The UK Diabetes Remission Clinical Trial (DiRECT) demonstrated that a weight loss strategy consisting of: (1) 12 weeks total diet replacement; (2) 4 to 6 weeks food reintroduction; and (3) a longer period of weight loss maintenance, is effective in reducing body weight, improving glycaemic control, and facilitating type 2 diabetes remission(1). The DiRECT protocol is now funded for type 2 diabetes management in the UK(2). Type 2 diabetes is a growing problem in Aotearoa New Zealand(3), but the acceptability and feasibility of the DiRECT intervention in our diverse sociocultural context remains unclear. We conducted a randomised controlled trial of DiRECT within a Māori primary healthcare provider in O¯tepoti Dunedin. Forty participants with diabetes and obesity who wanted to lose weight were randomised to receive the DiRECT intervention or usual care. Both groups received the same level of individualised support from an in-house dietitian. We conducted individual, semi-structured interviews with 26 participants after 3 months. Questions explored perspectives and experiences, barriers and facilitators, and future expectations regarding dietary habits and weight loss. Interview transcripts were analysed using inductive thematic analysis(4). Participants struggled with weight management prior to the study. Advice from doctors, friends and whānau, and the internet was prolific, yet often impractical or unclear. The DiRECT intervention was mentally and physically challenging, but rapid weight loss and an improved sense of health and wellbeing enhanced motivation. Participants identified strategies which supported adaptation and adherence. Food reintroduction beyond 3 months was an exciting milestone, but the risk of reverting to previous habits was daunting. Participants feared weight regain and felt ongoing guidance was required for a successful transition to a real-food diet. Conversely, usual care participants described a gradual and ongoing process of health-focused dietary modification. While this approach did support behaviour change, a perceived slow rate of weight loss was often frustrating. Across both interventions, self-motivation and whānau support contributed to perceived success, whereas busy lifestyles, social and cultural norms, and financial concerns presented additional challenges. The role of individualised and non-judgemental dietetic support was a central theme across both groups. In addition to nutrition education and practical guidance, the in-house dietitian offered encouragement and promoted self-acceptance among participants. At 3 months, positive shifts in perspectives surrounding food, health, and sense of self were identified, which participants largely attributed to the level of nutrition support received: a new experience for many. The DiRECT protocol appears an acceptable weight loss approach among New Zealanders with diabetes and obesity, but tailored dietetic and behavioural support must be prioritised in its implementation. Future research should examine the broader health benefits associated with providing greater dietetic support and the cost-effectiveness of employing nutrition-trained health professionals within the primary care workforce.

Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305 Australia.Cardiovascular disease (CVD) remains a major cause of global mortality. Poor diet quality, characterised by excessive consumption of energy-dense, nutrient-poor foods and insufficient intake of fruits, vegetables, and whole grains, is associated with an increased risk of CVD(1). This study compares the impact of two short-term dietary interventions, a Healthy Australian Diet adhering to national guidelines and a Typical Australian Diet representing current national consumption patterns, on several cardiometabolic outcomes. These outcomes include body weight, waist circumference (WC), body fat percentage (BFP), blood pressure (BP), fasting blood lipids and glucose concentrations. Data from an eight-week randomised, cross-over feeding study involving 34 adults (53% female, age 38.4 ± 18.1 years) were analysed, with participants randomly assigned to consume each diet for two weeks, separated by a two-week washout period. During each feeding phase, all food items were provided to ensure compliance. The Healthy Australian Diet adhered to the Australian Dietary Guidelines(2), including a balanced intake of the five food groups and meeting Acceptable Macronutrient Distribution Range targets(3), with saturated fat limited to ≤10% of energy. The Typical Australian Diet was formulated based on apparent consumption patterns in Australia(4), setting total fat intake at 40% of energy and total saturated fat at 15% of energy. Comprehensive data collection occurred at four key visits: week 0 (end of run-in; baseline 1), week 2 (post-feeding phase 1), week 4 (end of washout, baseline 2), and week 8 (post-feeding phase 2). Trained personnel measured WC using a tensible tape, while body weight and BFP measurements were obtained using bioimpedance analysis (Inbody 270; Biospace Co, Seoul, Korea). Blood pressure was recorded using the Uscom BP+ supra-systolic oscillometric central blood pressure device. Blood glucose and lipid (triglycerides, total-, low-density lipoprotein- [LDL] and high-density lipoprotein- [HDL] cholesterol) concentrations were measured after a 12-hour fast by an accredited pathology service. Differential changes in cardiometabolic variables between intervention groups were evaluated using linear mixed-effect models, adjusting for diet sequence, feeding phase, and subject ID as a random variable to account for potential autocorrelation. Post-hoc pairwise comparisons were conducted to assess the impact effects of each diet. There were no significant differences between the Healthy Australian Diet and the Typical Australian Diet with respect to weight, BFP, WC, blood triglycerides, systolic and diastolic BP. However, the Healthy Australian Diet led to a significantly greater decrease in total-, LDL-, HDL- and non-HDL cholesterol, and fasting blood glucose relative to the Typical Australian Diet (p<0.001). The results underscore the importance of promoting dietary intakes that align with Australian Dietary Guidelines for optimising the risk of CVD and impaired glucose tolerance. Conversely, the Typical Australian Dietary pattern demonstrated detrimental cardiometabolic effects over a short period of just two weeks.

