Pregnant women who develop pre-eclampsia (PE) and/or intra-uterine growth restriction (IUGR) have reduced polyunsaturated fatty acid (PUFA) status compared to healthy pregnancy(1). It is unknown if pregnant women diagnosed with Gestational Diabetes Mellitus (GDM), and their offspring, also have compromised PUFA status. To determine if women with GDM, and their offspring, have altered PUFA status compared to healthy pregnancy. Pregnant women were recruited from Glasgow Scotland, and Brisbane, Australia from antenatal clinics for this cross sectional study. Third trimester maternal blood samples were collected after an overnight fast and cord blood samples were collected at delivery. Plasma fatty acids were analysed using gas chromatography from women with GDM (n = 37) and healthy pregnancies (n = 27) and their respective offspring (n = 31, from women with GDM, and n = 27 from healthy women). T-tests were used to determine significant differences between maternal with GDM and healthy pregnancy, as well as for their offspring and significance was set at p<0.05. Previously, erythrocyte fatty acids were analysed from women with PE (n = 21), IUGR (n = 13) and healthy pregnancies (n = 86)(1). All results were expressed as mol percent of total fatty acids. There were no differences in maternal plasma arachidonic acid (4.51 ± 1.23 vs. 4.72 ± 0.64, p = 0.39) and plasma EPA & DHA (2.33 ± 0.74 vs 2.69 ± 1.04, p = 0.14) in women with GDM and healthy pregnancies, respectively. There were no differences in fetal plasma arachidonic acid (11.58 ± 2.26 vs. 12.63 ± 1.69, p = 0.08) and plasma EPA & DHA (4.44 ± 1.17 vs. 4.44 ± 1.00, p = 0.89) in offspring from women with GDM and healthy pregnancies, respectively. Women with PE and IUGR had approximately 25% lower erythrocyte EPA & DHA and 35% lower erythrocyte arachidonic acid compared to healthy pregnant(1). Offspring from women with PE and IUGR had approximately 25% lower erythrocyte EPA & DHA and 22% lower erythrocyte arachidonic acid compared to healthy pregnancy(1).Women with PE and IUGR had lower PUFA status likely due to reduced PUFA synthesis(1) and offspring from women with PE and IUGR had reduced PUFA status likely due to ectopic fat in placenta tissue(2). Women with GDM do not have compromised PUFA status suggesting there is no reduced synthesis and transport of PUFA. Offspring from women with GDM do not have reduced PUFA status suggesting there is no problem with PUFA transport across the placenta, unlike offspring from women with PE and/or IUGR. Women with GDM, and their offspring, do not have compromised plasma PUFA status compared to healthy pregnancy.

Breastfeeding is vital to infants’ health and development during their first year. The quality and quantity of breastmilk are closely linked to the mother’s nutrition [1]. However, for migrant women who become new mothers, various social, economic, and family factors can pose challenges that negatively affect their dietary and breastfeeding practices. Due to the limited research evidence, this study aimed to investigate the factors associated with breastfeeding duration in migrant women. The study sample was drawn from the Filipino Women’s Diet and Health Study (FiLWHEL). These women migrated to South Korea through marriage. At baseline (2014-2016), 504 women provided survey data, including demographic characteristics such as age, marital status, education, employment, income, and language proficiency. Anthropometric measures such as body mass index (BMI) and lifestyle factors were also recorded. Dietary intake of each food group was assessed using 24-hour recalls. We derived the Minimum Dietary Diversity for Women (MDD-W) from the ten food groups [2]. Breastfeeding (any) duration was defined as the average length in months per child. Multivariable logistic regression was used to evaluate the associations between participants’ characteristics and breastfeeding duration, with a cut-off of 12 months (<12 months; > = 12 months). Linear regression analysis was used to assess the relationship between each of these factors and breastfeeding duration in months. Out of the initial 504 women, 271 met the eligibility criteria, with the median age of 35 [interquartile range (IQR): 30,40] years, median breastfeeding duration of 4 [IQR: 1, 10] months, mean BMI of 23.8kg/m2, median (IQR) o fruits, vegetables, and legumes of 162.2 [76.9, 265.9] grams/day, and median of MDD-W score of 5 [IQR:4, 6]. Over 50% of the sample held a university degree or higher, but only 47.8% were employed. Most women were married (90%) and earned less than 20 million won (~AU$23,114.58) per year (65%). Over half had a good understanding of the Korean language. The cross-sectional regression analysis found no associations for breastfeeding length, except for the total fruit, vegetable, and legume intake. Women in the highest tertile of this consumption had a two-fold likelihood of breastfeeding for 12 months or longer [adj.OR (95% CI): 2.15 (0.99-4.68)]. While the MDD-W score had a positive association with breastfeeding for at least 12 months, it did not reach statistical significance [adj.OR: 1.11 (0.92-1.34)]. In the linear regression analysis, only vegetable consumption (per gram increase) was positively related to the length of breastfeeding (beta-coefficient: 0.016; SE: 0.006; p = 0.01). This study among Filipino migrant women in Korea suggests that higher consumption of fruit, vegetables, and legumes positively linked to breastfeeding for at least 12 months. Given the study’s small sample size, interpreting these results should be cautious and warrants further validation in other studies.

Sour foods, such as citrus fruits, some berries and fermented foods provide a range of nutrients and benefits important to mental health [1]. When sourness is perceived as unpleasant, intake of these foods may be reduced affecting mental health. Early research has shown changes to sour taste perception in depression and stress however, changes in anxiety have not been studied [4-8]. To address this gap and build on the knowledge base, a survey was conducted in which participants (n = 424) rated recalled intensity and liking of sour index foods and completed the Depression, Anxiety, and Stress Scale (DASS-21) to measure these states. Variations in sour taste and mood have been demonstrated between females and males, hence the data were explored for sex-differences. Standard least squares regression (post hoc Tukey’s HSD) compared means between groups, and nominal logistic regression assessed differences in distributions between categories. Recalled sour intensity was 16-19.2% higher in those with scores indicative of mild depression than in those with normal scores in the total sample (p range 0.03-0.04), and 17.9-21.3% higher in females (p values were 0.03). There were no differences in sour taste intensity between the intergroup means for anxiety or stress and no associations between sour liking and any of the mood states. The results suggest that the sourness of index foods increases in depression. Further research to elucidate the biological processes and possible taste-related genetic influences that may be occurring would be beneficial. With this knowledge it may be possible to screen for mood conditions by measuring changes to sour taste that appear alongside other signs and symptoms, create more tailored dietary interventions and develop additional therapeutics.

