produced unreliable rankings, especially in the youngest group. Five-year-olds produced significantly more consistent results than the younger children. These results indicate that using real foods as the stimuli produces the most reliable taste preferences with children in this young age range, but photographs may provide a convenient alternative with adequate reliability.

Age Factors↗

Psychosocial influences on older adults' interest in participating in bowel cancer screening.

BACKGROUND: As part of a multicenter, randomized controlled trial of the efficacy of flexible sigmoidoscopy for the prevention of bowel cancer, an investigation of the predictors of screening interest was carried out in a subsample of older adults. METHOD: The aim of the study was to establish the predictive power of the Health Belief Model (HBM) and to evaluate the contribution of HBM elements in mediating the effect of other demographic and health variables which have been found to be associated with screening interest and participation. A total of 5,099 participants were sent a postal questionnaire which examined screening interest, attitudes toward screen ing (benefits and barriers), perceived bowel cancer risk, bowel cancer worry, bowel symptoms, health status, state anxiety, and optimism. A total of 3,648 questionnaires were returned completed, giving a response rate of 71.5%. RESULTS: The results showed that threat, barriers, and benefits explained 47% of the variance in interest. Demographic and health variables were also associated with screening interest, although most of their effect was mediated by the HBM constructs. DISCUSSION: This community study in older adults showed a high level of interest in participating in screening. The large sample size provided the opportunity to test the value of the HBM model and to examine mediation of demographic and health variables. The HBM proved to be a good model of screening interest. These results further our understanding of the decision processes in participating in cancer screening and point to directions to increase the level of participation in community samples.

Attitude to Health↗

Randomized trial of the effects of cholesterol-lowering dietary treatment on psychological function.

PURPOSE: Epidemiological studies have suggested that cholesterol lowering could affect psychological functioning. This study was designed to test whether cholesterol-lowering diets adversely affect mood and cognitive function.5.2 mM [198 mg/dL]) to either a low-fat diet, a Mediterranean diet, or a waiting-list control. Cholesterol levels, psychological well-being (depression, anxiety, hostility), and cognitive function were assessed at baseline, 6 weeks, and 12 weeks. RESULTS: Total serum cholesterol levels fell significantly more in the intervention groups (8.2% reduction) than in the control group (P <0.001). All three groups showed a modest improvement in psychological well-being during the 12-week treatment period, but there were no differences among the groups. There were no between-group differences on three measures of cognitive function, but for a fourth measure, which involved the task with the greatest processing load, the two intervention groups did significantly worse (P <0.001) than the control group. The change in performance was correlated with the change in total serum cholesterol level (r = 0. 21, P = 0.01). CONCLUSIONS: Two dietary interventions that successfully lowered serum cholesterol levels had no adverse effect on mood. There was some evidence for a relative impairment in cognitive function in the treated groups in one of four cognitive tests, but additional studies will be required to determine the relevance of this finding.

Adult↗

Stress, dietary restraint and food intake.

OBJECTIVE: The purpose of this study was to examine the associations between work stress and nutritional status in relation to dietary restraint in a community sample of adults. METHODS: The design included a cross-sectional and a longitudinal study element. Ninety staff members (58 women and 32 men) of a large department store were assessed on four occasions over a 6-month period with measures of diet, weight, and perceived stress. Work stress was indexed in terms of the hours of work over the past 7 days, which provided an objective indicator of demand. RESULTS: Participants worked an average of 47 hours on the high-work-stress session compared with 32 hours on the low-work-stress session. The highest work-stress session was compared with the lowest work-stress session in the longitudinal analyses, and the moderating effects of gender and restrained eating were examined. High-workload periods were associated with higher energy and saturated fat and sugar intake. There was a significant moderating effect of restrained eating, with a hyperphagic response to work stress in restrained eaters, compared with no effect in unrestrained eaters. CONCLUSION: The results indicate that the associations between restraint and stress-induced eating that have been observed in the laboratory extend to the real-life setting. They raise the possibility that restrained eaters are particularly vulnerable to adverse effects of stress on health, through influences on food intake.

Adult↗

Intentional weight control and food choice habits in a national representative sample of adults in the UK.

