Margaret Allman-Farinelli

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• BSc DipNutrDiet MPhilPH PhD FDA FNSA
• Professor (Full) at The University of Sydney

Discretionary foods that are energy-dense and nutrient-poor contribute to over one third of total energy intake in Australian children and adults, and the typical portion sizes of many discretionary foods have increased significantly in the last two decades ⁽¹⁾ . The portion size norms (described as a typical perception of how much of a given food...

Ecological momentary assessment (EMA) may be a valid and acceptable method of assessing dietary intake in young adults ⁽¹⁾ . EMA may overcome some of the limitations associated with traditional dietary assessment methods such as high respondent burden and memory biases ⁽²⁾ by capturing time-sensitive data via concise dietary surveys. However, most...

Background: Sleep, physical activity, and nutrition (SPAN) are key determinants of both life expectancy (lifespan) and disease-free life expectancy (healthspan) yet are often studied and promoted in isolation. This study examined the joint association of these three behaviours with lifespan and healthspan. Methods: Prospective cohort analysis of 59...

Background Sleep, physical activity, and nutrition (SPAN) are critical behaviours for health, although they have traditionally been studied separately. We examined the combined associations of SPAN and the minimum between-individual variations associated with meaningfully lower all-cause mortality risk. Methods This prospective cohort analysis inc...

Aim This qualitative study aimed to gain insights from Australian consumers to inform the development of potential interventions to facilitate better portion control of discretionary foods. Methods Four focus group sessions were conducted online with Australian adults (aged 18–65). A semi‐structured question guide with proposed interventions in se...

Background There are limited data on the amount of discretionary foods that people normally consume and consider as appropriate at one eating occasion. This study aimed to provide an overview of the range and assess differences of the ‘normal portion size’ and ‘perceived appropriate portion size’ of energy-dense nutrient-poor discretionary foods am...

Early childhood is a key opportunity to establish healthy eating behaviors and prevent future non‐communicable diseases associated with poor diets. How to effectively intervene in the system of the many determinants influencing children's dietary intake remains unclear. This scoping review aimed to map the determinants of nutrition and eating that...

Often referred to as ‘the last unknown’, Papua New Guinea’s largely unexplored environments across its four distinct regions, the Highlands, New Guinea Islands, Momase, and Southern, exhibit remarkable diversity. Understanding this diversity is significant in contextualising the risk factors associated with developing non-communicable diseases. Thi...

The adoption of sustainable diets among middle-aged and older adults may lead to both improved health outcomes and lower environmental impact. Understanding the barriers and enablers that influence food choices and dietary patterns in this growing demographic is pivotal to inform the promotion of dietary change. A convergent integrated mixed method...

Medical Nutrition Therapy (MNT) services have shifted from only in-person to digital consultations. This may present a challenge to older patients if they are not digitally literate. This scoping review aimed to identify and analyse tools for assessing digital health literacy to guide dietetic practice in screening patients for digital care needs a...

Background Online food delivery (OFD) platforms offer easy access to an abundance of energy-dense and nutrient-poor takeaway foods and may exacerbate existing unhealthy food environments. Efforts to improve population diets include a range of policy recommendations focused on improving the healthiness of food environments; however, the way in which...

Background Major knowledge and practice gaps exist in aged care home services to support independence of older people with dementia. This research evaluates an adaptation of a community‐based rehabilitation model for care homes, namely Interdisciplinary Care Home‐bAsed Reablement Program (I‐CHARP), by examining whether (and, if so, how) I‐CHARP pro...

Background: The increase in serving sizes of energy-dense nutrient-poor discretionary foods over time, with attractively presented large servings and package sizes, has led to portion distortion and a new ‘normal’ for serving sizes. Little data exists on the variations of portion size norms of discretionary foods across settings. This study aimed t...

Objective The high availability of energy-dense nutrient-poor discretionary foods in large serving and package sizes may have shifted portion size norms (described as a typical perception of how much people choose to eat from a given food at a single eating occasion) towards larger sizes. Few public health recommendations exist around appropriate d...