Schools provide a unique opportunity to educate and motivate Pacific Island students and the wider Pacific Island community about food systems, food production activities (e.g., gardening and cooking) and to focus on the knowledge and skills needed to make healthy and sustainable food choices. Recent work(1) has identified limited access to appropriate and credible learning and teaching resources and varying integration of food and nutrition in the curriculum across the Pacific Islands (P.I) region. Teachers reported an ardent desire to incorporate nutrition into the curriculum, but were not sure how to do this, or where to source assistance, including credible learning materials. Stakeholders also reported requiring assistance to develop contextualised learning materials, and that there were limited options for upskilling in food, nutrition and agriculture. Recommendations from this work included the development of a tool to assist teachers to bridge the gap between understanding the benchmark or learning outcomes provided in curriculum and designing engaging and authentic activities and assessment to meet these. Therefore, this project aimed to identify food and nutrition curriculum materials available for Pacific Island educators, to inform the development of a web-based resource. In 2022, a systematic desk-based scoping activity was undertaken to identify any resources available to teach food and nutrition in Pacific Island schools (primary and secondary level) and professional development opportunities relevant for educators. The mapping identified over 70 resources, with resources from almost all countries identified. Some are available for specific countries, but few that are designed for use regionally. Some of these resources are directly aligned to food-based dietary guidelines, while others appear to be developed for specific activities by non-governmental organisations. Very few professional development activities were identified. Once a resource was identified, the project team used the CRAAP test(2) to evaluate the credibility of this. If deemed credible, the resource was tagged with key words (e.g., Tonga, gardening) and added for inclusion. The key resource categories (for tagging) were cooking, ocean and waterway foods, food in schools, food safety, healthy eating, sustainability, pacific research, teaching practice, gardening and WASH. A web designer developed the web-based resource through collaboration with the project team. Users can search for resources by country and/or topic. Based on the mapping of professional development activities, a professional development activity based on assessing the credibility of information was developed and added to the L&T toolkit. Users of the hub can share resources (their own) or identify other resources that could be added to the hub. There are limited resources and opportunities for Pacific Island food and nutrition teachers to upskill in food and nutrition education. School educators may benefit from more food and nutrition resources and professional development activities to complement those that are currently available.

National surveys in India, through measures of anthropometry and biomarkers, have identified a triple burden of malnutrition (undernutrition, micronutrient deficiencies and overnutrition) in adolescents(1). However, there is a dearth of high-quality data on individual dietary behaviour of this population(2) and the importance of sub-national dietary surveys in filling this gap has been identified(3). The objective of this study was to assess the intake of energy (E) and macronutrients and the contribution of macronutrients to E in a random sample of 11–13-year-old schoolchildren in Delhi, India. Method: The study was approved by The University of Adelaide Human Research Ethics Committee and the Independent Ethics Committee of the Centre for Chronic Disease Control, New Delhi. The target sample size of 360 was based on a ± 5% margin of error in estimated sugars intakes. Using the list of private schools in Delhi (n = 1374), a statistician external to the research team generated a random sample of 150 schools stratified by districts (n = 11). Using this list, schools were invited to participate, and recruitment continued until 10 schools consented. Teachers shared study information with parents; interested parents filled in the online consent form. Assent was obtained from schoolchildren. Participants recorded all food and drink consumed over three consecutive days, including one weekend day, in a food diary. Information recorded was entered into an online dietary assessment tool, Intake24 Southeast Asia version, during an interview with each participant. The Intake24 database of over 2400 food photographs of more than 100 foods was used to ascertain portion size. The Intake24 database converts food and drink reported into the intake of nutrients through integrated food compositional tables. Of 514 pupils providing consent, 393 participants (76.4%) (169 girls, 224 boys) completed the study. The median daily E intake was 10.8 (IQR 9.0 −12.5) MJ for girls, and 12.3 (IQR 10.3- 15.2) MJ for boys. For the 97 girls and 144 boys providing body weight data, Physical Activity Level ratios were 2.0 and 2.1 respectively. The median daily intakes for girls were: protein 64.6 (IQR 54.8-79.3) g; carbohydrate 336.5 (IQR 285.3- 393.6) g; and saturated fat 45.6 (IQR 34.8-58.3) g. The respective values in boys were: protein 74.4 (IQR 61.4; 89.4) g; carbohydrate 379.6 (IQR 317.8; 461.8) g; and saturated fat 54.6 (IQR 41.9-69.5) g. There were no significant between-gender differences in percent E from protein (10.2 (IQR 9.2; 11.4)), or carbohydrate (52.4 (IQR 48.7; 56.7)). Girls obtained less E from saturated fat (16.1 (IQR 11.0-18.2) compared with boys 16.3 (IQR 14.2 - 19.1) (P<0.05). In conclusion, in this sample of adolescents from private schools in Delhi, E intake was above FAO recommended levels and median total fat intake exceeded the recommended threshold of 35%(4).

