animals

Article
The Diets of Companion Cats in Aotearoa New Zealand:
Identification of Obesity Risk Factors
Rachel Forrest 1, * , Leena Awawdeh 1, *, Fiona Esam 2 , Maria Pearson 1 and Natalie Waran 1

1 Eastern Institute of Technology, Hawke’s Bay, 501 Gloucester Street, Taradale, Napier 4112, New Zealand;
[email protected] (M.P.); [email protected] (N.W.)
2 Companion Animals New Zealand, Wellington 6141, New Zealand; [email protected]
* Correspondence: [email protected] (R.F.); [email protected] (L.A.); Tel.: +64-6974-8000 (R.F. & L.A.)

Simple Summary: Currently, there is a paucity of studies exploring the behaviours of people living
in Aotearoa New Zealand regarding their responsibilities as pet owners and the factors that may
influence these behaviours. In order to improve pet management and, in turn, animal welfare, we
need to understand the factors that contribute to why humans behave the way they do towards their
animals so that we can implement effective behaviour change programmes to benefit animal welfare.
The current study aims to explore what companion cats in Aotearoa New Zealand are being fed
and identify possible owner-related risk factors for developing obesity in cats. Identifying these risk
factors may assist in developing future research and new approaches to obesity prevention in cats
that focus on positive behaviour changes in their owners.

Abstract: One in four New Zealand cats are overweight or obese, conditions associated with poor



health outcomes. As part of an online survey that was conducted from January 2019 to March 2019,


NZ residents aged ≥18 years were asked demographic questions along with questions related to the
Citation: Forrest, R.; Awawdeh, L.; body condition, breed and diet of their cat/s. From the responses, possible owner-related risk factors
Esam, F.; Pearson, M.; Waran, N. The for developing obesity were identified. Of the respondents, 65.5% (n = 1537) owned cat/s; the owners
Diets of Companion Cats in Aotearoa being more likely to be female, live rurally, or live with children. Most of the respondents fed their
New Zealand: Identification of
cat/s biscuits from the supermarket (63%) and wet food (57%). Almost half (45%) fed their cat/s
Obesity Risk Factors. Animals 2021,
specialised food from a pet shop or veterinary clinic and gave them treats, with 31% of respondents
11, 2881. https://doi.org/10.3390/
feeding their cat/s raw meat. Feeding cats a variety of food types may make it difficult to estimate
ani11102881
the appropriate amount of each needed to avoid excess caloric intake. In addition, approximately
Academic Editor: Leonardo Leonardi
30% of the respondents did not agree with the correct body condition statement, revealing a need for
owner education. These findings highlight important areas of cat nutrition requiring future research
Received: 31 August 2021 to better inform the development of healthy weight interventions for NZ cats.
Accepted: 30 September 2021
Published: 2 October 2021 Keywords: body condition; cats; companion animal; diet; feline; food; New Zealand; obesity; pet

Publisher’s Note: MDPI stays neutral

with regard to jurisdictional claims in
published maps and institutional affil- 1. Introduction
iations.
Globally, Aotearoa New Zealand (NZ) has one of the highest rates of pet ownership,
with 41% of the population having at least one cat [1]. Despite the large cat population
in NZ, there is a paucity of studies exploring the attitudes of New Zealanders towards
their responsibilities as pet owners and the cultural and regionally-specific factors that may
Copyright: © 2021 by the authors. influence these attitudes. Recently, the NZ Companion Animal Trust (NZCAT) funded
Licensee MDPI, Basel, Switzerland. a Furry Whānau (family) Wellbeing Research Study [2] to explore the attitudes of pet
This article is an open access article owners in NZ towards the health and wellbeing of dogs and cats along with the factors
distributed under the terms and that influence these attitudes. Here, those aspects of the study relating to the diet of cats
conditions of the Creative Commons
are presented.
Attribution (CC BY) license (https://
The domestic cat belongs to the Felis catus species, a small Carnivora mammal [3,4].
creativecommons.org/licenses/by/
Domesticated cats have unique nutritional dietary requirements based on their evolutionary
4.0/).

Animals 2021, 11, 2881. https://doi.org/10.3390/ani11102881 https://www.mdpi.com/journal/animals

Animals 2021, 11, 2881 2 of 13

adaptations to a diet mainly comprised of prey [4]. Some studies have reported a positive
association between the overall health of domesticated cats and the quality and type of
nutrition provided [5,6]. Therefore, the type and quality of cat diet may influence cat
welfare and overall general health, disease status, and even their longevity [7]. Cat obesity
has been associated with many health conditions, including osteoarthritis, diabetes, and
some types of cancer [8]. In NZ, it is estimated that one in four cats is overweight or
obese [9].
Obesity results from excess energy consumption relative to expenditure. As animals
are generally entirely reliant upon their owner for their nutrition, the ability of that human
to understand when their animal is becoming overweight/obese and take appropriate
action is critical. Numerous studies have reported that cat owners under- rather than
overestimate their cat’s body condition score, and therefore, cannot recognise that their
cat is overweight/obese [10]. Body condition scoring (BCS) is a widely used, practical
method that has been validated in cats to classify animals according to their level of body
fat [11]. Variability in reporting an accurate BCS has been reported between cat owners and
veterinary professionals, with studies suggesting that cat owners regularly underestimate
BCS [10,12,13].
An increase in domestic cat obesity has been reported worldwide [10,14,15], which
is highly concerning for cat welfare. Historically, in 1970, 6.5–12% of cats were reported
to be obese and/or overweight [16]. Two decades later, the prevalence of overweight
and/or obesity has increased to 18.9–52% in domestic cats in the USA, England, Canada
and Australia [13,17–19]. A similar pattern of cats being overweight/obese has been
reported in NZ [13]. In 1993, 26% of domestic cats were reported to be overweight and/or
obese in the North Island compared to 63% in 2007 [13,20]. Although some of the studies
recognised a similar obesity pattern in human populations, the exact association was
not characterised [14,21]. Although there are a large number of studies regarding the
prevalence and risk factors associated with human obesity, studies addressing this in cats
are scarcer.
According to Companion Animal New Zealand (CANZ) (2020), cats are the most
popular companion animal in NZ, with 41% of households sharing their home with at least
one cat and 1.219 million cats in households across the country. Cat ownership was found
to be highest among females (43%), people living outside of Wellington and Auckland
in the North Island (48%) and in rural areas generally across NZ (52%), households with
adults between 45 and 54 years of age (53%), children at home (48%), a higher income
bracket (46%), and that are NZ European (46%). Māori households were less likely to have
a cat/s (36%). The current study aims to explore what companion cats in NZ are being
fed and identify possible owner-related risk factors for the development of obesity in cats.
This information will help inform interventions aimed at maintaining a healthy weight in
pet cats.

