Globally, 537 million adults (20-79 years) had diabetes mellitus in 2021 (10.5%), and the estimate is projected to rise to over 643 million (11.3%) by 2030 (1). The estimated prevalence for Chile was 12.7%, 90–95% of which were type 2 diabetes mellitus (T2DM) cases (1). In the last decades, it has been shown the importance of diet quality in the management and prognosis of T2DM (2). Therefore, this study aimed to evaluate diet quality in subjects with T2DM from primary health care centres (PHCC) in Copiapo according to age group.

A cross-sectional study was performed within the CODIACO cohort, with data collected on 160 participants during 2023. This population-based study involved women and men from 30 to 65 years, with T2DM, and users of PHCCs of Copiapo. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer, and severe infectious or inflammatory diseases were excluded. Sociodemographic data were recorded, and diet quality was measured through a Mediterranean dietary index (MDI) validated in the Chilean population (3). Participants were categorised by age (≤ 50 years, 50-60 years, ≥ 60 years). The following categories were considered for MDI score: high (9-14 points), moderate (5-8.5 points), and low (<5 points) adherence. One-factor analysis of variance with the Bonferroni correction test and Chi-square test were used to assess differences in MDI according to age groups. The results were expressed as percentages or mean and standard deviation. A p-value of less than 0.050 was considered statistically significant. The CODIACO study was approved by the Scientific Ethics Committee of the University de Atacama. The project was funded by FONDECYT (N° 11180794).

The mean age of the participants was 55.64±7.48 years, and the MDI score was 6.28 (moderate diet quality). 19.4% of subjects (≤ 50 years, 13.7% of those aged 50-60 years, and 27.5% of those ≥ 60 years had low diet quality. Moderate diet quality was found in the majority of individuals from the three groups, with 72.2%, 78.1%, and 60.8%, respectively. Only 8.3% of the subjects ≤ 50 years, 8.2% of those aged 50-60 years, and 11.8% of those ≥ 60 years had high diet quality. No significant differences were observed between the means of the MDI scores of each group (p = 0.578), nor in the proportion of subjects with low, medium or high diet quality in each group (p = 0.325).

The findings of the present study showed subjects with T2DM and users of the PHCCs of Copiapo (Chile) had a moderate diet quality, mainly. The proportion of patients with low, moderate, and high diet quality was similar among those ≤ 50 years, those 50-60 years, and those ≥ 60 years. Further investigations are needed to evaluate in depth the diet in this population.

Currently, diabetes mellitus is a major health problem affecting 12.7% of people between ages 20 and 79 years in Chile, 90-95% of whom have type 2 diabetes mellitus(1). Diet is a cornerstone in the management of this pathology(2). Therefore, the aim of this study was to describe the food consumption frequency in subjects with type 2 diabetes mellitus and users of primary health care centres in Copiapo (Chile).

A cross-sectional study was conducted on 160 participants of the control of diabetes cohort (CODIACO) study in 2023. Women and men from 30 to 65 years with type 2 diabetes mellitus and users of primary health care centres of Copiapo were selected for the investigation. Pregnant and lactating women, and patients with diabetic neuropathy/nephropathy, cancer, and severe infectious or inflammatory diseases were excluded. It was administered a questionnaire about the frequency of consumption of certain food groups (fresh fruits; raw, cooked, precooked and frozen vegetables; nuts; legumes; blue and white fish; seafood; red and white meats; viscera; sausages; sweet ultra-processed foods; water; juices; carbonated drinks; coffee and tea), recording the frequency with which they were consumed (never, seldom, occasionally and usually). The results were expressed as mean and standard deviation or percentages. The CODIACO study was approved by the Scientific Ethics Committee of the University de Atacama. The project was funded by FONDECYT (N° 11180794).

The age of the 160 participants was 55.64±7.48 years. Usual consumption of raw or cooked vegetables (80.0%), fresh fruit (71.3%), legumes (55.6%), and white meat (75.0%) was reported by the great majority of the individuals. To a lesser extent, nuts (36.3%), white fish (31.9%), blue fish (30.6%), and red meat (30.0%) were also widely consumed on a regular way in these subjects. In contrast, pre-cooked (66.9%), frozen vegetables (57.6%), seafood (55.0%), sausages (65.7%), offal (84.4%), juices (55.7%), carbonated beverages (65.0%) and coffee (57.2%) were seldom or never consumed, mostly.

The results suggest relatively regular consumption of fruits, vegetables, legumes, and white meats in subjects with type 2 diabetes mellitus, users of primary health care centres in Copiapo (Chile). Otherwise, viscera, sausages, and precooked and frozen vegetables, as well as juices and carbonated beverages seem to be relatively little consumed in this population. Additional studies are required to know in depth the dietary habits of subjects with type 2 diabetes mellitus from the north of Chile.

Hypertension is the leading risk factor for cardiovascular disease (CVD), responsible for approximately 12.8% of global deaths(1). Twenty-four hour ambulatory blood pressure monitoring (ABPM) is effective in detecting, confirming, and monitoring hypertension(2). In comparison to seated clinic blood pressure (CBP), ABPM assesses overall blood pressure (BP) variability across 24 hours, identifying specific additional components such as nocturnal hypertension and altered daytime to night-time BP profiles (i.e. non-dipping pattern of BP). Furthermore, a non-dipping BP profile is an independent risk factor for CVD(3)(4). This study aimed to measure the prevalence of non-dipping in apparently healthy males and females aged >50 years.

After approval by TUS Research Ethics Committee, 100 participants not on antihypertensive medication were recruited from various workplace locations in Athlone, Ireland. ABPM was measured using a Welch Allyn 7100 ABPM and CBP was measured using an Omron M3 BP monitor. CBP was measured on the day immediately after the ABPM was performed (same arm for both measurements). Standard protocols for ABPM were employed using the NICE Guidelines(5). Awake and asleep BP levels were computed as the mean of all readings during each period. Night time was determined according to patient reported sleep period. Nocturnal hypertension was defined as an asleep SBP/DBP ≥120/70 mmHg and non-dipping was defined as a decline in SBP from wakefulness to sleep of <10%.