The role of flavonoids on cognitive performance in older adults has been intensively studied, with the subclass of anthocyanins showing promising outcomes(1). However, there is conflicting evidence in the case of individuals at high risk of developing dementia, namely those with mild cognitive impairment (MCI). A recent study has suggested that cognitive scores in people with MCI were higher in those who had higher anthocyanin intake (>10 mg)(2). Baseline data from 65 participants of an ongoing clinical trial that had an MIS (Memory Index Score) score ≤ 13 with self-reported subjective memory complaints, (mean age 69.1y ± 6.2) were used to investigate the relationship between dietary anthocyanin intake and indices of mood and cognitive performance. Repeated 24-hour dietary intake was recorded through Intake24 (a computer-based program) for three days (2Xweekday and 1Xweekend day) and anthocyanin intake was quantified using the PhenolExplorer food composition database. The primary outcome of interest was the Buschke and Grober Free and Cued Selective Reminding Test-Immediate Recall (FCSRT+IR) (assesses auditory anterograde memory functioning), while other cognitive functions assessed included: Spot the Word-2 (assessing premorbid estimate); Oral Symbol Digit Test (speed of processing); List Sorting (working memory); Trail Making Test A & B (speed of processing/executive function); and Verbal Fluency (language/semantic memory). Subjective memory complaints were assessed using the Memory Assessment Clinic-Q (MAC-Q) and mood was assessed using the Geriatric Depression Scale (GDS). Independent t-tests were used to compare differences in cognitive tasks and mood scores between high (>10 mg/d) and low consumers of anthocyanins (<10 mg/d). There was a trend for high anthocyanin consumers (n = 35, median = 44.87 (10.01, 177.83)) to score better on FCSRT-Delayed Free Recall scores (16.57 ± 3.74) compared to lower consumers (n = 30, median = 0.01 (0, 9.51)), (15.97 ± 0.18) with a mean difference (SE) of −1.06 (0.58) (p = 0.06) suggesting recall of 1.06 more words after a 20-30 minute delay. Higher consumers had a lower GDS score (1.77 ± 3.73) compared to lower consumers (3.73 ± 1.77), p = 0.01. Spot the word test scores (assesses premorbid verbal abilities using a robust lexical decision task) were higher for high anthocyanin consumers (53.06 ± 4.38) compared to lower consumers (50.40 ± 4.38), mean difference (SE) = −2.66 (1.10), p = 0.01, meaning participants with higher intake of dietary anthocyanin were able to point at 2.7 more real words than low consumers. Dietary consumption of anthocyanin in older adults with MIS is associated with beneficial effects on depressive scores and the ability to retrieve words. Further research is warranted to identify optimal dosage for recommended intake. This cross-sectional study used baseline data from a randomised controlled trial registered with the Australian New Zealand Clinical Trials Registry (ANZCTR):12622000065796.

Despite high UVB radiation from the sun in Australia (the primary source of vitamin D), vitamin D deficiency (serum 25-hydroxyvitamin D concentrations [25(OH)D] <50 nmol/L) is prevalent among Aboriginal and Torres Strait Islander peoples (27% of adults nationally; 39% of adults living in remote areas)(1). Vitamin D deficiency affects musculoskeletal health and may be associated with non-communicable diseases, such as type 2 diabetes and cardiovascular diseases, prevalent in Aboriginal and Torres Strait Islander peoples.(2, 3) Alternative to UVB radiation, vitamin D can also be obtained from foods (e.g., fish, eggs, and meat) and supplements. However, vitamin D intake in Aboriginal and Torres Strait Islander peoples is currently unknown. Hence, we aimed to provide the first estimate of absolute vitamin D intake in Aboriginal and Torres Strait Islander peoples. We used food consumption data from the 2012-2013 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey and vitamin D food composition data for vitamin D3, 25(OH)D3, vitamin D2, and 25(OH)D2. Absolute vitamin D intake was estimated by sex and remote and non-remote areas using bioactivity factors (BF) of 1 and 5 for 25(OH)D, which may be up to five times more bioactive than vitamin D. The estimated average requirement for vitamin D intake recommended by the Institute of Medicine is 10 μg/day(4). The estimated absolute vitamin D intake from food and beverages was low for Aboriginal and Torres Strait Islander peoples. The mean estimated absolute vitamin D intake of Aboriginal and Torres Strait Islander peoples was 2.9 μg/day and 5.3 μg/day for BF 1 and 5, respectively. Males had a higher mean intake (3.2 μg/day, BF 1 and 5.9 μg/day, BF 5) than females (2.6 μg/day, BF 1 and 4.7 μg/day, BF 5). Vitamin D intake was 2.9 μg/day (BF 1) and 5.2 μg/day (BF 5) in non-remote and 2.8 μg/day (BF 1) and 5.4 μg/day (BF 5) in remote areas. The high prevalence of vitamin D deficiency and low vitamin D intake highlights a need to promote vitamin D sufficiency through public health policies. The results from this study can be used to model food fortification strategies to provide evidence for the development of nutrition policies to improve the vitamin D status of the Aboriginal and Torres Strait Islander population.

Osteoporosis is a degenerative disease of the bone. The rate of bone loss is accelerated during the first postmenopausal years in women which results in their disproportionate prevalence of osteoporosis(2). Some of the factors contributing to the development and maintenance of bone mineral density (BMD) relate to diet, particularly the intake of protein, calcium and other micronutrients that play a crucial role in bone composition(3). The most common method of measuring BMD is dual-energy X-ray absorptiometry (DXA) which generates a two-dimensional image of the scan site (typically spine, hip and/or forearm) to determine areal BMD (aBMD). However, new methods have recently emerged, including High Resolution peripheral Quantitative Computed Tomography (HRpQCT), that offer more accurate three-dimensional measurements of volumetric BMD (vBMD) and microstructure of distal tibia and radius(4). The aim of this study was to examine the differences in the dietary intake of nutrients that represent organic or inorganic components of the bone, in early postmenopausal women with different spine aBMD and tibia and radius vBMD levels. One hundred and fourteen healthy early postmenopausal women with a lumbar spine or total hip BMD T score > −2.5 (measured by DXA) were recruited as part of a larger interventional study. Dietary intake was recorded using a 297-point self-reported validated food frequency questionnaire(5) for assessing the intake of energy, macro and micronutrients. Physical activity was self-reported using the validated Active Australia Questionnaire. Years since menopause were self-reported. DXA and HRpQCT scans measured L1-L4 spine, proximal femur aBMD, and distal tibia and radius vBMD respectively. Non-parametric statistical tests examined differences in dietary intake and physical activity levels between women at different levels of aBMD and vBMD. Data reported as median and interquartile ranges. There were no significant differences observed in the total sample between tertiles of aBMD and vBMD, regarding nutrient intake. However, for women with less than 3 years since menopause (i.e., the time-period of accelerated bone loss), lower dietary intakes of energy [8,658(3,324) vs 10,068(3,688) kJ/day; p = 0.047], protein [94(29) vs 103(32) g/day; (p = 0.044)], sodium [1,927(992) vs 2,625(2,185) mg/d; (p = 0.044)], potassium [4,064(1,373) vs 5,121(2,377) mg/d; (p = 0.041)], calcium [969(325) vs 1,214(652) mg/d; (p = 0.028)] and zinc [10(3) vs 12(4) mg/d; (p = 0.005)] were observed for women with osteopenia (−1< L1-L4 aBMD T-score <2.5) compared to those with normal L1-L4 aBMD (i.e., T-score > −1). No significant differences were observed for women with more than 3 years since menopause, with the only exception of alcohol intake (p = 0.033), which was found to be lower in women with osteopenia compared to those with normal aBMD. These findings highlight the importance of targeting osteopenic women within the first 3 years following menopause as candidates for tailored dietary intervention programs for preventing osteoporosis.

