Therese O'Sullivan

• B App Sci (Human Movement Studies) / B Hlth Sci (Nutrition and Dietetics) Hons; PhD
• Professor (Associate) at Edith Cowan University

Introduction Despite a growing multidisciplinary interest in the Child and Family Centred Care approach, its meaning remains unclear in extant literature. It is, therefore, crucial to explore, analyse, describe, and clarify the concept of the Child and Family Centred Care approach and its associated terms. Method A three‐phased principle‐based con...

Background Although many mothers initiate breastfeeding, supplementation with human-milk substitutes (formula) during the birth hospitalization is common and has been associated with early breastfeeding cessation. Colostrum hand expressed in the last few weeks before birth, known as antenatal colostrum expression (ACE), can be used instead of human...

Background: Previous research has suggested that toddlers are not provided with adequate dietary iron in long-day care (LDC) services. However, the iron bioavailability provided is unknown. The present study aimed to investigate the amount and bioavailability of iron provided to toddlers aged 2-3 years at LDC services. Methods: A cross-sectional...

Background Population-based studies show that the intake of omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFA) are associated with a range of health conditions. Therefore, the reliability of food frequency questionnaires (FFQ) as rapid and easily accessible screening tools for PUFA intake deserve investigation. Objective We aimed t...

Title: Seeing lockdown through the eyes of children from around the world: Reflecting on a children’s artwork project Mandie Jane Foster (1,2,14) PhD, RN, Senior Lecturer & Research Scholar, Nursing Mohammad Al-Motlaq (3) PhD RN. Associate Professor Maternal Child &Family Health Bernie Carter (4,5,1) PhD, RGN, RSCN, Professor of Children’s Nursing...

Background: The nutrition care process (NCP) and its associated standardised terminology (NCPT, referred to collectively as NCP/T) forms a problem-solving framework fundamental to dietetic practice. Global implementation would assist in confirming outcomes from dietetic care, but implementation rates have varied between countries. We investigated...

Background: Limited evidence supports the common public health guideline that children >2 y of age should consume dairy with reduced fat content. Objectives: We aimed to investigate the effects of whole-fat compared with reduced-fat dairy intake on measures of adiposity and biomarkers of cardiometabolic risk in healthy 4- to 6-y-old children. M...

The COVID-19 pandemic created new challenges for children including access to education and limiting social and emotional connections to extended family, friends, and the community. Globally, opportunities for sharing children’s self-reported experiences during lockdown were limited. The primary aim of this project was to create an art-eBook that...

This study explored the association between autistic-like traits in young adults and dietary intake in early childhood in the Gen2 Raine Study cohort. Data were available from 811 participants at years 1, 2 and 3 for the assessment of dietary intake, and at year 20 for measurement of autistic-like traits. Results showed as autistic-like traits incr...

The Australia and New Zealand Ministerial Forum on Food Regulation has supported the recommendations set out in the 2019 Health Star Rating System Five Year Review Report. Specifically, the forum supported, in principle, Recommendation 9, to mandate the Health Star Rating if clear uptake targets were not achieved while the system is voluntary. Give...

PurposeThe consumption of dietary flavonoids from plant-based foods has been related to the prevention of multiple chronic diseases. However, intake data from adolescents are lacking. We aimed to characterise the intake and major sources of dietary flavonoids among Australian adolescents and investigate changes during adolescence.Methods The Raine...

Background and Aims The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing in young populations. However, there are inadequate data regarding diagnosis of NAFLD. We aimed to validate three scoring systems against a previous standard of suprailiac skinfold thickness for diagnosing NAFLD in population-based adolescents. Methods Sev...

Background There is a growing momentum in paediatric ethics to develop respectful research and healthcare protocols. We developed, tested and refined our ‘Respectful Approach to Child-centred Healthcare’ (ReACH), to underpin respectful participant interactions in a clinical trial. Objective To determine whether a ReACH-based approach is acceptable...

Early parenthood can be stressful. Many parenting interventions emphasize skills training, as opposed to improving the parent-child relationship. We investigated whether the Respectful Approach intervention, based on building the parent-child relationship through observation and respect, improves stress and confidence in parents of infants and todd...

Issue addressed: Vulnerable populations are disproportionately affected by food insecurity, resulting in heightened risk of suboptimal dietary intake. Food insecure people appear to implement several coping strategies and dietary compromises to avoid hunger. Less explored in the literature is how these strategies impact consumption of food inside...

