The importance of dietary fibre consumption for health is widely recognised. However, there is a clear ‘fibre gap’ between actual and recommended fibre consumption(1,2). In the UK, average fibre intake is 18g(1). Fibre intake increases in relation to income, with fibre consumption particularly low in low-income households(3). The absence of a UK reference intake value for dietary fibre means nutrition and health claims are a key route for food manufacturers to promote dietary fibre to consumers(4). The aim of this study was to examine the relationship between perception of valence and understanding of approved fibre related nutrition and health claims, and marketing messages, and the intention to purchase products displaying these claims or messages.

An online survey was used to examine perception of valence and understanding of fibre-related nutrition and health claims, and any effects these claims, and other marketing messages related to fibre have on intention to purchase products, amongst the general population and individuals on a lower income in the UK. Data was collected from 560 respondents, with 84 classified as lowincome, based on an annual household income of below £17,100(5). Chi-squared tests were performed to examine associations, with post-hoc tests applied as appropriate.

Perception of valence was found to be significantly associated with intent to purchase for all the health and nutrition claims that were tested (p<0.001), such that participants who perceived a claim or term to be positive, were more likely to report that they would purchase a product displaying the claim. Three of the eight nutrition claims that were tested demonstrated a significant association between understanding and perception of valence (p<0.01), with only two demonstrating a significant association between understanding and intent to purchase (p<0.05). All four of the health messages that were tested demonstrated a significant association between perception of valence and intent to purchase (p<0.001), three demonstrated a significant association between understanding/interpretation and perception of valence (p<0.01), and two demonstrated a significant association between understanding/interpretation and intent to purchase (p<0.05). Thus, for many of the health claims and some health messages that were tested, there was no evidence to suggest that participants who understood the meaning of the claims would be more likely to perceive them positively or be more inclined to purchase a product displaying the claim or message.

Regardless of consumer understanding, claims must be perceived positively to significantly impact intent to purchase, so effort must be made to promote positive attitudes towards dietary fibre, and its associated health benefits. The wording of some claims may not be conducive to positive perceptions of dietary fibre.

Low- and middle-income countries (LMICs) experience a shifting nutrition landscape marked by rising overweight and obesity alongside persistent undernutrition. This new nutrition reality results in a double burden of malnutrition (DBM) (1). DBM is classified as the coexistence of overweight and obesity alongside undernutrition and micronutrient deficiencies, at all levels of the population. To address DBM, a set of recommended nutrition actions called double duty action (DDA) was publish by the World Health Organization (2) and Hawkes et al., (3). DDAs aims to lift the siloed view of malnutrition. For example, health services such as breastfeeding counselling is a DDA as breastfeeding prevents undernutrition and reduces the risk of overweight and obesity later in life. However, LMICs health programmes often prioritize undernutrition, hindering comprehensive DBM management (1). This scoping review aim to map existing LMICs’ health systems policy on the narrative of DBM and the implementation of DDAs to identify gaps and opportunities to tackle the DBM.

Arksey and O’Malley’s framework (4), with recommendations from Levac, Colquhoun, and O’Brien (5) was used. Countries were selected based on the 2022 World Bank criteria for LMICs (n=102).

Policy documents were extracted from WHO’s Global database on Nutrition Action Implementation (6) between June 16th and September 2nd, 2023. Exclusion criteria included policies predating 2011, lacking English translations, and countries facing significant domestic challenges.

To identify relevant text key search terms were based WHO DBM narrative (7) and DDAs characteristics were based on Hawkes et al., framework (3). When identified a full-text review of the relevant sections captured the narrative and extracted into an excel-sheet using a rubric format divided by country, policy title, and themes based on DBM narrative and DDAs characteristics.

This study included 51 countries (21 Southeast Asia, 19 Sub-Saharan Africa, 7 South Asia, and 4 Latin America and the Caribbean). Ninety-eight policy documents were identified and analysed. The majority focused on non-communicable disease prevention, national nutrition strategies, and health sector plans. Thirteen countries explicitly acknowledged DBM. Miscommunication or mistranslation were found as barriers to DBM narrative in six countries. Majority of the countries (54.9%) had a mismatch on the use of malnutrition definitions mainly focusing on undernutrition issues. If obesity was mentioned, the narrative was separated. Tanzania had incorporated the DDA framework into its policies. Regarding relevant DDA health system characteristics, 42 countries acknowledged breastfeeding, 29 nutrition in antenatal care, 28 complementary feeding, 21 growth monitoring, and 15 supplementation programmes.

Differential global efforts are needed to enhance advocacy, clarify definitions, and improve understanding of DBM and DDA narrative for health workers. Clearer terminology, DDA acknowledgment and consistent communication are crucial. Further research on health workers’ knowledge, attitudes and practice is essential to build capacity for effective DDA implementation.

All four United Kingdom (UK) nations have School Food Standards (SFS) which schools and local authorities must adhere to. Since the Welsh SFS were updated in 2013(1), the UK government has updated its healthy eating guidelines according to advice from the Scientific Advisory Committee on Nutrition (SACN)(2). The Welsh government is committed to revising their SFS to reflect the most up-to-date scientific evidence for nutrients and food. This study aimed to quantitatively and qualitatively content analyse (CA) school food provision (i.e., menus and/or price lists) pan-Wales to determine the extent to which it meets the latest healthy eating government recommendations for school-aged children. Secondly, menu design was thematically analysed (TA) to ascertain the language used and design elements(3).

Menus and/or price lists were collected cross-sectionally for the autumn 2023 term and 79% of the total population was sampled (n = 82/104). Welsh language documentation was translated into English via an online translation website prior to CA. The study protocol received approval from the Cardiff Metropolitan University School of Sport and Health Sciences ethics committee. The researchers developed an assessment tool inclusive of healthiness criteria based on SACN guidelines as well as the Welsh SFS and used this tool to CA and TA all 82 menus.

