Dr Xiaoyue Xu
School of Nursing and Midwifery
- Phone:(02) 40420767
One of my research focuses is diet and nutrition, one of the important underlying factors in the prevention of chronic diseases. By taking the lead, with support from my supervisors, my Masters of Nursing by research thesis in the United Kingdom, entitled ‘Exploring lifestyle intervention for promoting the health of patients with type 2 diabetes mellitus: a systematic review’, explored the lifestyle intervention in promoting health among patients with Type 2 diabetes.
My PhD project titled ‘Dietary intake, diet quality, dietary pattern and Nutrition-Related Non-Communicable Diseases (NR-NCDs) among older Chinese population’, was designed to improve people’s diet in the prevention of NR-NCDs. I am first author on all seven high-impact peer review journal articles from my PhD project. Using the framework of the CHNS, I conceptualized my specific research questions and conducted three cross-sectional studies to evaluate dietary intake, dietary quality, and the risk factors associated with suboptimal dietary intake and dietary quality. Three further cross-sectional studies were conducted to assess the associations between dietary patterns and NCDs or chronic conditions. A total of 2,745 older Chinese people were involved in these six studies. Finally, one longitudinal study was conducted to evaluate transitions in dietary patterns between 2004 and 2011, and to elucidate the associations between dietary patterns and change in BMI, weight, waist circumference and hypertension over that time period. A total of 6,348 observations were considered for this study.
This project is significant as it fills the knowledge gap on diet and nutrition status in the older population. I have also attended a number of national and international conferences to deliver and disseminate my research findings and the policy implications of the findings. My PhD research also produced a ‘Policy brief’ which proposed policy recommendations for the Chinese Nutrition Society based on my research findings with regard to dietary intake, dietary quality, and the association between dietary pattern and NCDs for older Chinese people.
Since completing my PhD in 2016, I have worked as a Post-Doc Research Fellow, School of Nursing and Midwifery, University of Newcastle. More recently I have been working on the data from the ARC Linkage-funded project entitled “Fit for Future: Safeguarding the health & well-being of the NSW nursing & midwifery workforce”. This large state-wide study examines the health of nurses, as the largest and oldest component of Australia’s health workforce. I am also involved in the analysis of findings from an NHMRC Partnership Project-funded study of health service use and clinical outcomes of people with Type 1 diabetes.
My teaching experience has been closely associated with public health and health policy related courses. I have lectured postgraduate Public Health courses at the University of Newcastle, such as modules in ‘Global Health’.
I have contributed to various government and non-government report, such as: United Nations, Department of Economic and Social Affairs, Population Division (2015). Directory of Research on Ageing in Africa: 2004-2015 (ST/ESA/SER.A/391); World Health Organization, Chinese Center for Disease Control and Prevention (2015). Health Status of Chinese Aged People and Coping Strategies; and World Health Organization, Chinese Center for Disease Control and Prevention (2015). The Optimal Control Strategies of Diabetes and Hypertension for Older Adults in China.
- Doctor of Philosophy, University of Newcastle
- Master of Sciences, University of Bedfordshire, England
- Master of Public Health, University of Newcastle
- Health Policy
- Health service
- Nutrition Epidemiology
- Public Health
- Chinese, nec (Mother)
- English (Mother)
Fields of Research
|111799||Public Health and Health Services not elsewhere classified||50|
|111099||Nursing not elsewhere classified||50|
|Title||Organisation / Department|
|Casual Academic||University of Newcastle
School of Nursing and Midwifery
|Dates||Title||Organisation / Department|
|4/04/2016 - 31/12/2016||Research Fellow||University of Newcastle
School of Nursing and Midwifery, Faculty of Health
|Dates||Title||Organisation / Department|
|20/11/2014 - 31/03/2016||Research Assistant||University of Newcastle
School of Medicine and Public Health, Faculty of Health
|Guest lecturer||27/02/2016 - 23/06/2017|
Public Health Implications of an Ageing population
|Guest lecturer||24/07/2017 - 24/11/2017|
For publications that are currently unpublished or in-press, details are shown in italics.