Of 92 participants recruited, 85 completed both ABPM and CBP measurements of which n = 30 male. Participants were stratified into BP categories according to the International Society of Hypertension (ISH) reference ranges for CBP[6]. BP category was defined according to seated CBP and by the highest level of BP, whether systolic or diastolic[6]. Hypertensive BP groups (grades 1 and 2) were merged into one group and renamed as “hypertensive”

Thirty-seven participants had normal CBP (43.5%), 24 had high normal CBP (28.2%), and 24 were classified as hypertensive (28.2%) of which 16 (43.2%), 2 (8.3%) and 9 (37.5%) were non-dippers, respectively. Data analysis shows a significantly higher proportion of non-dippers than dippers in the normal CBP group (Chi square, p=0.024) when compared to the higher CBP groups.

There is a high prevalence of non-dipping amongst adults with normal CBP. Therefore, CBP and ABPM classify adults differently with regard to BP status. Our results show the importance of using a combination of both CBP and ABPM to comprehensively determine BP status in adults over 50 years.

Physical activity has been demonstrated to be an effective intervention for the prevention and treatment of type 2 diabetes mellitus (DM2)(1,2). However, only 13.3% of the Chilean population are physically active(3,4). To our knowledge, there is no data on the physical activity performed by the diabetic population in Chile. Therefore, this study aimed to describe the level of physical activity in patients with DM2 in the Family Health Centres (CESFAM) of Copiapó (Chile).

The study employed a cross-sectional design, utilizing data from 25 participants in the CODIACO cohort. The study population comprised individuals of both sexes, between 30 and 65 years of age, diagnosed with DM2 and users of the CESFAMs of Copiapó, and who also had mobile devices capable of installing the accelerometry application ‘Physics Toolbox Sensor Suite’. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer, and severe inflammatory or infectious diseases were excluded. They were asked to activate and deactivate the application for 7 to 12 days, This mean the device had to be turned on at the beginning of an activity (waking) and off at the end of the day (bedtime), registering all daily activities. The percentages of time spent in each of the four body positions (upright, sitting, crouching, and lying down) were obtained from the total time spent using accelerometry(5). Once the Shapiro-Wilk test was P>0.05, all comparisons were made between times spent in each of the body positions using a one-factor ANOVA, with post-hoc analysis using Tukey’s test. A P-value of less than 0.05 was considered statistically significant. The CODIACO study was approved by the Scientific Research Ethics Committee of the Universidad of Atacama. The project was funded by FONDECYT N° 11180794.

There was an average daily activity of 9.6hr (upright = 2.2;sitting = 4.9;crouching = 0.7; supine = 1.6hr) in the sample. The one-factor ANOVA showed significant differences between all positions (P<0.001). The pos-Hoc test revealed a significantly longer time was observed in the sitting position, according to the z-axis position (51.32±12.5% of the total time) compared to the upright (23.5±8.7 %), supine (17.4±3.2 %) or crouching (7.78±0.6 %) positions (P < 0.050). Furthermore, differences were observed in the time spent in the upright position and the time spent in the supine (P<0.05) or crouching (P<0.05) positions, and between sitting and crouching positions (P<0.05).

This study demonstrated that patients diagnosed with DM2 at the CESFAM of Copiapó spent a significant portion of their daily activity in a sedentary and low position, with minimal engagement in an upright one. Since upright positions are associated with physical activities such as walking, climbing stairs, toileting, and cooking, obtaining 23.5% in this position suggests a lack of engagement in these activities.

Diabetes Mellitus (DM) represents a significant public health concern with a global impact(1,2). According to the International Diabetes Federation, in 2021 the global prevalence of this pathology was 10.5% and 12.7% in Chile(3). Of these cases, 90% are cases of type 2 Diabetes Mellitus (DM2). One of the risk factors for its management and prognosis, once diagnosed, is a sedentary lifestyle(3). A sedentary lifestyle rate of 86.7% has been reported in Chile(4). However, to our knowledge, there is no data on sedentary lifestyles in the diabetic population of the commune of Copiapó. Therefore, this study aimed to describe and compare the level of sedentary lifestyle in women and men with DM2 in the Family Health Centres (CESFAM) of Copiapó (Chile).

A cross-sectional study was conducted using data obtained from participants in the CODIACO cohort. Twenty-five individuals, comprising both sexes and aged between 30 and 65 years, diagnosed with DM2 and users of the CESFAMs of Copiapó, were included. These individuals also had mobile devices capable of installing the accelerometry application ‘Physics Toolbox Sensor Suite’. Pregnant and lactating women, patients with diabetic neuropathy or nephropathy, cancer, and severe inflammatory or infectious diseases were excluded. They were asked to activate and deactivate the application for 7 to 12 days, at waking and bedtime, respectively. Physical activity and sedentarism were determined when the accelerometer was over or below 0.6 mm/sec2 respectively from the total daily activity (%). WhatsApp transmitted the information recorded to estimate each participant’s sedentary lifestyle level. A Student’s t-test for independent samples was employed to compare the percentage of sedentary behaviour between women and men. The results were expressed as the mean and standard deviation. A P-value of less than 0.05 was considered statistically significant. The CODIACO study was approved by the Scientific Research Ethics Committee of the Universidad de Atacama. The project was funded by FONDECYT N° 11180794.

The number of women in the sample was 19 (76%) and the number of men was 6 (24%). The values of sedentary lifestyle for women were 85.32±9.5%, which was similar to those found in men, 82.5±10.31%. Although women show a higher tendency to increase sedentary lifestyle behaviour, The T-test did not determine differences between sexes (p>0.05), maybe, due to the high number of women compared with men in the sample.

The level of sedentary lifestyle in patients diagnosed with DM2 in the CESFAM of Copiapó is high and is in line with that observed in the general population in Chile. Furthermore, no differences are observed between men and women. Further studies are required to confirm this result and to investigate its cause to generate strategies to help reduce sedentary lifestyles in this population.

Ultra-processed foods (UPFs) consumption, characterized by high levels of sugars, unhealthy fats, and additives, yet low in nutrients, has increased significantly in recent decades(1). Previous studies have demonstrated the link between UPF consumption and Type 2 diabetes (T2D)(2). Considering the variation in these food categories across studies and the scarcity of large-scale studies focusing on specific UPF subgroups, this study aims to explore the prospective association between UPFs, their subgroups, and the incidence of T2D in a UK based cohort study.