Local authority organised primary school food provision was most likely to meet the predetermined healthiness criteria. Most secondary schools lacked fruit-based desserts (64%), red meat (95%) and milk (55%). Moreover, occasionally secondaries exceeded the allotted frequency for processed meat (11%), potatoes cooked in oil (22%) and high in fat, salt and sugar mid-morning snacks (18%). Instances were found where the healthiness criteria, identical to the current Welsh SFS, were not fulfilled. Regarding the TA of menu and/or price lists, four key themes were identified: (i) language, (ii) signalling, (iii) imagery and (iv) design. 12% menus featured the Welsh language. Descriptive language was apparent for cooking methods (‘freshly filled,’ ‘oven-baked’) or to popularise dishes (‘veggie-dawgs,’ ‘meatball wrapstar’). An array of keys and icons were employed to signal non-meat items or nutritionally balanced dishes. Logos, photos and illustrations were evident across most menus, yet the imagery could be seemingly unrelated to the school food provision. In particular, primary school menus were bright and colour was utilised to emphasise different weeks of the menu cycle. Issues around clarity were observed on secondary school price lists which could be overly long and include complex pricing structures.

This study has established the current school food and drink provision pan-Wales and provides policymakers with a baseline from which the SFS may be updated and include a formal monitoring process. Improvement in the amount and clarity of information on menus could also be considered at this stage.

Overweight and obesity rates have reached epidemic proportions and are still escalating. In the domain of childhood obesity prevention and management the school plays a vital role, due to its pedagogical position and exposure(1). The aim of this study was to conduct a systematic review examining the effectiveness, barriers and facilitators in school-based prevention and management interventions on childhood overweight and obesity.

The search criteria were, overweight and obese, 2-19 years old, school-based RCTs, no intervention, and change in overweight and obesity parameters (e.g., prevalence, BMI, waist circumference). Additional eligibility criteria were peer-reviewed articles published in the last 10 years, conducted in Europe, Canada, USA, or Oceania. The selection and data collection process were carried out by two reviewers and disagreements settled by a third. The clinical and statistical heterogeneity of studies lead to an analysis based on themes of recurring methods. The heterogeneity also resulted in that only the direction of the result could be analysed, with results reported as having a positive, negative, or inconclusive effect on the population based on the statistical tests performed. If a secondary obesity parameter showed a different effect direction it was noted as a contradicting result.

Of 8725 unique articles identified, 76 fulfilled the selection criteria. Two dimensions (nutrition and physical activity) with three intended mediators (knowledge, behaviour training, and environment) of interventions were identified.

Thirty-eight studies were conducted in Europe, 32 in North America, and 6 in Oceania. The median age of participants was 10.8 years. The median sex distribution of participants was 50.5%. Seventytwo percent of studies were cluster randomised at school level, and the rest on class or region. Only 22% of studies were blinded and the mean retention rate was 83.1%.

In nutrition, the most common interventions included a teaching component (n = 29), or both a teaching and behaviour component (n = 24). In physical activity, the most common intervention included a behavioural component (n = 33), followed by knowledge only (n = 22) and knowledge and behaviour (n = 18). From the summative analyses performed on the main outcome variable of each intervention, 61% of all intervention arms had a positive effect, ranging from 54% to 70%. Five percent had a negative effect, ranging from 0% to 10%. Of the interventions that had a positive effect 50% displayed contradicting results from other obesity markers, ranging from 6% to 44%. Of single components, environment was most effective for nutrition and least effective for physical activity. Too few studies had negative findings to warrant an analysis. Contradicting results were most frequent for the environmental component of the nutrition dimension.

Interventions targeting physical activity and nutrition can be effective in preventing and managing overweight and obesity. Depending on the intended mediator and number of mediators results may vary.

Children are at increased risk of dehydration(1–3), which can adversely impact cognition and mood(4–6). Many children begin their school day dehydrated and fail to replenish fluids adequately throughout the day(7–11), however, these findings have not been confirmed using objective measures of hydration(12,13). This study aimed to confirm hydration status of primary school-aged children across the school day using objective hydration assessments and to examine if changes in hydration are associated with cognition and mood.

Thirty children (mean age 9.4±0.5 years old, stature 1.4±0.5m, body mass 36.5±4.2kg, and body mass index 18.9±1.7 kg/m2) were recruited from a local primary school. Food and fluid intake were tracked via nutritional analysis of photographs. Urine osmolality (Uosm), serum osmolality (Sosm), urine specific gravity (USG) and self-reported urine colour (Ucol) were assessed at first void (Uosm only) or the start (9:00) and end (16:00) of the school day. Children’s self-reported mood were obtained via Visual Analogue Scales(100mm) (9:00, 10:30, 13:30, 16:00). Children completed cognitive assessments using the Computerised Mental Performance Assessment System (15:3016:00).

Mean total water intake was 759.9±240.7 mL. Children consumed more fluid at mealtimes than from water bottle (Mean Difference (MD) 154.3mL, t(29) =-5.763, p<0.001). From the start to the end of the day, significant increases in Sosm (MD 3.3mOsm/kg, t(21)=4.011, p = 0.002), USG (MD 0.0066, t(29)= 8.514, p = 0.005) and Ucol (MD 1.2, t(26) =15.558, p = <0.001), indicated reduced hydration. The prevalence of dehydration (Sosm >290mOsm/kg USG >1.030) increased from the start (17%) to the end of school (40%). A series of ANOVAs from the start to the end of the day showed feelings of boredom, hunger, tiredness, and thirst increased, and focus, and happiness decreased (p’s <0.05). Hydration measures were significantly associated with long term memory (LTM) (changes in Sosm, r =0.437, p = 0.042) and working memory (WM) (changes in Sosm r =0.462, p = 0.031, and USG, r= 0.403, p = 0.033).