Consumption of 300 mg of a New Zealand berry extract containing 105 mg anthocyanins for 7 days has been shown to increase running distance during repeated sprints to exhaustion(1). The supplemented group also displayed higher blood lactate concentration over the first thirty minutes of recovery time(1). However, there is limited research available on the acute effects of berry-derived anthocyanins on sports performance. We aimed to evaluate the effect of a single dose of 12 g of a New Zealand berry anthocyanin-enriched powder (NZBP) supplement containing 120 mg of anthocyanins on sprint performance in a randomised controlled crossover trial using the modified Loughborough Intermittent Shuttle Test (m-LIST). The m-LIST protocol consisted of 6 x 15-min blocks divided into four blocks of “prescribed-pace” activity (blocks 1 - 4) (participants exercise based on audible signals) followed by two blocks of “self-paced” (blocks 5, 6) running (no audible signals) with a 3-min rest period between each block. Each block consisted of repeated sequences of 3x20 m walks at 5.4 km/h, 1x15 m sprint, 3x20 m run and 3x20 m jog. Fourteen recreationally active males (mean ± SD age: 29.53 ± 9.35 years, height: 170.84 ± 24.13 cm, weight: 76.24 ± 8.26 kg, V˙O2max: 46.64 ± 4.40 mL∙kg-1∙min-1) participated in three indoor sessions. The first session focused on a multistage fitness test (beep test) to determine V˙O2max and the run and jog prescribed speeds for blocks 1 to 4. For the main trial visits (minimum 7-day wash-out period in between), participants consumed a body weight adjusted standardised dinner (lasagna, garlic bread, banana, and salad greens) and arrived at the laboratory fasted the next morning (between 6-7:30 am). They then consumed the study supplement (NZBP supplement or placebo mixed with 100 ml water) along with the standardised breakfast (100 g yogurt, 50 g granola, and 30 ml milk). One hour after breakfast the participants undertook a 10-min standardised warm-up, followed by the m-LIST protocol. No significant differences (two-way repeated measures ANOVA; p = 0.286) were found in average sprint speed from blocks 1 to 6 within or between NZBP and placebo groups. No effect of supplementation and no interaction effect was observed for sprint distance, sprint time, heart rate, reaction time, movement, or blood lactate concentration. The observed changes induced by repeated sprints on ratings of feeling scale, felt arousal scale, and perceived exertion (p = <0.001, all) were also not affected by supplementation (p = 0.679, p = 0.288, p = 0.327 respectively). Thus, an acute dose of NZBP containing 120 mg anthocyanins under the conditions reported here did not improve repeated sprint performance in recreationally active males.

The complementary feeding period (6-23 months of age) is when solid foods are introduced alongside breastmilk or infant formula and is the most significant dietary change a person will experience. The introduction of complementary foods is important to meet changing nutritional requirements(1). Despite the rising Asian population in New Zealand, and the importance of nutrition during the complementary feeding period, there is currently no research on Asian New Zealand (NZ) infants’ micronutrient intakes from complementary foods. Complementary foods are a more easily modifiable component of the diet than breastmilk or other infant milk intake. This study aimed to compare the dietary intake of micronutrients from complementary foods of Asian infants and non-Asian infants in NZ. This study reported a secondary analysis of the First Foods New Zealand cross-sectional study of infants (aged 7.0-9.9 months) in Dunedin and Auckland. 24-hour recall data were analysed using FoodFiles 10 software with the NZ food composition database FOODfiles 2018, and additional data for commercial complementary foods(2). The multiple source method was used to estimate usual dietary intake. Ethnicity was collected from the main questionnaire of the study, answered by the respondents (the infant’s parent/caregiver). Within the Asian NZ group, three Asian subgroups were identified – South East Asian, East Asian, and South Asian. The non-Asian group included all remaining participants of non-Asian ethnicities. Most nutrient reference values (NRV’s)(3) available for the 7-12 month age group are for total intake from complementary foods and infant milks, so the adequacy for the micronutrient intakes from complementary foods alone could not be determined. Vitamin A was the only micronutrient investigated in this analysis that had an NRV available from complementary foods only, allowing conclusions around adequacy to be made. The Asian NZ group (n = 99) had lower mean group intakes than the non-Asian group (n = 526) for vitamin A (274µg vs. 329µg), and vitamin B12 (0.49µg vs. 0.65µg), and similar intakes for vitamin C (27.8mg vs. 28.5mg), and zinc (1.7mg vs. 1.9mg). Mean group iron intakes were the same for both groups (3.0mg). The AI for vitamin A from complementary foods (244µg) was exceeded by the mean intakes for both groups, suggesting that Vitamin A intakes were adequate. The complementary feeding period is a critical time for obtaining nutrients essential for development and growth. The results from this study indicate that Asian NZ infants have lower intakes of two of the micronutrients of interest than the non-Asian infants in NZ. However, future research is needed with the inclusion of infant milk intake in these groups to understand the total intake of the micronutrients. Vitamin A intakes do appear to be adequate in NZ infants.