Obesity and COVID-19 are global pandemics listed by World Health Organization, which need urgent attention. Obesity involves low grade chronic inflammation, which is characterised by sustained pro-inflammatory innate immune responses mediated through activation of the NLR family pyrin domain-containing 3 (NLRP3) inflammasome/IL-1 axis, and is a strong risk factor for Diabetes and Heart diseases(1). Dietary fats provide energy, satiety, source of fat-soluble vitamins and essential fatty acids – Omega 3 (n-3) and Omega 6 (n-6) fatty acids, but must be consumed in right amounts and ratios. Essential fatty acids (EFA) deficiency and n-6/n-3 imbalance is linked with chronic illnesses such as, heart attacks, cancer, insulin resistance, stroke, obesity, and diabetes(2). Excess dietary fat intake and imbalance of fatty acids, contribute to obesity, inflammation, comorbidities and faster disease progression. A cross-sectional survey aimed to understand the fatty food frequency of overweight and obese middle age adults from Mumbai, India during the COVID-19 outbreak. Using purposive sampling, 100 adults (30-60 years), a questionnaire (demographics, anthropometrics and fat food frequency questionnaire) was administered. Data was analysed using SPSS 26.0. As per BMI standards, 60.2% participants were overweight, 12.6% were obese and 27.1% had normal BMI. For visible fat consumption, sunflower oil (47.6%), ghee (38.8%), rice bran oil (34%) groundnut oil (11.7%) and invisible fats – milk (100%). Other dairy products, nuts and oilseeds were consumed weekly. twice a week, majority (92.3%) consumed packaged high fat foods as compared to eating deep-fried items (58.9%). We concluded that excess dietary fat intake is high risk factor for obesity and related comorbidities diabetes, and hypertension. High BMI increases the risk for non-communicable diseases (NCDs) such as obesity, cardiovascular disease (CVD), insulin resistance and type 2 diabetes. People with co-morbidities are high risk groups for COVID-19 infection susceptibility. Hence, managing weight could be a cost-effective preventive strategy to help in delaying the onset and progression of NCDs, thereby lowering the susceptibility to COVID-19. Our findings have important implications in working towards adopting healthy fats and reducing mortality and reducing the global burden of pandemic. High dietary fat intake is a modifiable risk factor for overweight and obesity. Comorbidities increased risk for COVID-19 infection, disease severity and mortality. Hence, there is a need to understand the dietary fat consumption patterns in obesity and COVID-19. Dietary carbohydrate, sugar and fat quality in relation to obesity and pandemic such as, COVID-19 could be explored in future studies.

The local food environment plays an important role in food purchasing behaviours, and it is important to understand the how this context shapes the highly complex drivers of food choice for children and families. In Australia, children consume more than one-third of their total energy intake whilst at school(1), thus making the content of school lunchboxes an important target for nutrition promotion efforts. Supermarkets invest heavily in promoting food for inclusion in school lunchboxes, particularly in the ‘Back to School’ period, but little is known about the nutrition content or the packaging of the foods included in these promotions. This study aimed to examine the types and packaging of foods that are promoted by supermarkets as school lunchbox foods. Catalogues for six supermarket chains in Adelaide, South Australia were collected during the four weeks of January 2023, the window often described as the ‘Back to School’ period. An audit of the contents was conducted and items promoted specifically as ‘Back to School’ items were coded according to the type of food (fruits, vegetables, dairy, grains/cereals, protein or drinks), whether the items was packaged or unpackaged and the processing classification according to the NOVA criteria(2). Descriptive statistics were calculated. In the ‘Back to School’ period, each of the six supermarket chains produced 4 catalogues and items relating specifically to foods promoted for inclusion in school lunchboxes appeared in 18 of the 24 catalogues. A total of 151 food or drink items appeared in the ‘Back to School’ promotions in these catalogues, and 100% of these items were packaged; 29% were packaged in single-use plastic packaging, 25% were packaged in recyclable packaging and 46% were packaged in a combination of single-use plastic and recyclable packaging. In terms of foods, snack foods, including sweet (n = 32, 21%) and savoury (n = 21, 14%) snacks were highly represented (35% overall). Dairy products (n = 23, 15%), grains/cereal products (n = 23, 15%) and drinks (n = 20, 13%) were also featured, and spreads (e.g. vegemite, Nutella) appeared in 13% of catalogues (n = 12). Fruits (n = 8, 5%), vegetables (n = 3, 2%) and proteins (n = 5, 3%) did not appear in many catalogues. Seventeen (11%) foods were unprocessed, with 111 (74%) classified as ultra-processed foods. Supermarket catalogues promote ‘Back to School’ lunchbox foods that are overwhelmingly packaged and ultra-processed. Working with supermarkets to adapt the promotion of foods that are less packaged and less processed is an important step to improving the local food environment.