Children were less hydrated at the end of the school day suggesting inadequate fluid replacement during the school hours. Changes in hydration status across the school day were associated with subjective mood states. Furthermore, a decrease in hydration resulted in decreased performance in the memory tasks which could potentially hold implications on school performance. Children in this study had access to water throughout the day, however, most fluids were consumed at breakfast and lunch, suggesting interventions promoting sustained drinking throughout the day are required. For example, measures could be taken to educate parents and school staff on the importance of adequate hydration, and the need to remind children to drink throughout the day. For this to be effective, action needs to be taken across lesson time, meals, and break times.

In the UK, ‘The requirements for School Food Regulations, 2014’ specify the ‘type’ and ‘frequency’ of food and drinks that can be provided across the school day.(1) For example, there should be one or more portions of fruit per day. However, there is no monitoring and pupils can choose from a daily selection. Most studies have focused on pupil’s lunch intake(2,3) and there are limited large-scale UK studies. Whilst interventions are needed in schools to improve pupil’s dietary intake, identifying solutions is challenging. This study uses pupil-level purchase data to capture food and drink choices across the school day to identify potential opportunities for intervention development. One aim was to explore the food and drink purchases of UK secondary school pupils across the school day.

Ethics was obtained from Newcastle University (ref: 2482/26614). DPIA agreements were obtained from schools.

Secondary schools in Northeast England participated. Non-identifiable pupil-level purchase data from a four-week menu cycle were used that included: time, date, individual food and drink item, quantity, cost, and FSM status. Data were encrypted and transferred securely. Data were cleaned and manipulated in excel and Stata V18. Food and drink items were coded to 60 preliminary food and drink groups. Excel and Stata V18 were used for analyses; current analyses are descriptive.

Pupil-level purchase data (n = 3466) from five secondary schools were included. FSM pupils accounted for 29% (n = 1015), Year 7 pupils 25% (n = 848) decreasing to Year 11 pupils 17% (n = 580) of the total sample. The two meal types most pupils purchased were ‘Break & Lunch’ combined (58%, n = 2017; FSM 26% n = 524) and ‘Lunch only’ (20%, n = 659; FSM 41%, n = 268).

At break, the top five purchased items were: bacon/sausage bun (n = 7871; 21%) pizza snack (n = 5714; 15%), bagel/crumpet (n = 3697; 10%), fizzy fruit juice (n = 3344; 9%) and water (n = 3459; 9%). At lunch, the top five purchased items were: meal deal (n = 12,527; 16%), fizzy fruit juice (n = 7,895; 10%), hot meal (n = 6,963; 9%), biscuit (n = 5,803; 8%), and water (n = 5001; 6%). Food and drink purchases at break and lunch were similar by FSM status.

Preliminary findings show most pupils purchase at least one food and/or drink item at both break and lunch. Similar pupil purchasing was found regardless of FSM status. Future interventions need to consider the food and drink choices available at break and lunch. One school had a water only policy, therefore, school context and variation in the food and drink offer may impact findings. More detailed analyses will consider the effect of school, school year, meal type (breakfast, break, lunch) and Free School Meal Status (FSM) on pupil’s food and drink purchases using multi-level logistic regressions.

The diets of children in the UK are suboptimal(1), which may influence their immediate and future health and well-being(2). Schools offer convenient and prolonged access to children from diverse backgrounds, thus interventions within this setting have been suggested as a means to promote diet and health outcomes among this population(3). This study explored the effects of Project Daire(4), a school-based food intervention, on children’s diet diversity and diet quality as well as their attitudes towards health behaviours.

A factorial design cluster randomized controlled trial was conducted. Fifteen primary schools in Northern Ireland were randomized into one of four 6-month intervention arms: Nourish, Engage, Nourish and Engage or Control (Delayed). The Nourish intervention modified the school food environment, provided food-related experiences and increased access to local foods. The Engage intervention included educational activities on nutrition, food and agriculture. Data on food consumption at home, school and/or in total over a 24-hour period were collected using ageappropriate food frequency questionnaires at baseline, with follow-up at 6-months. Diet diversity score (DDS) and diet quality score (DQS) were developed based on adherence to the Eatwell Guide. Additionally, a Health Attitudes and Behaviour measure assessed 10-11 year old children’s attitudes towards importance of various health behaviours at both time points. Linear and logistic regression models were used to examine intervention effects and to account for school clustering.

A total of 445 children aged 6-7 and 458 aged 10-11 years old completed the trial. Results indicated that children aged 10-11 year old who received the Nourish intervention demonstrated higher school DDS (adjusted mean difference=2.79, 95% CI 1.40 – 4.19; p = 0.001) and total DDS (adjusted mean difference=1.55, 95% CI 0.66 – 2.43, p = 0.002) compared to their counterparts who did not. Subgroup analyses revealed that the increases in school DDS among 10-11 year old children in the Nourish group were apparent in both boys and girls (Boys: adjusted mean difference=2.4 95% CI 0.1 – 4.7, p = 0.04; Girls: adjusted mean difference=3.1 95% CI 1.6 – 4.6, p = 0.001). However, the increase in total DDS remained statistically significant only among girls, with an adjusted mean difference of 1.9 (95% CI 1.1-2.7, p<0.001). No statistically significant changes in DQS were detected in either age group. High levels of positive attitudes towards health behaviours were observed at baseline, with no clinically significant effects of either the Nourish or Engage interventions detected during the follow-up period.

The multi-component approach of the Nourish intervention, addressing both food provision and environment, showed promise in promoting diet diversity. Further research is warranted to develop sustainable implementation strategies for Daire, to explore additional intervention components to impact other outcomes, including diet quality, and to evaluate long-term effectiveness.

In Saudi Arabia, adolescent health is suboptimal; among those aged 15-29 years, 79% have insufficient levels of physical activity levels, 30% are living with overweight or obesity, and 10% of them have pre-diabetes(1).