The prevalence of food allergies in New Zealand infants is unknown; however, it is thought to be similar to Australia, where the prevalence is over 10% of 1-year-olds(1). Current New Zealand recommendations for reducing the risk of food allergies are to: offer all infants major food allergens (age appropriate texture) at the start of complementary feeding (around 6 months); ensure major allergens are given to all infants before 1 year; once a major allergen is tolerated, maintain tolerance by regularly (approximately twice a week) offering the allergen food; and continue breastfeeding while introducing complementary foods(2). To our knowledge, there is no research investigating whether parents follow these recommendations. Therefore, this study aimed to explore parental offering of major food allergens to infants during complementary feeding and parental-reported food allergies. The cross-sectional study included 625 parent-infant dyads from the multi-centred (Auckland and Dunedin) First Foods New Zealand study. Infants were 7-10 months of age and participants were recruited in 2020-2022. This secondary analysis included the use of a study questionnaire and 24-hour diet recall data. The questionnaire included determining whether the infant was currently breastfed, whether major food allergens were offered to the infant, whether parents intended to avoid any foods during the first year of life, whether the infant had any known food allergies, and if so, how they were diagnosed. For assessing consumers of major food allergens, 24-hour diet recall data was used (2 days per infant). The questionnaire was used to determine that all major food allergens were offered to 17% of infants aged 9-10 months. On the diet recall days, dairy (94.4%) and wheat (91.2%) were the most common major food allergens consumed. Breastfed infants (n = 414) were more likely to consume sesame than non-breastfed infants (n = 211) (48.8% vs 33.7%, p≤0.001). Overall, 12.6% of infants had a parental-reported food allergy, with egg allergy being the most common (45.6% of the parents who reported a food allergy). A symptomatic response after exposure was the most common diagnostic tool. In conclusion, only 17% of infants were offered all major food allergens by 9-10 months of age. More guidance may be required to ensure current recommendations are followed and that all major food allergens are introduced by 1 year of age. These results provide critical insight into parents’ current practices, which is essential in determining whether more targeted advice regarding allergy prevention and diagnosis is required.

Hospital placement is essential training for medical interns, involving shift work and high-pressure environments. This can increase physiological and psychological stress, which may be mediated by metabolites of microbial digestion(1). Nutrients of interest include those accessible to microbial digestion and associated with altered signalling within the microbiota-gut-brain axis (MGBA)(1). Fibre is fermented by gut microbes to produce short-chain fatty acids(2) and is associated with improved psychological outcomes(3). Tryptophan, a precursor to gut-derived serotonin(2), has been negatively associated with anxiety(4). Processed foods contain food additives, excess sugars, and saturated fats that may disrupt gut homeostasis(1) and impact psychological well-being(4). Lastly, total energy intake may determine the level of substrate available for microbial fermentation(2). Therefore, this research explores how microbiota-accessible food components interact with physical and psychological well-being in a cohort of medical interns undertaking their first-year of hospital placement. Participants were healthy medical interns, during first-year hospital placement (n = 21) from the Hunter New England Local Health District, NSW, Australia. Participants completed diet and wellbeing surveys at baseline and every 2 months over a 10-month period. 24-hour diet diaries were self-recorded from participants using a mobile application (Easy Diet Diary) and analysed using AusNut and the NOVA classification system of ultra-processed foods (ULP). Wellbeing surveys include depression, anxiety, stress scale (DASS), and PROMIS survey for mental (M), physical (P), and sleep well-being. Current data represents an ‘in-progress’ of the longitudinal data collection. This study utilised Spearman correlation and Tukey’s post hoc test for mixed methods analysis. From baseline to timepoint 3 (T3, 4 months) daily energy intake was consistent with cohort estimated energy requirements (EER). However, consumption ranged from 37% to 167% of EER, indicating a large variation of intakes. Energy consumed from ULP ranged from 30% to 34% (p = 0.6875). Baseline tryptophan intake (x¯ = 1139mg) was within the suggested target, whilst fibre intake (x¯ = 23g) was below the recommended intake. Neither saw significant changes from baseline to T3. Fibre intake was positively correlated with mental and physical well-being at baseline (x¯ = 23.1g, M: r = 0.474, p = 0.04, P: r = 0.608, p = 0.007), and timepoint 2 (x¯ = 31.5g, M: r = 0.647,p = 0.026, P: r = 0.780, p = 0.004) but not at T3. In addition, baseline consumption of sugar (x¯ = 18g) and poly-unsaturated fats (x¯ = 15g) were both negatively correlated with mental and physical well-being. Overall, no significant dietary changes were evident from baseline to mid-year collection in a first-year medical intern cohort during hospital placements. Fibre was significantly associated with mental and physical well-being, building on current understanding of fibre’s role in the MGBA. Planned metabolite analysis will explore the mechanisms of proposed microbiome-accessible nutrients alongside diet, well-being, and microbiota data. Findings from this study will identify how diet-microbiome interactions change under stress, with wider positive implications on intense workplace environments with the aim to preserve individual wellbeing.