Journal article (12 outputs)
Liu H, Byles JE, Xu X, Zhang M, Wu X, Hall JJ, 'Evaluation of successful aging among older people in China: Results from China health and retirement longitudinal study', Geriatrics and Gerontology International, 17 1183-1190 (2017)
Â© 2016 Japan Geriatrics Society Aim: China faces a Â¿time-bombÂ¿ of the aging population. Successful aging has long been a goal in the field of gerontology. The present study aim... [more]
Â© 2016 Japan Geriatrics Society Aim: China faces a Â¿time-bombÂ¿ of the aging population. Successful aging has long been a goal in the field of gerontology. The present study aimed to evaluate successful aging among Chinese older adults. Methods: Data on a total of 7102 people in the China Health and Retirement Study aged =60 years were analyzed in the present study. Successful aging is defined by the model of Rowe and Kahn including the following five indicators: Â¿no major diseases,Â¿ Â¿no disability,Â¿ Â¿high cognitive functioning,Â¿ Â¿high physical functioningÂ¿ and Â¿active engagement with life.Â¿ Using logistic regression analysis, crude and adjusted odds ratios with 95% confidence intervals were calculated to evaluate the relationship between sociodemographic parameters and successful aging. Results: The prevalence of successful aging was 13.2% among Chinese older people. The percentage of older people with the five indicators, Â¿no major diseases,Â¿ Â¿no disability,Â¿ Â¿high cognitive functioning,Â¿ Â¿high physical functioning,Â¿ and Â¿active engagement with lifeÂ¿ was 41.7%, 92.1%, 54.2%, 70.2% and 46.0%, respectively. Multiple logistic regression showed people who had received education of high/vocational school or above had significantly greater odds of successful aging compared with those with less than primary school education (P < 0.05). The effect of education to college level or above on cognitive functioning was 2.51-fold higher in women than men (P = 0.006). Older people from a non-agricultural Hukou had 1.85-fold higher odds of successful aging than those from an agricultural Hukou. Older people living in the central, northeast or western regions had lower odds of successful aging relative to those living in the east coast region (0.72, 0.72 and 0.56, respectively). Conclusions: The prevalence of successful aging is low among Chinese older people, and is affected by sociodemographic factors, such as education, Hukou and regions. Geriatr Gerontol Int 2017; 17: 1183Â¿1190.
Xu X, Hall J, Byles J, Shi Z, 'Dietary pattern, serum magnesium, ferritin, C-reactive protein and anaemia among older people', Clinical Nutrition, 36 444-451 (2017) [C1]
Â© 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Background & aims Epidemiological data of dietary patterns and anaemia among older Chinese re... [more]
Â© 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Background & aims Epidemiological data of dietary patterns and anaemia among older Chinese remains extremely scarce. We examined the association between dietary patterns and anaemia in older Chinese, and to assess whether biomarkers of serum magnesium, C-reactive protein (CRP) and serum ferritin can mediate these associations. Methods We analysed the 2009 China Health and Nutrition Survey data (2401 individuals aged =60 years for whom both dietary and biomarker data are available). Dietary data was obtained using 24Â¿h-recall over three consecutive days. Fasting blood samples and anthropometry measurement were also collected. Factor analysis was used to identify dietary patterns. Factor scores representing dietary patterns were used in Poisson regression models to explore the association between each dietary pattern and anaemia. Results Of the 2401 participants, 18.9% had anaemia, 1.9% had anaemia related to inflammation (AI), and 1.3% had iron-deficiency anaemia (IDA). A traditional dietary pattern (high intake of rice, pork and vegetables) was positively associated with anaemia; a modern dietary pattern (high intake of fruit and fast food) was inversely associated with anaemia. Progressively lower magnesium and BMI levels were associated with increasing traditional dietary quartiles; while a progressively higher magnesium and BMI levels were associated with increasing modern dietary quartiles (pÂ¿ < Â¿0.001). There were no significant differences (pÂ¿ > Â¿0.05) in CRP and serum ferritin across quartiles for either dietary pattern. In the fully adjusted model, the prevalence ratio (PR) of anaemia, comparing the fourth quartile to the first quartile, was 1.75 (95% CI: 1.33; 2.29) for a traditional dietary pattern, and 0.89 (95% CI: 0.68; 1.16) for a modern dietary pattern. The association between dietary patterns and anaemia is mediated by serum magnesium. Conclusion Traditional dietary pattern is associated with a higher prevalence of anaemia among older Chinese. Future studies need to examine whether correcting micronutrient deficiency (e.g. magnesium) by promoting overall healthy diet, rather than iron supplementation, is a suitable strategy for anaemia prevention in older Chinese people.
