Dr Alison Fielding

© 2015, BMJ Publishing Group. All rights reserved. Background: Promotion of healthy eating and physical activity in early childhood is recommended as a global chronic disease prevention strategy. Centre-based childcare services represent a promising setting to provide children with opportunities to improve healthy eating and physical activity. Evidence to inform implementation of childcare obesity prevention guidelines into routine practice in childcare, however, is lacking. This study aims to assess the effectiveness of an intervention, delivered to childcare staff, aiming to increasing service implementation of healthy eating and physical activity-promoting policies and practices. Methods and analysis: A pragmatic parallel group randomised controlled trial will be undertaken with 165 childcare services in the Hunter New England region of New South Wales, Australia. Services will be randomised to receive either a 10-month evidence-based performance review intervention with other resources to support practice change, or to a waitlist control group. The primary trial outcome is the proportion of services implementing all of the following recommended healthy eating and physical activity promoting practices: written nutrition, physical activity and small screen recreation policies; providing information to families regarding healthy eating (including breastfeeding), physical activity and small screen time; providing twice weekly healthy eating learning experiences to children; providing water and only plain milk to children; providing fundamental movement skills activities for children every day; and limiting and using electronic screen time more for educational purposes and learning experiences. Effectiveness will be assessed using a telephone interview of practice implementation with childcare staff at baseline and 12 months following baseline. Ethics and dissemination: The study was approved by the Hunter New England Human Research Ethics Committee and the University of Newcastle Human Research Ethics Committee. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. Trial registration number: Australian New Zealand Clinical Trials Registry ACTRN12614000972628.

Background: This study aimed to describe eating behaviors, food tolerance, and dietary intake after laparoscopic adjustable gastric banding (LAGB); explore associations between these variables; and examine the relationship between diet-related factors and percentage weight loss and quality of life after surgery. Methods: A cross-sectional survey was mailed to subjects who had previously undergone LAGB in Newcastle, Australia. Results: Sixty-seven subjects responded (55 females; mean age 49±11.5 years; postoperative body mass index [BMI] 34.5±5.4 kg/m2). Reported average weight loss since surgery was 20.5±9.2% (26.6±13.0 kg). Restraint (including flexible and rigid control) and disinhibition were higher than community norms and hunger trended toward being lower. The majority of respondents rated their eating ability as good (n=27, 40.3%) or excellent (n=15, 22.4%). Median reported energy intake was 4,833 kJ (3,823-5,961) per day. Protein and fat intake as a percentage of daily energy intake was within acceptable distribution ranges, although saturated fat intake exceeded recommendations. Fiber and several micronutrients were below estimated average requirements. BMI at time of surgery and satisfaction with eating ability were significantly associated with reported weight loss after surgery (adjusted R2=0.32, p<0.001), and satisfaction with eating ability and rigid control were significantly associated with physical well-being (adjusted R2=0.19, p=0.001). Conclusions: This study highlights that potential remains to improve aspects of eating behavior, food tolerance, and diet quality in some individuals who have undergone LAGB, and endorses the need for further development of multifactorial interventions to help optimize a range of diet-related factors after LAGB. © 2013 Mary Ann Liebert, Inc.