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"Twynstra, Jasna"
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Dietary Patterns and Brain Health in Middle-Aged and Older Adults: A Narrative Review
2025
Diet has a profound impact on brain health, particularly in middle-aged and older adults, who are at increased risk of cognitive decline and neurodegenerative diseases. Various dietary patterns, including the Mediterranean diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets, have been linked to improved cognitive function. While the relative effectiveness of these diets on brain health is generally supported by evidence, variability in study results suggests that further research is needed to fully understand their effects across diverse populations. The objective of this descriptive narrative review is to examine the role of dietary patterns in supporting brain health in aging populations and to propose practical dietary strategies for promoting cognitive well-being. A comprehensive review of the existing literature was conducted on PubMed in October 2024, with no restrictions on language, publication date (1966–2024), or geographic location. A total of 18 articles were included in this review, covering the years 2013–2023. Studies assessing the impact of the MedDiet, DASH, MIND, and Western diets on cognitive function in middle-aged and older adults were prioritized. The research findings were synthesized to identify common and unique recommendations across these dietary patterns. The MedDiet consistently showed beneficial effects on cognitive health, including improved memory, processing speed, and long-term protection against neurodegenerative conditions. The DASH and MIND diets demonstrated potential benefits, particularly for specific cognitive domains, but the results were more mixed and inconclusive. In contrast, adherence to a Western diet was associated with negative cognitive outcomes, including cognitive decline and smaller brain volumes. These findings underscore the importance of adopting healthy dietary patterns as a modifiable lifestyle factor to support cognitive aging and inform future public health strategies and clinical guidelines.
Journal Article
Correlates of Lifetime and Past Month Vape Use in a Sample of Canadian University Students
by
Twynstra, Jasna
,
Seabrook, Jamie A
,
Gilliland, Jason A
in
Adolescent boys
,
Adolescents
,
Alcohol
2021
Introduction:
This study examines correlates of lifetime (ie, ever vaped) and past month vape use among students aged 17 to 19 years, 20 to 25 years, and 26+ years from Western University in London, Ontario. The secondary objective is to assess lifetime and past month vape use among students not of legal age to purchase vaping products in Ontario (ie, those 17 to 18 years only).
Methods:
Using Qualtrics, a cross-sectional survey was sent via email to all students at Western University (N = 38 442), assessing their current and past risk-taking behaviors, mental health, sociodemographic characteristics, as well as questions pertaining to their family structure and socioeconomic background during childhood. Students were asked if they had ever vaped in their lifetime and about past month vape use. Logistic regression models were used to assess correlates of lifetime and past month vape use.
Results:
The sample consisted of 2626 university students. Compared to those ages 26+ years, teenage university students were 10 times more likely to have vaped in the past month and males were twice as likely as females to have vaped. Alcohol use doubled the odds of vaping in the past month, whereas cigarette, cannabis, or cocaine use approximately tripled the odds. Students who reported many sexual partners were far more likely to have vaped in the past month.
Conclusion:
Vape use is more common among teenage university students, males, those who drink alcohol, smoke, use cannabis or cocaine, and who report many sexual partners.
Journal Article
Does Dietitian Involvement During Pregnancy Improve Birth Outcomes? A Systematic Review
2024
Maternal diet during pregnancy can have a significant impact on maternal and offspring health. As nutrition counselling is an important component of prenatal care, registered dietitians (RDs) are uniquely trained professionals who can provide personalized nutrition counselling customized to an individual’s sociocultural needs. The objective of this systematic review was to determine if RD involvement during pregnancy is associated with a lower prevalence of adverse birth outcomes in the United States and Canada. The review was conducted through a search of four databases: PubMed, CINAHL, Embase, and Web of Science. A total of 14 studies were identified. Women had a lower prevalence of low birth weight and preterm infants when RDs were involved during prenatal care. While RD involvement during pregnancy was not associated with macrosomia, more research is needed to assess its relationship with small for gestational age, large for gestational age, and infant mortality. Future research should also investigate the specific dietary advice provided by RDs and the extent and timing of their involvement throughout pregnancy to better understand the mechanisms surrounding nutrition counselling, in utero development, and health outcomes.
Journal Article
Maternal Eating Disorders and Adverse Birth Outcomes: A Systematic Review and Meta-Analysis
by
Moussa, Nadin M.