Dimitrelis S, Perry L, Gallagher R, Duffield C, Sibbritt D, Nicholls R, Xu X, 'Does nursesÂ¿ role, health or symptoms influence their personal use of ingestible complementary and alternative medicines?', Complementary Therapies in Medicine, 35 39-46 (2017) [C1]
Â© 2017 Elsevier Ltd Objectives To investigate the influence of work-related characteristics, health, health behaviours and symptoms on ingestible biologically-based Complementary... [more]
Â© 2017 Elsevier Ltd Objectives To investigate the influence of work-related characteristics, health, health behaviours and symptoms on ingestible biologically-based Complementary and Alternative Medicine (CAM) use within the Australian nursing and midwifery workforce. Background CAM use is widespread worldwide, but there is little research into nursesÂ¿ and midwivesÂ¿ personal use of ingestible CAM in Australia. Methods An online survey in 2014Â¿15 used validated instruments and items to examine use of ingestible biologically-based CAM (herbs, foods and vitamins, minerals, amino acids, enzymes and other supplements), and the health and work-related characteristics of 5041 nurses and midwives recruited through the New South Wales Nurses and Midwives Association and professional networks. Results A small proportion of nurses (6.8%) identified as personal CAM users. Most were female, older, worked in foundational roles (frontline Registered and Enrolled Nurses/Midwives) and used one CAM, most commonly a multivitamin, although Vitamin D, Fish Oil, Calcium and Glucosamine Â± Chondroitin were also common. In comparison to non-users, CAM users were less likely to take sick days or indulge in risky drinking, but more likely to be symptomatic (with stiff joints, bodily/joint pain, severe tiredness, allergies, indigestion/heartburn), diagnosed with osteoarthritis and to adhere to healthy diet recommendations. Conclusions Findings showed a credible pattern of front line workers with physically demanding workloads that impact their physical health and are linked to frequent symptoms, using CAM treatments and achieving some success in being able to continue working and avoid sickness absence. Further investigation is warranted to protect and maintain the health of the nursing and midwifery workforce.