2. Materials and Methods

2.1. Participants and Data Collection
An online survey was developed and offered to the people of NZ via Survey Mon-
key©. The 2019 NZ Pet Survey was developed by Eastern Institute of Technology (EIT)
researchers Dr Rachel Forrest (Associate Professor, Research) and Maria Pearson (Lecturer
and Researcher, School of Nursing) in consultation with Natalie Waran (Professor—One
Welfare, EIT), EIT Centre of Veterinary Nursing staff, PatuTM Aotearoa staff, Jael Reiri (Kaiti-
aki Māori, Lecturer, School of Nursing, EIT) and Mark Farnworth (Associate Professor—
Animal Welfare, Nottingham Trent University). The Survey Monkey© link was distributed
through email networks and distributed online via social media (in particular Facebook)
and PatuTM websites (which have a high Māori engagement), with a snowball sampling
approach being used to promote the survey and recruit participants [22]. The survey
remained open for approximately three months (from 8 January 2019 to 31 March 2019).
Animals 2021, 11, 2881 3 of 13

The survey asked the following demographic and cat diet- and body condition-specific
questions:
• Are you: Female, Male, Gender diverse?
• To which ethnic group do you belong? Tick as many as apply: NZ European, Other
European, Māori, Samoan, Cook Island Māori, Tongan, Niuean, Chinese, Indian,
Don’t know, Other (please specify)
• To which age range do you belong? 18–24 years, 25–34 years, 35–44 years, 45–54 years,
55–64 years, 65–74 years, 75–84 years, 85 years and over
• In which region do you currently live? Northland, Auckland, Bay of Plenty, Waikato,
Taranaki, Gisborne, Hawke’s Bay, Manawatu-Wanganui, Wellington, Nelson, Marlbor-
ough, Tasman, West Coast, Canterbury, Otago, Southland, Other (please specify)
• In the last 12 months, what was your total household income? Less than $14,000,
$14,001–48,000, $48,001–70,000, $70,001–100,000, Over $100,000, Would rather not say
• What is your highest completed qualification? National Certificate level 1, National
Certificate level 2, National Certificate level 3, National Certificate level 4, Trade
certificate, Diploma or Certificate level 5, Advanced trade certificate, Diploma or
Certificate level 6, Teachers Certificate or Diploma, Nursing Diploma, Bachelor Degree,
Bachelor (Hons), Postgraduate Certificate/Diploma, Master’s Degree, PhD, Other
(please specify)
• Including yourself, how many adults (over 18 years of age) live at your usual address?
0, 1, 2, 3, Other (please specify)
• How many children under 18 years of age live at your usual address? 0, 1, 2, 3, 4, 5,
Other (please specify)
• Were you born in New Zealand? Yes, No
• Where were you brought up? Tick as many as apply: In a town or city, On a farm or
rurally, On a lifestyle block, Other (please specify)
• Where do you live now? In a town or city, On a farm or rurally, On a lifestyle block,
Other (please specify)
• Do you own a cat? Yes, No
• How many cats do you own? 1, 2, 3, 4, Other (please specify)
• My cat is a pedigree. (Selected if it applied)
• What do you feed your cat/s? Tick all that apply: My cat is fed cat biscuits from the
supermarket, my cat is fed specialised cat food from a pet shop or vet clinic, My cat is
fed raw meat, My cat is fed wet food, My cat is fed table scraps/human food, My cat
is fed food that I have cooked for them, My cat is fed treats, Other (please specify)
• Health/Care section. Please choose the option (Strongly agree, Agree, Neutral, Dis-
agree, strongly disagree) that most closely describes how you feel about the following
statements. Cats should: have a specialised diet from a pet shop or vet clinic; have
ribs, hips, and a spine that are not visible but are easily felt; Please provide further
explanation if required.
With regard to the food type/s fed, in NZ, the phrase cat biscuits refers to dry food or
kibble (as opposed to a dry treat) and wet food is typically bought in cans or foil packets
and is available as pate or in chunks with jelly, gravy or broth.

2.2. Statistical Analysis

Respondents were not required to answer all the questions and were provided with
the option to skip questions as they desired. For the demographic questions, where a
respondent chose “Other, please specify” if possible, the information was recoded into
the appropriate category. For example, those who did not select European but identified
as British were recoded as European. Various categories were collapsed as necessary for
statistical analyses to maintain adequate sample sizes.
The qualitative data from the diet-specific questions were analysed independently
by at least two researchers for emergent themes and categories using a general inductive
approach [23]. The quantitative data in the form of forced responses to survey questions
Animals 2021, 11, 2881 4 of 13

were analysed using descriptive statistics. Where appropriate, inferential statistics such
as correlations (Spearman’s Chi-square), z-tests, and binary logistic regressions were
employed to explore the associations between the demographic data and the participant
responses to the questions asked. All statistical analyses were carried out using IBM SPSS
Statistics (version 25) software.
Forward stepwise binary regressions were used to explore if gender (female, male),
ethnicity (Māori, NZ European, Other), age (18–24 years, 25–34 years, 35–44 years, 45–54
years, 55–64 years, 65–74 years, 75–84 years), income range (<$14,000, $14,001–48,000,
$48,001–70,000, $70,001–100,000, >$100,000), qualification level (1–10), being brought up
rurally (yes, no), currently living in a town (yes, no), the number of children, and or the
number of adults present in the household impacted on cat ownership or were associated
with an owner’s choice of diet for their cat/s.
For each of the Health/Care statements, cross-tabulations along with Chi-square and
z-tests (α = 0.05) were used to explore if the respondent answer choices were associated
with gender, ethnicity, age range, household income bracket, qualification level, whether
or not they had a child or children, whether or not they had a rural upbringing, or whether
they were currently living in a town/city.
Any owner-related risk factors that were identified were compared to any demo-
graphic factors that were found to impact on cat ownership.