,
Milembamane, Mantala
,
Twynstra, Jasna
in
Abortion, Spontaneous - epidemiology
,
Abortion, Spontaneous - etiology
,
Analysis
2024
Previous systematic reviews have reported on the relationship between eating disorders (EDs) and birth outcomes, but there are no existing meta-analyses on this topic. This systematic review and meta-analysis examines the association between lifetime maternal EDs, including anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) with low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), large for gestational age (LGA), and miscarriage. Four databases were systematically searched for quantitative literature on maternal EDs that preceded birth outcomes. Eighteen studies met the inclusion criteria and were included in the review. The meta-analyses included 6 studies on miscarriage, 11 on PTB, 4 on LBW, 9 on SGA, and 4 on LGA. The Mantel–Haenszel random effects model was used to test the associations between EDs and birth outcomes. The results showed significant positive associations between AN and LBW (OR 1.74, 95% confidence interval (CI) 1.49, 2.03), AN and SGA (OR 1.39, 95% CI 1.17, 1.65), BN and PTB (OR 1.19, 95% CI 1.04, 1.36), and BED and LGA (OR 1.43 95% CI 1.18, 1.72). EDs were not significantly correlated with miscarriage. These findings reveal the importance of screening for and treating EDs in pregnant women.
Journal Article
Registered Dietitians’ Experiences and Perceptions in Providing Prenatal Nutrition Care in Canada: A Cross-sectional Study
by
Francis, Joelle
,
Twynstra, Jasna
,
Wilding, Sarah
in
Accessibility
,
Adult
,
Attitude of Health Personnel
2025
Purpose: To explore Canadian Registered Dietitians’ (RDs) roles and experiences in prenatal care.
Methods: This cross-sectional study utilized an online, anonymous, original survey. Eligible RDs, who are members of Dietitians of Canada (DC) and provide care for pregnancy, were invited to participate through their publicly available online profiles on the DC website.
Results: Of the 71 RDs who completed the survey, 97.1% provided nutrition care when requested by the client, 68.8% in times of complications, and 60.0% through referrals. RDs most frequently discussed topics on foods to avoid, supplementation, and healthy eating. Only 4.3% of RDs felt that other prenatal healthcare providers (HCPs) are providing adequate nutritional care, while all (100.0%) RDs believed that they should be the ones providing nutrition care for pregnancy, and most (88.6%) thought they should start providing nutrition counselling during preconception. Most (92.9%) respondents acknowledged that barriers exist in accessing RDs for nutrition advice. Recommendations for improving RD accessibility included increased government funding, involvement in standard care and referrals, awareness, and remote access.
Conclusions: Canadian RDs would like to play a larger role in prenatal care through a more integrated approach with other prenatal HCPs and improved access to dietetic services for all pregnant people.
Journal Article
Identifiable Dietary Patterns of Pregnant Women: A Canadian Sample
by
Twynstra, Jasna
,
Mosher, Lydia Tegwyn
,
Seabrook, Jamie A.
in
Carbohydrates
,
Cardiovascular disease
,
Data collection
2022
Purpose: To estimate the percentage of a sample of pregnant women in Canada following a vegetarian, vegan, low-carbohydrate, gluten-free, Mediterranean, or well-balanced diet, before and during pregnancy and to explore if pregnant women received and were satisfied with nutrition information received from health care providers (HCPs). Methods: Participants were conveniently sampled through Facebook and Twitter. An online survey collected data on sociodemographic characteristics, maternal diet, and whether women received and were satisfied with nutrition information from their HCPs. The McNemar test assessed changes in the proportion of diets followed before and during pregnancy. Results: Of 226 women, most followed a well-balanced diet before (76.9%) and during (72.9%) pregnancy (p = 0.26). Vegetarian, gluten-free, vegan, and low-carbohydrate diets were the least followed diets before and during pregnancy (vegetarian: 7.6% vs 5.3%; gluten-free: 4.9% vs 4.0%; vegan: 2.7% vs 2.2%; low-carbohydrate:4.0% vs 0.4%). Overall, the number of women following restrictive diets before pregnancy was significantly reduced throughout pregnancy (19.1% vs 12.0%, p < 0.001). Only 52.0% of women received nutrition information from their primary HCP, and 35.6% were satisfied with the nutrition information received. Conclusions: Most women followed a well-balanced diet before and during pregnancy and approximately one-third were satisfied with the information received from HCPs.