OBJECTIVE: To establish the association between intentional weight control and specific eating behaviours. DESIGN: An interview-based survey of a representative sample of the UK population including questions about demographic characteristics, weight and height, intentional weight control and eating behaviours. Associations among the eating behaviours, and between weight control and eating behaviours, were examined. SUBJECTS: 1894 men and women completed the interview (70% response rate). RESULTS: Approximately equal proportions of the sample were 'not bothered about weight' (30%), 'watching their weight' (36%), or 'trying to lose weight' (28%). More men were 'not bothered' and more women were 'trying to lose'. People who were trying to lose or were watching their weight were more likely to report restricting fats, sugars, snacks, and the amount eaten at meals, than those who were not bothered, but there were no differences between weight watchers and weight losers. The overall level of restriction among weight losers was modest. There were no group differences in eating breakfast, fruits or vegetables, skipping meals or fasting. CONCLUSIONS: Around two-thirds of the adult population of the UK appear to be concerned about weight control, and this is reflected in somewhat higher than average adherence to recommended restrictive dietary habits.

Adolescent↗

Evaluation of a modified cognitive-behavioural programme for weight management.

OBJECTIVE: To evaluate a modified cognitive-behavioural treatment (M-CBT) for weight management which addresses both the psychosocial costs and the physiological health risks of obesity, without a focus on weight loss. DESIGN: Randomized controlled trial comparing M-CBT with standard cognitive-behavioural therapy (S-CBT). SUBJECTS: Sixty-three overweight women with body mass index (BMI) > or = 28 kg/m2, mean age = 47.5 and mean BMI = 35.4. MEASURES: Weight, waist and hip circumference, blood lipids, blood glucose, blood pressure, psychological well-being, depression, self esteem, stress, binge eating, eating style, body image, nutrient intake, aerobic fitness, activity levels, patient satisfaction with treatment. RESULTS: Both M-CBT and S-CBT achieved improvements in a broad range of physical, psychological and behavioural variables. Weight loss in the S-CBT group was greater than in the M-CBT group immediately after treatment, but both groups lost weight. Participants in the M-CBT group continued to lose weight up to the 1 y follow-up. M-CBT was evaluated positively by participants. CONCLUSIONS: Both M-CBT and S-CBT programmes were successful at inducing modest weight loss, as well as improving emotional well-being, reducing distress, increasing activity and fitness, improving dietary quality and reducing cardio-vascular disease risk factors. The improvements were maintained or continued at 1 y follow-up. These results suggest that treatment based on the new weight-control paradigm which emphasizes sustained lifestyle change without emphasis on dieting, can produce modest benefits to health and well-being.

Adipose Tissue↗

HSE performance tests for dosimetry services.

In the United Kingdom a dosimetry service that measures and assesses whole-body or part-body doses arising from external radiation must successfully complete a performance test. Results of the performance tests for routine whole-body, routine extremity/skin and special accident dosimetry, carried out over the past six years by the AEA Technology Calibration Service at Winfrith, and DRaStaC, the AWE Calibration Service at Aldermaston, are presented. The test involves irradiating groups of dosemeters to known doses of gamma radiation and determining the bias and relative standard deviations for each dose group. The results are compared with the pass criteria specified by the UK Health and Safety Executive. For routine whole-body dosimetry, both the film badge and thermoluminescent dosemeter (TLD) perform adequately for irradiations between 0.6 and 30 mSv. For higher doses up to 250 mSv, where the slow emulsion of the film is used, the film badge shows poorer performance with a tendency to overestimate the dose. For routine extremity/skin dosimetry there is a wider spread of relative standard deviation results than is seen for routine whole-body dosimetry. This is to be expected since the results will include dosemeters that are based on 'disposable' TLDs and ones based on lithium fluoride powder in sachets. For special accident dosimetry the dosemeters are tested between 0.26 and 6 Gy. For the highest dose group the film badge invariably underestimates the true dose, whereas the TLD has a tendency to overestimate it.

Information Services↗

An experimental investigation of the influence of health information on children's taste preferences.

