A. J. Hure

University of Newcastle Australia · Priority Research Centre for Gender, Health and Ageing

The VALID BP project was initiated to increase the availability of validated blood pressure measuring devices (BPMDs). The goal is to eliminate non validated BPMDs and minimise over- and underdiagnosis of hypertension caused by inaccurate readings. This study was undertaken to assess the potential return on investment in the VALID BP project. The F...

In studies that contain repeated measures of variables, longitudinal analysis accounting for time-varying covariates is one of the options. We aimed to explore longitudinal association between diet quality and non-communicable diseases. Participants from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) were included...

The Australian National Preventive Health Strategy 2021–2030 recommended the establishment of evidence-based frameworks to enable local public health services to identify strategies and interventions that deliver value for money. This study aimed to review the cost-effectiveness of preventive health strategies to inform the reorientation of local p...

Introduction The VALID BP project was initiated to increase the availability of validated blood pressure measuring devices (BPMDs). The goal is to eliminate non validated BPMDs and minimise over- and underdiagnosis of hypertension caused by inaccurate readings. This study was undertaken to assess the potential return on investment in the VALID BP p...

Background One of the challenges for countries implementing food policy measures has been the difficulty in demonstrating impact and retaining stakeholder support. Consequently, research funded to help countries overcome these challenges should assess impact and translation into practice, particularly in low-resource settings. However, there are st...

Non-communicable diseases (NCDs) and multimorbidity (≥two chronic conditions), are increasing globally. Diet is a risk factor for some NCDs. We aimed to investigate the association between diet quality (DQ) and incident NCDs. Participants were from the Australian Longitudinal Study on Women’s Health 1973–78 cohort with no NCD and completed dietary...

Background One of the challenges for countries implementing food policy measures has been the difficulty in demonstrating impact and retaining stakeholder support. Consequently, research funded to help countries overcome these challenges should assess impact and translation into practice, particularly in low-resource settings. However, there are st...

Aims The burden and health costs of Type 2 Diabetes Mellitus continue to increase globally and prevention strategies in at-risk people need to be explored. Previous work, in both animal models and humans, supports the role of zinc in improving glucose homeostasis. We, therefore, aimed to test the effectiveness of zinc supplementation on glycaemic c...

Background and aims Observational studies have demonstrated that the pneumococcal polysaccharide vaccine (PPV) is associated with reduced risk of cardiovascular events. This may be mediated through IgM antibodies to OxLDL, which have previously been associated with cardioprotective effects. The Australian Study for the Prevention through Immunisati...

Background Hypertriglyceridaemia (HTG) (defined as ≥1.7mmol/L) has a prevalence of 18-33% with significant inter-regional variation. Despite meta-analyses demonstrating its association with increased risk of cardiovascular disease, only 40% of HTG is identified in the community resulting in underutilisation of lipid lowering therapy and specialist...

Objective: To identify the optimal AUSDRISK threshold score to screen for pre-diabetes and diabetes. Methods: A total of 406 adult patients not diagnosed with diabetes were screened in General Practices (GP) between May and October 2019. All patients received a point of care (POC) HbA1c test. HbA1c test results were categorised into diabetes (≥6.5%...

Diet quality indices (DQIs) can be useful predictors of diet–disease relationships, including non-communicable disease (NCD) multimorbidity. We aimed to investigate whether overall diet quality (DQ) predicted NCD, multimorbidity, and all-cause mortality. Women from the 1945–51 cohort of the Australia Longitudinal Study on Women’s Health (ALSWH) wer...

The identification and measurement of psychosocial factors that are specific to pregnancy and relevant to gestational weight gain is a challenging task. Given the general lack of availability of pregnancy-specific psychosocial assessment instruments, the aim of this study was to develop a short-form psychosocial assessment tool for the detection of...