A total of 7,774 participants aged 40-69 years without T2D (69% men and 31% women) from the Whitehall II cohort, who had dietary intake data at baseline (1993/1994) and follow-up data on T2D incidence available, were included in the analyses. Food intake was assessed using a validated 127item food frequency questionnaire (FFQ). We applied the NOVA classification to categorize FFQ items into four classes based on the level of processing. The intake of UPFs per day was calculated as a percentage of the total daily food intake in grams to account for UPFs that do not provide energy. The incidence of T2D was evaluated from 1993/1994 to 2007/2009 through self- reports and oral glucose tolerance test results. Multivariate Cox regression models were employed to assess the prospective association between UPFs consumption (in quintiles) and T2D risk, adjusting for socioeconomic factors, family history of T2D, lifestyle characteristics, total energy intake, and indicators of nutritional quality.

During the 15-year follow-up, 954 cases of T2D were confirmed. In multivariable models adjusted for family history of T2D, socioeconomic, and lifestyle factors, the highest UPF consumption quintile [mean 33% of total daily intake (grams)] was associated with an increased risk of T2D [HR: 1.35, 95% CI: 1.06-1.71] compared to the lowest quintile [mean 9.6% of total daily intake (grams)]. Adjustment for total energy intake slightly increased the risk of T2D [HR: 1.46, 95% CI: 1.12-1.91].

Additional adjustments for sugar, sodium, and fat intake further increased the risk of T2D [HR: 1.51, 95% CI: 1.15-1.98]. Among UPFs subgroups, only the intake of soft drinks was significantly associated with an increased risk of T2D [HR: 1.02, 95% CI: 1.01-1.08], whereas no significant associations were found for other UPFs subgroups. Similar results were found after multiple imputation of missing values.

In UK midlife adults, higher UPF consumption tends to be prospectively associates with an increased risk of T2D, with notable variations across UPFs subgroups. These findings suggest that the association between UPFs intake and T2D might be independent of nutritional quality and energy intake, indicating that food processing itself could be a contributing factor. This study provides evidence to support efforts to limit UPF consumption as a strategy to alleviate the population burden of T2D.

Weight recurrence (WR) is a frequent complication in patients post metabolic and bariatric surgery (MBS)(1). However, there is no consensus on WR definitions(2). Patients’ preoperative characteristics are believed to have an association with WR(1). This study aimed to evaluate WR 3 to 13 years after laparoscopic sleeve gastrectomy (LSG) using three commonly used definitions and investigate potential risk factors.

A retrospective analysis examined data from patients’ medical records who underwent primary LSG between 2008 and 2019. Inclusion criteria were patients aged 18 years or older, eligible for MBS, and with at least three years of follow-up. Those with previous MBS, revised surgical procedures post-LSG, or who had the surgery in 2019 were excluded. Dividing the analysis into three post-LSG periods (1st year, 2nd year and >2nd year). The primary outcome was WR over time utilizing three definitions: >10% increase in nadir weight, >10% increase in nadir weight (nadir 1 to 2 years), and percentage of excess weight loss (EWL) <50% with a body mass index (BMI) >35 kg/m2. Survival analysis techniques were used to assess the occurrence and timing of WR. Potential risk factors of WR including age, gender, BMI, obesity-related comorbidities, duration post-LSG, and attendance to follow-up visits were assessed using binary logistic regression.

Only 219 out of 2982 patients met the inclusion criteria and were included in the analysis. Patients’ mean age and BMI were 37.21±10.44 years and 45.92±6.99 kg/m2, respectively, with females constituting the majority (64%). Weight recurrence varied between different definitions, ranging from 31% to 61%. The estimated median time for WR was significant starting from 9 years when applying the nadir weight definitions while from 6 years when EWL<50% & BMI>35 kg/m2 definition was used. Binary logistic regression analysis identified several risk factors for WR considering the definition of EWL <50% with BMI >35 kg/m2: older age [OR 1.104, 95% CI (1.0591.151), p-value <0.001] and higher preoperative BMI [OR 1.352, 95% CI (1.242-1.473), p-value <0.001]; while male gender [OR 0.314, 95% CI (0.137−0.720), p-value 0.006] and frequent follow-up visits [OR 0.528, 95% CI (0.382−0.730), p-value <0.001] were protective factors against WR. Other definitions did not demonstrate significant associations except for a longer duration post-LSG as a risk factor for WR when applying the definition of >10% increase from nadir weight (nadir weight 1 to 2 years) [OR 1.153, 95% CI (1.050-1.267), p-value 0.003].

This study explored factors that influenced WR post-LSG. Potential risk factors including age, gender, BMI, and time varied according to the WR definition applied. More research is necessary to establish a consensus on a suggested definition that aligns with the clinical parameters and comorbidity status of patients for application in upcoming research and clinical settings.

Complementary feeding describes the transition from milk feeding to family foods or ‘solids’ and should occur around six months of age(1). Diet in the early years can influence health in later life by shaping food preferences1 and may increase the risk of obesity and metabolic disorders later in life(2,3). Parents can find the period of complementary feeding stressful due to experiencing a lack of support for parents during this stage(4). This study investigated how parents of infants under two years of age engaged with information about complementary feeding using qualitative methods informed by critical realism and information behaviour theories.

Dyadic, semi-structured interviews were conducted with parents of infants aged four to twentyfour months in southwest England to explore their information needs. Interviews were conducted in person or online at the convenience of the participant. Data were recorded and transcribed verbatim and analysed using thematic analysis.

Ten interviews were conducted and four overarching themes were identified:

1. 1) “I don’t really remember them giving advice about weaning”

Although parents initially relied on NHS resources, gaps led them to seek additional guidance from online platforms or commercial sources. They required both practical support for infant feeding but also emotional support as transitioning onto solids could be a stressful experience.

1. 2) “Just done what you’re expected to do”

Parents’ perceptions of societal expectations regarding infant feeding could influence their feeding practices. This sometimes conflicted with their knowledge of complementary feeding, leading to dual beliefs and behaviours, such as altering feeding behaviours in public to adhere to social norms.