Intake of free sugars is associated with a risk of non-communicable diseases including dental caries, and authoritative organisations recommend limiting intake to <5% energy intake (E) or lower (1, 2). National surveys of schoolchildren in India indicate the prevalence of obesity is rising >10%/year(3) and that 52.5% of young adolescents are affected with dental caries(4), yet, there is a dearth of data on dietary intake of sugars by this population. The objective of this research was to assess the intake of total and free sugars, and the contribution of food sources to free sugars intake, in a random sample of 11–13-year-old schoolchildren in Delhi, India. The study was approved by The University of Adelaide Human Research Ethics Committee and the Independent Ethics Committee of the Centre for Chronic Disease Control, New Delhi. The target sample size of 360 was based on a ± 5% margin of error in estimated sugars intake. A statistician external to the research team generated a random sample of 150 schools stratified by district (n = 11). Schools were recruited in turn from the list until 10 schools had consented. Teachers shared study information with parents who were invited to complete an online consent form. Child assent was obtained before data collection. Participants recorded all food and drink consumed over three consecutive days, including one weekend day, in a food diary. The information recorded was entered into an online dietary assessment tool, Intake24 (Southeast Asia version), during an interview with each participant during which portion size was ascertained with reference to the database of over 2400 food photographs of more than 100 foods. The Intake24 database converted food and drink reported into the intake of total and free sugars through integrated food compositional tables. Of 514 pupils providing consent, 393 participants (76.5%) (169 girls, 224 boys) completed the study. In girls, the median (IQR) daily intakes of total and free sugars were 95.0 (70.1-120.2) g/day and 43.0 (28.1-68.5) g/day respectively. The corresponding values in boys were significantly higher at 104.0 (80.2-138.7) g/day and 53.1 (34.1-76.5) g/day (p = 0.004). No between-gender difference was observed in the median percent contribution of sugars to E: total and free sugars contributed 14.9% (IQR 11.4-18.1%) and 7.1% (IQR 4.8-10.1%) respectively. The percent contribution of the main sources of sugars to free sugars intake were: (i) Sugars Preserves and Syrups (31.2% (IQR. 9.6-51.7%)); (ii) Cakes and Biscuits (13.7% (IQR 0-26.4%)); (iii) Desserts (5.4% (0-17.5%)) and (iv) Sugar-Sweetened Beverages and Juices (2.1% (IQR 0-15.7%)). In conclusion, in this sample of 11-13-year-old schoolchildren from Delhi, free sugars intake was above the WHO <5% E threshold. Forms of sugars that are added to foods by the consumer made the largest contribution to intake.

Acute Appendicitis (AA) is an inflammatory condition of the vermiform appendix in the caecum of the colon. Genetic polymorphisms have been suggested as risk factors predisposing to AA susceptibility but have remained relatively unknown, due to insufficient sample size in previous analyses. Therefore, the primary research aim was to identify genetic variants associated with AA. It was hypothesised that gene polymorphisms associated with AA will provide a connection to other diet-related inflammatory diseases. Genetic variants associated with AA were studied via a Genome-Wide Association Scan (GWAS) using the Global Biobank Meta-Analysis Initiative (GBMI). The GBMI is a collaborative consortium of 23 biobanks with a publicly released repository of de-identified genetic data linked with digital health records spanning 4 continents with a study population size of over 2.2 million consented individuals of multiple ancestral backgrounds1. A linear regression model was used to estimate the association between single nucleotide polymorphisms (SNPs), across the human genome, and AA by each contributing biobank. The results were then meta-analysed with a total of 32,706 cases and 1,075,763 controls. In the present study, the free open-source Complex Traits Genetic Virtual Lab (CTG-VL) platform was used to access, analyse, and visualise the GWAS summary statistics of AA2. Genome-wide significantly associated SNPs (p-value < 5 x 10-8) were further searched for their associations with health-related traits in publicly available GWAS summary statistics. Upon analysis, significantly associated SNPs for AA were identified within or nearby nine genes. HLX, NKX2-3, LTBR, and DLEU1 are genes involved in immune responses; IRF8 associated with maturation of myeloid cells; OSR-1 responsible for transmembrane ion transporter activity; NCALD a regulator of G protein-coupled signal transduction. In addition, based on the hypothesis, the SNP of key clinical importance was the HLA-C rs2524046 (p-value = 2.38 x 10-8), with the AA risk-increasing allele C being also strongly associated with a higher risk of coeliac disease (CD). The CD is an autoimmune condition where gluten, a protein present in grains such as barley, rye, and wheat, elicits an inflammatory response that results in damage to the small intestine lining. Considering how both AA and CD share the same SNP, it is possible to speculate whether gluten initiates a similar pathophysiological mechanism that exacerbates inflammation in the vermiform appendix in AA. In conclusion, the top AA associated SNPs suggests its development could be due to immunological responses influenced by dietary nutrient intake. The HLA-C SNP is common to AA and CD, suggesting that the gluten protein found in certain cereal grains possibly contributes to the pathophysiology of AA like CD. This warrants further investigations into whether dietary gluten could play a key role in AA development.

With continuing population growth and increased urbanisation, the prevalence of apartment living will also increase. The food practices and diet of apartment residents may differ to those in lower density, detached or semi-detached housing. Food practices may be impacted by physical constraints of apartment kitchens (size, storage, cooking facilities) and the influence of the surrounding community food environment, particularly in smaller apartments. High-rise apartment residents spend a larger proportion of their weekly household budget on eating foods prepared out of the home 1. This is concerning given meals prepared outside the home tend to be of lower diet quality 2 and are associated with higher body weight 3. This study investigated how kitchens, residents’ food practices and hypothesised barriers to healthy eating were portrayed on popular TikTok videos associated with hashtags denoting small apartments. Using the keyword ‘microapartment’, the top four most viewed hashtags relevant to the topic were identified: #studioapartment (190.5 million views), #smallapartment (152.5 million views), #tinyapartment (62 million views), and #microapartment/ #microapartments (4.9 million views combined). The most liked videos (n = 50) from each of these four hashtags and #apartment (as a comparator) were selected for investigation. Using a REDCap survey, two researchers independently coded a random sample of 15 videos, with comparison and discussion to tighten codebook definitions and reduce ambiguity. Subsequently over half of all videos were coded by at least two researchers, achieving acceptable inter-rater reliability (Cohen’s kappa >0.8). Each video was coded for engagement characteristics, user profile, and characteristics of individuals appearing. Further coding included apartment size, kitchen features displayed or mentioned, and food practices (grocery shopping, cooking at home, and eating foods prepared out of the home). Videos were categorised as having positive sentiment if they depicted the apartment in an explicitly positive way, including promoting or encouraging an aspect of apartment living or indicating support for a behaviour. Conversely, videos were coded as being of negative sentiment where they depicted a clear negative position on an aspect of apartment living. Else, the video was coded as neutral sentiment. The majority of videos (87%) portrayed apartment living with a positive or neutral sentiment; with only 2% of videos portraying kitchen size or function negatively. The expected physical constraints of small apartment kitchens were not evident in the videos, nor were interactions with the food environment surrounding the apartment. Indeed, in the small number of videos portraying the food practices of cooking, shopping and eating, the videos highlighted the ability to undertake these practices despite limitations of size and facilities. As the food practices of residents of small apartments are not well researched, it is not known whether their portrayal on TikTok may indeed reflect reality, or may be a glamorisation.