Obesity is a significant health issue in Aotearoa; effective and pragmatic strategies to facilitate weight loss are urgently required. Growing recognition of the circadian rhythm’s impact on metabolism has popularised diets like time-restricted eating (TRE)(1). The 16:8 TRE method involves limiting food intake to an 8-hour daily eating window and can lead to weight loss without other substantial changes to diet(2). Nonetheless, TRE requires accountability and tolerating hunger for short periods. Continuous glucose monitors (CGM) are small wearable biofeedback devices that measure interstitial glucose levels scanned via smartphones. By providing immediate feedback on the physiological effects of eating and fasting, CGM use may promote adherence to TRE(3). This pilot study aimed to 1) investigate how CGM affects adherence to TRE and 2) assess the feasibility of CGM use while undertaking TRE. This two-arm randomised controlled trial enrolled healthy adults from Dunedin, assigning them to TRE-only or TRE+CGM groups for 14 days. Successful adherence to TRE was defined a priori as maintaining an 8-hour eating window on 80% of days. CGM feasibility was defined a priori as scanning the glucose monitor thrice daily on 80% of days. Secondary outcomes included well-being, anthropometry, glucose levels, and overall TRE and CGM experiences via semi-structured interviews. Twenty-two participants were randomised into two groups: TRE-only (n = 11) and TRE+CGM (n = 11, with n = 2 excluded from analysis post-randomisation for medical reasons). Participants had a diverse range of ethnicities, the mean age was 32 (+/-14.9) years, and 55% were female. The TRE+CGM group adhered to the 8-hour eating window for an average of 10.0 days (range 2-14) compared with 8.6 days (range 2-14) in the TRE-only group. Both groups had similar mean eating window durations of 8.1 hours. Five (56%) participants in the TRE+CGM group achieved the a priori criteria for TRE adherence, compared to 3 (27%) in the TRE-only group. Participants in the TRE+CGM group performed an average of 8.2 (+/-5.6) daily scans, with n = 7 (78%) of participants meeting the a priori CGM feasibility criteria. Neither group reported consistent adverse psychological impacts in DASS-21 and WHO-5 scores. Interviews highlighted that CGM increased hunger tolerance during fasting as participants felt reassured by their normal glucose levels. CGM aided TRE accountability by acting as a biological tracker of food intake. Participants reported that TRE led to improved energy and self-efficacy, a more productive daily routine, and healthier food choices. Promisingly, 72% of participants would use CGM and undertake TRE in future. This study demonstrates that using CGM while undertaking TRE is feasible and can improve adherence by enhancing hunger tolerance and accountability. Overall, participants experienced increased awareness of eating habits and physiological mechanisms. Over the longer term, this simple and synergistic approach may be a helpful weight loss strategy.

Almost half of countries globally are implementing national strategies to lower population salt intake towards the World Health Organization’s target of a 30% reduction by 2025(1). However, most are yet to lower population salt intake(1). We conducted process evaluations of national salt reduction strategies in Malaysia and Mongolia to understand the extent to which they were implemented and achieving their intended outcomes, using the findings to generate insights on how to strengthen strategies and accelerate population salt reduction. Mixed methods process evaluations were conducted at the mid-point of implementation of the strategies in Malaysia (2018-19) and Mongolia (2020-21)(2). Guided by theoretical frameworks, information on the implementation, mechanism and contextual barriers and enablers of the strategies were collected through desk-based reviews of documents related to salt reduction, interviews with key stakeholders (n = 12 Malaysia, n = 10 Mongolia), and focus group discussions with health professionals in Malaysia (n = 43) and health provider surveys in Mongolia (n = 12). Both countries generated high-quality evidence about salt intake and salt levels in foods, and culturally-specific education resources in 3 and 5 years respectively. However, in Malaysia there was moderate dose delivered and low reach in terms of education and reformulation activities. Within 5 years, Mongolia implemented education among schools, health professionals and food producers on salt reduction with high reach but with moderate dose and reach among the general population. There were challenges in both countries with respect to implementing legislative interventions and both could improve the scaling up of their reformulation and education activities to have population-wide reach and impact. In the first half of Malaysia’s and Mongolia’s strategies, both countries generated necessary evidence and education materials, mobilised health professionals to deliver salt reduction education and achieved small-scale salt reformulation in foods. However, both faced challenges in implementing regulatory policies and the scaling up of their reformulation and education activities to have population-wide reach and impact could be strengthened. Similar process evaluations of existing salt reduction strategies are needed to strengthen intervention delivery and inform areas for adaptation, to aid achievement of the WHO’s global target of a 30% reduction in population salt intake by 2025.

Young, older, pregnant, and immunocompromised (YOPI) people are most vulnerable to foodborne illnesses due to impaired or underdeveloped immune systems(1). There is a lack of information regarding how YOPI groups access, receive or use information about food safety, what influences their food safety behaviour, and their preferences for receiving food safety advice. The objective of this research was to develop a better understanding of how YOPI consumers in New Zealand access and use food safety information, the types and sources of food safety information used, how information and advice are obtained, and how these influence their decision-making about food safety practices and related behaviours. Research questions were guided by a rapid review of literature. Twenty qualitative focus groups (comprising of either young, old, pregnant, or immunocompromised individuals) based in one of three locations in New Zealand were conducted. This was complemented with data from health care providers from relevant sectors (nutritionists, dietitians, aged care providers, cancer nurses, Well Child Tamariki Ora providers, and midwives). Recruitment included a focus on ethnic groups (Māori and Pasifika) to ensure diversity of experiences and perspectives were represented in the research and to reflect NZFS’s interest in developing fit-for-purpose messages and resources for these YOPI populations. Thematic and segmentation analysis was conducted to understand current food safety behaviours and how to best communicate food safety matters. Typologies of participants were developed by grouping participants based on common features: attitudes, beliefs, and experiences. The research revealed most participants are comfortable with their food safety practices and reported habitual behaviours. Many YOPI did not perceive themselves to be at a greater risk of foodborne illness, particularly older people. A key finding was that access to information does not necessarily lead to behaviour change. Groups undergoing periods of change (immunocompromised, pregnant and young) were more likely to seek additional information. Families and health professionals are trusted sources of information, with all groups reporting some use of the internet as an information source. An individual’s risk perception was the main motivating factor for obtaining and following advice. Habit, cost of food, and lack of information were key barriers to obtaining or acting on information, along with pregnant people reporting social pressures as a reason to not obtain or act on relevant advice. In general, there are three key types of food-safety messaging all groups would like to receive: situation-specific advice; information received alongside other key information (e.g., starting solids); and general information for the whole population. Gaining insights into YOPI preferences on food safety matters can aid the development of appropriate communication and engagement methods of the risks and impacts of food safety matters to vulnerable people.