The Saudi Guidelines for the Prevention and Management of Obesity recommend implementing school-based interventions to prevent obesity among adolescents(2). Understanding the school setting through a school-based environmental audit can provide insight into the barriers and enablers of obesity prevention strategies in schools (3), which can inform the design of schoolbased interventions. One such tool, the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) tool, assesses the school environment in relation to healthy eating (HE) and physical activity (PA). The reliability and feasibility of this tool has been tested across 256 schools in 12 different countries. Therefore, the ISCOLE tool can be used to conduct reliable environmental audits across international school settings(3). The ISCOLE tool(3) was used along with the Saudi Ministry of Education (MOE) canteen policy checklist to examine the school environment in relation to HE and PA.

The Saudi MOE canteen policy is a checklist of banned and recommended food and drink items sold to students. Three female high schools were selected from differing economic deprivation levels (high, medium, and low deprivation) in Riyadh, Saudi Arabia. The ISCOLE tool covers the domains of HE and PA provisions, school facilities and policies, and was completed by the researcher in conjunction with a senior school staff member. The researcher accessed the school canteens and examined the items present. Checklists were completed and pictures taken for documentation. Ethical approval was granted from the Saudi MOE, Princess Noura University’s Institutional Review Board, and affirmed by Queen’s University Belfast.

There were notable differences between the three high schools sampled. Middle and low deprivation schools had PA and HE policies under development, a specific time allocated for PA, HE promotion and a school shop; the high deprivation school did not have any of these. The results of the MOE canteen checklist illustrated that many ‘banned’ food items were available in the middle and low deprivation schools, including nectar juices, pre-packaged croissants, chocolates, and popcorn. Regarding ‘recommended’ food items, both schools offered sandwiches and bottled water. None of the schools offered healthy food at subsidized prices and only the low deprivation school had access to a small outdoor soccer area.

In Saudi Arabia, female high schools face significant challenges regarding a school environment that supports both HE and PA. These challenges include the absence of HE provision and lack of suitable PA facilities. Understanding the school context will help support the development of a future school-based obesity prevention intervention.

With the rising rates of non-communicable diseases in Nigeria, there is need to understand the links between diet and health using an accurate and efficient dietary assessment method. The new online dietary assessment tool comprising a database of local Nigerian and West African diets, myfood24 West Africa (1), was piloted in a healthy adult population in Nigeria.

Participants were staff of Michael Okpara University of Agriculture Umudike, Abia State in southeast Nigeria, at least 18 years, not pregnant, not had childbirth in the last 3 months, and not diagnosed with diabetes. A pre-recorded video demonstration of food recording with myfood24 was sent to participants. One-day 24-hour recall was self-recorded by either participants or by the researcher on behalf of the participants. Participants who used myfood24 on their own completed the usability questionnaire to rate their agreement with system usability statements and provided feedback on the system.

179 adults were recruited for the study and a total of 1345 food/drink entries were made with a median number of 7 (IQR: 5, 9) food/drink entry per day per participant. Foods from our new West African food database contributed to 60-82% of the energy and nutrient intake. Mean energy intake was 1844 (SD 781) kcal; with energy coming from 28% fat, 63% CHO, and 9% protein. 53 (30%) participants used myfood24 on their own, with a mean age of 38.5±8.7 years. There was no significant difference in the energy intake (p = 0.67) and body mass index (p = 0.82) of participants who used myfood24 on their own and those who did not. 39 out of 53 participants completed the user questionnaire. The mean system usability score was 74 (95% CI 65, 83), indicating a good usability. Participants found the tool easy to use and estimate portion sizes of local foods; it was educative showing levels of macronutrient consumed; and more efficient than manual recording of foods but some participants commented that a few local foods were missing.

myfood24 will support research investigation of relationships between diets and health in Nigeria. There is also now an offline function removing reliance on WiFi. Feedback from participants will inform future updates of the database.

There is no regular, routine measurement of food and nutrient intake undertaken regionally in the UK. This makes evaluation of local public health interventions challenging. Consumers want to be more sustainable in what they are eating. Social media penetration in the UK is 90%(1), with ∼47m people using Facebook, a potential route to study recruitment. Nutritional analysis software with accurate underpinning food composition and sustainability data could enable quick and easy large scale data collection. This study aimed to collect diet and sustainability measures using online tools and to test the feasibility of using social media to obtain a large, regionally focused sample in a short time.

We undertook a rapid, time limited, regional (Yorkshire and Humber) food and nutrient tracking survey ‘One day: Diet in Yorkshire and Humber’ for use with policy makers(2). A Facebook (FB) boost approach was used to recruit a regional sample of adults. Participants completed a brief online demographic survey and used myfood24® to give a detailed measure of their food intake for the previous day. myfood24® generic and branded databases were used(3) which include sustainability metrics.

The FB posts were boosted for 21 days and reached 76.9k individuals. Just under £1,000 was spent on 3 FB boosts and 1,428 participants completed the questionnaire. 673 participants also completed the one-day diet diary. Hull, Barnsley and Doncaster had the highest rates of overweight and obesity in the region. Overall nutrient values recorded were similar to national survey data for older women. Intakes of fibre (mean 18g, SD 11) and iron (mean 9.6mg, SD 5.0) were low. For the first time, measures of sustainability from the diet were calculated from myfood24®.

The mean greenhouse gas emissions (GHGE) were 5.9(kg CO2 eq/day) (95% CI 5.6, 6.1); land use 9.0 (m2year/day) (95% CI 7.6, 10.3) and water use 582 (l/day) (95% CI 551, 611). Regression analysis showed that for each additional 100kcal consumed there was a significant increase in GHGE of 0.9 (kg CO2 eq/day) (95% CI 0.8, 1.1). Land and water use were also significantly increased with increasing energy intake. Adjusting for total energy, protein intake was positively associated with all 3 metrics. Carbohydrate was inversely associated with GHGE and land use. However, fat intake was not associated with any of the sustainability measures. Portions of fruit and vegetables consumed were positively associated with water use only.

Diet is clearly linked to sustainability. The mean GHGE from diet is equivalent to driving an average car ∼22km/day. We successfully recruited a large sample in a short timeframe using FB. Participants were able to use online tools to report food intakes. This data is relevant to local and national policy makers to monitor and evaluate public health programmes.