Healthcare costs are lower for adults who consume more vegetables; however, the association between healthcare costs and fruit and vegetable varieties is unclear. Our aim was to investigate the association between (i) baseline fruit and vegetable (F&V) varieties, and (ii) changes in F&V varieties over time with 15-year healthcare costs in an Austra...

This aim of this paper is to set the scene for the need for impact assessment and return on investment in funded cardiovascular research in Australia, starting with the historical perspective on waste in health and medical research. Recently there has been a substantial move from discussion and policy about the need for research translation, into p...

Prenatal nutrient exposures can impact on brain development and disease susceptibility across the lifespan. It is well established that maternal macronutrient intake during pregnancy influences foetal and infant development. Therefore, we hypothesise that macronutrient intakes during pregnancy are correlated with cognitive development during early...

Objective Examine the relationship between preconception stress and offspring birth weight. Setting Population-based cohort study linked with state-based administrative perinatal data. Participants 6100 births from 3622 women from the 1973–1978 cohort of the Australian Longitudinal Study of Women’s Health who (1) recorded a singleton birth betwee...

Background The relationship between diet quality and health care costs is unclear. Objective The aim of this study was to investigate the relationship between baseline diet quality and change in diet quality over time, with 15-year cumulative health care claims/costs. Design Data from a longitudinal cohort study were analyzed. Participants/setti...

Distilling the complexity of overall diet into a simple measure or summative score by data reduction methods has become a common practice in nutritional epidemiology. Recent reviews on diet quality indices (DQI) have highlighted the importance of sound construction criteria and validation. The aim of this current review was to identify and critical...

Background Whilst a cancer diagnosis may prompt health behaviour change, there is limited evidence regarding whether such changes are maintained in the long-term. We aimed to investigate the impact of cancer diagnosis on health behaviour changes over the long-term survivorship period among breast cancer survivors (BCSs).Methods The sample comprised...

Background: Cancer diagnosis may be a cue for health behavior change. Previous research that assessed the impact of a cancer diagnosis on multiple health behavior (MHB) change is limited by small sample size, cross-sectional study design, and a focus on individual rather than multiple behaviors. This study investigated the impact of a cancer diagn...

Background: Accumulating evidence suggests that breastfeeding exclusivity and duration are positively associated with child cognition. This study investigated whether DNA methylation, an epigenetic mechanism modified by nutrient intake, may contribute to the link between breastfeeding and child cognition. The aim was to quantify the relationship b...

Understanding patterns of dietary change over time can provide important information regarding population nutrition behaviours. The aims were to investigate change in diet quality over 12 years in a nationally representative sample of women born in 1946–1951 and to identify characteristics of women whose diet quality changed over time. The Australi...

Background: Active participant monitoring of adverse events following immunization (AEFI) is a recent development to improve the speed and transparency of vaccine safety postmarketing. Vaxtracker, an online tool used to monitor vaccine safety, has successfully demonstrated its usefulness in postmarketing surveillance of newly introduced childhood...

Background: It is hypothesised that epigenetic mechanisms including DNA methylation may underlie the relationship between early-life nutrition and child cognitive outcomes. This study aimed to identify dietary patterns associated with the intake of one-carbon metabolism nutrients in children aged 2-3 years. Methods: A validated 120-item semi-qua...

The push to identify low value care has led to scrutiny of pathology test re-ordering. The objective of this study was to identify the patterns of ordering pathology tests among inpatients in teaching hospitals and model strategies to reduce unnecessary testing. This was a retrospective cohort study of all adult medical and surgical inpatients admi...

Purpose Multiple health behaviours (not smoking, minimal alcohol consumption, and maintaining a healthy weight by having a healthy diet and regular physical activity) improve quality of life and longevity of cancer survivors. Despite international guidelines, there are no existing reviews that synthesise cancer survivors’ adherence to healthy lifes...