1. 3) “This is what works for us”

Parents found that following complementary feeding guidance was challenging. Many parents followed their child’s appetite and discussed finding balance in their children’s diets. Parents also referred to balancing the idealised version of complementary feeding they strived for while remaining realistic to practicalities.

1. 4) “I had done the research and he just kinda went along with it”

Complementary feeding practices were linked to perceptions of good parenting. Mothers, in particular, adhere to societal norms and ideals of infant care, which influenced their informationseeking patterns. This adherence to societal constructs often resulted in gendered disparities, with mothers primarily responsible for seeking information while fathers played a supportive role.

Findings suggest that current services are not meeting parents’ information needs about complementary feeding. Accessible information from credible sources is required to enable parents to make informed feeding decisions and to follow them confidently during the critical phase of complementary feeding. Policymakers should address the impact of social media and commercial baby food companies, considering parental emotional well-being and ensuring information accessibility regardless of gender.

Inadequate dietary intakes are widespread amongst pre-school aged children, with 56% of preschool children worldwide suffering from a deficiency in at least one of iron, zinc or vitamin A(1). The neurological and physical development of children is sensitive to changes in micronutrient status, with nutrient deficiencies at this age likely to have irreversible effects on childhood development(2). This study aims to evaluate the major influences on the dietary patterns, feeding practices and eating behaviours of young children in Ireland.

A self-administered, web-based survey was administered to parents/guardians of 18-36 months old children. The survey consisted of 103 questions, delivered across 5 sub-sections (demographics, parental nutrition knowledge, feeding practice, barriers to healthy eating and dietary patterns). Validated questionnaires were used to assess fussy eating (Child Eating Behaviour Questionnaire, CEBQ) and parental feeding practice (Child Feeding Questionnaire,

CFQ)(3–5). Adherence with the 2020 FSAI Scientific Recommendations for Food-Based Dietary Guidelines for 1-5-Year-Olds in Ireland was evaluated using FFQ-style questions to estimate consumption patterns of food groups.

Parents/guardians (n = 1141) answered with respect to 608 male and 529 female toddlers, with a mean ( ± SD) age of 26.2± 5.8 months. The greatest barriers to healthy eating reported by parents/guardians were food fussiness (49%), time to prepare healthy foods (47%), provision of unhealthy foods by caregivers outside the home (47%), the short shelf life of “healthy foods” (42%) and the marketing of unhealthy foods to children (42%). The children’s food pyramid was recognised by 76% of parents. A large number of toddlers met the FSAI’s dietary recommendations for consumption of fish (70%) and fruit and vegetables (97%). Fewer children met the FSAI’s recommendations for consumption of processed meat (24%), beverages (40%), red meat (52%) and confectionary (57%).

Using the CEBQ food fussiness scale, 36% had a score indicative of moderate to severe fussy eating (Score ≥ 3). Higher levels of food fussiness were noted among children who did not meet recommendations for consumption of red meat (2.81 vs 2.64, p = 0.001), fish (2.82 vs 2.68, p = 0.010) and confectionary (2.85 vs 2.62, p<0.001). The nutrition knowledge assessment showed that parents had a mean ( ± SD) knowledge score of 58.0± 14.6%. Higher knowledge scores were observed among parents/guardians of toddlers who met the dietary recommendations for dairy (64% vs 47%), fish (59% vs 56%), red meat (59% vs 57%), confectionary (59% vs 57%) and fruit and vegetables (58% vs 55%) (all p<0.05).

This study highlights a multitude of interrelated and dynamic factors, particularly fussy eating and parental nutrition knowledge, that influence the dietary intakes and patterns of toddlers. Understanding these factors may help to guide the development of targeted multi-factorial interventions to improve dietary quality among toddlers.

Optimal nutrition during infancy and early childhood is crucial for promoting healthy growth, development, and overall well-being(1). Concerns arise regarding commercially available Food Products for Infants and Young Children (FIYC) due to potential imbalances in sugar, salt, fat content, and inappropriate promotion. The World Health Organization’s (WHO) Nutrient and Promotion Profile Model (NPPM) assesses the nutritional quality and promotional practices of commercial baby foods for children under 36 months. This study evaluates and compares the compliance of FIYC products in the UK and Kyrgyzstan with the NPPM guidelines.

This study evaluated the compliance of FIYC products in the UK and Kyrgyzstan with the WHO’s NPPM guidelines. Data on commercially available FIYC products for children aged 6-36 months were collected from both countries (UK: n = 469 products, 21 brands; Kyrgyzstan: n = 203 products, 20 brands). The NPPM website was utilized to assess nutritional composition (energy, sugar, protein, salt) against WHO guidelines and evaluate labelling information (ingredient lists, nutrient/health/marketing claims, breastfeeding recommendations) for adherence to NPPM criteria(2). Data analysis for comparison across the two countries employed SPSS v29.

Analysis of 672 FIYC products using the NPPM website revealed distinctly different compositions between the UK (n = 469) and Kyrgyzstan (n = 203). The UK dataset contained a higher proportion of meals (38%) compared to fruits and vegetables (30%). Conversely, Kyrgyzstan had a higher percentage of fruits and vegetables (52%) and cereals (26%). Nutrient assessments displayed varying pass rates. Pass rates for products in the model were higher for the UK compared to Kyrgyzstan for energy density (75% vs. 47%), total fat (98% vs. 67%), and sodium (69% vs. 10%). However, Kyrgyzstan had a higher protein pass rate (96% vs. 94%). Regarding sugars, the UK achieved a 50% pass rate for total sugar compared to only 7% in Kyrgyzstan, with free sugar addition pass rates of 81% and 73% respectively. Promotion assessments revealed a similar compliance for the lower age recommendation (from 6 months) (85% UK, 76% Kyrgyzstan). However, all products failed the total marketing, health, and promotional claims evaluation. Breastfeeding instruction compliance was also low, with only 5% (UK) and 35% (Kyrgyzstan) passing.

In conclusion, the study identified both strengths and weaknesses in FIYC product compositions and nutritional profiles across the UK and Kyrgyzstan. However, more work is needed in adhering to marketing, health claims, and breastfeeding instruction guidelines in both countries. Stronger policies to improve FIYC are needed across the WHO European Region promoting child health and reducing future disease risk.