The physical location of liquor stores near schools can strongly influence the chances of youth accessing and consuming alcohol(1). As children transit to and from school, it is feasible that the presence of liquor stores near schools could also increase their exposure to alcohol advertising. Cumulative exposure to advertising influences alcohol attitudes, intentions and alcohol use(2), so reducing children’s exposure to alcohol advertising is important to delay the initiation of drinking and reduce future harms. As this has not yet been investigated in Australia, the aim of this study was to investigate whether the presence of a liquor store near a school was associated with an increased prevalence of outdoor alcohol advertising in Perth, Western Australia. We identified all outdoor alcohol advertising within a 500m radius (audit zone) of 64 randomly selected primary and secondary schools from low and high socio-economic areas across metropolitan Perth. We recorded the size, type, setting, and location of each advertisement during field data collection. Each zone was categorised by the presence or absence of at least one liquor store within the school audit zone, and results compared across these stratifications. Over half (56%) of the 64 school audit zones had at least one alcohol advertisement. On average, there were 5.9 alcohol advertisements per zone. School audit zones that contained a liquor store (59%) had over thirty times the average number of alcohol advertisements compared with audit zones that did not contain a liquor store (9.7 vs 0.3). The majority of all the alcohol advertisements identified (63%) were located outside a liquor outlet as opposed to other food businesses (2%), along the roadside (31%), on a bus shelter (3%) or on/outside another business (0.5%). Our findings that Perth schools with a liquor store nearby had more outdoor alcohol advertising within a 500m radius, compared with schools without a nearby liquor store, were independent of school type (primary or secondary) or the socio-economic status of the area. This poses significant concerns about the exposure of underage populations to outdoor alcohol advertising, and the resultant influence on alcohol use. These results underscore the necessity for policy interventions to mitigate children’s exposure to alcohol marketing, especially during the daily school commute, by regulating the location of liquor stores and alcohol promotion near schools. It will be important to incorporate the voices of children when developing future policies to assert their right to be consulted, heard and appropriately influence their environments.

A ‘Blackout Rage Gallon’ (borg) is a dangerous new alcohol consumption trend popular with young people. It involves creating a customised, individual alcoholic beverage by replacing half the water in a four litre (gallon) jug with alcohol (usually spirits), flavourings, electrolytes and caffeinated energy drinks or caffeine supplements. The most prevalent ‘recipe’ calls for the addition of 750ml of alcohol. The ‘blackout’ part of the name refers to the intent of one person to consume the borg in one session, thereby encouraging risky alcohol use. Indeed, there have been reports in popular media of multiple hospitalisations attributed to consumption of borgs at college events in the United States. Part of the attraction of the trend is to label the borg with a clever name, usually incorporating the term ‘borg’. The trend has gained traction recently on TikTok, which has become an important, yet unregulated, source of information for the public including young people(1). We investigated TikTok videos associated with the hashtag #borg to better understand this dangerous new phenomenon. We identified and analysed highly viewed TikTok videos (n = 105) for engagement, techniques, characteristics of featured individuals, and the portrayal of alcohol and risky drinking behaviours. Alcohol was visible in three quarters of the videos analysed (n = 78), and consumed in one third (n = 34). The average amount of alcohol present was well in excess of safe drinking guidelines (865ml) One quarter of videos (n = 25) promoted alleged benefits such as control of volume of consumption, protection from drink spiking, and mitigation of side effects due to addition of electrolytes and water. Alarmingly, only 9 videos included a warning about potential harms of the borg or alcohol in general. Indeed, videos discussing potential harms and benefits tended to encourage the use of borg, for example ‘I’m on board with the borg’. Our study found the borg TikTok trend encourages risky drinking in a fun and entertaining way, supporting previous studies where the majority of content was positively portraying a product or behaviour(2). As there is an association between viewing alcohol-related content on social media and alcohol use(3), there is an urgent need for social media content restrictions to limit the visibility of risky alcohol consumption, particularly to underage users.

Food insecurity, the inadequate or insecure access to food due to financial constraints, is a growing concern in high-income countries like Australia(1). Food insecure adults may have reduced diet quality due to constraints on food purchasing and consumption(2) but further research is needed to understand how the severity of food insecurity impacts diet quality in an Australian setting. This study aimed to examine the relationship between diet quality and increasing severity of household food insecurity using validated measurement tools. A cross-sectional, online survey of Australian adults (aged 18 years+) used the USDA Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately, or severely food insecure. The Australian Recommended Food Score (ARFS; score between 0–73) determined diet quality (ARFS total) and sub-scale scores for eight food groups(3), with higher scores indicating higher diet quality. Diet quality score results are further categorised as “needs work” (<33), “getting there” (33-38), “excellent” (39-46) or “outstanding” (47+). Survey-weighted linear regression (adjusted for age, sex, income, education, location, household composition) analyses indicate that 45% of participants were living in households that experienced food insecurity, comprising 7% marginally, 18% moderately and 20% severely food insecure households. The ARFS total survey-weighted mean score for the whole sample (n = 804) was 32.4 (SD = 9.8). As the severity of household food insecurity increased, ARFS scores decreased. Marginally food insecure respondents reported a mean ARFS score three points lower than food-secure adults (B=-2.7; 95%CI [−5.11, −0.34]; p = 0.03), and scores reduced by six points for moderately (B=-5.6; 95%CI [−7.26, −3.90]; p<0.001) and twelve points for severely food insecure respondents (B=-11.5; 95%CI [−13.21, −9.78]; p<0.001). Marginally food insecure respondents had significantly lower vegetable sub-scale scores, moderately food insecure respondents had significantly lower sub-scale scores for all food groups except dairy, severely food insecure respondents had significantly lower scores for all sub-scale scores. Poorer diet quality is evident in adults living with any food insecurity but gets progressively worse as the severity of food insecurity increases. Interventions to reduce food insecurity and increase diet quality are required to prevent adverse nutrition-related health outcomes in food-insecure populations in Australia and beyond.