Issue addressed: Food environments surrounding schools have a strong influence on the adolescent's food choices. Moreover, the prevalence of diet-related chronic diseases is higher in regional than metropolitan areas in Australia. Understanding school food environments in these different settings is crucial for informing future strategies to impro...

Aim The aim of this study was to examine expectations, perceptions and attitudes about dietetics services among the Australian and New Zealand public, to provide insights for building a future dietetics workforce that will meet consumer needs. Methods A cross‐sectional, anonymous, online survey was employed to gain perspectives of a representative...

Home Enteral Tube Feeding (HETF) is a viable option for people within primary care settings when oral intake is insufficient to meet nutritional needs. As HETF is not a risk-free therapy, guidelines exist to enable its safe provision. This review aims to summarise existing guidelines and their recommendations pertaining to the provision of HETF and...

Aims: To describe an Aboriginal cultural immersion delivered to dietetics students at a large university in Australia and assess its effectiveness as a method to teach Aboriginal history, culture, diet, and health in dietetics. Methods: Taking a strength-based approach, Aboriginal processes of learning were privileged, with the cultural immersio...

Adolescent obesity continues to be a public health challenge with poor quality diets contributing to its etiology. As part of the process to plan health promotion and policy interventions, understanding adolescents perceived facilitators and barriers to healthful eating is important. An integrative convergent mixed‐methods systematic review was use...

For artificial intelligence (AI) to support nutrition care, high quality and accuracy of its features within smartphone applications (apps) are essential. This study evaluated popular apps’ features, quality, behaviour change potential, and comparative validity of dietary assessment via manual logging and AI. The top 200 free and paid nutrition-rel...

There is a rising prevalence of non-communicable diseases (NCDs) in Papua New Guinea (PNG), adding to the disease burden from communicable infectious diseases and thus increasing the burden on the healthcare system in a low-resource setting. The aim of this review was to identify health and nutrition promotion programs conducted in PNG and the enab...

Background The aim of this study was to determine the long-term effect of increasing water intake in patients with autosomal dominant polycystic kidney disease (ADPKD) on longitudinal changes in health-related quality of life (HRQoL) in the setting of a clinical trial. Methods Self-completed HRQoL (using the KDQoL-SF, v.1.3 questionnaire) was asse...

While a large proportion of the population in Papua New Guinea (PNG) maintain a subsistence lifestyle, exposure to modernisation and industrialisation since European contact has influenced a transition towards Western diets. This review aimed to scope and summarise the published research on dietary intake among Pacific Islander adults in PNG. Four...

Food environments surrounding secondary schools are a known influence on the purchasing and consumption habits of adolescents(1). Understanding their obesogenic potential is important for informing strategies to create more healthful food environments for adolescents, particularly for those living in regional areas, and is a key component of Austra...

Food environments around secondary schools are a strong influence on adolescents’ food purchasing habits1. We conducted a repeat cross-sectional study using Google Street View to examine school food environments in regional and metropolitan NSW, Australia over 17-years. Findings showed that unhealthful food outlets such as fast-food franchises, con...

Objective It is unknown how well menu-labelling schemes that enforce the display of kilojoule (kJ) labelling at point-of-sale, has been implemented on Online Food Delivery services (OFDs) in Australia. This study aimed to examine the prevalence of kJ labelling on the online menus of large food outlets with more than 20 locations in the state or 50...

Aims In 2019, the Australian Academy of Science in collaboration with the nutrition community published the decadal plan for the science of nutrition. This article aims to review progress towards each of its pillar goals (societal determinants, nutrition mechanisms, precision and personalised nutrition, and education and training) and two enabling...

Background There are limited data on the amount of discretionary foods that people normally consume and consider as appropriate at one eating occasion. This study aimed to provide an overview of the range and assess differences of the ‘normal portion size’ and ‘perceived appropriate portion size’ of energy-dense nutrient-poor discretionary foods am...

Purpose Young adults eat erratically and later in the day which may impact weight and cardiometabolic health. This cross-sectional study examined relationships between chrononutritional patterns and diet quality in two young adult populations: a university and community sample. Methods Three days of dietary data were collected including food image...