Childhood obesity is a serious public health concern worldwide. One in five children are overweight or obese in Ireland1. Suboptimal growth, either in pregnancy or infancy, can increase the risk of obesity in childhood2. National policy fails to recognise early life exposures as potential contributors to Ireland’s obesity epidemic. This research examines the impact of ‘Labour and Birth’, ‘Birth Weight Status’, and ‘Maternal BMI’ on infant growth in the first weeks of life.

This research is a secondary analysis of data collected as part of the WellFed study, a randomised placebo-controlled trial investigating the effect of a maternal dietary supplement comprised of a milk protein hydrolysate and yeast beta-glucan (Wellmune®) (LS-23-07-OSullivan). The supplement does not influence the present findings. Mother and infant anthropometrics were measured during two study visits, at approximately 4 and 8-weeks postpartum. Participants completed a series of questionnaires to obtain basic demographic, birth and lifestyle data. Infant weight and length percentiles were calculated using the UK-WHO 0-2 years: weight-for-age percentiles and the UK-WHO 0-2 Years: length-for-age percentiles for both males and females. Statistical analysis was performed using IBM SPSS Statistics (version 27).

Data from 51 mother-infant dyads show infants delivered via cesarean section weighed less at the 4-week (4.1± 0.4 vs 4.5± 0.5 kg, p = 0.015) and 8-week follow-up (5.1± 0.5 vs 5.5± 0.6 kg, p = 0.021) and were shorter at the 8-week follow-up (56.3± 1.9 vs 57.7± 2.0 cm, p = 0.030) compared to infants born vaginally. Infants born following induction were significantly heavier at the 8-week follow-up compared to those not-induced (5.8± 0.7 vs 5.2± 0.5 kg, p = 0.006). In this cohort, 40% of infants were classified as large-for-gestational-age (LGA). Across the 8-week study period, 50% of LGA infants dropped two or more growth percentiles.

Observations from this study highlight a high prevalence of LGA infants in this cohort which raises concern for the national prevalence of LGA infants in Ireland. Interventions during labour and birth were shown to influence infant growth in this study. These findings highlight the need for further investigation into the relationship between early life exposures and growth during infancy and childhood. Implementing healthcare policies focusing on reducing the number of elective birthing procedures performed and targeting obesity amongst women of reproductive age are possible measures that can be implemented to help tackle the obesity crisis in Ireland.

Cow’s Milk Allergy (CMA) is estimated to affect 2-3% of infants, typically developing in the first year of life(1). The risks of misdiagnosing CMA include acute reactions, micronutrient deficiencies, growth faltering, increased burden on healthcare systems, and reduced quality of life for infants and caregivers(2). The guidelines for diagnosis and management are not always followed due to lack of awareness, or difficulties with implementation(1,3). The aim of this study was to obtain parent-reported data on the diagnosis and management of CMA in Ireland.

A 23-item questionnaire was developed and distributed through an online parenting club, targeting parents of infants aged 0-12 months with CMA. The quantitative and qualitative data was analysed on SPSS (V29) using descriptive statistics and cross-tabulation tests.

A total of 62 parents with an infant under 12 months responded that their infant currently has (n = 56) or previously had CMA (n = 6). Five cases were self-diagnosed and were partially excluded from analysis. General practitioners (42%) and paediatricians (39%) were the most common healthcare professionals (HCPs) to diagnose CMA.

The number of visits it took before receiving a CMA diagnosis ranged from 1-15 visits, with a median of 2 visits. Some infants were diagnosed on their first appointment (n = 11) while others took 4-5 months before being diagnosed (n = 2). Only 23% of infants underwent a skin-prick/blood test, suggesting most HCPs were using symptom resolution to decipher a diagnosis.

An extensively hydrolysed formula (EHF) was recommended as first-line management to most formula-fed infants (82%, n = 40), while 14% (n = 7) were initially recommended an amino acid formula (AAF). Of the 17 suspected non-IgE infants who did not exclusively breastfeed, only 41% were given advice to reintroduce standard infant formula after 2-4 weeks of being on a hypoallergenic formula, to assess if symptoms reappeared. Of this 41%, only 57% followed this advice. Of breastfeeding mothers (n = 30), 87% were advised to eliminate cow’s milk from the maternal diet, however 57% were not advised on reintroduction upon symptom resolution(1). Faltering growth was reported in 11% (n = 5) of formula-fed infants and all were prescribed an EHF, despite guidelines recommending an AAF if faltering growth is evident(1). After diagnosis, 26 infants (46%) had no follow-up with their HCP. Of the 22 infants diagnosed by a paediatrician, 77% received a follow-up appointment which was significantly greater compared to follow-up rates from other HCPs (P = 0.006). Limitations include the use of a small convenience cohort and selfreporting of data.

These results indicate a clear gap between CMA diagnosis and management guidelines, and their practical implementation within the Irish healthcare setting. Any strategy to further educate and support HCPs in this specialist area of healthcare could mitigate risk of misdiagnosis, delayed diagnosis, and inappropriate management.

Suboptimal feeding practices in the first two years of life are risk factors for poor child growth and development(1). Sociodemographic predictors of infant and young child feeding (IYCF) practices are well documented (maternal age, education, marital status, sociodemographic status)(2). However, psychosocial factors have received less attention, and few studies have considered complementary feeding practices. Therefore, this study aimed to explore associations between maternal depression, exposure to intimate partner violence, perceived social support, and stimulating home environments, and IYCF practices among mother-infant dyads in Malawi.

Khula is a longitudinal birth cohort that aims to characterise brain development across the first 1,000 days of life(3). At the third study visit, when infants were approximately 10–16 months of age, mothers completed a series of psychosocial questionnaires: Edinburgh Postnatal Depression Scale (EPDS; score 0–30), Intimate Partner Violence Questionnaire (IPV), Multidimensional Scale of Perceived Social Support (MSPSS). The Family Care Indicators (FCI) was used to assess stimulation and support for early learning within the home (score 0–17). Information on infant’s dietary intakes during the previous 24 hours was used to determine the WHO IYCF indicators: minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)(4). Logistic regression modelling was used to identify significant associations between maternal psychosocial measures and IYCF indicators.

