Enabling better nutrition and healthy living through ... · Dr Marc Adam, Dr Shamus Smith, Prof Clare Collins •Project Manager: Dr Kerith Duncanson •Software Engineers: Josh Crompton,

Enabling better nutrition and healthy living through virtual

care platforms

Clare CollinsProfessor of Nutrition and Dietetics

Director of Research, School of Health Sciences

Priority Research Centre in Physical Activity and Nutrition

NHMRC Senior Research Fellow

Faculty of Health and Medicine

The University of Newcastle

@ProfCCollins

Image from dreamstime.comThe University of Newcastle | CRICOS Provider 00109J | www.newcastle.edu.au

Getting eHealth innovations to optimise nutrition at key life-stages and health

conditions out there

Image from dreamstime.com

The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au

• Tracy Burrows, Melinda Hutchesson,

Megan Rollo, Tamara Bucher, Lesley

Wicks, Amanda Patterson, Tracy

Schumacher, Hannah Lucas, Tracy

Schumacher, Rebecca Haslam, Lee

Ashton, Vanessa Shrewsbury & HDR

candidates

• Phil Morgan, Robin Callister, Manohar

Garg, Dave Lubans, Ron Plotnikoff ,

Amanda Baker, Geoff Skinner, Shamus

Smith, Roger Smith, Lisa Wood, Kym Rae,

Loretta Wetherall

• Helen Truby, Caryl Nowson, Lisa Moran,

David Sibritt, Julia Lowe, Pete Kelly, Tony

Okely, Louise Baur, May Boggess

• Wollongong Uni, Sydney Uni, ACAORN,

Monash Uni, St Andrew’s Scotland; ETH

Zurich, Baylor College of Medicine,

University of Vermont, USA.

• NHMRC, ARC

• nib foundation,

• Coal & Allied, Heart Foundation

• DARP, MLA

• University of Newcastle

• HMRI / HCRF

• Benefactors (HRMI): Thompson Family,

Kirwina, Gastronomic lunch

• Newcastle Permanent, The Greater,

Medibank Charitable Trust

• JHH Charitable Trust

• Aust Paed Endocrine Society

• Aust Diabetes Educators Society

• Dietitians Association of Australia

• Lions Club

AcknowledgementsCollaborators and Funding Support

OUTLINE

1. Why Nutrition

2. Getting on the IT path in nutrition & dietetic research

3. Stories from our frontline

4. Opportunities and challenges for N&D and IT

5. Where to from here


OUTLINE

1. Why Nutrition



4. Opportunities and challenges for N&D and IT



Poor nutrition contributes to malnutrition in all its forms▪ High Body Mass Index (BMI) – risks for non-communicable diseases (NCDs)

▪ Dietary Risks – risks for NCDs (eg low grains, F&V, nuts, high sodium, trans fats)

▪ Child & maternal undernutrition – risks for nutrient deficiencies & infectious diseases

5% 10% 15% 20% 25%

DALYs Disability-Adjusted Life years lost

With Permission Prof T Lobstein; Swinburn, et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. The Lancet. Jan 27 2019 Graphic by Nico Villarete

www.rappler.com/move-

ph/issues/hunger/86284-ending-

hunger-malnutrition-effects

Poor dietary patterns account for the greatest proportion of Australia’s national burden of disease *

Poor nutrition - 10% Obesity - 8.5%Smoking - 8.2%

* Disability adjusted life years


Institute for Health Metrics and Evaluation. Global burden of diseases, injuries and risk factors study 2010. 2013; Available from: www.healthdata.org

http://www.healthdata.org/

OUTLINE

1. Why Nutrition


3. Opportunities and challenges for N&D and telehealth





Food Amt Pro Fat CHO Fibre Fe Ca Vit B1 Vit B2 Folate

Dietary assessment

in the 1980s

Collins, O’Loughlin, Henry, etal. Normal growth in cystic fibrosis associated with attending a specialised CF centre. Archives of Disease in Childhood, 1999; 81 (3): 241-6.