3. Results
3.1. Demographic Description of the Respondents
Nationally, 2744 people responded to the online survey. A description of the demo-
graphics of these respondents can be found in the Furry whānau wellbeing: Working with
local communities for positive pet welfare outcomes report prepared for the NZCAT [2]. In short,
92.3% of the respondents were female, and the majority of the respondents identified as NZ
European (83.4%), with 8.3% (n = 229) of respondents identifying as Māori. Māori are the
indigenous people of NZ. All age ranges were represented by both males and females, and
by Māori and non-Māori, with a decline in respondent numbers for the older age ranges.
New Zealand is divided into 16 regions for local government purposes; however, poor
representation of males in some regions meant that this factor could not include in any
of the inferential statistical analyses. Of the respondents that disclosed their household
income (n = 2251), there was a relatively even distribution across the income brackets above
14 K, and there were similar percentages of Māori and NZ European, and male and female
respondents, in each. Likewise, there were similar percentages of respondents for each
of NZ Qualification Authority (NZQA) levels for Māori and NZ European, and male and
female respondents, in each. Of the respondents, 25% indicated that they had lived rurally
as a child (had a rural upbringing) and at the time of the survey, 76% of the respondents
lived in a town or city. Of those respondents that had a rural upbringing, 68% currently
dwelled in a town or city. No differences in the percentage of respondents who had a rural
upbringing or town/city dwelling due to ethnicity or gender were observed. How these
demographics impacted on the likelihood of owning cat/s is presented in the next section.

3.2. Cat Companionship

A total of 2358 respondents answered the pet companionship questions. Of these,
37.5% (n = 885) respondents owned both dog/s and cat/s and 28% (n = 652) owned cat/s
only. Nine per cent of the respondents indicated that their cat was a pedigree, with the
likelihood of owning a purebred cat increasing with qualification level (odds ratio 1.120,
p = 0.012). Of the respondents, the information from 1800 could be used in the binary
regression analysis for cat ownership (yes, no). Gender (odds ratio 0.587, p = 0.003, with
males being less likely to own a cat) and the number of children (odds ratio 1.276, p < 0.001)
were retained in the model. As the number of children increased, there was an increased
likelihood of having cat companion(s). Not surprisingly, place of residence was associated
with the number of household cats, with those living in a town or city owning fewer
Animals 2021, 11, 2881 5 of 13

pets (p < 0.029). For cats, household income level was associated with the number of
household cats (p = 0.003) along with the age range (p = 0.024). Bonferroni corrected
pairwise comparisons revealed that those with an income under 14 K had more household
cats, with those in this income bracket having an average of three cats compared to the
two-cat average for each household of the other income brackets. Those respondents in the
18–24 years, 75–84 years and 85 plus years of age brackets had an average of one household
cat compared to the two-cat average for each of the other age ranges.

3.3. Demographics of Cat Owner Respondents

Of the survey respondents, 1537 owned a cat/s, 9.4% indicating that their feline
companion/s were pedigree. A total of 1533 cat-owning respondents disclosed their
gender and age group. Of these, 93.8% were female, 5.5% male and 0.2% gender diverse;
23.5% selected 45–54 years, 21.9% selected 35–44 years, 18.3% selected 25–34 years, 15.9%
selected 55–64 years, 12.5% selected 18–25 years and 7.8% selected an age group above
64 years. Of those cat-owning respondents that disclosed their ethnicity (n = 1514), 82.2%
were NZ European and 8.1% were Māori. Household income brackets were indicated by
1278 respondents, with 5.3% indicating less than 14 K, 20.7% indicating between 14 and
48 K, 20.8% indicating between 48 and 70 K, 25.0% indicating between 70 and 100 K, and
28.2% indicating over 100 K. The number of adults per household was provided by 1525
cat-owning respondents, with 19.3% of households having one adult, 54.9% having two
adults, 15.4% having three and the remainder having four or more adults. The number of
children per household was provided by 1528 cat-owning respondents, with 69.3% not
having any children, 13.9% having one child, 12.6% having two, the remainder having
three or more children. One-quarter (25.2%) of the cat-owning respondents (n = 1534) were
brought up rurally. At the time of the survey, three-quarters (74.8%) of those cat-owning
respondents (n = 1532) lived in a town or city.

3.4. Feeding Practices

Table 1 displays the percentage of respondents who selected each diet choice and,
based on the binary logistic regression analyses, which variables were indicated to be
associated with these choices. A majority of the respondents selected biscuits from the
supermarket (63%) and wet food (57%). Almost half of the respondents (45%) also fed
their cat/s specialised food from a pet shop or veterinary clinic and gave them treats. A
respondent’s cat/s were more likely to be fed biscuits from the supermarket as age range
and or the number of children in the household increased and less likely as qualification
level increased. The opposite was true for the likelihood that a respondent’s cat was fed spe-
cialised cat food from a pet shop or veterinary clinic. Gender, age-range and qualification
level influenced if a respondent selected that they fed their cat/s raw meat, with females
(32% versus 22% of males) and those with increased age being more likely to feed their cat
raw meat and a decreased likelihood as qualification level increased. As the number of
adults and children in the household increased, so did the likelihood that the respondent
selected ‘My cat is fed table scraps/human food’. This likelihood decreased with increased
household income. With increased household income, a decreased likelihood that ‘My cat
is fed food that I have cooked for them’ was selected. Whereas as the age range increased,
there was an increased likelihood of a cat having a home-cooked meal. As the age range
and number of children increased, there was a decreased likelihood that ‘My cat is fed
treats’ was selected, but an increased likelihood if the respondent was a town/city dweller
(46% versus 40%).
Animals 2021, 11, 2881 6 of 13

Table 1. Positive responses to the question “Which of these apply to your cat/s?” and factors and or variables that impact
on the likelihood (odds ratio) of a positive response.

Number Percentage
What Do You Feed Your Cat/s? Associated Variables and Odds Ratio * (p-Value)
n %
Age range 1.164 (<0.001)
My cat is fed cat biscuits from
945 62% Qualification level 0.941 (0.026)
the supermarket
Number of children 1.330 (<0.001)
Age range 0.893 (0.008)
My cat is fed specialised cat food from a pet
682 45% Qualification level 1.102 (<0.001)
shop or vet clinic
Number of children 0.756 (<0.001)
Gender: male/female 0.455 (0.021)
My cat is fed raw meat 480 31%
Age range 1.204 (<0.001)
Age range 1.207 (<0.001)
My cat is fed wet food 871 57%
Qualification level 0.920 (0.002)
Household income 0.807 (0.002)
My cat is fed table scraps/human food 199 13% Number of adults 1.242 (0.016)
Number of children 1.244 (0.009)
My cat is fed food that I have cooked Age range 1.253 (0.025)
78 5%
for them Household income 0.745 (0.012)
Gender: male/female 0.398 (0.003)
Age range 0.882 (0.003)
My cat is fed treats 683 45%
Number of children 0.704 (<0.001)
Town/city dwelling 1.389 (0.024)
* An odds ratio of greater than 1 indicates an increased likelihood of a positive response, whereas an odds ratio of less than one indicates a
decreased likelihood of a positive response.