Data were analysed for 153 dyads. Mean maternal age was 27.0 ± 6.0 years, 84.1% were married, 52.8% had some/completed secondary education, and the majority were either employed (45.1%) or housewives (41.7%). The median (Q1, Q3) EPDS score was 2 (0, 6), 12% of women had been exposed to IPV in the previous 12 months, and mothers reported medium levels of perceived social support. The median FCI total score was 6 (5, 8). Among infants (mean age 13.3 ± 1.7 months), 97.4% were still being breastfed, and 54.2%, 73.2% and 45.1% achieved MDD, MMF and MAD, respectively. Women with higher EPDS scores were less likely to breastfeed at around 1 year (OR 0.53, 95% CI 0.29, 0.96; p = 0.04). However, this relationship was not significant after controlling for maternal age, education, marital status, and socioeconomic status. Exposure to IPV in the previous 12 months, MSPSS score and FCI total score were not associated with any IYCF indicators. Stimulation within the home environment was positively associated with dietary diversity score in unadjusted multiple regression (β 0.17, 95% CI −0.002, 0.15; p = 0.05), although this was no longer significant in adjusted analyses.

In this study, we found little evidence of associations between psychosocial factors and IYCF practices. Early screening for postnatal depression may benefit women and infants and should potentially be considered during infant feeding counselling in low-resource settings. The indications of improved dietary diversity with greater familial interactions should be examined in larger, diverse populations.

The significant rise in childhood obesity is a public health challenge, and it is estimated that nearly 25% of children in England start school with overweight or obesity1; those from ethnic minorities and more disadvantaged areas are disproportionately affected2. The transition from exclusive milk feeding to the introduction of solid foods is an important stage in a child’s growth and development as eating habits and behaviours established in early life have been shown to continue into late childhood3. Given the increase in prevalence of childhood obesity, the aim of this study was to describe the weaning diet of infants and explore associations between sociodemographic characteristics.

The analysis included mother-infant pairs from the UK Pregnancies Better Eating and Activity Trial (UPBEAT), an antenatal diet and physical activity intervention which recruited women with obesity from ethnically diverse inner-city settings4. Maternal sociodemographic characteristics were recorded at baseline (15-18 weeks’ gestation). Infant dietary patterns were derived using factor analysis of a parent reported interviewer-administered food-frequency questionnaire at 6-months of age. To explore relationships between infant dietary patterns and sociodemographic characteristics, a multiple linear regression model was developed and included the following maternal exposures; age, body mass index (BMI), time spent in education, ethnicity, parity, smoking and breastfeeding prevalence at the 6-month follow-up. The model was also adjusted for age of introduction of solids and the UPBEAT intervention arm.

720 mother-infant pairs were recruited at 6-months postpartum, and 542 were included in this analysis as weaning had started. There was no effect of the UPBEAT intervention on infant dietary patterns. The average age of introduction of solid foods was 5 ± 0.87 months. Two dietary patterns were identified in the infants. The first pattern defined as ‘Processed’ was high in rusks, baby pouches, porridge, fruit puree, yoghurt, juice, desserts, snacks and meat, fish or savoury-based meals. The second pattern, defined as ‘Healthy’ was high in breakfast cereals, potatoes, yoghurt, biscuits, fruit, vegetables, bread, meat and fish-based meals and pasta. The Processed pattern in the infant was associated with lower maternal age (beta-coefficient −0.01; 95% confidence interval −0.03, −0.003), higher maternal BMI (0.02; 0.003, 0.04), less time spent in education (−0.06; −0.09, −0.02), lower breastfeeding prevalence (−0.28; −0.51, −0.05) and a lower infant age of introduction of solid foods (−0.20, −0.30, −0.10). Women of Black ethnicity were less likely to adhere to a Healthy pattern (−0.40, −0.63, −0.15).

A processed dietary pattern at 6-months of age is associated with several maternal sociodemographic factors, including lower educational attainment, lower age at birth and higher BMI. These results support the need to for targeted public health programmes which promote healthier weaning practices.

The introduction of complementary foods, also known as 'weaning', refers to the process of introducing solid foods into an infant’s diet, alongside breast milk or infant formula milk(1). According to the Food Safety Authority of Ireland (FSAI) guidelines, weaning should commence around 6 months of age, with no earlier or later than 17 or 26 weeks, respectively(2). These guidelines provide evidence-based recommendations aimed at promoting optimal infant health, growth, and development(3). The aim of this study was to gain an insight into parental attitudes towards weaning and the common challenges faced when introducing solids.

Data was collected using a 16-item questionnaire. Parents of infants aged 0–12 months were recruited through an online parenting club and descriptive statistics were performed using IBM SPSS (V29) to determine percentages.

Of the 215 participants, 64% (n = 137) had initiated solid food introduction to their infants, with the age of these infants ranging from 4-12 months. Of those, the majority (80%, n = 109) followed FSAI guidelines(2), introducing new foods daily or every few days. The main factors guiding this decision were signs of readiness and developmental milestones, cited by 76% of respondents (n = 104). Among those who began weaning (n = 137), 70% reported a positive experience, though the majority (92%, n = 126) encountered challenges along the way. These included infant’s refusal to eat (34%, n = 47), allergy concerns (41%, n = 56), and difficulty determining appropriate portion sizes (48%, n = 66). Our findings showed that 12% (n = 16) of infants aged 6-9 months and 2% (n = 3) of infants aged 10-12 months had not yet been introduced to meat, poultry, or fish. Additionally, 4% of parents (n = 6) waited until their infants were at least 9 months old to introduce these foods, despite guidelines recommending early exposure to iron-rich foods(2).

Most parents with infants aged 0-6 months (64%, n = 78) had not started weaning. Among them, 26% (n = 20) felt very confident about beginning the process, while 25% (n = 19) lacked confidence in introducing solid foods to their infants.

Among all participants, information on weaning commonly came from family/friends (68%, n = 147), healthcare professionals (60%, n = 128), and social media (46%, n = 99). When asked about resources they would like access to, nearly two-thirds of parents (64%, n = 138) expressed interest in weaning recipe ideas. Additionally, 53% (n = 114) highlighted the need for guidelines on the appropriate amount of milk to give during weaning.