The United Nations’ Agenda 2030 provides a framework of 17 Sustainable Development Goals (SDGs) to achieve peace and prosperity for people and planet, now and into the future(1). The United Nations Decade of Action on Nutrition emphasises that food and nutrition are key levers for optimising both human and planetary health and that individuals working in food, nutrition and health play an essential role in contributing to the SDGs(2,3). This project aimed to (i) map the work being done by staff and higher degree students at Monash University’s Department of Nutrition, Dietetics and Food and its alignment with the SDGs, and (ii) assess the impact of this process on workforce capacity to embed the SDGs in future work activities. Three mapping workshops; one pilot, one in-person and one online, were conducted (n = 28), beginning with a short expert-led seminar about the SDGs before participants engaged in an interactive activity to record their work activities (research, education or engagement) relating to the SDGs. Mapping data were analysed to determine which SDGs were being prioritised and in what type of activities. To determine the impact on workforce capacity, participants completed pre- and post-workshop surveys that assessed their knowledge of and confidence regarding the SDGs. From the three workshops, 129 work activities were described, each linked to one or more of the SDGs. Of those, 41% were education, 36% were research, and 23% were engagement activities. Work activities spanned all 17 of the SDGs, with the most commonly aligned being Goal 3 Good Health and Wellbeing (53% of work activities), Goal 10 Reduced Inequalities (37% of work activities), Goal 4 Quality Education (36% of work activities), Goal 12 Responsible Consumption and Production (34% of work activities), and Goal 17 Partnerships for the Goals (27% of work activities). The pre- and post-workshop surveys indicated increased staff knowledge and confidence related to the SDGs. The percentage of participants that could correctly identify the number of SDGs increased from 43% to 96%, and the percentage of participants that recognised the correct aim of the SDGs increased from 43% to 86%. Regarding confidence in talking about the SDGs, the percentage of staff who indicated that they ‘avoid talking about them’ or are ‘not confident’ decreased from 39% to 4%, and the number of staff who were confident talking about the SDGs ‘in general terms’ increased from 39% to 75%. Nutrition professionals are well-placed to support progress towards each of the SDGs. Workshops such as these provide an opportunity to increase workforce capacity to discuss, share and relate their work to the SDGs and provide a periodic pulse-check to identify opportunities for greater contribution to this urgent, global Agenda.

Vitamin D deficiency and insufficiency have been found in general population but especially in women of childbearing age. Although Vitamin D can be obtained from food source (few naturally) and produced from skin sunlight exposure, it can come from a reliable source via supplementation. Supplementing 15 µg daily could meet the recommended dietary allowance for 19 years and older and 20 µg for 70 years older. Daily supplementation greater than 100 µg is not recommended. Unlike water-soluble vitamins B and C, Vitamins A, D, E, and K are fat-soluble. This property of Vitamin D affects not only the delivery of it in drink but also absorption at the small intestine and bioavailability (i.e., serum level). This study focused on enhancing the solubility of vitamin D using a novel botanical solubilizer. Using rubusoside (RUB), isolated from stevia and other plants, Vitamin D3 (cholecalciferol; VD3) was experimented for solubility enhancement. VD3 was processed with RUB to form the VD3-RUB structure in powder form. Solubility of this powder in physiologic solutions of water, gastric or intestinal fluid, stability over time, and dilutability for achieving desired supplementation levels were examined. The VD3-RUB complex structure in water solution was characterised for particle size and shape using dynamic light scattering techniques. VD3 in water solution after filtration was quantified on HPLC. VD3 was practically insoluble in water. However, in the presence of 10% w/v RUB as the botanical solubilizer, VD3 became soluble in water to a concentration of 4,500 µg/mL. This water-soluble concentrate appeared clear and was freely dilutable to a drink containing amounts of VD3 ranging from 15 µg to 100 µg. Particle size analysis indicated the presence of approximately 4 nm spherical particles. HPLC analysis of the water solution detected RUB and VD3. These drinks were stable and remained clear and transparent for at least eight weeks. A packet of water-soluble Vitamin D3 powder was also developed for addition to a glass of water in the amount of 15 µg VD3. The packet, similar to the instant coffee powder, produced an instant Vitamin D drink containing the recommended dietary allowance of 15 µg. The water-soluble VD3 powder was also dissolvable in simulated gastric fluid and intestinal fluid, and stable for at least two hours. This solubility enhancement could aid in absorption and improve oral bioavailability, seen in the work with oily ceramides(1) and insoluble curcumin(2). It is especially advantageous for making drinks as the solubilizer is generally regarded as safe by the US FDA.