Of the 1525 respondents that answered the questions regarding what they feed their
cat/s, 84 provided further comment. Table 2 shows the themes that emerged from these
comments for each food choice with representative quotes. Several respondents pointed out
that good quality and specialised diet cat biscuits could be purchased from the supermarket.
Some of the respondents shared that they had tried food purchased from a pet shop or
veterinary clinic but that it either did not suit their cat/s or was too expensive. Several
comments also highlighted that supermarket cat biscuits were used in combination with
other food types. This theme also emerged in the comments about specialised cat food,
raw meat, and wet food. Raw meat appeared to be occasionally fed and often associated
with the respondent’s own dinner routine. Many of the respondents commented that
they feed their cat/s fish and that their cat/s were hunters and ate whatever prey they
caught. Several respondents highlighted the fact their cat was a thief. Health reasons were
provided as an explanation for providing home-cooked pet food. Treats ranged from being
used as a reward to reinforce desired behaviours to overt spoiling. Wet food was also
indicated to be a treat in some households. Other themes that emerged from comments
highlighted that some owners had cats on different diets due to their specific needs or they
did not feed their cat/s any specific type of diet. Two respondents noted that their cats also
ate dog food.
Animals 2021, 11, 2881 7 of 13

Table 2. Thematic analysis of comments provided about respondents’ cat diets in the 2019 New Zealand Pet Survey.

Category Representative Quote/s

Good quality biscuits “I don’t feed them the cheap biscuits from the supermarket. They get Purina”
Specialised diet available “Special urinary diet from the supermarket”
Supermarket biscuits
In combination with other food types “Biscuits for In-door cats from Countdown and RC Dental biscuits from work (Vet clinic)”
Only viable option “ . . . the only food, that I’ve found, which doesn’t flare up his allergies is from the supermarket”
Health reasons “Our three cats are each prescribed a different medicated food for health issues by our vet”
Online/imported “Blackhawk, brought in from Australia.”
Specialised cat food
Expensive “Black hawk was too rich for her and senior pet store foods $$$”
In combination with other food types “Mix of vet/supermarket dry food”
Varied meat types “Tuna and chicken” “Rabbits and fish” “Fresh fish” “ . . . add chicken livers & lambs heart/kidney . . . ”
Prey “My cat is a hunter and often supplements his diet” “They also eat whatever they hunt (mostly rabbits)”
Raw meat During dinner preparation “Occasional treats inc raw snapper and raw beef if we are cooking some”
Occasional: As a treat, fussy “The raw meat is very occasional, he is a bit fussy about different food”
In combination with other food types “Mainly raw meat, some commercial wet food, few biscuits and treats each day (they are spoilt)”
As a treat/Occassinal “Wet food as a treat once or twice a week”
Wet food Health reasons “My cat was in an accident and can only eat wet food”
In combination with other food types “Dry food from specialist. Wet food from supermarket”
Occasional “She gets occasional bits of meat or fish off my dinner plate”
Table scraps/human food
Stolen “One cat steals human food off the plate so have to monitor her around food”
Recommended “When recommended by the vet . . . I cooked softer foods that she could eat more easily”
Home-cooked pet food
Supplement “I often cook chicken in the crockpot for them as the broth is very good for them”
As a reward/for training “Treats only for when clipping claws or giving medication”
Occasional: meat, dairy “Occasionally licks of yoghurt, ice cream”
Treats Part of the dental routine “Treats are aimed to help with cleaning teeth”
Unhealthy “My cats very rarely get treats, as they aren’t healthy”
Spoilt “treats each day (they are spoilt)”
Dog food “She also likes eating dog biccies that are always available” “Dog roll if she chooses and milk”
Other Variety “My cat has variety in food.”
Individualised diets “One cat is fed dry biscuits and the other wet food (neutered male prone to cystitis)”
Animals 2021, 11, 2881 8 of 13

3.5. Attitudes towards Appropriate Body Condition and Specialised Pet Food
The respondents were asked to indicate their level of agreement with best practice
statements describing appropriate body conditions and another about the need for a
specialised diet. The results are shown in Table 3. The majority of the respondents either
strongly agreed or agreed that cats (70.2%) should have ribs, hips, and a spine that are not
visible. In contrast, those who strongly agreed or agreed with the statement that cats should
have a specialised diet from a pet shop or veterinary clinic were in the minority (Table 3).
Several significant associations were detected (Chi-square p < 0.001). For cats, associations
were observed regarding “should have a specialised diet” with a lower percentage of those
respondents with children either strongly agreeing (6% vs. 9%) or agreeing (13% vs. 19%)
and a higher percentage disagreeing (21% vs. 11%) when compared to the percentage of
respondents who do not have children. Again, the age range also influenced the level
of agreement with a higher percentage for 18–24 and 25–34 year age group respondents
agreeing, and a lower disagreeing and strongly disagree than the 35–44 and 45–54 year
age groups. Additionally, a lower percentage of those in the 18–24 and 25–34 age range
strongly disagreed compared with the 55–64 and 65–74 age ranges.

Table 3. Percentage of 2019 New Zealand Pet Survey respondents are selecting each level of agreement for the statements
regarding appropriate body conditions and specialised pet food.