Promotion of sustainable healthy diets requires comprehensive metrics to assess environmental impact of foods consumed1. Existing food systems are failing to meet the needs of current and future generations, by operating outside several planetary boundaries. Promoting healthy diets from sustainable food systems is central to realizing the 2030 Sustainable Development Goals. Standard food composition tables do not include sustainability metrics. The aim of this work was to add UK focussed sustainability metrics to the food composition table used in myfood24.

Greenhouse gas emissions (GHGE), land and water use were added to each food item in the myfood24 UK generic and branded databases. This is recorded as per 100g of product. The values for GHGE2 takes account of factors including production method, land use management, feed used, soil and climate, processing and transport of both the product and aspects of its production e.g., fertiliser and feed. Values were weighted for UK trade statistics to reflect values for the UK food supply. Land use and freshwater withdrawals were also added.

Exploration of the sustainability metrics in the myfood24 database by food category show, as expected, that meat (1.5 kg CO2eq, SD 1.4), fish (1.8 kg CO2eq, SD 1.0) and dairy (1.3 kg CO2eq, SD 0.8) plus dried herbs/spices (1.4 kg CO2eq, SD 1.2) have the highest GHGE per 100g. In the meat category, beef and lamb had GHGE ∼3.8 kg CO2eq with pork and chicken having lower values ∼1.0 kg CO2eq. Plant based protein sources had much lower GHGE per 100g, with pulses at 0.3 CO2eq (SD 0.2) and nuts at 0.2 CO2eq (SD 0.2). Land use was by far the highest per 100g for lamb (63 m2year/day, SD 18) with beef next at 8 m2year/day (SD 4). Chocolate (5 m2year/day, SD 2) was the sixth highest food category for land use. Drinks, vegetables, fruit and potatoes had the lowest land use values. Regarding water use, seafood per 100g had high values at 484l/day (SD 167), followed by nuts (218l/day, SD 172), lamb (171l/day, SD 36) and rice (164l/day SD 42). Drinks, potatoes and breads had the lowest land use values per 100g.

Through addition of sustainability metrics to food and nutrient composition databases we can measure the impact of food intake in relation to both nutrients and sustainability. This linked data will help us to understand how to adapt our diets to be healthier and better for the planet.

Portion sizes have increased substantially over the past several decades and are thought to contribute to rising rates of overweight and obesity.(1) People eat more when provided with larger portions, and over time, consider larger portions as normal.(2) Providing descriptive labeling and visual cues can be helpful in guiding consumers to appropriate portion selection.(3) Globally, few countries regulate servings sizes for packaged foods. Instead, Nutrition Facts are reported per 100g or 100mL, and/or per amount declared by the manufacturer. These variations lead to inconsistencies in on-pack portion sizes and may cause consumer confusion.(4) Our objective was to develop a methodology to establish globally relevant portion size recommendations for both nutrient-dense and discretionary foods that could be implemented in countries where permitted.

A stepwise and systematic approach incorporated values from regulated serving sizes (n = 10), portion recommendations from food-based dietary guidelines (FBDG; n = 90, aggregated into 6 regions), and food consumption data from Europe (n = 24 countries) and Australia for a total of 18 possible data inputs. These inputs were used to derive Global Portion Values (GPVs) as the median of all values for 50 food and beverage categories including both nutrient-dense and discretionary foods. To better understand the consistency of input values, 25th and 75th percentiles, and dispersion of input values, assessed as percent of median absolute deviations (MAD)/median, were calculated.

GPVs were calculated for milk and dairy (n = 6 food groups), protein foods (n = 5), mixed dishes (n = 5), grains (n = 7), fruits and vegetables (n = 5), snacks and sweets (n = 11), sauces and condiments (n = 5), fats, oils and sugars (n = 4) and beverages (n = 2). The number of inputs for each portion value ranged from 6 (Appetizers/hors d’oeuvres) to 18 (juices). Only 5 of 50 food groups had fewer than 10 inputs;

21 had ≥15. Dispersion ranged from 0-33%; 88% of GPVs were considered “consistent” (dispersion

<25%) and 8 categories had 0% variation, indicating high consistency across all inputs. Example

GPVs for nutrient-dense foods include: 240mL for milk (16 inputs, 8% dispersion); 30g for cheese (17 inputs, 0% dispersion); 90g for main dishes (meat, poultry, fish) without sauce (16 inputs, 13% dispersion); 50g for bread and rolls (17 inputs, 20% dispersion); 130g for canned vegetables (10 inputs, 2% dispersion). Example GPVs for discretionary foods include: 30g for chocolate (15 inputs, 17% dispersion); 30g for potato chips and crisps (12 inputs, 17% dispersion); and 30mL for salad dressing (13 inputs, 0% dispersion).

This novel method incorporating regulated serving sizes, portions from FBDGs and actual intakes can be used to derive portion recommendations for commonly consumed foods and beverages. If adopted, these values could improve consistency in portion labeling in countries where they are permitted and therefore guide consumers to more appropriate portions.

Nutrition research relies on food databases which are extensively used in dietary surveys, clinical practice, research, and policy development (1). Online data volume is expected to increase up to 180 zettabytes by 2025, due to a proliferation of internet-connected devices, the growth of social media platforms, and a digital transformation of industries (2). Webscraping, a method to extract data from websites, has been previously used in Ireland to evaluate online retailer information as a potential source for monitoring food reformulation efforts in the Irish retail market (3). This study aims to outline a process for, and evaluate the use of, webscraping on online supermarket websites to increase data availability to researchers.

An online supermarket website was selected to trial the new process. Octoparse software version 8 was downloaded. 12 data fields of interest were identified; cost, lifestyle, net weight, Directions for use, Storage instructions, Nutrition information, Front of pack information, legal name, brand name, manufacturer, ingredients, and allergy advice. A process was defined for data web scraping in four main steps; 1) collection of category level URL’s, 2) collection of product level URL’s, 3) collection of data at product level within defined fields and 4) data cleaning and re-structuring. A workflow was created in Octoparse for steps i - iii and step iv was completed using Excel version 16.69.1.