Depression is a major cause of disability in adolescents. Higher dietary fibre intake has been associated with lower depressive symptoms in adults but there is a lack of research in adolescents. We examined the association between dietary fibre intake (Commonwealth Scientific and Industrial Research Organisation (CSIRO) food frequency questionnaire...

Purpose: Potential links may exist between vitamin A intake and myopia via various pathways. In this study, we examined the association between dietary vitamin A intake during adolescence and myopia in early adulthood. Methods: We performed a prospective analysis utilizing data collected from participants of the Raine Study Gen2. Dietary vitamin...

A high dietary fibre intake has been associated with improvements in inflammatory conditions in adults. However, little is known on whether associations between dietary fibre and inflammation are evident during adolescence. We examined the relationship between dietary fibre intake measured by food frequency questionnaire and the inflammatory marker...

Background Bile acids (BAs) are synthesized by the liver and modified by gut bacteria, and may play an intermediary role between the gut microbiome and liver in promoting fibrosis in non‐alcoholic fatty liver disease (NAFLD). We investigated the associations between serum and faecal BAs, gut microbiome and fibrosis in patients with and without NAFL...

Dietary guidelines commonly recommend that children aged >2 y consume reduced-fat dairy products rather than regular- or whole-fat dairy. In adults, most studies have not found the consumption of whole-fat dairy products to be associated with increased cardiometabolic or adiposity risk. Associations in children could differ due to growth and develo...

Abdominal pain is a common reason for medical visits. We examined the prevalence, gastrointestinal, and emotional significance of abdominal pain in a population-based cohort serially followed up from birth to 17 years. Children and adolescents from Generation 2 of the Raine Study participated in comprehensive cross-sectional assessments at ages 2,...

Background: To explore the barriers and enablers experienced by nutrition and dietetic professionals in the implementation of the standardised Nutrition Care Process (NCP) across 10 different countries. NCP related beliefs, motivations and values were investigated and compared. Methods: A validated online survey was disseminated to nutrition and...

The consortium of trillions of microorganisms that live inside the human gut are integral to health. Little has been done to collate and characterize the microbiome of children. A systematic review was undertaken to address this gap (PROSPERO ID: CRD42018109599). MEDLINE and EMBASE were searched using the keywords: “healthy preadolescent children”...

Objective Dietary fibre is essential for a healthy diet; however, intake is often inadequate. Understanding of sources of dietary fibre and familial factors associated with intake in adolescents is limited, hampering efforts to increase intake. We aimed to determine adequacy of dietary fibre intake in adolescents, examine how intake changes from mi...

Many higher education institutions struggle to provide interprofessional practice opportunities for their pre-licensure students due to demanding workloads, difficulties with timetabling, and problems with sourcing suitable placements that provide appropriate practice opportunities. A series of complex unfolding video-based simulation scenarios inv...

Background and aims Bowel patterns are varied in the general population. Gastrointestinal symptoms are common reasons for clinical visits. We aimed to examine the usual bowel pattern and the prevalence and significance of gastrointestinal symptoms in a population‐based cohort of Australian adolescents. Methods Seventeen‐year‐old adolescents (n=127...

The use of antenatal colostrum expression in the weeks prior to birth may help improve long-term breastfeeding, but few large-scale studies exist. Typically, antenatal colostrum expression instruction relies on face-to-face education, making large interventions costly. We aimed to determine whether an expert online instructional video can improve k...

Dietary compromises related to food insecurity profoundly undermine health and constitute a serious public health issue, even in developed nations. The aim of this study was to explore the impact of food labelling and product attributes on the purchasing choices of food-insecure households in Australia. An online survey containing 19 food choice an...

Background The Nutrition Care Process (NCP) and NCP Terminology (NCPT) is a systematic framework for critical thinking, decision making, and communication for dietetics practitioners worldwide, aiming to improve quality and patient safety in nutrition care. Although dietetics practitioners in several countries have implemented the NCP/NCPT during r...

Background Dietitians in countries across the world have been implementing the Nutrition Care Process (NCP) and Terminology (NCPT) during the past decade. The implementation process has been evaluated in specific countries and in smaller international studies; however, no large international study comparing implementation between countries has been...

Aim Many dietitians are yet to incorporate the Nutrition Care Process and Terminology (NCPT) into practice. The present study investigated factors predicting (i) NCPT use, (ii) perceived importance of NCPT implementation and (iii) perceived NCPT applicability to personal dietetic practice among dietitians in the Asia‐Pacific region. Methods Dietet...