Strongly Total Strongly Total

Statement—Cats Should: N Agree Neutral Disagree
Agree Agree Disagree Disagree
have ribs, hips, and a spine
that are not visible but are 2250 27.1% 43.1% 70.2% 20.2% 6.6% 3.0% 9.6%
easily felt
have a specialised diet from a
2247 8.0% 17.2% 25.2% 58.1% 13.3% 3.3% 16.7%
pet shop or vet clinic

4. Discussion
This study interrogated the relevant data from a recent national survey funded by
the NZ Companion Animals Trust [2] and identified two possible risk factors that may
contribute to companion cats in NZ becoming overweight or obese, namely, incorrect
owner perception of body condition and feeding a varied diet making control of caloric
intake challenging. These factors are discussed in detail below. As is typical of online
surveys, the majority of respondents were female [24,25]. However, previous studies in
NZ have found that “No matter what the companion animal, it is typically the female
household head that takes responsibility for pet food buying and feeding duties”, p. 14 [26].
Thus, the gender bias in this sample was appropriate for this investigation. Nevertheless,
caution must be taken when interpreting the statistical analyses where gender is identified
as a significant factor, with the results highlighting areas of further research. There was
not a representative sample of Māori in the survey respondents, with 8.3% being well
below the 16.7% of the national population estimate in 2020 [27]. While the findings of this
study will help to inform future research areas and the development of a healthy weight
intervention for cats in NZ, research with an indigenous perspective is paramount.
The current study identified incorrect owner perception of body condition as a poten-
tial risk factor for cats becoming overweight or obese. The BCS is a validated scale that
can classify cats into three groups: under-weight (1–3), ideal-weight (4–5) and overweight
and obese (6–9) based on visual observation and palpation of superficial boney promi-
nences [11,28]. A score of 5 is associated with the ability to palpate the ribs with minimum
fat coverage with there being a strong correlation between BCS and body fat mass [11].
Many studies have reported that owners underestimating feline BCS can be considered a
risk factor for cats being overweight/obese [10,12,18,29–31]. In the current study, a total
of 70.2% of respondents correctly indicated that cats should have ribs, hips, and a spine
that are not visible but are easily felt. However, one in ten respondents disagreed with
Animals 2021, 11, 2881 9 of 13

this, identifying incorrect owner perception of appropriate body condition as a potential

risk factor for cats becoming overweight or obese. In addition, a further two out of ten
respondents choose a neutral response (neither agreeing or disagreeing with the correct
body condition statement), indicating a lack of confidence in their knowledge around
this subject. Collectively, these findings suggest the need for educational programmes for
NZ cat owners that enable them to correctly identify feline BCS and detect any changes
regarding their pets BCS, allowing the owner to modify their cat’s diet. To accompany
any educational programme, pre- and post-intervention studies should be undertaken to
determine the level of agreeance between the BCS for a cat by the owner and a veterinary
professional, evaluate the effectiveness of the intervention and also estimate the percentage
of cats in NZ that are overweight/obese.
Sixty-two per cent and 57% of cat owners stated in the online survey that they buy
dry (biscuits) and wet (canned) foods from the supermarket. Additionally, 45% indicated
that they bought specialised food from a pet shop or veterinary clinic and while the food
type was not disclosed a walk into any pet store or veterinary clinic in NZ will reveal that
the bulk of the pet food they sell is dry. The preference for feeding dry food aligns with
previous studies which found that the popularity of dry over wet food could be due to
affordability, convenience and long shelf life [18,32]. The current study did not investigate
the rationale behind feeding the selected cat food but we would speculate that perceived
food quality also influenced diet.
Numerous studies have reported a positive association between cat obesity and the
predominant consumption of dry pet food as is, regardless of the quality of the food, and it
has been suggested this is a consequence of dry food typically having higher calories per
gram in comparison to wet food [18,29,32–34]. However, none of these studies [18,29,32–34]
reported the quantity of dry food that the cats consumed; therefore, the reported cat obesity
may also have been a consequence of more food being consumed to reach satiety due to
gastric extension. This phenomenon has been studied in dogs but not cats [35,36]. Some
studies have also found an association between the type of food and the feeding frequency
in cats [37,38]. Given that both the quality and quantity of food ingested influence energy
intake, the association between feeding protocols factors (type of food, frequency and
quantity provided) must be considered when evaluating the effect of diet on body weight
and condition. No data were collected regarding the feeding frequency, duration, and exact
amount the cat was fed in the current study and these dietary aspects should be the focus
of future research in the area of cat nutrition in NZ.
Raw meats were reported to be fed to cats by 31% of respondents in the current
study, with raw meat often being referred to as being occasional and or a treat. Wales et al.
(2019) have reported that any particular type of raw feeding decreased the risk of obesity
and provided beneficial enrichment [39]. The latter was potentially due to the extra time
needed to chew the raw materials. Furthermore, other studies have supported Wall et al.
(2019) and claimed raw meats have nutritional and behavioural benefits compared with
conventional processed diets [39–41]. In contrast, another study has found that there is
a positive association between obesity risk and the frequency of feeding raw meat and
fish [19]. In addition, raw meat could act as a vector for some potential pathogens for pets
and their owners [40]. In the current study, males were less likely to feed their cat/s raw
meat and treats. Taken together, as part of a healthy weight programme for NZ cats, owners,
in particular males, could be encouraged to occasionally provide their cat/s raw meat and
fish from trusted sources to ensure it is free of pathogens as part of their feline diet.
In this study, respondents also indicated that typically wet food was viewed as a
treat and fed in combination with dry food unless health reasons dictated otherwise.
Previous studies have found that cats prefer wet (canned) over dry food due to moisture
similarity with meat [42,43], thus being consistent with use as a treat. However, Rowe
et al. (2015) have suggested that the regular daily consumption of wet foods may reduce
obesity risk. This could be due to the high water content combined with low calorific
concentration found in cats’ wet food meaning that cats need to consume a larger quantity
Animals 2021, 11, 2881 10 of 13