Perry L, Xu X, Duffield C, Gallagher R, Nicholls R, Sibbritt D, 'Health, workforce characteristics, quality of life and intention to leave: The 'Fit for the Future' survey of Australian nurses and midwives.', J Adv Nurs, 73 2745-2756 (2017)
Nicholls R, Perry L, Gallagher R, Duffield C, Sibbritt D, Xu X, 'The personal cancer screening behaviours of nurses and midwives', Journal of Advanced Nursing, 73 1403-1420 (2017)
Â© 2016 John Wiley & Sons Ltd Aim: The aim of this study was to identify the personal cancer screening behaviours of nurses and midwives in New South Wales, Australia, and i... [more]
Â© 2016 John Wiley & Sons Ltd Aim: The aim of this study was to identify the personal cancer screening behaviours of nurses and midwives in New South Wales, Australia, and identify factors predictive of cancer screening uptake. Background: The nursing workforce may have a higher risk for some cancers and is ageing. In Australia, more than 40% are over 50Â¿years Â¿ an age where cancer incidence rises rapidly, but when screening may reduce cancer mortality. Nurses and midwives are important health role models for the population, but their engagement in cancer screening is unknown. Design: A cross-sectional survey conducted in 2014Â¿2015. Methods: Data were obtained from the Â¿Fit for the FutureÂ¿ study on 5041 working nurses and midwives in New South Wales, Australia and analyses were conducted on subsets of age-eligible respondents. Demographic, geographical and occupational data were analysed in relation to population-based screening for breast, cervical and bowel cancers and opportunistic screening for prostate and skin cancer screening participation, in line with Australian recommendations. Results: NursesÂ¿ and midwivesÂ¿ recent screening rates were higher than the Australian general population across relevant age groups. Compared with full-time nurses and midwives, part-time/casual/pool workers were significantly more likely to undertake cervical, breast and bowel screening. Compared with those working office hours, shift workers were significantly less likely to undertake breast and bowel screening, but more likely to undertake skin screening. Conclusions: Disparities in reported screening prevalence and factors predictive of screening uptake indicate opportunities for targeted strategies to inform and/or promote workforce engagement with screening programmes and protect the health of this ageing workforce.
Liu H, Xu X, Hall JJ, Wu X, Zhang M, 'Differences in depression between unknown diabetes and known diabetes: Results from China health and retirement longitudinal study', International Psychogeriatrics, 28 1191-1199 (2016) [C1]
Copyright Â© International Psychogeriatric Association 2016. Background: Both diabetes and depression have become serious public health problems and are major contributors to the ... [more]
Copyright Â© International Psychogeriatric Association 2016. Background: Both diabetes and depression have become serious public health problems and are major contributors to the global burden of disease. People with diabetes have been shown to have higher risk of depression. The purpose of this study was to observe the differences in depression between older Chinese adults with known or unknown diabetes. Methods: Data came from the national baseline survey of China Health and Retirement Longitudinal Study (CHARLS). The Center for Epidemiologic Studies Depression Scale was used to assess depression. Participants with a history of diabetes diagnosis were considered to have known diabetes, and those with newly-diagnosed diabetes were considered to have unknown diabetes. Multiple logistic regression analysis was applied to estimate odds ratio (OR) for depression in predictor variables. Results: Overall, 39.1% of the 2,399 participants with diabetes suffered from depression. The prevalence of depression was significantly higher (p < 0.001) in people with known diabetes (43.5%) than those with unknown diabetes (35.1%). The biggest differences between the two groups were found in the middle aged, in women, in the less educated and in married people. In known diabetes, people treated with traditional Chinese medicine (TCM) coupled with oral western medicine (WM) and/or insulin had two-fold odds of depression compared to those without treatment. Conclusion: The knowledge of having diabetes, treatments and suffering from other chronic diseases were associated with the higher prevalence of depression in people with known diabetes compared to those with unknown diabetes. Prevention of depression in diabetics should receive more attention in the middle aged, women and the less education.