83 category level page links were generated and entered into Octoparse software. Webscraping was completed on 3,095 product level URLs. Data on 1,450 products (47%) were successfully scraped as they had data within the 12 defined data fields. A new dataset was created for the 1,450 products with data fields including information on nutrition (energy, fat, of which saturates, carbohydrate, of which sugars, fibre, protein and salt), costs per serving and per kg, lifestyle factors (e.g. whether a product was vegetarian or vegan), ingredient lists and allergy advice. 637 products (44%) were found to have vegetarian/vegan claims. Micronutrient level data was limited.

An increased availability of online data presents an opportunity for the development of new and more systematically updated datasets, and may increase the availability of information on branded products. Webscraping enables researchers to create new databases, and systematically update datasets, with less resources. This study enhances the availability of data and may enable researchers to explore new avenues for understanding food environments. Future research should test the process on additional websites to increase coverage of the Irish retail market and across different regions, identify sources with more in-depth nutritional data, and evaluate use case in mobile applications. Web scraping offers a promising tool for advancing research in food science and nutrition, and providing access to diverse datasets for research and innovation that change with the times.

The previous National Adult Nutrition Survey (NANS) (2008-10) in Ireland collected dietary data using a 4-day weighed food record(1), however, the more recent NANS II (2020-21) used 2x24-hour dietary recalls as per EU guidance(2) (collected by telephone due to the Covid-19 pandemic social distancing guidelines). The aim of this study was to investigate the relative validity of two telephone 24-hour dietary recalls against a 4-day weighed food record to estimate energy, macronutrients, dietary fibre and salt intakes in a convenience sample of adults to ascertain comparability between the two methods.

A total of 40 participants (19-64 years; 55% female) visited Munster Technological University on four occasions as part of this study. Participants were equally randomised (to complete the food record first followed by the dietary recalls or to complete one dietary recall first, then the food record followed by the 2nd dietary recall (corresponding to the last food record day)). Participants were trained in completing the food record (with researcher visits on day 2/3 and upon completion to review the record/check for completeness). The researcher-led 24-hour dietary recalls were conducted via telephone (at least 7 days apart) (photographic food atlas provided to participants in advance). For both methods, a high level of researcher interaction was employed with detailed dietary data collected at brand level for updating of food composition tables. UK and Irish food composition tables were used to estimate energy and nutrient intakes (food sources only) and mean daily intakes of energy, macronutrients, total sugars, saturated fat, dietary fibre and salt (g, % total energy (%TE), g/10MJ) were estimated from both methods. Differences between methods were assessed using; mean percent difference (calculated as ((mean food record-mean 24-hour recall)/mean food record)*100), paired sample t-tests (to examine differences between mean intakes), Pearson coefficient analyses (to investigate the strength and direction of associations) and cross-classification tertile analysis (nutrient-specific; to quantify the level of agreement between the categorisation of estimates)(3).

The mean percent difference between methods was acceptable (1-10% difference) for all nutrients except total sugars in both grams (13% difference) and %TE (11% difference). Paired-samples t-tests showed no significant difference between methods. Correlations ranged from 0.53−0.86 (good) for energy and nutrients, except dietary fibre (0.48: acceptable) (p<0.001). Fifty to eighty percent of participants were classified in the ‘exact agreement’ category of intake by cross-classification with 90-100% of participants classified in the ‘exact agreement/adjacent category’.

These findings suggest that two 24-hour telephone dietary recalls may be comparable with a 4-day weighed food record for the estimation of energy, macronutrients, dietary fibre and salt intakes in adults. The methodologies used for both methods (high researcher involvement, brand level data, matching food composition databases) are important for accuracy and their similarities may have improved comparability.

Responses to the Scottish Government commitment to Net Zero(1) will increase the demand for land from multiple sectors in Scotland and potentially take land out of food production. Choices about where and what foods are produced is important for nutritional security, but has rippling consequences for land use, rural populations and across the food system. To support choices about where and what might be produced, we present an estimate of the nutritional value of agricultural commodities produced in Scotland.

Building on a Scottish Government-built model, annual agricultural census data were used to identify commodities for human consumption, which were matched to the minimally processed foods from each commodity. We focused on the value of the least processed form of each commodity, before food processing and ingredients from elsewhere are incorporated. For example, wholewheat flour and hulled barley. Nutrient data for each food were drawn from the UK Composition of Foods Integrated Dataset(2) and the energy and 27 macro and micronutrients were extracted for each food item. Using average yield and production data, the supply of nutrients was estimated.

Cereals could provide many nutrients, but are mostly used for non-food products (approximately 1% of barley and 12.5% of wheat are for human consumption(3)) so their realised contribution is attenuated. Vegetables are an important source of nutrients despite relatively little hectarage, however, their contribution to the nutrient supply is largely driven by large yields of potato and carrot (particularly for vitamin A). Given the quantity produced, milk is the largest source of nutrients, but livestock meat, which uses a significant proportion of agricultural land (including fodder crops, animal feed and grazing) has a disproportionately small contribution to nutrient supply. However, recognising nutrients vary between products which needs to be considered. Energy (71% of population needs), fibre (64.1%), iron (68.5%), selenium (59.7%), niacin (90.5%) and vitamins D (21.1%) and E (55.8%) all have a low supply from Scottish land.

These results are based on a nutrient supply from production of commodities on the land in Scotland, and the supply from primary production is not always what consumers have access to and the supply of nutrients often changes in food processing along the whole food chain. The supply of nutrients for human consumption is not only from domestic production and about half of the diet in Scotland is from imported foods (especially fruit and vegetables)(4). However, the aim of this study was to estimate the potential of supply from current agricultural production. Understanding the potential and realised nutrient supply from domestic agricultural production helps to evidence a discussion about how agriculture is valued, the opportunities to reimagine food production to maximise the supply of nutrients across Scotland and consider uses of land.