In conclusion, our findings indicate that while most parents appear compliant with the recommended timing of weaning, challenges still persist. Moreover, there is a notable reliance on various sources for weaning information, with a demand for resources like weaning recipes and milk quantity guidelines. These insights highlight the importance of tailored support and education to facilitate a positive weaning experience for both parents and infants.

In 2020, the Food Safety Authority of Ireland (FSAI) published, for the first time, food-based dietary guidelines for 1 to 5-year-olds. The guidelines highlight suboptimal intakes of vitamin D (VitD) and iron in toddlers and preschoolers. To help parents meet their child’s daily nutrient requirements, the FSAI recommends parents of 1-5 year-olds offer their child (1) a low-dose (5 μg/day) VitD-only supplement during the extended winter months (2) 30 g red meat three days a week and (3) 30 g ready-to-eat cereals (RTECs) with added iron (≥ 12 mg iron per 100 g) five days a week(1). Findings from our previous survey of parents of 1- to 5-year-olds (n=185) revealed low awareness of, and adherence to, the FSAI recommendations (2). The present qualitative study aimed to gain insight into factors influencing parental guideline adherence.

One-to-one, online, semi-structured interviews were conducted among a sample of 15 parents of 1to-5-year-olds who had completed our online survey (2). Participants were college-educated mothers, with the majority being Irish and within the age range of 36 to 45 years old. The interviews investigated participants’ attitudes towards the recommended items and perceived barriers and facilitators of adherence to the recommendations. Qualitative data were analysed using Braun and Clarke’s six-phase thematic analysis framework (3), facilitated by NVivo 12 Plus software.

Thematic analysis identified five themes capturing factors that were perceived to influence guideline uptake by parents: (1) Perceptions of healthy eating (i.e., eating a varied, balanced, and nutrient-dense diet); (2) Impact of the community food environment on the accessibility of the recommended items (i.e., food price and availability in community settings); (3) The interplay between family members’ dietary preferences and meal choices within the familial food setting (e.g., child food dislikes and picky eating habits, as well as parents’ preferences and experiences about the recommended items); (4) Convenience in food preparation and supplement use (i.e., time, energy, and skills required to adhere to the recommendations); and (5) Gaps in communicating the guidelines and opportunities to promote them (i.e., visibility of credible nutrition-related information).

Overall, this study showed that guideline adherence is a complex, multi-dimensional phenomenon that is affected by individual factors, the food and nutrition environment. It highlights the need for implementing a holistic approach, such as the socio-ecological model, to improve guideline adherence that involves families, healthcare professionals, policymakers, and the food industry to create a supportive, positive food environment for parents.

A period of the life course where optimal nutrition and food security are crucial for the life-long health and wellbeing of women/birthing parents and infants is preconception, pregnancy, and infancy.(1) It is estimated that nearly one in every four households with pre-school children (0-4 years) experience food insecurity (FI) in the UK.(2) Yet, we lack an evidence-base exploring experiences of FI in this life course stage.(3,4) This study aimed to explore women’s experiences of food insecurity during and after pregnancy, including its influence on infant feeding decisions.

This study was ethically approved (Ref No: LRS/DP-23/24-39437) and pre-registered on OSF Registries (https://osf.io/9hn6r). Semi-structured mixed format individual interviews were conducted between November 2023 and February 2024. Pregnant individuals, those who had given birth ≤12 months ago, ≥18 years old, food insecure, residing in South London and with recourse to public funds were recruited through purposive sampling. The topic guide was informed by FI, pregnancy and postpartum related literature and piloted (n = 2). Interviews were audiorecorded and professionally transcribed. Demographic data was summarised using SPSS. Inductive thematic analysis was used to analyse the data and was completed using NVivo.

Eleven food insecure participants (2 pregnant, 9 new mothers; 2 White European, 9 Black African/Caribbean/British women) participated in the study. Six women were 0-6 months postpartum, and 3 women were between 6-12 months postpartum. The preliminary findings are represented by three themes: 1) A dichotomy: knowing vs affording, 2) Adaptive food coping strategies, and 3) Infant feeding practices. Participants shared detailed accounts of valuing a healthy diet and adapting food practices, yet they still were unable to meet their dietary needs and desires during and after pregnancy. Participants described worry around breastmilk supply; quality and quantity. Complimentary feeding was also identified as a source of worry. “She is still breastfeeding fully. I don’t want to change to milk, which maybe, sometimes, I might not be able to afford it…I won’t stop until she is 1.”Whilst the cost of formula feeding was a driver of a more severe experience of FI.

Policy and practice recommendations include enhancing local breastfeeding support to address FI specific concerns around breastmilk supply and at national level, advocating for greater support for adequate healthy food provision and for a price cap on infant formula. Future interventions must support maternal mental health given the high cognitive stress identified with living with FI during and after pregnancy. Further high-quality research is needed 1) amongst asylum seekers and refugees and non-English speakers who may also experience FI, and 2) exploring cultural influences on breastfeeding and the relationship with FI.

According to WHO estimates, in 2022, over 37 million children aged five and younger were overweight1. Emerging evidence is linking excessive weight gain before the age of 3 years with later cardiometabolic risks2. Breastfeeding has been reported to be protective against early obesity in children between 2 and 6 years of age3. Additionally, breastfeeding infants reduces rapid weight gain at the end of infancy4. Waist-to-hip ratio (WHR) and mid-upper-arm circumference (MUAC) are cost-effective methods of measuring adiposity distribution. Studies employing these methods in children, particularly in South Africa (SA) are lacking. This study investigates the association between the duration of breastfeeding and WHR and MUAC among a small South African cohort.

A cross-sectional study consisting of 262 Black African children aged 1-to-5 years of age was conducted. Children were recruited from local SA clinics via the convenience sampling technique during routine immunisation clinic visits. Data were analysed using R (R-core team 2022) & SPSSVS28 (IBM 2021). The London Metropolitan University sub-ethics committee, the Durban University of Technology (SA University) and the KwaZulu-Natal Department of Health granted ethics for the study. The relevant authorities granted gatekeeper permission from all the facilities before the commencement of data collection. Participants gave informed consent in the local language and were made aware that they could withdraw at any time without any consequences. The waist and hip circumference in centimetres were measured using anthropometric tape, WHT was then calculated by dividing the waist circumference by the Hip circumference. The MUAC was measured using a MUAC tape. The measurements were taken by trained personnel Duration of breastfeeding (weeks) was used as the outcome variable and the WHR and (MUAC) were used as predictor variables. Pearson’s correlation test was used to measure the relationship between the predictor variables. A p-value of <0.05 was considered significant.