Background: Inadequate or excessive gestational weight gain is associated with both short and long-term adverse maternal and infant health outcomes. The practice of routine maternal weight monitoring has been suggested as an effective health promotion intervention, both as a screening tool for adverse maternal and infant outcomes and as a weight m...

Objectives: To examine the effectiveness of different strategies for recruiting participants for a large Australian randomised controlled trial (RCT), the Australian Study for the Prevention through Immunisation of Cardiovascular Events (AUSPICE). Design, setting, participants: Men and women aged 55-60 years with at least two cardiovascular risk...

Lifestyle behaviours have an important role in preventing cancer, reducing treatment side effects, and improving survival and quality of life for cancer survivors. This study investigated adherence to multiple lifestyle behaviours among women with and without a cancer history. From the Australian Longitudinal Study on Women’s Health (ALSWH) surveys...

Background Diabetes is increasing in incidence, morbidity and treatment costs globally, hence prevention strategies need to be explored. Animal studies and some human data have shown that zinc can improve glycaemic control, but the impact of this effect in a pre-diabetic population remains uncertain. This study is designed to investigate whether zi...

Background: Low birthweight is more common in infants of indigenous (Aboriginal and/or Torres Strait Islander) than of White Australian mothers. Controversy exists on whether fetal growth is normally different in different populations. Objective: We sought to determine the relationships of birthweight, birthweight percentiles, and smoking with p...

Background The pneumococcal polysaccharide vaccine (PPV) has been associated with reduced risk of cardiovascular events in human observational studies. Animal studies suggest that the phosphorylcholine epitope in the Streptococcus pneumoniae cell wall is structurally similar to oxidized low-density lipoprotein (oxLDL), hence PPV induces the product...

Background: During the early postnatal period, the impact of nutrition on DNA methylation has not been well studied in humans. The aim was to quantify the relationship between one-carbon metabolism nutrient intake during the first three years of life and global DNA methylation levels at four years. Design: Childhood dietary intake was assessed u...

Background: Epidemiological studies have demonstrated that folate, iodine and iron intake during pregnancy impacts on foetal brain development and cognitive function. However, in human studies, the relationship with other dietary nutrients is less clear. Objective: This systematic review aims to critically appraise the current literature and met...

Adequate nutrition during early life is essential to support the neurological processes that underlie human brain development and cognition. Children who fail to meet their cognitive potential achieve fewer schooling years and are at an increased risk of adult delinquency. Maximising child cognition through nutrition interventions hold major socioe...

Worldwide, dietary supplement use among reproductive aged women is becoming increasingly common. The aim of this study was to investigate dietary supplement use among Australian women during preconception. Self-reported data were collected prospectively for the Australian Longitudinal Study on Women’s Health (ALSWH). The sample included 485 women a...

Objective To determine rates of vaginal delivery, emergency caesarean section, and elective caesarean section for first and second births in Australia, and to identify maternal predictors of caesarean section. Methods Data were from the Australian Longitudinal Study on Women’s Health. A total of 5275 women aged 18–38 years, who had given birth to t...

Background Type 2 diabetes is associated with significant morbidity and mortality. Modifiable risk factors have been found to contribute up to 60% of type 2 diabetes risk. However, type 2 diabetes continues to rise despite implementation of interventions based on traditional risk factors. There is a clear need to identify additional risk factors fo...

The role of physical activity in the relationship between perceived stress and type 2 diabetes. (DOC)

Complete directed acyclic graph demonstrating hypothesised causal pathways between perceived stress and type 2 diabetes across the observation period. (DOC)

Sensitivity analysis examining the longitudinal association between Body Mass Index (BMI) and type 2 diabetes, using a time lag approach. (DOC)

Longitudinal models (with and without a time lag), reporting odds ratios and 95% confidence intervals (CI) for the relationship between perceived stress and type 2 diabetes/glucose intolerance (sensitivity analysis). (DOC)

Sensitivity analysis comparing the total causal effect of stress on diabetes with physical activity treated as a time-varying confounder using a marginal structural model and a mediator using standard regression. (DOC)

Purpose: To examine the longitudinal association between diet quality and depression using prospective data from the Australian Longitudinal Study on Women's Health. Methods: Women born in 1946-1951 (n = 7877) were followed over 9 years starting from 2001. Dietary intake was assessed using the Dietary Questionnaire for Epidemiological Studies (v...

