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
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
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
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
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
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
Institute for Health Metrics and Evaluation. Global burden of diseases, injuries and risk factors study 2010. 2013; Available from: www.healthdata.org
OUTLINE
1. Why Nutrition
2. Getting on the IT path in nutrition & dietetic research
3. Opportunities and challenges for N&D and telehealth
4. Stories from our frontline
5. Where to from here
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
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
2. Getting on the IT path in nutrition & dietetic research
3. Stories from our frontline
4. Challenges and opportunities for N&D and IT
5. Where to from here
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
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
Research-to-Action Cycle
Nutrition Science Communication
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
Prof Clare Collins @ProfCCollins
Goal 1 Evidence
Goal 2 Methods
Goal 3Interventions
Goal 4 Translation
Research-to-Action Cycle
Nutrition Science Communication
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
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
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
▪ 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
Research-to-Action Cycle
Nutrition Science Communication
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
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
™
™
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
2. Getting on the IT path in nutrition & dietetic research
3. Stories from our frontline
4. Challenges and opportunities for N&D and IT
5. Where to from here
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
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
Research-to-Action Cycle
Nutrition Science Communication
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
Prof Clare Collins @ProfCCollins
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”
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
▪ 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
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
Image from dreamstime.com
Summary
OUTLINE
1. Why Nutrition
2. Getting on the IT path in nutrition & dietetic research
3. Stories from our frontline
4. Challenges and opportunities for N&D and IT
5. Where to from here ?
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
The future is now
The University of Newcastle | Prof Clare Collins | @ProfCollins | CRICOS Provider 00109J | www.newcastle.edu.au
@ProfCCollins@UONPRCPAN@@Uni_Newcastle@HMRIAustralia