The current environmental, climate and health challenges require critical transitions to diets and food production systems that are more sustainable, in turn providing diets that are adequate nutrition, affordable and environmentally friendly. Recent studies have identified cultural acceptability as an important dimension in sustainable diets(1). Mathematical optimization models have been developed to deal with the complexities of all the dimensions, yet diet acceptability has had limited successful integration into these models(2). This systematic review explored two research questions in the context of dietary optimisation studies; how is acceptability defined and operationalised?; how does including acceptability impact dietary optimisation solutions?

A hybrid search strategy was implemented. The first used the PRISMA guidelines to conduct a systematic search on two electronic databases (PubMed, Embase) for articles published between January 2013 and April 2024. Search terms were developed through preliminary readings and included: diet OR diets OR dietary AND modelling OR modeling OR optimisation OR optimization OR optimize OR optimize OR linear programming AND acceptabl*. Articles in English optimising acceptable diets for adults (18+) were included. The second used the snowball method for identifying relevant articles from previous searches(3). Backward snowballing was conducted by identifying references from the initial set and forward snowballing was conducted through Web of Science in June 2023.

Fifty-one studies fulfilled the inclusion criteria. European countries had the largest representation (n=41; 20 from France, 7 from The Netherlands); 43 studies took a population-based modelling approach, 7 on individual-based modelling and 1 study used both approaches. The review identified 12 modelling approaches, where linear programming was most frequently used (n=26), followed by non-linear programming (n=7) and quadratic (n=6). The majority of studies that optimised for acceptability used the minimal deviation from observed diet as the objective function (n=32). Baseline dietary data for observed diets were primarily from National surveys (n=36), followed by local surveys (n=5), however, 25 studies used data that was 8 – 16 years older than the publication date. Majority of studies included at least one acceptability constraint (n=45), ranging from setting boundaries on certain foods (n=34), removal of certain foods/food groups (n=12), limiting deviation (n=15).

The full analysis of the studies is ongoing; however the current results highlight the varying methods used to operationalising ‘acceptable’ diets in diet optimisation literature. A conceptual framework for integrating acceptability into diet optimisation studies is currently under development, aiming to highlight the various ways in which ‘acceptability’ is operationalised through the modelling process from data inputs, models chosen to validation of the solutions. It is anticipated that this work will highlight new opportunities for further modelling for acceptable diets.

Food-Based Dietary Guidelines (FBDGs) are valuable tools for providing dietary recommendations to different population groups across the globe(1). However, while the World Health Organization (WHO) and the Food and Agriculture Organization (FAO) have issued guidelines to support the development of FBDGs(2), a lack of consistency persists in how these are applied by individual countries in their derivation approach and monitoring efforts(3,4). This review compares the methodologies used by public health bodies to develop FBDGs.

Documents describing FBDGs and their development were obtained via the FAO online repository of FBDGs, and information could be found directly from the FBDG or from their joint scientific report. A spreadsheet was created to report details on the approaches used to derive dietary guidance for the general adult population, with a focus on the type and specificities of the data used, when applicable (characteristics of the study population, food intake assessment methodology, analysed consumption patterns, and nutritional requirements inputted if diet modelling was applied). General information such as the year of issue and stakeholders involved in the elaboration of the guidelines was also retrieved.

A total of 96 FBDGs were accessed and translated into English for analysis: 11 in Africa, 16 in Asia, 34 in Europe, 29 in Latin America and the Caribbean, 4 in the Near East, and 2 in North America, published on average in 2014. Of these, 60 FBDGs (63%) were developed based on scientific consensus, 43 (45%) mentioned a review of current evidence on the associations between dietary patterns and health outcomes, 26 (27%) derived the recommendations according to energy and/or nutritional requirements, and 15 (16%) used a statistical/mathematical optimisation method to develop quantitative guidance. 10 FBDGs (10%) did not provide any information on the rationale used to derive the values.

The general lack of FBDG revision using up-to-date evidence as well as the low use of typical consumption resources and specifically of national intake data represents a limitation to the development of relevant guidelines for food consumption. Ultimately, although consideration of local cultural practices is necessary, this study highlights the need for harmonisation of strategies to enhance the accuracy and therefore the effectiveness of FBDGs in promoting healthier eating habits.

Retrospective studies highlight the negative effect of increased consumption of ultra-processed foods on the Crohn’s disease (CD) risk(1), however studies investigating their consumption during the disease course are lacking. The aim of the present study was to assess the consumption of ultraprocessed foods and its association with diet’s quality and clinical outcomes in CD.

Dietary intake and habits were assessed through two non-consecutive 24-hour recalls and a food frequency questionnaire, respectively. Diet’s quality was assessed through the MedDietScore (range 0-55, higher values indicate higher adherence to the Mediterranean dietary pattern(2,3) and CVD score (range 0-11, higher values indicate higher adherence to dietary guidelines for the prevention of cardiovascular disease(4). NOVA classification was used to estimate the intake of ultra-processed (NOVA 4) foods(5). Follow-up data were collected at 6, 12 and 24 months [need for intensification/change of biologic agent, start of biologic agent/corticosteroids, disease activity, overall adverse clinical outcome (need for surgery, change of medication, start of biologic agent, administration of corticosteroids, need for hospitalization, cancer)].

250 adults [54.8% males, aged 41.2 ± 14.1 years, 26.9% obesity] were evaluated. The percentage of NOVA 4 in the daily energy intake was 25.7% (16.8, 41.8%). Higher consumption (4th quartile) of NOVA 4 was associated with higher energy (p = 0.033), protein (p = 0.023) and carbohydrates (p = 0.028) intake; lower MUFA intake (p = 0.001), fruit consumption (p = 0.007) and CVD score (p = 0.031); and higher consumption of red meat (p = 0.001), sweets (p = 0.009) and soft drinks (p<0.001), compared to the lowest consumption (1st-3rd quartile). No differences were observed between higher NOVA 4 consumption and disease outcomes, after adjustment for age, sex, disease location, disease activity and energy intake at 6, 12 and 24 months.