Recruitment can be an issue for paediatric research. We aimed to investigate parental opinions of paediatric clinical assessments, and to combine findings with recent literature to inform the design of a clinical dietary trial. We used convenience sampling to recruit 17 parents of children aged 2–6 years from two community playgroups in Perth, West...

Food insecurity is considered a “wicked” problem due to the highly complex and at times undefined casual factors. Although many stakeholders are working to address the problem, a possible divergence exists between their views on food insecurity and those of the people who are actually experiencing the problem. The purpose of this study was to inves...

Although diet-induced weight loss is first-line treatment for patients with nonalcoholic fatty liver disease (NAFLD), long-term maintenance is difficult. The optimal diet for improvement in either NAFLD or associated cardiometabolic risk factors, regardless of weight loss, is unknown. We examined the effect of two ad libitum isocaloric diets (Medit...

Infant formula is often used as a treatment for neonatal hypoglycaemia in Australia; however, there are concerns that this may jeopardise mother-baby bonding and breastfeeding. Successful use of glucose gel as an alternative treatment for hypoglycaemia has been reported. We wanted to investigate in a pilot study whether the use of glucose gel has t...

Issue addressed: Currently, two food sufficiency questions are utilised as a proxy measure of national food security status in Australia. These questions do not capture all dimensions of food security and have been attributed with underreporting of the problem. The purpose of this study was to investigate food security using the short form of the...

Aim: Three years following a state-wide Nutrition Care Process Terminology (NCPT) implementation project, the present study aimed to (i) assess changes in NCPT knowledge and attitudes, (ii) identify implementation barriers and enablers and (iii) seek managers' opinions post-implementation. Methods: Pre-implementation and three years post-impleme...

Aim: Assessing changes in dietetic perceptions, attitudes and knowledge regarding the Nutrition Care Process Terminology (NCPT) is important to determine implementation effectiveness. This study aimed to investigate changes in the perceptions and attitudes of Australian dietitians over a three-year period, identify changes in benefits and barriers...

Reduced fat dairy products are generally recommended for adults and children over the age of two years. However, emerging evidence suggests that dairy fat may not have detrimental health effects. We aimed to investigate prospective associations between consumption of regular versus reduced fat dairy products and cardiometabolic risk factors from ea...

Aim: The aim of this study was to investigate the associations between early diet and academic performance during childhood. Methods: Participants were from the Western Australian Pregnancy Cohort (Raine) Study (n=2287). Frequency of consumption of food and beverages were collected at the one, two and three year follow-ups, using a 24-hour food...

AimThe Academy of Nutrition and Dietetics has led the development and dissemination of the Nutrition Care Process (NCP), incorporating the Nutrition Care Process Terminology as the standardised language. This research investigates and compares the views of Australian dietitians pre and post NCP implementation to inform development of an NCP impleme...

Aim Information on attitudes and knowledge of practising dietitians regarding the N utrition C are P rocess ( NCP ) and I nternational D ietetics and N utrition T erminology ( IDNT ) would be useful to inform effective implementation. The present study aimed to: (i) explore dietitians' expectations, perceptions and anticipated benefits of NCP / IDN...

AimIncorporation of the Nutrition Care Process (NCP) and NCP Terminology (NCPt) into clinical dietetics practice is advocated in Australia; however, no evidence-based implementation process exists, which may hinder uptake. Based on formative research findings from the Attitudes Skill Knowledge (ASK) NCP survey and using a change management framewor...

Background: Malnutrition is an important concern for patients undergoing dialysis therapy. We aimed to investigate predictors of nutritional status in a population of in-centre Western Australian haemodialysis (HD) patients and compare dietary protein intakes to national guidelines of 1.2-1.4 g/kg body weight/day.

Almost all previous studies examining the associations between glycaemic load (GL) and metabolic syndrome risk have used a daily GL value. The daily value does not distinguish between peaks of GL intake over the day, which may be more closely associated with the risk of the metabolic syndrome. The aim of the present study was to investigate the cro...

Despite the increasing use of dietary patterns (DP) to study diet and health outcomes, relatively few studies have examined the reliability of DP using different dietary assessment methods. Reduced-rank regression (RRR) is an emerging statistical method that incorporates a priori information to characterise DP related to specific outcomes of intere...