Food accessibility was considerably impacted by restrictions during the coronavirus disease 2019 (COVID‐19) pandemic, leading to growth in the online food retail sector, which offered contact‐free delivery. This systematic review aimed to assess the change in use of online food retail platforms during COVID‐19. The secondary aim was to identify die...

Objectives To evaluate the effect of a coaching intervention compared with control on physical activity and falls rate at 12 months in community-dwelling people aged 60+ years. Design Cluster randomised controlled trial. Setting Community-dwelling older people. Participants 72 clusters (605 participants): 37 clusters (290 participants) randomise...

Background Mobile ecological momentary assessment (EMA) is a powerful tool for collecting real-time and contextual data from individuals. As our reliance on online technologies to increase convenience accelerates, the way we access food is changing. Online food delivery (OFD) services may further encourage unhealthy food consumption habits, given t...

Background Sleep, physical activity, and nutrition (SPAN) are crucial modifiable factors for health, yet most research has examined them independently rather than exploring their combined and incremental impact on disease risk and mortality. Objective To determine the collective associations of SPAN exposures and establish clinically relevant targ...

Snacking outside main meals may contribute to the high intakes of discretionary foods (i.e., unhealthful foods) among young adults. This study assessed the snacking behaviours of Australian young adults including the contribution of snacking to energy and nutrient intakes, the main foods consumed, and portion sizes. A secondary analysis of the MYMe...

It has now been 25 years since the World Health Organisation (Geneva, Switzerland) drew attention to the obesity epidemic (later becoming a pandemic) [...]

Objectives: The aim of this article is to explore the differences in the prevalence, sociodemographic determinants, and effects of food insecurity between international and domestic students in an Australian university during the COVID-19 pandemic. Methods: This study uses a cross-sectional online survey. The questionnaire contained the 18-item...

Access to food is a right that every individual must have to ensure a standard of living that is sufficient for maintaining good health and wellbeing. This review, developed and implemented by a team of First Nations and non-First Nations peoples, aimed to scope the literature on programs addressing food security for First Nations peoples in Austra...

Rationale & objective: The development of new therapies for autosomal dominant polycystic kidney disease requires clinical trials to be conducted efficiently. In this study, the factors affecting the recruitment and retention of participants enrolled in a 3-year randomized controlled trial in autosomal dominant polycystic kidney disease were inves...

Background Perceived portion size norms (typical perception of how much of a given food individuals choose to eat at a single occasion) may have shifted towards larger sizes due to the ubiquity of large serving sizes. However, there is a lack of validated tools to assess such norms for energy-dense and nutrient-poor discretionary foods. This study...

BACKGROUND Mobile ecological momentary assessment (EMA) is a powerful tool for collecting real-time and contextual data from individuals. As our reliance on online technologies to increase convenience accelerates, the way we access food is changing. Online food delivery (OFD) services may further encourage unhealthy food consumption habits, given t...

Issue addressed: More attention to the diet and nutritional status of international students in Australian universities is indicated. This qualitative research aimed to provide an in-depth understanding of dietary changes among international students after they arrived in Australia. Methods: Semi-structured interviews were conducted with interna...

N-of-1 trials provide a higher level of evidence than randomized controlled trials for determining which treatment works best for an individual, and the design readily accommodates testing of personalized nutrition. The aim of this systematic review was to synthesize nutrition-related studies using an N-of-1 design. The inclusion criterion was adul...

Conventional dietary assessment methods are based predominately on Western models which lack Aboriginal and Torres Strait Islander knowledges, methodologies, and social and cultural contextualisation. This review considered dietary assessment methods used with Aboriginal and Torres Strait Islander populations and assessed their applicability. Four...

Self-directed care is a revolutionary approach empowering recipients of long-term services and supports to choose who will provide the care and supports they need. Bradley, Fenton, and Mahoney define self-direction as a way that individuals who need long-term care in the public sector interact with public-service systems by encouraging them to exer...

Background Evidence shows that promoting physical activity among older people without providing fall prevention advice may increase fall rates. The Coaching for Healthy AGEing (CHAnGE) trial measured the effect of a physical activity and fall prevention program on physical activity and falls among community-dwelling people aged 60+. Design Cluster...