of wet cat food to exceed their daily required energy to gain weight [44,45]. While avoiding
dry food and providing wet food may decrease obesity risk in cats, this strategy may
negatively impact oral health conditions and increase the risk of periodontal disease [46–48].
Some studies found that providing hard chewable materials helped control plaque and
periodontal disease [46,48]. Additionally, other studies proposed a positive association
between wet diets and periodontal disease [49,50]. In the 2019 NZ Pet Survey, only 44% of
the respondents indicated that their cat’s teeth are cleaned by the veterinarian when needed
and 9% with their own cat’s teeth implying that for approximately half the respondent’s,
dry food plays an important role in the oral health of their cat/s.
Collectively, findings presented in this discussion, support the provision of both dry,
wet and raw food. Interestingly, as age increased in the present study, so did the likelihood
of the respondent’s cat/s being fed biscuits from a supermarket, raw meat, and homecooked
food suggesting the older the respondent the more likely their cat/s were being provided
with a varied diet. A varied diet can often make it difficult to control the caloric intake;
therefore, consideration regarding the quality and quantity of both and ensuring that cats
do not consume more than their daily requirement. That stated this is challenging if a cat
supplements its diet by hunting prey. Cat access to the outdoors and the impact of their
predatory behaviours on wildlife is a contemporary issue in NZ [51–53]. While several
studies have suggested that unrestricted outdoor access improves cats’ overall health and
welfare [10,12,44] and that limited outdoor access can be considered a potential risk factor
for obesity in cats [19,44], this needs to be balanced against “the potential negative impacts
of cats on communities, other species, and ecosystem” p5 [54]. In the 2019 NZ Pet Survey,
86% and 55% of respondents indicated their cat/s had free indoor-outdoor access during
the day and at night, respectively [2]. Furthermore, 6% of the respondents indicated that
they confined their cat/s at daytime while 27% confined their cat/s inside at night [2].Those
who kept their cats inside did so to keep their cats safe and or protect birdlife, and some
mentioned that their cat/s had access to a conservatory or catio [2]. Future studies to
investigate the effect of activity level and enrichment provided for the cats on the risk of
obesity are needed. In addition, the correlation between the feeding protocols and the
access to outdoor activity needs to be explored.
Ohland et al. (2018) found that obese cats were more likely found in two-adult
households [29]. Interestingly in this study, the number of adults in a household was not
found to be associated with food type (dry, wet, raw), where the food was bought from
(supermarket, pet shop or veterinary clinic) or whether a cat/s is feed treats, home-cooked
meals or table scraps. Thus, the number of adults in a household is unlikely to be an
obesity risk factor in NZ. Conversely, the number of children in a house was found to be
positively associated with both the likelihood of owning cat/s and the likelihood of cat/s
being fed biscuits from the supermarket and table scraps and negatively associated with
the likelihood of cat/s being fed a specialised diet from a pet shop or veterinary clinic or
treats. These results could reflect the time constraints due to caring for both children and
animals, making convenience a main driver in feline diet-related choices. This notion is
further supported by the fact that no associations were detected with income and food
type (dry, wet, raw), where the food was bought from (supermarket, pet shop or veterinary
clinic) or whether a cat/s is feed treats. Wall et al. (2015) suggested that owners with jobs,
thus higher income, might select a more expensive diet to provide better quality food but
found no evidence between obese cats and the owner’s income [12]. In this study, the only
association with income and feline diet was that, with increasing income, cat/s were less
likely to be fed table scraps or food specifically cooked for them.
Qualification level, on the other hand, may influence the quality of diet provided to
cat/s, with increasing qualification level being associated with a decreased likelihood of
being fed cat biscuits from a supermarket or wet food and an increased likelihood of being
fed specialised cat food from a pet shop or veterinary clinic. Interestingly, with increasing
qualification level, there was also an increased likelihood the respondent owned a pedigree
cat. Pure breed cats have been associated with low obesity risk among cats [12]. This could
Animals 2021, 11, 2881 11 of 13

be because breeders and breed societies often provide extensive educational resources for
owners and continued support and advice throughout the animal’s lifetime.
The difference in the sources where cat owners obtained their cat food was one of
the interesting findings of the current study. Overall, 45% reported that they feed their
cat food from specialised pet shops or veterinary clinics, independent of income bracket.
The usage of pet stores and veterinary clinics as a source of information for diet selection
is in agreement with previous studies [6,55]. While the reasons for buying from a pet
store or veterinary clinic were not investigated, this finding suggests that these sites
can be used in the promotion and or provision of healthy weight interventions to all
socioeconomic groups.

5. Conclusions
This study has identified two possible owner-related risk factors that may contribute
to companion cats in NZ becoming overweight or obese: incorrect owner perception of
body condition and feeding a varied diet making control of caloric intake challenging. The
identification of these risk factors highlights important areas of cat nutrition requiring
future research to better inform the development of healthy weight interventions for NZ
companion cats. Further research that explores BCS, its perception by owners versus
veterinary professions, and its associations with activity, and type and frequency, quality
and quantity of food are required, along with studies from an indigenous perspective.
Guidelines for providing cats with a varied diet for optimal weight, nutritional value,
dental health and environmental enrichment also need to be developed as most of the
cat owners involved in this study provided their cat/s with a combination of food types
and treats. Regardless of socioeconomic group, the findings of this study suggest that
for approximately half of the cat owners in NZ, veterinary clinic and pet store staff are
well placed to play an essential role in encouraging them to monitor their pet’s BCS and
ensure their cat is fed appropriate amounts of a high-quality diet, including treats for
environmental enrichment. However, for those households with children, which are also
more likely to have cat/s, a healthy weight intervention for cats needs to be conveniently
accessed, for example at a supermarket, as cat owners from these households are less likely
to buy food from a pet store or veterinary clinic.

Author Contributions: Conceptualisation, R.F., M.P. and N.W.; methodology, R.F., M.P. and N.W.;
data curation and formal analysis, M.P. and R.F.; interpretation of data; R.F., F.E. and L.A.; writing—
original draft preparation, R.F., F.E. and L.A.; writing—review and editing, R.F., L.A., F.E., M.P. and
N.W.; supervision, N.W.; project administration, R.F. and M.P.; funding acquisition, R.F., M.P. and
N.W. All authors have read and agreed to the published version of the manuscript.
Funding: The 2019 New Zealand Pet Survey was funded by the New Zealand Companion Ani-
mals Trust.
Institutional Review Board Statement: This study was conducted according to the guidelines of
the Declaration of Helsinki and approved by the Eastern Institute of Technology (EIT) Research and
Ethics Approval Committee (REAC ref 19/53).
Informed Consent Statement: Informed consent was obtained from all subjects involved in this study.
Data Availability Statement: The data presented in this study are available on request from the
corresponding author.
Conflicts of Interest: The authors declare no conflict of interest. The funders had no role in the design
of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or
in the decision to publish the results.
Animals 2021, 11, 2881 12 of 13