Dietary fat is a major energy source and an essential nutrient that supports healthy growth and development in young children(1). Despite the important role of dietary fat in early childhood, our understanding of fat intake trends during this period is limited, particularly among Australian children. Insufficient evidence has led to the establishment of an Adequate Intake (AI) for infants aged 0-12 months in Australia, while no recommendation is available for children ages 1-5 years. This study aimed to comprehensively describe fat intake and major food sources in young Australian children. The data of children at ages 9 months (n = 393), 18 months (n = 284), 3.5 years (n = 244), and 5 years (n = 240) from the Melbourne InFANT Program were used(2). At each time point, child dietary intake data were collected via three 24-hour recalls. Food measurement booklets were utilised to estimate food portions. Food groups and nutrient intakes per day were calculated using the 2007 AUSNUT Food Composition Database. Daily energy (kJ/d) and fat (g/d) intake, the contribution of fat to total energy intake, and key food sources of fat intake were calculated. Descriptive statistics (mean and SD) were used to summarise all data. The mean daily energy intake increased from 3490 kJ/d at 9 months to 5889 kJ/d at 5 years. The mean (SD) fat intake (g/d) was 33.7 (8.0) (Australian AI is 30 g/d) at 9 months, 37.5 (9.5) at 18 months, 44.6 (13.4) at 3.5 years, and 49.0 (15.1) at 5 years. The WHO/FAO recommends that total fat intakes should constitute a minimum of 35% of energy (%E) for children aged 6-24 months, gradually reducing to a range of 25% to 35 %E for children aged 2 to 5 years(3). Notably, 40% of children at 9 months, 76% at 18 months, 14% at 3.5 years, and 12% at 5 years had fat intakes below the WHO/FAO recommendations. In contrast, 24% of children at 3.5 years and 28% at 5 years exceeded the recommendation. At 9 months, the primary source of fat was formula/breastmilk, while at later ages, the major sources were milk/milk products, cakes/cookies, and breads/cereals. The proportion of fat from discretionary foods, such as cakes/cookies, processed meats, butter, oil or fat spreads, increased with age. The percentage of total fat from fish, nuts, and seeds was low, contributing <4 %E at all time points. The study highlights a significant proportion of children exceeding or falling below fat intake recommendations. Moreover, the results suggest low consumption of healthy fat sources such as fish, nuts, and seeds. The study findings will contribute to the refinement of fat recommendations in young Australian children and contribute to interventions that aims to improve fat intakes.

Circadian clocks play a key role in metabolic homeostasis, and disruption of circadian rhythms is inextricably intertwined with metabolic disorders [1]. Emerging evidence in the literature suggests that polyphenols possess the potential to modulate metabolic processes associated with circadian rhythms. This review aims to evaluate the effects of polyphenols on metabolic homeostasis via circadian rhythms and their potential mechanism(s) of action on circadian rhythmicity of clock components and linked metabolic processes, by critically assessing the literature on mammalian cells in vitro. To ensure that all relevant studies in this area were included, a systematic search protocol was developed by defining the inclusion and exclusion criteria based on the population, intervention, comparator and outcome framework, along with limiting the source of evidence to original research written in English. Three databases (Ovid Medline, Web of Science, and Scopus) were searched with no time constraints. The search identified 5842 studies and, after duplicate removal and initial screening, 48 studies were reviewed in full. Of those, 38 were eligible for inclusion. The included studies were published between 2008-2023, with a notable surge in publications after 2016, which is indicative of the growing attention towards polyphenols and circadian biology. 33 polyphenols were examined for their effects on circadian cellular processes (n = 16 papers), expression of clock genes and/or proteins (n = 26), or circadian rhythm features of clock genes (n = 10). A handful of studies examined the role of polyphenols in regulating disrupted glucose and lipid metabolism through clock components. The findings suggested that the underlying mechanisms were BMAL1-dependent. It must be noted that the effects of the reported polyphenols were elucidated at concentrations exceeding the normal range found in human plasma and target tissues (˃ 10 μM). However, a single study revealed that (−)-epigallocatechin-3-gallate (EGCG) at a physiologically-relevant concentration (10 μM), improved hepatic glucose metabolism [2]. Further, the polyphenols reported in this review exhibited the potential to influence numerous clock components, mainly BMAL1, PER2 and RORα/γ, at mRNA and/or protein levels when administered at physiologically-relevant concentrations. These polyphenols include nobiletin, tangeretin, curcumin, bavachalcone, cinnamic acid, (−)-epigallocatechin-3-gallate, resveratrol and Urolithin A. Polyphenols have the potential to regulate circadian oscillators and associated metabolic processes in various types of cells. However, there is significant methodological heterogeneity among the studies, which makes it difficult to compare outcomes. Thus, this review will help future research in the field of circadian impacts of polyphenols to integrate standardised approaches, in aspects such as utilisation of a synchronisation method and physiologically-relevant concentrations of polyphenols (≤ 10 μM) in cultured cells. This is critical for understanding how polyphenols might modulate circadian-metabolic health in humans.

Childhood obesity has been a public health concern worldwide(1). Parents are a crucial part of the weight monitoring of children(2). But effects of parental perception of children’s weight on children’s weight change remain inconclusive. This systematic review and meta-analysis aimed to evaluate the effects. A systematic search of six databases was conducted from inception to March 2023 based on Cochrane guidelines. Longitudinal studies were included. Data were synthesised using a semi-quantitative approach and meta-analysis. Finally, nine studies with a total of 25,475 respondents were included in the systematic review and meta-analysis. The pooled results showed that compared to children perceived as normal weight, children who were perceived as overweight or obese by their parents had a statistically significantly greater weight gain (pooled coefficient β = 0.43, 95% confidence interval (CI): 0.1, 0.76, p<0.05) during follow-up. Conversely, children perceived as underweight presented less weight gain (β=-0.16, 95%CI: −0.3,-0.02, p<0.05) during follow-up compared to children perceived as normal weight. However, parental misperception of their children’s weight was not statistically significantly associated with children’s weight change (underestimation: β = 0.04, 95% CI:-0.37, 0.44, p>0.05; overestimation: β=-0.09, 95% CI:-0.06, 0.23, p>0.05). We found that parental perception of children’s weight, not parental misperception, might influence children’s subsequent weight change. Longitudinal and intervention studies using validated measurements and including potential confounders and mediators are needed to confirm the causalities.