Background Excessive gestational weight gain is associated with short and long-term adverse maternal and infant health outcomes, independent of pre-pregnancy body mass index. Weighing pregnant women as a stand-alone intervention during antenatal visits is suggested to reduce pregnancy weight gain. In the absence of effective interventions to reduce...

In this issue of the Journal, Isanaka et al. (Am J Epidemiol 2016;000(00):000-000) set out to update an incidence correction factor used for estimating numbers of cases of severe acute malnutrition (SAM) in children aged 6-59 months. The total number of current SAM cases (prevalent cases) increases by the number of new (incident) cases and decrease...

Objective: To assess whether diet quality before or during pregnancy predicts adverse pregnancy and birth outcomes in a sample of Australian women. Design: The Dietary Questionnaire for Epidemiological Studies was used to calculate diet quality using the Australian Recommended Food Score (ARFS) methodology modified for pregnancy. Setting: A po...

Background: Research has shown that vaccination with Streptococcus pneumoniae reduced the extent of atherosclerosis in experimental animal models. It is thought that phosphorylcholine lipid antigens in the S. pneumoniae cell wall induce the production of antibodies that cross-react with oxidized low-density lipoprotein, a component of atherosclero...

There is increasing evidence for the role of nutrition in the prevention of depression. This study aims to describe changes in diet quality over 12 years among participants in the Australian Longitudinal Study on Women’s Health in relation to changes in depressive symptoms. Women born between 1946 and 1951 were followed-up for 12 years (2001–2013)....

Antioxidants and fatty acids are associated with depression and inflammation, and inflammation appears to predict depression risk, hence the associations between these nutrients and depression may be mediated by inflammation. We hypothesized that inflammatory markers – interleukin (IL)-6 and C-reactive protein (CRP) mediate the associations between...

Many epidemiological studies that focus on pregnancy rely on maternal self-report of perinatal outcomes. The aim of this study was to evaluate the agreement between self-reported perinatal outcomes (gestational hypertension with or without proteinuria, gestational diabetes, premature birth and low birth weight) in a longitudinal study and linked to...

AimThis study aimed to assess the impact of including healthier options on fast food restaurant menus on total energy of parent-reported intended purchases and frequency to eat at fast food outlets for young children.Methods Parents from an existing health survey cohort were approached to participate. They were eligible to participate if they resid...

Aim: To compare dietary intakes of young children to the Australian Guide to Healthy Eating (AGHE) and Nutrient Reference Values (NRVs). Methods: Dietary intakes of 54 children (50% girls) aged two to three years (mean 2.7 years) from the Women and Their Children's Health (WATCH) study were reported by mothers using a validated 120-item food freque...

Animal models and clinical studies suggest a mechanistic link between the pneumococcal polysaccharide vaccine (PPV) and a cardiovascular protective effect. However, conflicting results exist from several large observational studies in humans. We set out to systematically review current literature and conduct meta-analyses of studies on PPV and card...

The prenatal environment can influence development of offspring blood pressure (BP), which tracks into adulthood. This prospective longitudinal study investigated whether maternal pregnancy dietary intake is associated with the development of child BP up to age four years. Data are from 129 mother-child dyads enrolled in the Women and Their Childre...

Overweight and obesity is prevalent among women of reproductive age (42% BMI > 25 kg/m2) and parity is associated with risk of weight gain. Weight gain greater than that recommended by the Institute of Medicine (IOM )is also associated with lower rates of breastfeeding initiation and duration in women. The aim of this pilot randomised controlled tr...