References
1. Companion Animals New Zealand. Companion Animals in New Zealand 2020; Author: Auckland, New Zealand, 2020. Available
online: https://www.companionanimals.nz/publications (accessed on 20 August 2021)ISBN 978-0-473-53489-9.
2. Forrest, R.; Pearson, M.; Thomson, S.; Bakri, H.; Steiner, E.; Waran, N. Furry Whānau Wellbeing: Working with Local Communities for
Positive Pet. Welfare Outcomes; Prepared for the New Zealand Companion Animal Trust (NZCAT); Eastern Institute of Technology:
Hawke’s Bay, New Zeland, 2019; ISBN 978-0-9951429-2-3.
3. Duffy, D.C.; Capece, P. Biology and impacts of Pacific Island invasive species. 7. The domestic cat (Felis catus) 1. Pac. Sci. 2012, 66,
173–212. [CrossRef]
4. Serpell, J.A. Domestication and history of the cat. Domest. Cat Biol. Its Behav. 2000, 2, 180–192. [CrossRef]
5. Wernimont, S.M.; Radosevich, J.; Jackson, M.I.; Ephraim, E.; Badri, D.V.; MacLeay, J.M.; Jewell, D.E.; Suchodolski, J.S. The effects
of nutrition on the gastrointestinal microbiome of cats and dogs: Impact on health and disease. Front. Microbiol. 2020, 11, 1266.
[CrossRef]
6. Dodd, S.A.S.; Dewey, C.; Khosa, D.; Verbrugghe, A. A cross-sectional study of owner-reported health in Canadian and American
cats fed meat- and plant-based diets. BMC Vet. Res. 2021, 17, 53. [CrossRef] [PubMed]
7. Delgado, M.; Dantas, L.M. Feeding cats for optimal mental and behavioral well-being. Vet. Clin. Small Anim. Pract. 2020, 50,
939–953. [CrossRef] [PubMed]
8. Zoran, D.L. Obesity in dogs and cats: a metabolic and endocrine disorder. Vet. Clin. Small Anim. Pract. 2010, 40, 221–239.
[CrossRef]
9. Gates, M.; Zito, S.; Harvey, L.; Dale, A.; Walker, J. Assessing obesity in adult dogs and cats presenting for routine vaccination
appointments in the North Island of New Zealand using electronic medical records data. N. Z. Vet. J. 2019, 67, 126–133. [CrossRef]
[PubMed]
10. Rowe, E.C.; Browne, W.J.; Casey, R.A.; Gruffydd-Jones, T.J.; Murray, J.K. Early-life risk factors identified for owner-reported feline
overweight and obesity at around two years of age. Prev. Vet. Med. 2017, 143, 39–48. [CrossRef] [PubMed]
11. Laflamme, D. Development and validation of a body condition score system for dogs. Canine Pract. 1997, 22, 10–15.
12. Wall, M.; Cave, N.J.; Vallee, E. Owner and cat-related risk factors for feline overweight or obesity. Front. Vet. Sci. 2019, 6, 266–266.
[CrossRef]
13. Cave, N.; Allan, F.; Schokkenbroek, S.; Metekohy, C.; Pfeiffer, D. A cross-sectional study to compare changes in the prevalence
and risk factors for feline obesity between 1993 and 2007 in New Zealand. Prev. Vet. Med. 2012, 107, 121–133. [CrossRef]
14. German, A.J.; Holden, S.L.; Moxham, G.L.; Holmes, K.L.; Hackett, R.M.; Rawlings, J.M. A simple, reliable tool for owners to
assess the body condition of their dog or cat. J. Nutr. 2006, 136, 2031S–2033S. [CrossRef]
15. Verbrugghe, A. Chapter 1 Epidemiology of small animal obesity. In Obesity in the Dog and Cat, 1st ed.; Cline, M.G., Murphy, M.,
Eds.; CRC Press: Boca Raton, FL, USA, 2019. [CrossRef]
16. Anderson, R.S. Obesity in the dog and cat. Vet. Annu. 1973, 1441, 182–186.
17. Russell, K.; Sabin, R.; Holt, S.; Bradley, R.; Harper, E. Influence of feeding regimen on body condition in the cat. J. Small Anim.
Pract. 2000, 41, 12–18. [CrossRef] [PubMed]
18. Robertson, I.D. The influence of diet and other factors on owner-perceived obesity in privately owned cats from metropolitan
Perth, Western Australia. Prev. Vet. Med. 1999, 40, 75–85. [CrossRef]
19. Scarlett, J.; Donoghue, S.; Saidla, J.; Wills, J. Overweight cats: Prevalence and risk factors. Int. J. Obes. Relat. Metab. Disord. J. Int.
Assoc. Study Obes. 1994, 18, S22–S28.
20. Allan, F.; Pfeiffer, D.; Jones, B.; Esslemont, D.; Wiseman, M. A cross-sectional study of risk factors for obesity in cats in New
Zealand. Prev. Vet. Med. 2000, 46, 183–196. [CrossRef]
21. Hoenig, M. The cat as a model for human nutrition and disease. Curr. Opin. Clin. Nutr. Metab. Care 2006, 9, 584–588. [CrossRef]
22. Baltar, F.; Brunet, I. Social research 2.0: Virtual snowball sampling method using Facebook. Internet Res. 2012, 22, 57–74. [CrossRef]
23. Thomas, D.R. A general inductive approach for analyzing qualitative evaluation data. Am. J. Eval. 2006, 27, 237–246. [CrossRef]
24. Voigt, L.F.; Koepsell, T.D.; Daling, J.R. Characteristics of telephone survey respondents according to willingness to participate.
Am. J. Epidemiol. 2003, 157, 66–73. [CrossRef] [PubMed]
25. Smith, W. Does gender influence online survey participation? a record-linkage analysis of university faculty online survey
response behavior. 2008; Online Submission.
26. Mackay, J. Companion Animals in New Zealand July 2011; The New Zealand Companion Animal Council Inc.: Wellington, New
Zeland, 2011. Available online: https://www.companionanimals.nz/publications (accessed on 27 August 2021).
27. StatsNZ. Māori Popultaion Estimates: AT 30 June 2020; New Zealand Government: Wellington, New Zealand, 2020. Available online:
https://www.stats.govt.nz/information-releases/maori-population-estimates-at-30-june-2020 (accessed on 27 August 2021).
28. Teng, K.T.; McGreevy, P.D.; Toribio, J.-A.L.; Raubenheimer, D.; Kendall, K.; Dhand, N.K. Strong associations of nine-point body
condition scoring with survival and lifespan in cats. J. Feline Med. Surg. 2018, 20, 1110–1118. [CrossRef]
29. Öhlund, M.; Palmgren, M.; Holst, B.S. Overweight in adult cats: A cross-sectional study. Acta Vet. Scand. 2018, 60, 5. [CrossRef]
[PubMed]
30. Basit, A.; Askari, S.; Zafar, J.; Riaz, M.; Fawwad, A. NDSP 06: Prevalence and risk factors for obesity in urban and rural areas of
Pakistan: A study from second National Diabetes Survey of Pakistan (NDSP), 2016–2017. Obes. Res. Clin. Pract. 2021, 15, 19–25.
[CrossRef] [PubMed]
Animals 2021, 11, 2881 13 of 13