IT kinda just happened … …

Measuring diet quality and alignment with Australian Dietary Guidelines www.healthyeatingquiz.com.au

OUTLINE

1. Why Nutrition



4. Challenges and opportunities for N&D and IT



Goal 1 Evidence

Goal 2 Methods

Goal 3Interventions

Goal 4 Translation

Research-to-Action Cycle

Nutrition Science Communication

eHealth innovations to optimise nutrition at key life-stages and health conditions

Goal 1 Evidence

Goal 2 Methods

Goal 3Interventions

Goal 4 Translation



Systematic reviews to synthesise evidence on diet-related outcomes

Develop novel, validated tools to measure dietary intake using technology and provide real-time feedback on intake

Conduct feasibility and efficacy trials, targeted to life stage (pregnancy) and health risk (CVD, type 2 and gestational diabetes)

Translate results to ‘real world’ settings in consultation with

consumers, health professionals and industry partners

Systematic reviews of eHealth technologies

▪ To evaluate effectiveness of eHealth interventions for the prevention and treatment of overweight and obesity in adults

Prof Clare Collins @ProfCCollins

Systematic reviews of translation

▪ To synthesise knowledge translation studies on dietary evidence for prevention / treatment of CVD into practice in those at high CVD risk

▪ No diet studies with specific aim of KT


Goal 1 Evidence

Goal 2 Methods

Goal 3Interventions

Goal 4 Translation








Optimising nutrition to improve health and well being

1001storia.polimi.itMigraine Diet

Real-time analysis

Personal reports

Australian Eating Survey®

Online AES® Nutrition Assessment with real-time feedback compared to national recommendations

E: [email protected]: www.australianeatingsurvey.com.au

mailto:[email protected]

http://www.australianeatingsurvey.com.au/

24 | The University of Newcastle

Australia Eating Survey® (AES)

▪ Assesses usual food and nutrient intake over the past 3-6 months▪ Personalised feedback report generated for each user

E: [email protected]: www.australianeatingsurvey.com.au

mailto:[email protected]

http://www.australianeatingsurvey.com.au/

▪ Fat quality, vegetable & fruit intake measured by FFQ

▪ Red blood cell membrane fatty acids measured by gas chromatography

▪ Plasma carotenoids measured by HPLC

▪ Skin carotenoids by spectrophotometry

Biomarkers of dietary intakes

ServAR▪ An augmented reality (AR) tool for food portion size guidance

ServAR▪ An augmented reality (AR) tool for food portion size guidance

Goal 1 Evidence

Goal 2 Methods

Goal 3Interventions

Goal 4 Translation








Optimising nutrition to improve health and well being

1001storia.polimi.itMigraine Diet

Real-time analysis

Personal reports

Dietitian view

Client view

A feasibility study investigating tailored video-coaching for nutrition and exercise care for postpartum women

Lisa Vincze: Accredited Practising Dietitian, Accredited Exercise Physiologist; PhD CandidatePriority Research Centre for Physical Activity and Nutrition, School of Health Sciences, University of Newcastle

1. IMPLEMENTATION...2. ACCEPTABILITY...3. PRELIMINARY EFFICACY...

…of an exercise and nutrition program for women up to 12 months postpartum delivered by an Accredited Practising

Dietitian (APD) and Accredited Exercise Physiologist (AEP) via video conferencing.

▪ Women aged ≥18 years who were 3-12 months postpartum▪ Weight status: >2kg above self-reported pre-pregnancy weight OR BMI ≥25.0kg/m2

▪ Cleared for exercise (ESSA pre-exercise screening tool)

32

The Team

• Prof Clare Collins

• Dr Tracy Burrows

• Dr Chris May

• Ms Li Kheng Chai (Supported by a APA &

Barker’s family scholarship

• Ms Denise Wong See

• Mr Ashley Young

• Ms Carol Teh

Parenting SMS support

Thinking how to encourage your little chef to help with cooking today? Visitcookingmattersaustralia.com.au/cooking-with-kids!

Remember, your child looks up to you and your choices!

Diet Bytes and Baby Bumps

Evaluating feasibility of tailored smart phone nutrition assessment and support in pregnant indigenous and non-indigenous women

Diet Bytes & Baby Bumps, image-based dietary records, purpose-built brief Selected Nutrient and Diet Quality (SNaQ) tool + tailored nutrition advice + dietary feedback via smartphone 1) Short video summary sent to smartphone; 2) Follow-up telephone consult with dietitian

Example Diet Bytes entry

Photo + voice dietary record

Analysis of dietShort video feedback

Mobile app

Diet Bytes and Baby Bumps

… from little

things, big

things grow …

Measuring diet quality and alignment with Australian Dietary Guidelines www.healthyeatingquiz.com.au