Background Dairy intake is likely to influence dietary energy density (ED) and nutrient density (ND), which are factors representing aspects of dietary quality. Although evidence suggests dairy intake is unlikely to contribute to obesity, intake tends to decrease over adolescence, potentially as a result of concerns around weight gain. We examined...

Energy drinks are predominantly targeted to young adult consumers; however, there has been limited research into their effects on psychological functioning in this demographic group. This study examined cross-sectional associations between energy drink consumption and mental health in a population-based sample of young adults participating in the W...

Although obesity is a major risk factor for non-alcoholic fatty liver (NAFL), not all obese individuals develop the condition, suggesting that other factors such as diet may also contribute to NAFL development. We evaluated associations between fructose and total sugar intake and subsequent diagnosis of NAFL in obese and non-obese adolescents in a...

Energy drinks are becoming increasingly popular among young people. The purpose of this study was to determine the prevalence of energy drink consumption and its associations with socio-demographic characteristics, alcohol, cigarette and illicit drug use in a population-based sample of young adults participating in the Western Australian Pregnancy...

We summarized the data related to foods high in saturated fat and risk of mortality. We searched Cochrane Library, MEDLINE, EMBASE, and ProQuest for studies from January 1952 to May 2012. We identified 26 publications with individual dietary data and all-cause, total cancer, or cardiovascular mortality as endpoints. Pooled relative risk estimates d...

AimThis research aimed to cross‐sectionally quantify fructose consumption and identify major food sources of fructose in adolescents participating in the 14‐year follow up of the Western Australian Pregnancy Cohort (Raine) Study. Methods Subjects were 822 adolescents aged 13–15 years participating in the Raine Study. Dietary intake was assessed by...

Objectives: Poor dietary habits have been implicated in the development of nonalcoholic fatty liver disease (NAFLD); however, little is known about the role of specific dietary patterns in the development of NAFLD. We examined prospective associations between dietary patterns and NAFLD in a population-based cohort of adolescents. Methods: Partic...

Background & aims: Hand grip strength (HGS) has been found to respond to nutrition deprivation and repletion but few studies have investigated its use as an independent nutrition assessment tool. We conducted an observational study to determine if HGS can predict nutrition status independently of other factors. Methods: The Patient Generated Sub...

Background Despite the increasing understanding of the mechanisms relating to weight loss and maintenance, there are currently no validated public health interventions that are able to achieve sustained long-term weight loss or to stem the increasing prevalence of obesity in the population. We aimed to examine the models of energy balance underpinn...

AimThis research aimed to evaluate an online electronic record prototype incorporating the Nutrition Care Process and International Dietetics and Nutrition Terminology. Methods Concept design and programming were conducted to create a prototype from an existing online records program. Twelve dietitians from Perth and surrounds trialled the prototyp...

Dairy nutrients, such as calcium, are particularly important in adolescence, a critical time for growth and development. There are limited Australian data following individuals through adolescence, evaluating changes in dairy nutrient and dairy product consumption. We used a validated food frequency questionnaire to investigate consumption in adole...

Objective: The current prevalence of mental health problems in Western populations is approximately 20% and half of all adult mental health disorders are estimated to originate in adolescence. Diet plays an important role in modulating psychological wellbeing and B-vitamins are vital for the synthesis of neurotransmitters such as serotonin. We aim...

Evidence that fructose intake may modify blood pressure is generally limited to adult populations. This study examined cross-sectional associations between dietary intake of fructose, serum uric acid and blood pressure in 814 adolescents aged 13-15 years participating in the Western Australian Pregnancy Cohort (Raine) Study. Energy-adjusted fructos...

Obesity has origins extending to antenatal and early postnatal periods; however, the relationship between early postnatal diet and subsequent obesity is not well defined. The aims of this study were to determine whether early childhood dietary quality was associated with (a) infant and adolescent nutrition and (b) body mass index (BMI) in childhood...

Previous studies on maternal work hours and child diet quality have reported conflicting findings possibly due to differences in study design, lack of a comprehensive measure of diet quality and differing ages of the children under investigation. The present study aimed to prospectively examine the impact of parental work hours from age 1 year to a...

The Omega-3 Index, a measure of long-chain omega-3 fats in red blood cell membranes, predicts heart disease mortality in adults, but its association with cardiovascular risk factors in younger populations is unknown. We determined the Omega-3 Index in adolescents participating in the Western Australian Pregnancy (Raine) Cohort, assessed association...