Knowing the type and quality of the most popular foods consumed by a population can be useful in the design of technologies for monitoring food intake and interventions. The aim of this research was to determine the most frequently consumed foods and beverages among the Australian population and provide recommendations for progressing the design of...

Online food delivery (OFD) platforms have become increasingly popular due to advanced technology, which is changing the way consumers purchase food prepared outside of the home. There is limited research investigating the healthiness of the digital food environment and its influence on consumer choice and dietary behaviours. This study is the first...

Poor diet quality is commonly reported in young adults. This study aimed to measure the diet quality of students attending a large Australian university (including domestic and international students), and to examine the effect of food security status and other key factors likely to impact their diet quality. Using the Automated Self-Administered 2...

Background Portion size norms (described as a typical perception of how much of a given food individuals choose to eat in one eating occasion) may have shifted towards larger sizes due to the high availability of large package and serving sizes. This is especially concerning for discretionary foods that are energy-dense and nutrient-poor. Currently...

Growing social media use in young adults may have applications in health promotion. This study aimed to determine the acceptability and feasibility of using Instagram to disseminate nutritional information to young Australians and assess the most preferred post style. A cross-sectional web-based pilot survey was conducted in 18–30-year-olds residin...

Studies have shown that young adults follow less structured eating patterns compared with older cohorts. This may have implications for dietary assessment methods which rely on memory and structured meal patterns. Our aim was to describe the intra-individual variation of eating times in young adults aged 18–30 years. Participants (n = 41) wore an A...

NOVA classification distinguishes foods by level of processing, with evidence suggesting that a high intake of ultra-processed foods (UPFs, NOVA category 4) leads to obesity. The Australian Dietary Guidelines, in contrast, discourage excess consumption of “discretionary foods” (DFs), defined according to their composition. Here, we (i) compare the...

Context Portion size norm is described as the perception of how much of a given food people choose to eat. Reducing the portion size norm of foods that are high in saturated fat, added sugar, and added salt toward smaller sizes might be a potential strategy to promote appropriate portion size selections. However, an overview of existing portion siz...

The present study examined the association of contextual factors (social and food preparation location) with the energy density of meals and snacks consumed in a sample of young Australian adults (18-30 years old) identified using wearable camera technology. Over three consecutive days, a subsample of young adults wore a wearable camera that captur...

Young adults are frequent consumers of food prepared outside the home (FOH). In a cross-sectional survey, the MYMeals study, we showed FOH provided one-third of meals and snacks for young Australian adults, yet it contributed higher proportions of energy and nutrients of concern, such as saturated fat and sodium. This study aimed to determine the d...

Despite health advice and campaigns, discretionary beverages remain a source of added sweeteners (sugar and intense sweeteners) and fat in the dietary intakes of many young adults. This study aimed to determine discretionary beverage consumption amongst 18 to 30-year-olds residing in New South Wales, Australia. Data were collected in 2017/2018 duri...

Background The rapid adoption and sustained use of social media globally has provided researchers with access to unprecedented quantities of low‐latency data at minimal costs. This may be of particular interest to nutrition research because food is frequently posted about and discussed on social media platforms. This scoping review investigates the...

Mobile-based ecological momentary assessment (mEMA) offers a novel method for dietary assessment and may reduce recall bias and participant burden. This review evaluated mEMA methodology and the feasibility, acceptability and validity as a dietary assessment method in young people. Five databases were searched from January 2008 to September 2021 fo...

Purpose This study examined the association of social contexts and food preparation location with the quality of meals and snacks (predominately from the five food groups (FFG) versus discretionary foods) in a sample of young Australian adults (18–30 years old) using wearable camera technology. Methods A sub-sample from the cross-sectional MYMeals...

As food intake patterns become less structured, different methods of dietary assessment may be required to capture frequently omitted snacks, smaller meals, and the time of day when they are consumed. Incorporating sensors that passively and objectively detect eating behavior may assist in capturing these eating occasions into dietary assessment me...