Promotion of healthy diets often involves provision of information about which food types are most favourable for health. This is based on the assumption that the rational consumer will, other things being equal, choose the food that they know is healthier. However, health information may not always have a positive effect, since there is evidence that some people, particularly children, believe that healthiness and tastiness are mutually exclusive characteristics. To the extent that taste governs preferences and consumption, the characterization of a food as healthy could reduce its anticipated pleasantness. The present study tested the idea that a 'healthy' label would reduce liking for a novel drink. The results showed that the children rated a 'healthy labelled' drink as less pleasant and said they would be less likely to ask their parents to buy it than the same drink presented with control information. These results suggest that care may need to be exercised in promoting foods to children through an emphasis on health, unless the implications of healthiness can be rendered more positive.

Carbonated Beverages↗

Demographic variation in nutrition knowledge in England.

This paper describes a nutrition knowledge survey carried out on a cross-section of the adult population of England (n = 1040), looking at knowledge relating to current dietary recommendations, sources of nutrients, healthy food choices and diet-disease links. Serious gaps in knowledge about even the basic recommendations were discovered, and there was much confusion over the relationship between diet and disease. Significant differences in knowledge between socio-demographic groups were found, with men having poorer knowledge than women, and knowledge declining with lower educational level and socio-economic status. Possible reasons for these differences and implications for public education campaigns and socio-economic inequalities in health are discussed.

Adult↗

Acceptability of flexible sigmoidoscopy screening in older adults in the United Kingdom.

OBJECTIVES: To assess the acceptability of bowel cancer screening using flexible sigmoidoscopy (FS). SETTING: Adults aged 55 to 64 recruited from general practices in Welwyn Garden City and Leicester, which were the pilot and start up centres of a multicentred randomised controlled trial of FS screening (the ICRF/MRC Flexible Sigmoidoscopy Screening Trial). METHODS: Screenees (n=4422) were sent a three month follow up questionnaire that included measures of satisfaction with information given before the test, facilities at the test unit, attitudes of the staff, and explanation of the results. Measures of pain, embarrassment, feelings of being "in control" during the test, willingness to encourage others to have the test, and gladness to have participated were also included. In addition, semistructured telephone interviews were conducted with 60 screenees, stratified by screening outcome and gender. RESULTS: The follow up questionnaire was completed by 94% of screenees. Responses indicated a high level of satisfaction with the procedure: 99% were satisfied with the information given before the test, the facilities, the attitudes of the staff, and the explanation of their results; 91% reported only mild or no pain; 97% reported little or no embarrassment; and 99% were glad they had the test. Satisfaction ratings varied little by gender or outcome group. The quantitative results were reinforced by the qualitative data, which also revealed high acceptability. CONCLUSION: In the context of a clinical trial with dedicated trial staff, FS is a well tolerated procedure. There are high levels of satisfaction with service provision and positive attitudes towards the programme.

Colorectal Neoplasms↗

Predictors of attendance in the United Kingdom flexible sigmoidoscopy screening trial.

OBJECTIVE: To investigate predictors of attendance in the United Kingdom flexible sigmoidoscopy screening trial. DESIGN: Prospective design in which participants completed a postal questionnaire before being sent their invitation for screening. SETTING: Welwyn Garden City and Leicester, United Kingdom. PARTICIPANTS: A total of 2758 patients aged 55 to 64, registered with general practices in the two centres, who (a) expressed interest in having the screening test, (b) completed a postal questionnaire, and (c) were subsequently invited for screening. MAIN RESULTS: The attendance rate among questionnaire responders was 76.1%. Multiple logistic regression analysis yielded a final model that included nine independent predictors of attendance. Patients with the following characteristics were more likely to attend: men; home owners; non-smokers; those who had regular check ups at the dentist; those with better subjective health; those who minded less about having medical tests; those who said they would definitely rather than probably take up the offer of sigmoidoscopy screening; and those who perceived less barriers and more benefits to having the test. CONCLUSIONS: The findings are broadly consistent with previous studies of screening participation, although subjective health emerged as an important predictor in this study. There was no evidence for "reverse targeting": attenders were not at lower (or higher) risk for colorectal cancer compared with non-attenders. The findings relating to attitudes and beliefs could be used in efforts to improve attendance, for example by developing information leaflets that address barriers to screening. Other findings could be used to target interventions to subgroups that have relatively low rates of screening participation.