Consumption of ultra-processed foods had a median contribution to about ¼ of total daily energy intake in this sample of people with CD, which is almost half of that reported in young adults in Greece(6) or the general population in UK, USA and various countries in Europe(7,8). Although higher consumption of ultra-processed foods was associated with lower diet’s quality, it was not associated with adverse clinical outcomes at 6, 12 and 24 months of follow-up.

Over consumption of sugar-sweetened beverages (SSBs) is associated with an increased risk of weight gain and dietary related noncommunicable diseases.(1) Consumption of energy drinks (EDs) by children and adolescents is linked to poor health and social outcomes.(2) To address high sugar content in beverages in Ireland, the Sugar Sweetened Drinks Tax (SSDT) was introduced in 2018 and applies to SSBs, including EDs, with a sugar content of 5 g/100 ml or more.(3) SSBs and EDs are also prioritised for sugar reduction in the Irish reformulation strategy.(4)

The aim of this study was to examine the mean analysed sugar (g) content of carbonated SSBs and EDs on the Irish market in 2023 against the Irish SSDT differential rate thresholds. A secondary aim was to determine a 2023 benchmark for the mean labelled caffeine (mg) content of EDs.

A convenience sample of SSBs (n = 67) and EDs (n = 28) were collected from Dublin-based supermarkets in 2023. Samples were sent to the Public Analyst Laboratory, Galway for sugar analysis, using high–performance anion-exchange chromatography/pulsed amperometric detection. The mean, standard deviation (SD), minimum and maximum (min-max) analysed sugar (g) per 100 ml and per suggested serving size were determined and assessed against the SSDT lower rate of 5–7.99 g/100 ml and upper rate of >8 g/100 ml. The mean, SD and min-max labelled caffeine (mg) content per serving of EDs containing caffeine (n = 18) was determined. Statistical analysis was completed using RStudio v4.3.0.

The mean analysed sugar (g) of SSBs (n = 67) and EDs (n = 28) was 4.48 g/100 ml (SD 1.53; min-max 1.6 g–10.7 g) and 6.56 g/100 ml (SD 3.31; min-max 1.5 g–14 g), respectively. In SSBs (n = 54) and EDs (n = 22) that provided a suggested serving size, the mean analysed sugar (g) was 11.17 g per serving (SD 3.75; min-max 4 g–26.75 g) and 25.93 g per serving (SD 18.17; min-max 9.75 g–70 g), respectively. In this sample 31% (n = 21) of SSBs and 50% (n = 14) of EDs had a sugar (g) content above the taxable rate. Of these, 10% (n = 2) of SSBs and 64% (n = 9) of EDs were above the SSDT upper taxable rate. Caffeine containing EDs (n = 18) had a mean labelled caffeine (mg) content of 129.17 mg per serving (SD 39.38; min-max 70 mg–160 mg).

The majority of carbonated SSBs in this sample were below the SSDT lower differential threshold.

However, the majority of EDs had a high sugar content and were liable for SSDT at the higher rate. These findings agree with a 2019 study and show EDs remain high in sugar and caffeine.(5) Given their association with poor health outcomes in children and adolescents, EDs on the Irish market require additional reformulation to meet sugar reduction targets.(2)

Foods for Specific Groups (FSGs) are a category of products for vulnerable groups including “processed cereal-based foods and baby foods” (PCFBF); “food for special medical purposes” (FSMPs); “infant formula” (IF) and “follow-on-formula” (FOF) as per Regulation (EU) No 609/2013(1). Specific labelling and compositional requirements are set out in the legislation for each of these categories of foods. The Food Safety Authority of Ireland (FSAI) ensures the enforcement of these regulations through service contracts with official agencies including the Health Service Executive (HSE) and the Department of Agriculture, Food and the Marine (DAFM)(2). The aims of this study were to: (1) Identify the categories and quantities of FSGs tested by official agencies in 2022 and (2) Investigate the compositional compliance of products tested.

FSG products were analysed by Official Laboratories (OLs) using accredited methods for potassium, selenium, iodine, zinc, manganese, magnesium, molybdenum, phosphorus, calcium, folic acid, sodium, iron, chromium, vitamin B2 and vitamin B1. Both the measure of uncertainty (MoU) and limit of quantification (LOQ) values were reported. Data was extracted from FSAI’s National Food Safety Surveillance database. Samples were categorised as IF, FOF, PCFBF or FSMPs as per the legislation. FSG products not available for sale in Ireland were excluded. Nutrient concentrations were assessed against the limits permitted in legislation.

Of the total FSG products tested (n92) in 2022, nearly two-thirds (n64) were produced for the Irish market, with the remainder (n28) produced for export. The majority (n51) of Irish products were sampled by the HSE including IF (n10), FOF (n8) PCFBF (n7) and FSMPs (n26). The remaining Irish products (n13) were sampled by DAFM - IF (n6), FOF (n6), and FSMPs (n1). The majority of PCFBF (n6), IF (n14), FOF (n13) tested were deemed compliant, while only 44% (n12) of FSMPs sampled were compliant with the legislation. Possible non-compliance of FSMPs was due to high levels of selenium, chromium, and molybdenum. Possible non-compliance of FOF and IF was due to high levels of selenium. PCFBF possible non-compliance was due to high levels of potassium. However, the analytical MoU values for the nutrients ranged from 0.04 % to 44% which makes judgement of compliance difficult in some instances.

This study gives an overview of FSG products tested by official agencies including their compliance with compositional regulations. Overall, compositional compliance across FSG products is high. However, possible non- compliances were identified due to the wide range of MoUs and their overlap with some permitted limits for certain nutrients. Another issue identified is that some LOQs were higher than the maximum permitted level in legislation. Future work for the FSAI will involve working with the OLs to accredit more sensitive methods, thus facilitating better official controls.