Online food delivery usage has soared during the 2019 novel coronavirus (COVID-19) pandemic which has seen increased demand for home-delivery during government mandated stay-at-home periods. Resulting implications from COVID-19 may threaten decades of development gains. It is becoming increasingly more important for the global community to progress...

The role of portion control plates in achieving healthy diets is unclear. The aim of this scoping review was to systematically map findings from peer reviewed and grey literature to provide evidence for the use of portion control plates to promote healthy eating and nutrition-related knowledge in children and adults. A secondary aim was to review t...

Aim: The COVID-19 pandemic has disrupted the Australian food supply with potential ramifications on food security. This scoping review aimed to synthesise current evidence on the prevalence of food insecurity and changes to factors related to food insecurity during the COVID-19 pandemic in Australia. Methods: A comprehensive search strategy was...

The study of food consumption, diet, and related concepts is motivated by diverse goals, including understanding why food consumption impacts our health, and why we eat the foods we do. These varied motivations can make it challenging to define and measure consumption, as it can be specified across nearly infinite dimensions—from micronutrients to...

The unrelenting obesity pandemic in Middle Eastern (ME) adolescents living in Australia warrants culturally responsive and locally engineered interventions. Given the influence of parents on the lifestyle behaviours of adolescents, this qualitative study aimed to capture the opinions of ME parents on the barriers and enablers to sufficient physical...

Nutrition interventions developed using behaviour theory may be more effective than those without theoretical underpinnings. This study aimed to document the number of theory-based healthy eating interventions, the involvement of dietitians/nutritionists and the behaviour theories employed from 2000 to 2020. We conducted a review of publications re...

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databas...

In patients with autosomal dominant polycystic kidney disease (ADPKD), drinking more water could potentially reduce urine osmolality and suppress arginine vasopressin release and decrease the rate of kidney cyst growth and its associated organ dysfunction. In a 3-year trial, adults with ADPKD randomized to drink more water so as to lower urine osmo...

The unyielding obesity epidemic in adolescents from Middle Eastern (ME) backgrounds warrants culturally-responsive and co-designed prevention measures. This study aimed to capture the opinions of ME parents residing in Australia on the crisis and their enablers and barriers to healthy eating interventions given their influence on adolescent eating...

Aims This systematic review aimed to evaluate the quality of dietary assessment methods in randomised controlled trials (RCTs) focusing on people with type 2 diabetes (T2DM), and its impact on the favourability of conclusions. Research Methods & Procedures MEDLINE, EMBASE, CINAHL and CENTRAL were searched, from inception until September 2019 for R...

The obesity epidemic in adolescents from Middle Eastern (ME) backgrounds necessitates co-designed and culturally-responsive interventions. This study’s objective was to gather the opinions, attitudes, capabilities, opportunities and motivations of ME adolescents residing in Australia on healthy eating and physical activity (PA) behaviours to inform...

Background University students may experience a high prevalence of food insecurity. The impacts of food insecurity on dietary intake and meal patterns of students have not been fully researched. Objective This systematic review aimed to examine the association between food insecurity and dietary outcomes among university students. Methods Nine el...

Background: There are numerous guidelines developed for bone health. Yet, it is unclear whether the differences in guideline development methods explain the variability in the recommendations for vitamin D and calcium intake. The objective of this systematic review was to collate and compare recommendations for vitamin D and calcium across bone he...

Objectives Diet is critical in diabetes management and new nutritional interventions are continuously being tested in randomized controlled trials. However, to make meaningful conclusions about the efficacy of dietary treatments, it is critical to be certain that the participants adhered to the dietary intervention and the dietary changes are valid...

Objectives Tertiary education students have been found to experience a higher prevalence of food insecurity than the general population. This systematic review aims to examine the existing evidence on the association between food insecurity and dietary outcomes among higher education students. Methods Nine electronic databases and gray literature...

New technologies may improve the validity of dietary and physical activity assessment and thereby associated findings for lifestyle-related bone health research. This scoping review mapped the evidence for the validity of new technologies that measure bone-related dietary and physical activity risk factors in adolescents and young adults. A systema...