Age Factors↗

Mood and drinking: a naturalistic diary study of alcohol, coffee and tea.

Understanding the pattern of associations between mood and consumption of alcohol, coffee and tea may provide information about the factors governing beverage drinking. The associations between mood and the consumption of alcohol, coffee and tea during everyday life were assessed. A naturalistic study was carried out with 18 male and 31 female volunteers from two working groups (psychiatric nursing and school teaching). Participants completed daily records of drink consumption, together with ratings of anxious and positive moods for 8 weeks. Potential moderators of associations were self-reported drinking to cope, high perceived job demands and social support at work. Day-by-day associations were analysed using Spearman correlations. There were substantial individual-differences in associations between mood and daily alcohol, coffee and tea consumption. Overall, alcohol intake was associated with high positive and low anxious mood. This effect was not present among participants with high drinking to cope ratings. Coffee and tea drinking were not consistently related to mood across the entire sample. However, job demands influenced the association between coffee consumption and anxious mood in men, and those who experienced high job demands drank more coffee on days on which they felt anxious. In contrast, women but not men who enjoyed high social support at work felt more relaxed on days on which they drank more tea. These results indicate that people vary widely in the extent to which mood is related to the drinking of alcohol, coffee and tea. The strength of associations is influenced by gender, motivational factors, and by stress and coping resources.

Adaptation, Psychological↗

Perceived effects of stress on food choice.

Self-reported effects of stress on eating behaviour and food were assessed in a brief questionnaire in 212 students. Snacking behaviour was reportedly increased by stress in the majority of respondents (73%) regardless of gender or dieting status. The overall increase in snacking during stress was reflected by reports of increased intake of "snack-type" foods in all respondents, regardless of dieting status. In contrast, intake of "meal-type" foods (fruit and vegetables, meat and fish) was reported to decrease during stressful periods. The majority of the respondents reported an effect of stress on overall amount eaten, but while snacking, roughly equal numbers reporting decreased intake (42%) and increased intake (38%). The direction of change in intake could be predicted in part by dieting status, with dieters being more likely to report stress hyperphagia and nondieters being more likely to report stress hypophagia.

Adult↗

Development of a general nutrition knowledge questionnaire for adults.

OBJECTIVE: This paper describes the development of a reliable and valid questionnaire to provide a comprehensive measure of the nutritional knowledge of UK adults. The instrument will help to identify areas of weakness in people's understanding of healthy eating and will also provide useful data for examining the relationship between nutrition knowledge and dietary behaviour which, up until now, has been far from clear. DESIGN: Items were generated paying particular attention to content validity. The initial version of the questionnaire was piloted and assessed on psychometric criteria. Items which did not reach acceptable validity were excluded, and the final 50 item version was administered to two groups differing in nutritional expertise on two occasions to assess the construct validity and test-retest reliability. SETTING: The questionnaire was developed in 1994 in the UK. SUBJECTS: Three hundred and ninety-one members of the general public, recruited via their places of work, completed the questionnaire at the piloting stage. The final version was administered to 168 dietetics and computer science students following a university lecture. RESULTS: The internal consistency of each section was high (Cronbach's alpha = 0.70-0.97) and the test-retest reliability was also well above the minimum requirement of 0.7. Nutrition experts scored significantly better than computer experts [F(1167) = 200.5, P<0.001], suggesting good construct validity. CONCLUSIONS: The findings demonstrate that the instrument meets psychometric criteria for reliability and construct validity. It should provide a useful scale with which to reassess the relationship between knowledge and dietary behaviour.

Adolescent↗

A patient preference study comparing raltitrexed ('Tomudex') and bolus or infusional 5-fluorouracil regimens in advanced colorectal cancer: influence of side-effects and administration attributes.