Journal Article
A Review of Statistical Reporting in Dietetics Research (2010–2019): How is a Canadian Journal Doing?
2021
Despite the widespread use of statistical techniques in quantitative research, methodological flaws and inadequate statistical reporting persist. The objective of this study is to evaluate the quality of statistical reporting and procedures in all original, quantitative articles published in the Canadian Journal of Dietetic Practice and Research (CJDPR) from 2010 to 2019 using a checklist created by our research team. In total, 107 articles were independently evaluated by 2 raters. The hypothesis or objective(s) was clearly stated in 97.2% of the studies. Over half (51.4%) of the articles reported the study design and 57.9% adequately described the statistical techniques used. Only 21.2% of the studies that required a prestudy sample size calculation reported one. Of the 281 statistical tests conducted, 88.3% of them were correct. P values >0.05–0.10 were reported as “statistically significant” and/or a “trend” in 11.4% of studies. While this evaluation reveals both strengths and areas for improvement in the quality of statistical reporting in CJDPR, we encourage dietitians to pursue additional statistical training and/or seek the assistance of a statistician. Future research should consider validating this new checklist and using it to evaluate the statistical quality of studies published in other nutrition journals and disciplines.
Journal Article
Use of an Experiential Learning Assignment to Prepare Future Health Professionals to Utilize Social Media for Nutrition Communications
2016
Social media has become a popular platform for reputable health organizations to disseminate health information to the public. However, future health professionals may receive little training in social media communication. To train future dietetic professionals, we incorporated a social media assignment into a Communications course curriculum to facilitate effective use of social media for the profession. For the assignment, students were instructed to make 2 posts on Facebook. The posts were due 3 weeks apart so that students received feedback on their first post before making their second post. To demonstrate the type of social media communication commonly used by reputable health organizations, the first post raised awareness or provided nutrition education. The second post used Facebook’s “comment” feature, to respond to another student’s first post, demonstrating the use of social media for community engagement. Both posts included a hyperlink that the user could click to get more information. Students were evaluated on the hook, main points, professionalism, credibility, and effectiveness of inviting the reader to the hyperlinked website and its ease of navigation. Dietetics educators should be encouraged to incorporate social media education into their curriculums for the benefit of future dietitians and their clients.
Journal Article
Use of an Experiential Learning Assignment to Prepare Future Health Professionals to Utilize Social Media for Nutrition Communications
by
Twynstra, Jasna
,
Dworatzek, Paula
in
Consumer health information
,
Experiential learning
,
Medical personnel
2016
Pour les organismes liés à la santé de renom, les médias sociaux sont devenus une plateforme populaire de diffusion de renseignements sur la santé à l'intention du public. Cependant, il est possible que les futurs professionnels de la santé reçoivent peu de formation sur la communication dans les médias sociaux. Nous avons intégré un travail sur les médias sociaux au sein d'un cours en communication afin de former les futurs professionnels en diététique à l'utilisation efficace des médias sociaux dans le cadre de leur profession. Pour ce travail, les étudiants devaient publier 2 interventions sur Facebook. Celles-ci étaient séparées de 3 semaines afin que les étudiants reçoivent de la rétroaction sur leur première intervention avant de publier la seconde. Pour illustrer le type de communication couramment utilisé dans les médias sociaux par les organismes liés à la santé de renom, le contenu de la première intervention était de la sensibilisation ou de l'éducation à la nutrition. La seconde intervention devait être une réponse à l'intervention d'un autre étudiant, effectuée au moyen de la fonction « Commentaire » de Facebook, afin d'illustrer l'utilisation des médias sociaux pour l'engagement au sein de la communauté. Les deux interventions contenaient un hyperlien sur lequel l'utilisateur pouvait cliquer pour en savoir plus. Les critères d'évaluation des étudiants étaient l'accroche, les thèmes évoqués, le professionnalisme, la crédibilité et l'efficacité à inviter le lecteur à consulter le site Web accessible au moyen de l'hyperlien, ainsi que la facilité de navigation sur celui-ci. Les éducateurs en diététique doivent être incités à intégrer une formation sur les médias sociaux au sein de leurs programmes, et ce, dans l'intérêt des futurs diététistes et de leur clientèle.
Journal Article