Diet Quality, Morbidity and Mortality

▪ Majority found inverse relationship between diet quality score and health

outcomes

▪ Higher diet quality moderately protective

▪ All-cause mortality risk 17-42%

▪ CVD mortality 18-53%

▪ CVD risk 14-28%

▪ Cancer mortality 13-30%

▪ All-cancer risk 7-35%

Wirt A and Collins CE. Diet Quality - What is it and does it matter? Public Health Nutrition 2009:12(12);2473-92

Higher Scores in those who repeat the HEQ™

Williams RL, Rollo ME, Schumacher T, Collins CE. Diet quality scores of Australian adults who have completed the Healthy Eating Quiz NUTRIENTS 2017, 9(8), 880; doi:10.3390/nu9080880

HEQ™ linked to our programs and external websites

www.cookingmattersaustralia.com.au

www.healthydadsandkids.com

™

http://www.cookingmattersaustralia.com.au/

™

VISIDA

▪The Voice-Image-Sensor technologies for Individual Dietary Assessment (VISIDA) system

▪Combination of technologies to collect dietary intake data

▪Supported by funding from the Bill & Melinda Gates Foundation

@VISIDAproject

Team• Investigators : Dr Megan Rollo, A/Prof Tracy Burrows

Dr Marc Adam, Dr Shamus Smith, Prof Clare Collins

• Project Manager: Dr Kerith Duncanson

• Software Engineers: Josh Crompton, Connor Dodd

• Research Dietitians: Janelle Windus (Cambodia),

Janelle Skinner, Felicity Steel

• PhD candidates: Philipp Rouast (Engineering), Hamid

Heydarian (Engineering), Naomi Saronga (Nutrition)

Target population and countries

▪ Mothers or other adult women who care for the child (e.g. grandmother, aunt) and children aged ≤5 years

▪ Countries: ▪ Australia, Cambodia and Tanzania

▪ Partner Organisations:▪ This Life Cambodia (TLC)

▪ Muhimbili University of Health and Allied Science (MUHAS)

49

2. Analysis of dietary

intake data

Web-based Content Management

System (CMS):

E. speech-to-text and quick search to

facilitate matching to records in food

composition databases;

F. Tools for quantification, including

wiremesh, reference image and

measures databases.

Offline ‘lite’ version

3. Interpretation of dietary

intake data

1. Collection of dietary

intake data

Hybrid capture consisting of:

Active:

A. Image-voice food record application

to capture of recipe/preparation &

eating occasion

+

Passive:

B. Wrist-worn sensor to detect hand-to-

mouth movements

Ground truth measures as required:

C. Time-lapse camera; and

D. Spherical video camera*.

VISIDA

Included within CMS to facilitate

identification of at-risk individuals

and prioritise intervention

CD

B

VISIDA system

A

VISIDA

F

E

OUTLINE

1. Why Nutrition






Challenges

“… I usuallyeat really

healthy! …”

Where can you find decent, trustworthy

nutrition information?

https://theconversation.com/what-is-a-balanced-diet-anyway-72432

Opportunities

Goal 1 Evidence

Goal 2 Methods

Goal 3Interventions

Goal 4 Translation









Free - Massive Online Open Course (MOOC)

ATC 2019 Prof Clare Collins @ProfCCollins

Next course starts 4th Sept 2019

“As a 58 year old woman, I found this course to be literally a life saver! ….It really put me on a path to better health. I was able to enjoy weight loss as a

benefit of better eating”

“I am 42 and have tried every diet going. I finally feel empowered and I am enjoying my food for the first

time in years…...No more ‘specialist’ weight loss programs, no more

feeling powerless or depressed. Thank you so so much. The course has been life

changing and I will recommend to all of my friends”


▪ Nutrition is omnipotent

▪ The IT path in clinical nutrition & dietetics needs to move

into health services

▪ Seize opportunities and learn from the challenges

▪ Keep moving forward

▪ The future looks interesting


Image from dreamstime.com

Summary

OUTLINE

1. Why Nutrition




5. Where to from here ?


The future is now


@ProfCCollins@UONPRCPAN@@Uni_Newcastle@HMRIAustralia

Documents

Enabling better nutrition and healthy living through ... · Dr Marc Adam, Dr Shamus Smith, Prof Clare Collins •Project Manager: Dr Kerith Duncanson •Software Engineers: Josh Crompton,