Current chemotherapy regimens used in advanced colorectal cancer (ACRC) are similar in terms of efficacy, but differ importantly in terms of side-effects and administration profiles. These differences may impact significantly on patients' lives. We have evaluated patient preferences between raltitrexed ('Tomudex') and 5-fluorouracil-based chemotherapy regimens, with regard to side-effect attributes (raltitrexed and Mayo regimens) and administration attributes (raltitrexed, Mayo, De Gramont and Lokich regimens) in a study based on 82 patients with ACRC. Patients completed a series of rating tasks on how 'upsetting' these attributes were to them using a visual analogue scale (VAS) in a structured interview conducted by a research nurse. Mucositis and asthenia were the most and least upsetting side-effects, respectively. The side-effect profile of raltitrexed was clearly preferred by 78% of patients versus 14% for Mayo (P < 0.001). When side-effects and administration attributes were combined into an overall profile, 91% of patients selected raltitrexed as their clearly preferred regimen, versus 6% for Mayo (P < 0.001). The administration regimen of raltitrexed was ranked most acceptable (mean rank score 1.5 compared with Mayo 2.6, De Gramont 2.7, and Lokich 3.3). Given similar palliative effects, patients with ACRC exhibit preferences for raltitrexed over other regimens, based on administration and/or side-effect attributes. Such preferences should constitute an important part of decisions relating to the choice of chemotherapy regimen in ACRC.

Adult↗

The list heuristic for studying personality correlates of food choice behaviour: a review and results from two samples.

Over the past half century, a methodology has been used to investigate predictors of eating behaviour which involves the use of a list of foods, with subjects answering some preference question(s) about each food. For each person, the number of foods which elicit a particular response, usually of rejection, is used as a psychometric measure of their eating behaviour. We refer to this as the list heuristic. There has been great variability in the exact design used and comparing across studies is difficult. We tackle this issue by comparing "sublists" within one study. Previous list heuristic studies have found a link between behaviour and both anxiety and sensation seeking. Food choice behaviours can also be studied through psychometric questionnaires of more traditional design. Such studies have produced similar results and suggest a distinction between neophobia and general "pickiness". The list heuristic is used here in two studies. Our results are notably different, finding no relationships with anxiety and only weak relationships with sensation seeking. Further, results concerning food neophobia measures (list heuristic and questionnaire) suggest problems in differentiating food neophobia from more general food rejection behavior.

Adolescent↗

Fruit and vegetable consumption, nutritional knowledge and beliefs in mothers and children.

Increasing fruit and vegetable consumption is an important health behaviour. Parental and other psychosocial influences on children's fruit and vegetable consumption are poorly understood. The contribution of a variety of psychosocial and environmental factors to consumption of fruit and vegetables by children aged 9-11 years was explored. Ninety-two mothers and children (48 girls and 44 boys) were recruited via urban primary health-care practices. Socio-economic and educational level, nutritional knowledge and health- and diet-related beliefs and attitudes were assessed in mothers and children by questionnaires and semistructured interviews. Mothers>> diets were measured by a food frequency questionnaire, while children's diets were assessed by 3-day diaries (N=80). The pattern of influence of the various measures on fruit and vegetable consumption was compared with that on children's confectionery intake. The children's intakes of macronutrients were typical for the U.K. (37% fat, 50% carbohydrate and 13% protein by energy; 12 g/day fibre), while median fruit, fruit juice and vegetable intake amounted to about 2.5 servings/day. Univariate correlations and subsequent multiple regression analyses revealed quite different influences on the three food types. Independent predictors of children's fruit intake included mothers>> nutritional knowledge (beta=0.37), mothers>> frequency of fruit consumption (beta=0.30) and mothers>> attitudinal conviction that increasing fruit and vegetable consumption by their children could reduce their risk of developing cancer (beta=0.27; multiple r2=0.37,p<0.0001). Children's vegetable consumption was independently explained by the child's liking for commonly eaten vegetables (beta=0.36) and the mother's belief in the importance of disease prevention when choosing her child's food (beta=-0.27 r2=0.20,p<0.001). Children's confectionery consumption was predicted by the mother's liking for confectionery (beta=0.32) and the children's concern for health in choosing what to eat (beta=-0.26 r2=0.16, p<0.005). Children's consumption of fruit and vegetables are related to different psychosocial and environmental factors. Promotion of this behaviour may require attention to nutritional education and child feeding strategies of parents.

Adult↗