Of the total 262 children that participated in our study, 50.5% were male while 49.5% were female. The average age of the participants was three years. Our data (both WHR & MUAC) was normally distributed according to the generalised linear model. The minimum breastfeeding duration was zero weeks while the maximum duration was 104 weeks (24 months). The mean waist-to-hip ratio was 0.9143, while the mean MUAC was 16.13cm. According to the Pearson correlation test, breastfeeding duration is negatively associated with both WHR (r = −0.18, p< 0.768) and MUAC (r = 0.17 p< 0.790), but this association is not statistically significant.

Increasing breastfeeding duration was weakly associated with a decrease in both WHR and MUAC. In our study, although there is a trend in the correlation between breastfeeding duration, WHR and MUAC, the relationship between these predictors is not significant. Further studies, with larger samples, are needed to validate these findings.

Early-life experiences play a crucial role in shaping later-life outcomes, potentially impacting the health of multiple generations(1). The 'Developmental Origins of Health and Disease (DOHaD)' theory underscores the significance of early environmental factors in influencing immediate and future well-being(2); evidence dating back to the 1980s links exposures such as malnutrition to epigenetic changes and the development of chronic diseases(2). Despite increasing interest in multigenerational associations, further empirical evidence is needed to fully understand the connection between grandparents’ early-life experiences and the growth outcomes of their grandchildren. The objective of this research was to examine the relationship between grandparents’ occupation group, population dietary quality (PDQ), and geographical area of residence in early-life and their grandchildren’s growth outcomes at birth, 5- and 10-years, and to illustrate how the mapping of data from previous studies to recent studies based on socioeconomic status and demographic information can offer significant insights into health outcomes.

Data from the Lifeways Cross-Generational Cohort Study (2001-2013)(3,4) were used to identify children with at least one grandparent born after the foundation of the Irish Free State; thus, ranging from infancy to young adulthood when the 1948 National Nutrition Survey (NNS)(5) was conducted. The data from the grandparents of these children were then linked to the NNS categories of occupation group, PDQ and geographical area, based on information collected through the Lifeways baseline questionnaire. Associations between socioeconomic factors pertaining to maternal and paternal grandparents’ and grandchildren’s growth outcomes were tested statistically.

Significant associations were observed between female grandchildren’s waist-z-scores (WACZ) at age 10 and the occupational group of the paternal grandmother (p = 0.030). Female grandchildren of skilled workers exhibited larger median waist circumferences (67 cm) compared to those with professional paternal grandmothers (58.6 cm) (p = 0.049). Poor PQD in both maternal grandmothers and grandfathers was positively associated with ponderal index (PI) in their female grandchildren (p = 0.022, r = 0.169; p = 0.002, r = 0.252 respectively) but not in their male grandchildren (p = 0.176, r = 0.108; p = 0.800; r = 0.022, respectively). Conversely, good PQD in maternal grandparents was inversely associated with PI in their grandchildren (p = 0.041, r = −0.111; p = 0.035, r = −0.125). No association was observed between the early-life geographical area of residence of grandparents and their grandchildren’s growth outcomes at any age.

This study contributes insights into the relationship between the socioeconomic factors and population dietary quality of grandparents and growth outcomes in their grandchildren. The study highlights the importance of grandparents’ early-life experiences in shaping some growth outcomes in their grandchildren. This research also highlights how the mapping of data from prior studies to recent studies based on socioeconomic status and demographic data can provide valuable insights into health outcomes. Further research using this approach could lead to meaningful public health findings and is required to corroborate these study findings.

In the absence of specific dietary guidelines and perceived inadequate dietary support from healthcare professionals (HCPs), people living with psoriasis (PLwP) often make restrictive or misinformed dietary changes(1) Following self-prescribed dietary modifications without the guidance of HCPs could negatively impact health and well-being (2). There is high demand for dietary advice among both HCPs involved in psoriasis care and PLwP(3). Research suggests that online content about psoriasis treatment is frequently inaccurate and typically not produced by HCPs(4). Therefore, PLwP need easily accessible support to help them navigate the nutritional information they may encounter, to enable them to make evidence-based informed decisions. This study aimed to develop a user-friendly and evidence-based guide to help PLwP in the UK navigate nutritional information.

A 4-phase User-Centered Design (UCD) approach was employed, utilising the UCD-11(5) framework, to co-design a guide that provides evidence-based information for nutritional navigation support for PLwP. Phase 1 involved the establishment of an expert panel which included experts in dermatology, nutrition and individuals with lived experience of psoriasis. The expert panel defined the scope and focus of the guide and from this the initial version of the guide was developed. The subsequent phases involved iterative design and content refinement, incorporating feedback from potential users through think-aloud methodology. Subsequently, the expert panel reviewed and provided input to complete the formation of the final guide.

The UCD-11 framework effectively engaged prospective users in the design and development of the guide and ensured a user-centered focus. The expert panel provided insights that enhanced the accuracy and relevance of the guide. Iterative design phases incorporated continuous user feedback, improving the quality, usability and visual design of the guide. The think-aloud methodology provided real-time insights into the guide’s clarity and functionality. Participants found the format clear and wording easy to read but made suggestions to improve usefulness. This included: “It would be useful to have more information on what dairy alternatives are and further sign-posting” and “explain what nightshades actually are”. Furthermore, participants highlighted other dietary recommendations they commonly see, and the need for clearer information on these. This feedback facilitated further refinements based on user insights.

Developing evidence-based dietary support materials using a co-design approach and UCD framework, resulted in a tailored guide that met the needs of service users. This approach facilitated the creation of user-friendly, evidence-based advice with input from experts and key stakeholders in psoriasis care. Future research should focus on exploring the value of the guide to healthcare professionals involved in psoriasis care. Additionally, monitoring effectiveness and use of the guide, by PLwP and HCPs, will help improve implementation, identify barriers to effective use and inform any necessary updates to the guide.