The fundamental principle of veganism is to avoid all possible animal exploitation and therefore, animal ethics has always been a primary motivator. Nowadays, the environment and health are also common motivators. Omission of all animal products leads to dietary exclusion of vitamin B12, limited intake of omega-3 fatty acids, specifically EPA and DHA, and intake of low bioavailable iron sources1. Obtaining the knowledge to appropriately plan and replace nutrients through food or supplementation is key to avoiding deficiencies and subsequent consequences. This study aimed to determine the effect of motivation for being vegan on intake of key nutrients and nutritional knowledge. This cross-sectional, observational study recruited participants, who had followed a vegan diet for minimum 2 years. Demographics and nutrition knowledge were obtained from questionnaires. Motivation type was determined using the validated vegetarian eating motives inventory (VEMI) – participants scored the importance of animal ethic, environment and health. Intakes of vitamin B12 and iron, were collected using a 4-day food diary and assessed against Estimated Average Requirement (EAR). Blood samples were taken to determine status of vitamin B12, haemoglobin, serum ferritin, and omega-3 index. Omega-3 index score ≤4 indicates increased risk of coronary heart disease. Animal ethics was the greatest motivator to become vegan, with 83.5% of participants scoring it as very important, compared to 71.7% of people stating the environment, and 53.3% stating health. No association was found between all motivation types and intake of vitamin B12 and iron, nor omega-3 index. Mean vitamin B12 intake (supplements excluded) of 2.11ug/day ± 3.43 exceeded the EAR of 2.0ug/day for both men and women, however intakes ranged between 0.00 and 37.63ug/day. Mean intake of iron (18.77mg/day) exceeded the EAR for both men and women. Overall mean omega-3 index was 3.16%. Both men (162.24g/L) and women (151.44g/L) had adequate mean Hb serum concentrations. Mean serum ferritin was within normal range for both men (64.86ug/L ± 43.48) and women (32.55ug/L ± 26.04). Overall mean serum vitamin B12 was within normal range (316.54pmol/L ± 146.18), however a large range was observed from 72.00pmol/L to 1,015pmol/L. Males and females had similar knowledge, with only one question regarding fibre content in cornflakes found to be significantly different (P = 0.012). Knowledge was varied e.g., 100% of participants could identify that pasta was a carbohydrate source, yet could not identify which fats are most important to reduce. Mean vitamin B12 intake exceeding EAR and normal status despite limited vegan sources, indicates high consumption of high bioavailable fortified foods, and supplementation. Iron status shows large consumption of iron rich foods to overcome bioavailability issues, reflected by adequate iron intake, after increasing EAR by 80% to meet recommendations. The mean omega-3 index shows a low cardioprotective omega-3 fatty acid intake.

Primary school aged children (aged 4-12 years) in Australia consume approximately 40% of daily energy from energy-dense, nutrient poor foods and fewer than 5% meet the recommended guidelines for vegetables and fruit (ABS 2018). Poor eating habits in children can track into adulthood increasing the risk of non-communicable diseases later in life (Nicklaus 2013). Children spend a large amount of time at school where they are provided with social contexts which influence behaviour development (FAO, 2022) and thus are ideal settings for teaching children about food and nutrition (FAO, 2022; WHO 2017). This pilot study was designed in response to a call to action from a local primary school in southeast Melbourne facing disadvantage. Anecdotally, the school reported poor food literacy with many students bringing unhealthy lunches. The school asked us to design, pilot, and evaluate a student education program enabling healthier lunches among these children. The aim of the study was to explore the effectiveness of a 4-week food and nutrition education program delivered to grade 4 students within a disadvantaged area targeting, children’s food-related knowledge, behaviours and self-efficacy (confidence) to pack a healthy lunch. The program delivered weekly 1-hour interactive sessions over four weeks (October-November 2022). Topics included healthy eating, designing healthy lunches and food safety and were delivered using interactive games, activities, quizzes and food tasting. Students completed an online survey measuring their knowledge, self-efficacy and behaviour (e.g. foods packed in their lunchbox) pre- and post- program. A comparative analysis of the pre- and post-survey responses was performed using McNemar Tests in SPSS version 29.0. Sixty students completed both the pre- and post-surveys. A significant increase (p<0.001) in knowledge of recommended daily serves of fruit (pre 43%, post 80%) and vegetables (pre 17%, post 54%) was observed. There was also a significant (p<0.001) increase in student’s ability to identify ‘sometimes food’. No changes were observed in identification of ‘everyday food’, sources of protein and sources of dairy food or safety knowledge. Children’s confidence to make healthy food swaps significantly increased from pre- to post- program (27%45%, p = 0.035). We observed significant increases in children’s food and nutrition related knowledge for some topics and confidence to make healthy food swaps following completion of the program. A program of longer duration may be beneficial to observe additional improvements in knowledge as well as behaviour change, including foods packed in school lunches.