The eight well-known food security indicators were developed in 1997 using a stepwise process that involved five focus group interviews (one Māori, one Pakeha, two Pacific, and one mixed ethnicity) of 8-16 people, all of whom were either on a low income or were government beneficiaries(1). As part of the development of the tools and methods for a future New Zealand National Nutrition Survey, these eight indicators were considered for inclusion. The Māori and Technical Advisory Groups convened for the development of the National Nutrition Survey foresaw issues with the interpretation of some of the questions given the changes in the food environment and sources of food assistance in the last 25 years and recommended that cognitive testing should be conducted to see if changes were required. Participants were recruited through two community organisations, a local marae, and community Facebook pages. Participants were given the option of participating in a one-on-one interview or as part of a focus group. During each session, participants were asked five (three original and two new) questions relating to food security (running out of basics, use of food assistance, household food preparation and storage resources). After each question, the participants were asked a series of additional probing questions to ascertain whether they had interpreted the question as intended. All interviews were audio recorded and transcribed, and a qualitative analysis was performed on the transcripts to determine areas of concern with each question. A total of 46 participants completed the cognitive testing of the food security questions, including 26 aged 18-64 years, and 20 aged 65+ years. Participants also spanned a range of ethnicities including 8 Māori, 15 Pasifika, 15 Asian, and 8 New Zealand European or Other. Just over half of the participants (n=24) reported themselves to be financially secure, 16 participants reported that their financial security was borderline, 1 participant reported that they were not at all financially secure, and 5 participants declined to answer. Variable interpretations of terms by participants were found in all questions that were tested. Therefore, answers to the food security questions may have not reflected the actual experience of participants. This study also identified other dimensions of food security not assessed by the current eight indicators (e.g., lack of time, poor accessibility). These findings indicate that the food security questions need to be improved to ensure they are interpreted as intended and that new questions are needed that considers all dimensions of food insecurity (i.e., access, availability, utilisation, and stability). These new and amended questions should be cognitively tested in groups that are more likely to be experiencing food insecurity.

Food environments around secondary schools are a strong influence on adolescents’ food purchasing habits1. We conducted a repeat cross-sectional study using Google Street View to examine school food environments in regional and metropolitan NSW, Australia over 17-years. Findings showed that unhealthful food outlets such as fast-food franchises, consistently dominated school food environments over 2007-2023. Increasing levels of poor nutrition among youth has been raised as a concern2 by the Health Advisory Panel for Youth at the University of Sydney [HAPYUS] - an established group of 16 adolescents aged 13-18 years residing in NSW3. To gain further insight into the study findings and how it may impact adolescents’ health, it is critical to include voices of adolescents in this research. The aim of this sub-study was to engage with members of our youth advisory group and conduct a consultation exercise on these study findings, drawing upon their lived experiences of school food environments. In Aug-2023, we engaged four youth advisors from HAPYUS. Study authors provided an overview of the study and its findings to the youth advisors via a Zoom call. Youth advisors formulated a 500-word statement on their perspectives and lived experiences of food environments surrounding their high schools over the subsequent 4 weeks. Adolescents agreed that physical proximity to unhealthy food outlets around schools was a key contributor to unhealthy eating habits however also recognised social and economic factors which play a significant role in shaping poor diets. The following quotes from their combined statement reflect social and economic concerns: i) “[We] observed on a daily basis young people were opting to travel to the closest food court for fast food, or in some extreme cases, even order fast food via a meal delivery app, to be delivered to the school - as opposed to choosing the closest outlet” ii) “Overpriced foods in schools with some drinks costing 2x more than a heavily discounted KFC meal, no meaningful difference between foods sold at canteens and those sold at fast food outlets - heavily processed, packaged snacks, pre-made reheated foods” iii) “Most unhealthy food outlets choose a location that is not only close to schools but also close to major shopping centres and food courts… ideal for an after-school social catchup as it appears to accommodate the needs of a large group of people.” Consultation findings revealed the importance of social and economic factors that must be analysed in addition to adolescents’ physical proximity to food outlets around their schools. Youth advisors call for governments to take immediate action to implement policies that ensure schools have cheap and healthy foods at canteens to mitigate against the purchase of foods from nearby unhealthy food outlets.