Studies have identified prenatal flavour exposure as a determinant of taste preferences in infants; however, these studies have focused on relatively small samples and limited flavours. As many parents struggle with getting children to accept a variety of nutritious foods, a study of the factors influencing food acceptance is warranted. The objecti...

Background: Nutrition plays a fundamental role in fetal growth and birth outcomes. Objective: We synthesized effects of dietary interventions before or during pregnancy on neonatal and infant outcomes. Design: Randomized controlled trials that assessed the whole diet or dietary components and neonatal or infant outcomes were included. Two auth...

Background A high rate of stillbirth was previously observed in the Australian Longitudinal Study of Women’s Health (ALSWH). Our primary objective was to test the validity and reliability of self-reported stillbirth data linked to state-based administrative datasets. Methods Self-reported data, collected as part of the ALSWH cohort born in 1973–19...

Background: Validation of a food frequency questionnaire (FFQ) is important, as inaccurate and imprecise information may affect the association between dietary exposure and health outcomes. Objective: This study assessed the validity of the Older Australian's FFQ against plasma carotenoids and Vitamin E. Methods: A random subsample (n = 150) o...

A number of alcohol guidelines worldwide suggest that pregnant women should abstain from alcohol. However, high prevalence rates of alcohol consumption during pregnancy still exist. It is unknown whether there are problems with the dissemination of guideline information that is potentially contributing to such consumption. This qualitative study ai...

Problem Obesity in pregnancy is associated with an increased incidence of maternal and foetal morbidity and mortality, from conditions like preeclampsia, gestational diabetes, preterm birth and stillbirth. Between 20% and 25% of pregnant women in Australia are presenting to their first antenatal appointment with a body mass index (BMI) ≥30 kg/m2, d...

Background Several animal and human studies have shown that zinc plays a role in reducing depression, but there have been no longitudinal studies in both men and women on this topic. The aim of this study was to investigate dietary zinc, and the zinc to iron ratio, as predictors of incident depression in two large longitudinal studies of mid-age an...

Dietary intake during pregnancy influences maternal health. Poor dietary practices during pregnancy have been linked to maternal complications. The objective was to determine the effect of dietary intervention before or during pregnancy on pregnancy outcomes. A systematic review was conducted without date restrictions. Randomised controlled trials...

Risky patterns of alcohol use prior to pregnancy increase the risk of alcohol-exposed pregnancies and subsequent adverse outcomes. It is important to understand how consumption changes once women become pregnant. The aim of this study was to describe the characteristics of women that partake in risky drinking patterns before pregnancy and to examin...

Evidence supports strong associations between healthful eating patterns and maintaining a healthy weight with favourable health outcomes for breast cancer survivors (BCS). The present study aimed to evaluate the diet quality of Australian BCS and to determine whether diet quality differed between BCS and age-matched healthy controls (HC) or by geog...

Pregnant women are exposed to a large number of confusing messages on weight gain, nutrient supplements and food avoidance. This article presents a summary of the evidence so that the risks and benefits of nutrition information can be weighed up. In most cases the evidence is not as clear as guidelines and recommendations present. Differences of sc...

Studies of single nutrients on depression have produced inconsistent results, and they have failed to consider the complex interactions between nutrients. An increasing number of studies in recent years are investigating the association of overall dietary patterns and depression. This study aimed to systematically review current literature and cond...

To identify predictors of antenatal alcohol consumption among women who usually consume alcohol. Prospective cohort study. Australian Longitudinal Study on Women's Health (ALSWH). A total of 1969 women sampled from the ALSWH 1973-78 cohort. Women were included if they were pregnant in 2000, 2003, 2006 or 2009. The relationship between antenatal alc...

Surprisingly, only limited studies have examined the relationship between diet quality and the health care costs to government or to individuals. Additionally, very few studies have examined whether diet quality is able to predict future health care costs.