Aim: To provide dietitians with information on the proposed introduction of electronic medical records in Australia and New Zealand and discuss potential benefits and challenges. Methods: An overview of the current status regarding electronic health (e-health) records is given along with suggestions on how dietitians may like to become involved. I...

Previous randomized controlled trials have demonstrated that omega-3 polyunsaturated fatty acids (n-3 PUFA) are beneficial in reducing symptoms of depression. However, there is limited evidence regarding the influence of dietary n-3 PUFA intake on mood in adolescents drawn from population studies. Objective: In the present investigation, we examine...

Interest in empirically derived dietary patterns has increased over the past decade. However, relatively few studies have evaluated dietary patterns using different dietary methods, or in young populations. We quantitatively compared dietary patterns from a FFQ with those from a 3 d food record (FR) in a cohort of adolescents. Subjects from the Wes...

Evidence that intake of polyunsaturated fatty acids (PUFAs) may modify blood pressure (BP) is generally limited to middle-aged or hypertensive populations. This study examined cross-sectional associations between BP and dietary intake of PUFAs in 814 adolescents aged 13-15 years participating in the Western Australian Pregnancy Cohort (Raine) Study...

High dietary glycaemic carbohydrate, as measured by the dietary glycaemic index and glycaemic load has been associated with increased risk of the metabolic syndrome in adults, but limited research exists for younger populations. We aimed to evaluate associations between dietary glycaemic carbohydrate and insulin resistance or the prevalence of the...

Scatter plots of glycemic carbohydrate variables against HOMA

Previous epidemiological investigations of associations between dietary glycemic intake and insulin resistance have used average daily measures of glycemic index (GI) and glycemic load (GL). We explored multiple and novel measures of dietary glycemic intake to determine which was most predictive of an association with insulin resistance. Usual diet...

Dietary fat consumed during childhood and adolescence may be related to the development of cardiovascular and other chronic diseases in adulthood; however, there is a lack of information on specific fatty acid intakes and food sources in these populations. Our study aimed to assess fatty acid intakes in Australian adolescents, compare intakes with...

Erring on the side of caution may reduce long term health risks

Overweight and other risk factors for cardiovascular disease (CVD) as well as their clustering, are increasingly prevalent among adolescents. We examined dietary patterns, CVD risk factors, and the clustering of these risk factors in 1139 14-year-olds living in Western Australia. Usual dietary intake was assessed using a food frequency questionnair...

Aims: Dietary glycemic index (GI) and glycemic load (GL) have been associated with risk of chronic diseases, yet limited research exists on patterns of consumption in Australia. Our aims were to investigate glycemic carbohydrate in a population of older women, identify major contributing food sources, and determine low, moderate and high ranges. M...

Background: Diets with a high postprandial glycemic response may contribute to long-term development of insulin resistance and diabetes, however previous epidemiological studies are conflicting on whether glycemic index (GI) or glycemic load (GL) are dietary factors associated with the progression. Our objectives were to estimate GI and GL in a gro...

To investigate the associations between dietary patterns and mental health in early adolescence. The Western Australian Pregnancy Cohort (Raine) Study is a prospective study of 2900 pregnancies recruited from 1989-1992. At 14 years of age (2003-2006; n=1324), the Child Behaviour Checklist (CBCL) was used to assess behaviour (characterising mental h...

Accurate measurement of dietary intake is essential for understanding the long-term effects of adolescent diet on chronic disease risk. However, adolescents may have limited food knowledge and ability to quantify portion sizes and recall dietary intake. Therefore, food frequency questionnaires (FFQs) deemed appropriate for use among adults may not...

Dietary intake during adolescence contributes to lifelong eating habits and the development of early risk factors for disease in adulthood. Few studies have examined the dietary patterns of adolescents and the social and environmental factors that may affect them during this life stage. The present study describes dietary patterns in a cohort of ad...

Breakfast consumption has been associated with better mental health in adulthood, but the relationship between breakfast and mental health in adolescence is less well known. The aims of the present study were to evaluate breakfast quality in a cohort of adolescents and to investigate associations with mental health. Cross-sectional population-based...

Glycemic intake influences the rise in blood glucose concentration following consumption of a carbohydrate containing meal, known as the postprandial glycemic response. The glycemic response is a result of both the type and amount of carbohydrate foods consumed and is commonly measured as the glycemic index (GI) or glycemic load (GL), where the GI...