Xu X, Byles J, Shi Z, McElduff P, Hall J, 'Dietary pattern transitions, and the associations with BMI, waist circumference, weight and hypertension in a 7-year follow-up among the older Chinese population: a longitudinal study', BMC PUBLIC HEALTH, 16 (2016) [C1]
Liu H, Byles JE, Xu X, Zhang M, Wu X, Hall JJ, 'Association between nighttime sleep and successful aging among older Chinese people', Sleep Medicine, 22 18-24 (2016) [C1]
Â© 2016 Elsevier B.V. Objective This study aims to assess the association between sleep and successful aging among ChineseÂ¿=60 years of age. Methods Data were collected from the ... [more]
Â© 2016 Elsevier B.V. Objective This study aims to assess the association between sleep and successful aging among ChineseÂ¿=60 years of age. Methods Data were collected from the baseline survey of the China Health and Retirement Longitudinal Study. Two self-reported questions about sleep quality and duration were examined. Successful aging was defined following Rowe and Kahn's multidimensional model. To assess the adjusted association between sleep and successful aging, multivariable logistic regression was applied. Results The average number of self-reported hours of sleep was 6.2Â¿Â±Â¿2.0 among older Chinese people. Successful aging was related to sleep duration, with the proportion of those adults considered to be aging successfully falling into the following sleep duration categories ( < 6Â¿h Â¿ 7.8%; 6Â¿h Â¿ 16.3%; 7Â¿h Â¿ 19.1%; 8Â¿h Â¿ 14.7%; andÂ¿=9Â¿h Â¿ 12.8%). The plots between sleep duration and successful aging were an inverse U-shape. Participants who slept less than 6Â¿h per day had lower odds ratios of successful aging [odds ratio (OR)Â¿=Â¿0.52, 95% confidence interval (CI) 0.40Â¿0.67] relative to those who slept for 7Â¿h per day. Compared with those who reported poor sleep less than once a week, older people who reported poor sleep five to seven days a week showed a lower ratio of successful aging (ORÂ¿=Â¿0.29, 95% CI 0.21Â¿0.39). Conclusion Older age, shorter or longer sleep, and poor sleep were related to lower odds of, rates of successful aging. Most older Chinese adults experience insufficient sleep and poor sleep quality, which could be an important influential factor in successful aging.
Xu X, Hall J, Byles J, Shi Z, 'Dietary pattern is associated with obesity in older people in China: Data from China health and nutrition survey (CHNS)', Nutrients, 7 8170-8188 (2015) [C1]
Â© 2015 by the authors; licensee MDPI, Basel, Switzerland. Background: No studies have been conducted to explore the associations between dietary patterns and obesity among older ... [more]
Â© 2015 by the authors; licensee MDPI, Basel, Switzerland. Background: No studies have been conducted to explore the associations between dietary patterns and obesity among older Chinese people, by considering gender and urbanization level differences. Methods: We analyzed data from the 2009 China Health and Nutrition Survey (2745 individuals, aged e 60 years). Dietary data were obtained using 24 h-recall over three consecutive days. Height, Body Weight, and Waist Circumference were measured. Exploratory factor analysis was used to identify dietary patterns. Multinomial and Poisson regression models were used to examine the association between dietary patterns and Body Mass Index (BMI) status/central obesity. Results: The prevalence of general and central obesity was 9.5% and 53.4%. Traditional dietary pattern (high intake of rice, pork and vegetables) was inversely associated with general/central obesity; modern dietary pattern (high intake of fruit, fast food, and processed meat) was positively associated with general/central obesity. The highest quartile of traditional dietary pattern had a lower risk of general/central obesity compared with the lowest quartile, while an inverse picture was found for the modern dietary pattern. These associations were consistent by gender and urbanization levels. Conclusions: Dietary patterns are associated with general/central obesity in older Chinese. This study reinforces the importance of a healthy diet in promoting healthy ageing in China.