Bitter taste perception plays a dual role in human nutrition and evolutionary biology; being identifiable in nutrient-dense foods such as cruciferous vegetables and historically signalled toxic compounds. The TAS2R38 gene, part of the taste 2 receptor family, is central to individual differences in bitter taste perception(1). While genetic variations are influential, dietary habits and food preparation also impact taste perception. However, research investigating the interplay between these factors and genetic variations in influencing bitter taste sensitivity and food intake is limited. This study aimed to elucidate the relationship between bitter taste sensitivity and TAS2R38 haplotype variations in the context of bitter food consumption among Australian adults. A cross-sectional, mixed-methods study was conducted. Healthy adults who had maintained a stable diet for at least three months were eligible. Data collection was via an online survey (REDCap), capturing self-reported demographics, dietary patterns specific to bitter foods including metrics of bitter food avoidance, frequency, liking and perceived healthfulness, alongside a Dietary Quality Index (DQI) derived from a food frequency questionnaire(2). Bitter taste sensitivity was assessed using self-reported intensity perceptions of 6-n-propylthiouracil (PROP) taste strips(3). Genotyping was conducted via TaqMan qPCR assays on DNA extracted from buccal swabs to ascertain TAS2R38 haplotypes. Data analysis utilised Analysis of Covariance (ANCOVA) and regression models, with all tests adjusted for confounding variables such as gender, age, and smoking status. A total of 222 participants (47.5 ± 17.7 years; 86% female; BMI 27.3 ± 7.1 kg/m2) completed the study. PROP sensitivity was strongly correlated with TAS2R38 haplotype, with supertasters predominantly having PAV/PAV, medium tasters with PAV/AVI, and non-tasters with AVI/AVI (p = 0.002). However, no relationship was observed between PROP sensitivity and either the frequency, liking, or avoidance of bitter foods (p>0.05). DQI was significantly related to bitter food consumption; individuals in the lowest DQI quintile consumed bitter foods more frequently than those in the third (p = 0.007) and top quintiles (p = 0.001). The perceived healthfulness of bitter foods was significantly higher in those with AVI/AVI haplotypes (non-tasters) compared to those with PAV/AVI (medium tasters) (p = 0.001). Counterintuitively, participants who reported greater enjoyment of bitter tastes consumed bitter foods less frequently (p<0.001). Our study confirms that TAS2R38 variants are predictive of PROP taste sensitivity, consistent with literature that identifies PAV/PAV individuals as supertasters. However, neither PROP sensitivity nor TAS2R38 haplotype influenced bitter food frequency or preference consumption patterns. Interestingly, those with lower Dietary Quality Index scores and less enjoyment of bitter taste consumed bitter foods more often. These observations highlight the need to investigate other factors influencing bitter food intake, such as additional sensory characteristics or psychological and behavioural aspects.

Iron deficiency anaemia (IDA) in pregnancy is a significant public health problem worldwide, but little is known about factors associated with dietary iron intake among pregnant women especially from low- and middle-income countries(3). This study assessed factors associated with dietary iron intake among pregnant women attending primary health centres in Ifako-Ijaiye Lagos, Nigeria. Sociodemographic information and dietary intakes were elicited from 432 apparently healthy singleton pregnant women using a pre-tested questionnaire and 24 hour- dietary recall, respectively. Dietary iron intakes was estimated from foods and drinks reported using the West African Food Composition Table and adjusted for energy intakes using the residual method(1). Chi-square test and one-way ANOVA was used to compare categorical and continuous variables respectively by tertiles of energy-adjusted dietary iron intakes at a two-sided P<0.05(2).Mean age and dietary iron intake was 28.5 ± 4.6years and 20.3 ± 3.3mg/day, respectively for all respondents. Energy-adjusted iron intakes by tertiles of energy-adjusted dietary intakes were; 16.6 ± 1.4mg/day for the first tertile, 19.7± 1.0mg/day for the second tertile and 23.7 ± 2.0mg/day for the third tertile. Age, gestational age, parity, education, marital status, and income differed insignificantly by tertiles of energy-adjusted dietary iron intakes. Current evidence suggests a statistically insignificant association between sociodemographic factors and dietary iron intakes in this sample, but further studies are vital for designing culturally relevant interventions to promote the consumption of iron-rich foods among women in this population.

TikTok is a global social media platform popular with young people, encouraging viewers to engage with user-generated video content (through likes, shares and comments) and mimic displayed behaviours (by creating similar videos or content). It is therefore a powerful and engaging tool that has potential for the widespread dissemination of information (or misinformation) and to influence behaviours. Social media is saturated with the promotion of ‘diet culture’ and has a strong influence on the eating behaviours of young people (1,2). This is concerning as childhood and adolescence are critical periods of growth requiring optimal nutrition (3). This study aimed to investigate how dieting is portrayed on TikTok and consider the potential implications for public health. A cross-sectional descriptive content analysis was undertaken of 50 videos from each of the five most popular diet-related hashtags (#diet, #whatieatinaday, #wieiad, #dietitian, #diettips). A codebook was developed to analyse the body-related content referenced (weight measurement, calories, body image, body checking, body comparisons over time) and collect the engagement for each video (likes, comments and shares). Overall, the 250 videos contributed to a total of 197.2 million likes (M = 789,051.0, SD = 923,335.0), 126,7251 comments (M = 5,069.0, SD = 9,315.3), and 3.8 million shares (M = 15,423.2, SD = 41,271.3). Most videos featured adults (n = 205, 82%), and only a small number of videos featured identifiable children or adolescents (n = 16, 6.4%). The information and advice regarding diets and eating behaviours came from two types of sources: 'experts’ and regular creators sharing their personal experience. Almost half of the videos were educational or instructional (n = 116, 46.4%), of which 74 (63.8%) were posted by users who claimed expert status. The most common titles by those claiming to be experts were “dietitian” (n = 43, 58.1%), “health and wellness coach” (n = 7, 9.5%), “doctor” (MD; n = 6, 8.1%), “fitness trainer” (n = 6, 8.1%), and “nutritionist” (n = 3, 4.1%). Of the videos that specifically mentioned a certain diet, the most common diets were low calorie (n = 32, 12.8%), vegan (n = 14, 5.6%), self-reported healthy eating (n = 12, 4.8%), and fasting (n = 10, 4.0%). The use of humour was the only feature significantly associated with engagement. Health professionals are presented with a unique opportunity to widely and positively influence the public by utilising the popularity of TikTok amongst young people to disseminate evidence-based information and promote healthy eating behaviours. Our findings suggest that experts using authentic, humorous, and engaging personas would be more likely to be popular on this platform.