31. Colliard, L.; Paragon, B.M.; Lemuet, B.; Bénet, J.J.; Blanchard, G. Prevalence and risk factors of obesity in an urban population of
healthy cats. J. Feline Med. Surg. 2009, 11, 135–140. [CrossRef] [PubMed]
32. Slater, M.R.; Scarlet, J.M.; Donoghue, S.; Erb, H.N. The repeatability and validity of a telephone questionnaire on diet and exercise
in dogs. Prev. Vet. Med. 1992, 13, 77–91. [CrossRef]
33. Smith, C.A. Changes and challenges in feline nutrition. J. Am. Vet. Med. Assoc. (USA) 1993, 203, 1395–1400.
34. Peng, M. How does plate size affect estimated satiation and intake for individuals in normal-weight and overweight groups?
Obes. Sci. Pract. 2017, 3, 282–288. [CrossRef]
35. Pappas, T.N.; Melendez, R.L.; Debas, H.T. Gastric distension is a physiologic satiety signal in the dog. Dig. Dis. Sci. 1989, 34,
1489–1493. [CrossRef]
36. Chandler, M. New thoughts about obesity. Companion Anim. 2018, 23, 686–695. [CrossRef]
37. Camara, A.; Verbrugghe, A.; Cargo-Froom, C.; Hogan, K.; DeVries, T.J.; Sanchez, A.; Robinson, L.E.; Shoveller, A.K. The daytime
feeding frequency affects appetite-regulating hormones, amino acids, physical activity, and respiratory quotient, but not energy
expenditure, in adult cats fed regimens for 21 days. PLoS ONE 2020, 15, e0238522. [CrossRef]
38. Raynor, H.A.; Goff, M.R.; Poole, S.A.; Chen, G. Eating frequency, food intake, and weight: A systematic review of human and
animal experimental studies. Front. Nutr. 2015, 2, 38. [CrossRef]
39. Wales, A.; Lawes, J.; Davies, R. How to . . . Advise clients about raw feeding dogs and cats. BSAVA Companion 2019, 2019, 10–15.
[CrossRef]
40. Freeman, L.M.; Chandler, M.L.; Hamper, B.A.; Weeth, L.P. Current knowledge about the risks and benefits of raw meat–based
diets for dogs and cats. J. Am. Vet. Med. Assoc. 2013, 243, 1549–1558. [CrossRef]
41. Davies, R.; Lawes, J.; Wales, A. Raw diets for dogs and cats: A review, with particular reference to microbiological hazards. J.
Small Anim. Pract. 2019, 60, 329–339. [CrossRef]
42. Zaghini, G.; Biagi, G. Nutritional peculiarities and diet palatability in the cat. Vet. Res. Commun. 2005, 29, 39–44. [CrossRef]
[PubMed]
43. Pekel, A.Y.; Mülazımoğlu, S.B.; Acar, N. Taste preferences and diet palatability in cats. J. Appl. Anim. Res. 2020, 48, 281–292.
[CrossRef]
44. Rowe, E.; Browne, W.; Casey, R.; Gruffydd-Jones, T.; Murray, J. Risk factors identified for owner-reported feline obesity at around
one year of age: Dry diet and indoor lifestyle. Prev. Vet. Med. 2015, 121, 273–281. [CrossRef]
45. Beynen, A.C. Cat food composition and caloric intake. Dier-en-Arts 2018, 8, 186–189. [CrossRef]
46. Buckley, C.; Colyer, A.; Skrzywanek, M.; Jodkowska, K.; Kurski, G.; Gawor, J.; Ceregrzyn, M. The impact of home-prepared diets
and home oral hygiene on oral health in cats and dogs. Br. J. Nutr. 2011, 106 (Suppl. 1), S124–S127. [CrossRef]
47. Adler, C.J.; Malik, R.; Browne, G.V.; Norris, J.M. Diet may influence the oral microbiome composition in cats. Microbiome 2016, 4,
23. [CrossRef] [PubMed]
48. Kim, B.; Kang, S.; Susanti, L.; Park, Y.; Kim, S.; Shim, J.; Lee, E.; Seo, K. Development of dental hygiene gum for cats considering
their anatomical features of dentition. J. Vet. Sci. 2019, 20, e47. [CrossRef] [PubMed]
49. Watson, A. Diet and periodontal disease in dogs and cats. Aust. Vet. J. 1994, 71, 313–318. [CrossRef]
50. Gawor, J.P.; Reiter, A.M.; Jodkowska, K.; Kurski, G.; Wojtacki, M.P.; Kurek, A. Influence of diet on oral health in cats and dogs. J.
Nutr. 2006, 136, 2021S–2023S. [CrossRef] [PubMed]
51. Hadidian, J. Cats and Wildlife: An Animal Welfare Perspective; WellBeing International Studies Repository: Potomac, MD, USA, 2021.
52. Woolley, C.K.; Hartley, S. Activity of free-roaming domestic cats in an urban reserve and public perception of pet-related threats
to wildlife in New Zealand. Urban. Ecosyst. 2019, 22, 1123–1137. [CrossRef]
53. Rowan, A.N.; Kartal, T.; Hadidian, J. Cat demographics & impact on wildlife in the USA, the UK, Australia and New Zealand:
Facts and values. J. Appl. Anim. Ethics Res. 2019, 2, 7–37. [CrossRef]
54. The National Cat Management Strategy Group. New Zealand National Cat Management Strategy Group Report Companion
Animals New Zealand. 2020. Available online: https://www.companionanimals.nz/publications (accessed on 20 August 2021).
55. Kamleh, M. Perceptions and Attitudes towards Human and Companion Animal Nutrition, Nutrition Education and Nutrition
Guidance Received from Healthcare Professionals. Ph.D. Thesis, University of Guelph, Guelph, ON, Canada, 2019. Available
online: https://atrium.lib.uoguelph.ca/xmlui/handle/10214/17482 (accessed on 19 July 2021).