Xu X, Hall J, Byles J, Shi Z, 'Assessing dietary quality of older Chinese people using the Chinese Diet Balance Index (DBI)', PLoS ONE, 10 (2015) [C1]
Â© 2015 Xu et al. Background/Objectives: Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality for Chinese people. The present cross-sectiona... [more]
Â© 2015 Xu et al. Background/Objectives: Few studies have applied the Chinese Diet Balance Index (DBI) in evaluating dietary quality for Chinese people. The present cross-sectional study assessed dietary quality based on DBI for older people, and the associated factors, in four socioeconomically distinct regions in China. Methods: The China Health and Nutrition Survey (CHNS) involves 2745 older Chinese people, aged 60 or over, from four regions (Northeast, East Coast, Central and West) in 2009. Dietary data were obtained by interviews using 24 hour-recall over three consecutive days. Four indicators: Total Score (TS), Lower Bound Score (LBS), Higher Bound Score (HBS) and Diet Quality Distance (DQD) from DBI were calculated for assessing dietary quality in different aspects. Results: 68.9% of older people had different levels of excessive cereals intake. More than 50% of older people had moderate or severe surplus of oil (64.9%) and salt (58.6%). Intake of vegetables and fruit, milk and soybeans, water, and dietary variety were insufficient, especially for milk and soybeans. 80.8%of people had moderate or severe unbalanced diet consumption. The largest differences of DQD scores have been found for people with different education levels and urbanicity levels. People with higher education levels have lower DQD scores (p < 0.001), and people living in medium and low urbanicity areas had 2.8 and 8.9 higher DQD scores than their high urbanicity counterparts (p < 0.001). Also, significant differences of DQD scores have been found according to gender, marital status, work status and regions (p < 0.001). Conclusion: DBI can reveal problems of dietary quality for older Chinese people. Rectifying unbalanced diet intake may lead to prevention of non-communicable diseases (NCDs). Dieticians and health care professionals need to increase dissemination and uptake of nutrition education, with interventions targeted at regions of lower socioeconomic status.
Xu X, E Byles J, Shi Z, J Hall J, 'Evaluation of older Chinese people's macronutrient intake status: Results from the China Health and Nutrition Survey', British Journal of Nutrition, 113 159-171 (2015) [C1]
Copyright Â© 2014 The Authors. Little is known about the macronutrient intake status of older Chinese people. The present study evaluated the macronutrient intake status of older ... [more]
Copyright Â© 2014 The Authors. Little is known about the macronutrient intake status of older Chinese people. The present study evaluated the macronutrient intake status of older Chinese people (aged =A 60 years), investigated whether they had intake levels that met the Dietary Reference Intakes (DRI), and explored the associations between macronutrient intakes and age groups, sex, education levels, work status, BMI groups, urbanicity levels and four socio-economic regions of China (Northeast, East Coast, Central and Western). Dietary intake data of 2746 older Chinese with complete dietary intake data in the Longitudinal China Health and Nutrition Survey (2009 wave) carried out across four diverse regions were analysed. Dietary intake data were obtained by interviews using 24A h recalls over three consecutive days. The MUFA:SFA ratios were calculated based on the Chinese Food Composition Table. Less than one-third of the older Chinese people included in the present study had intake levels meeting the adequate intake for carbohydrate-energy and fat-energy; less than one-fifth had intake levels meeting the recommended nutrient intake for protein-energy; and more than half of the older people had fat-energy intakes higher than the DRI. There were strong associations between the proportions of energy from the three macronutrients and education levels, urbanicity levels and the four socio-economic regions of China, with older people living in the East Coast region having different patterns of macronutrient-energy intakes when compared with those living in the other three regions. Macronutrient intakes across different urbanicity levels in the four regions revealed considerable geographical variations in dietary patterns, which will affect the risk factors for non-communicable diseases. Clinical interventions and public health policies should recognise these regional differences in dietary patterns.
Xu X, Hall J, Byles J, Shi Z, 'Do older Chinese people's diets meet the Chinese Food Pagoda guidelines? Results from the China Health and Nutrition Survey 2009', PUBLIC HEALTH NUTRITION, 18 3020-3030 (2015) [C1]
|Show 9 more journal articles|
Conference (2 outputs)
Yates A, Xu X, Byles JE, 'COPD RISK AND FRUIT/VEGETABLE CONSUMPTION AMONG OLDER CHINESE PEOPLE', GERONTOLOGIST (2016)
Xu X, Byles JE, Hall J, Shi Z, 'DIETARY TRANSITION AND NON-COMMUNICABLE DISEASE RISK AMONG OLDER CHINESE PEOPLE', GERONTOLOGIST (2016)