Nutrition transitions are key contributors to the obesity epidemic plaguing South Pacific Island countries (SPIC). Prior to European contact and colonisation, traditional Pacifica diets consisted mainly of root crops, indigenous fruits and vegetables, freshwater proteins and seafood(1). This diet has been replaced by diets high in processed foods which are high in salt, sugar and unhealthy fats(2). Various political, economic, environmental and socio-cultural factors have been associated with the proliferation of unhealthy foods in Pacifica diets. However, very few studies have examined how these changes have impacted individual food choices. This study aims to address the gap in the knowledge of food choice motives of Pacific Islanders. An online qualitative survey was used(1) to explore how the nine food choice motives in the widely used Food Choice Questionnaire (FCQ)(3) impact food choice and (2) to identify additional food choice motives, not captured in the FCQ. The first section of the survey included open-ended questions which explored the top three food choice motives of the participants. This section was followed by a series of open-ended questions exploring participant’s views on the nine food choice motives from the FCQ. The last part of the survey asked participants to identify any other food choice motives which were not already identified in the survey. An exploratory qualitative approach, employing inductive and deductive thematic analyses, was used to analyse results(4). The sample (N = 105) was predominantly female (73%), living with family (72%) and the average age was 22.06 years (S.D = 5.0). It consisted of 28% indigenous Fijians, 26% Fijians of Indian descent, 15% Solomon Islanders, 13% I-Kiribati and smaller percentages of students from Niue (3%), Samoa (5%), Tonga (5%) and Vanuatu (5%). Of the nine FCQ motives, the most commonly identified top three food choice motives included price (n = 54), health (n = 45), and sensory appeal, especially taste (n = 40). Participants also identified three new food choice motives which many ranked in their top three motives: satiety concerns (n = 22), food quality and hygiene when eating out (n = 26) and religious or cultural food restrictions (n = 11). Additionally, issues with face validity of the health, convenience, price, weight control and familiarity food choice motives from the FCQ were identified. These findings highlight the importance of validity studies prior to using FCQ, and more broadly other similar instruments, with understudied populations like that of SPIC. The findings also provided important insights into the food choice motives of Pacific Islanders and can inform public health interventions for encouraging healthy eating. Further research using an adapted FCQ with larger and diverse samples will increase its effectiveness of measuring food choice motives in the region.

Plant-based milk import has been increasing in the Fijis supermarkets. While this milk may cater for vegans(1) and people with allergies from dairy milk, the question always remains that if the plant-based milk are equally nutritious and available at reasonable price in comparison to the dairy milk. Dairy milk is commonly consumed by the Fijian population while the plant-based milk is positioning itself into the market as alternatives. Therefore, this paper is aimed at comparing the nutrient content and price of milk from dairy cows and plant milk sources available in the supermarkets in Fiji. This study examines different brands of dairy and plant-based milk in 6 major supermarket chains in the central part of Fiji. There was 22 dairy milk, 6 soya milk, 5 almond milk and 4 oat milk sampled from these supermarkets. The median value of milk nutrient composition and price for dairy milks and different plant-based milks were calculated as the data was not normally distributed. The Kruskal- Wallis test was conducted to further analyse the difference between the nutrient composition and price of dairy milks and plant-based milk. The energy composition in the dairy milk was significantly higher (p < 0.01) when compared with plant-based milks soya almond milk and oat. There was a significant difference (p < 0.01) in dairy milk protein, fat and saturated fat when compared to plant-based milks. The result indicated that the protein, fat, and saturated fat are both significantly higher in cow’s milk. Milk carbohydrate analysis indicate higher composition in dairy milk therefore a significant difference (p < 0.01) was noted when compared to almond milk(except soya and oat milk). There is a significant difference (p < 0.01) in sugar indicating cow’s milk having higher sugar when compared to plant-based milk (except soya milk The sodium composition in the dairy milk and all the plant- based milk showed no significance difference (p > 0.05) in the composition. There was also significant difference (p < 0.05) in comparison of calcium composition of dairy milk and plant-based milk indicating almond milk with lower calcium. The phosphorus composition in dairy milk and plant-based milk indicates that there is a strong significant difference (p < 0.01) (except soya and oat milk). The riboflavin composition was significantly higher (p < 0.01) in dairy milk compared to soya and oat milk. Lastly, there was significant difference (p < 0.01) between price of dairy milk when compared to plant-based milk. The study concludes that there is more nutrient in dairy milk and the price is significantly lower than plant-based milk at which these nutrients are available in dairy milk.

The diagnosis of functional constipation (FC) relies on patient-reported outcomes evaluated as criteria based on the clustering of symptoms. Although the ROME IV criteria for FC diagnosis is relevant for a multicultural population(1), how an individual’s lifestyle, environment and culture may influence the pathophysiology of FC remains a gap in our knowledge. Building on insights into mechanisms underpinning disorders of gut-brain interactions (formerly functional gastrointestinal disorders) in the COMFORT Cohort(2), this study aimed to investigate the differences in gastrointestinal (GI) symptom scores among participants with FC in comparison to healthy controls between Chinese and non-Chinese New Zealanders. The Gastrointestinal Understanding of Functional Constipation In an Urban Chinese and Urban non-Chinese New Zealander Cohort (GUTFIT) study was a longitudinal cohort study, which aimed to determine a comprehensive profile of characteristics and biological markers of FC between Chinese and non-Chinese New Zealanders. Chinese (classified according to maternal and paternal ethnicity) or non-Chinese (mixed ethnicities) adults living in Auckland classified as with or without FC based on ROME IV were enrolled. Monthly assessment (for 3 months) of GI symptoms, anthropometry, quality of life, diet, and biological samples were assessed monthly over March to June 2023. Demographics were obtained through a self-reported questionnaires and GI symptoms were assessed using the Gastrointestinal Symptom Rating Scale (GSRS) and Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS). This analysis is a cross-sectional assessment of patient-reported outcomes of GI symptoms. Of 78 enrolled participants, 66 completed the study (male, n = 10; female, n = 56) and were distributed across: Chinese with FC (Ch-FC; n = 11), Chinese control (Ch-CON; n = 19), non-Chinese with FC (NCh-FC; n = 16), non-Chinese control (NCh-CON; n = 20). Mean (SD) age, body mass index, and waist circumference were 40 ± 9 years, 22.7 ± 2.5 kg/m2, and 78.0 ± 7.6 cm, respectively. Ethnicity did not impact SAGIS domain scores for GI symptoms (Ethnicity x FC severity interaction p>0.05). Yet, the constipation symptoms domain of the GSRS was scored differently depending on ethnicity and FC status (Ethnicity x FC interaction p<0.05). In post hoc comparison, NCh-FC tended to have higher GSRS constipation severity scores than Ch-FC (3.4 ± 1.0 versus 3.8 ± 0.8 /8, p<0.1) Although constipation symptom severity tended to be higher in NCh-FC, on the whole, ethnicity did not explain variation in this cohort. FC status was a more important predictor of GI symptoms scores. Future research will assess differences in symptom burden to explore ethnicity-specific characteristics of FC.