Unhealthy food environments are major drivers of obesity and diet-related diseases(1). Improving the healthiness of food environments requires a widespread organised response from governments, civil society, and industry(2). However, current actions often rely on voluntary participation by industry, such as opt-in nutrition labelling schemes, school/workplace food guidelines, and food reformulation programmes. The aim of the REFORM study is to determine the effects of the provision of tailored support to companies on their nutrition-related policies and practices, compared to food companies that are not offered the programme (the control). REFORM is a two-country, parallel cluster randomised controlled trial. 150 food companies were randomly assigned (2:1 ratio) to receive either a tailored support intervention programme or no intervention. Randomisation was stratified by country (Australia, New Zealand), industry sector (fast food, other packaged food/beverage companies), and company size. The primary outcome is the nutrient profile (measured using Health Star Rating [HSR]) of foods and drinks produced by participating companies at 24 months post-baseline. Secondary outcomes include company nutrition policies and commitments, the nutrient content (sodium, sugar, saturated fat) of products produced by participating companies, display of HSR labels, and engagement with the intervention. Eighty-three eligible intervention companies were invited to take part in the REFORM programme and 21 (25%) accepted and were enrolled. Over 100 meetings were held with company representatives between September 2021 and December 2022. Resources and tailored reports were developed for 6 touchpoints covering product composition and benchmarking, nutrition labelling, consumer insights, nutrition policies, and incentives for companies to act on nutrition. Detailed information on programme resources and preliminary 12-month findings will be presented at the conference. The REFORM programme will assess if provision of tailored support to companies on their nutrition-related policies and practices incentivises the food industry to improve their nutrition policies and actions.

Protein is a required macronutrient for maintenance of muscle mass. Current guidelines recommend daily intake of 0.8 g of dietary protein per kilogram body weight (kg bw), regardless of age(1). However, factors such as age and physiological changes may increase this requirement to 1.5g/ kg bw/day for older adults with sarcopenia(2). Therefore, protein-fortified foods are used to enhance the protein intake of older adults. Milk protein concentrate (MPC) and pea protein isolate (PPI) ingredients are used to increase the protein content of different foods(3–6). However, their addition changes the functional and sensory properties of the final protein-fortified product(7). Therefore, enzymatic hydrolysis is employed to improve the techno-functional properties of these ingredients, however, the bitterness of the resulting hydrolysates limits their application. This study aimed to investigate the effect of hydrolytic enzyme preparation on the taste properties of MPC and PPI hydrolysates when incorporated as ingredients in protein-fortified tomato soup.

Solutions of MPC and PPI containing 3% total solids (w/w) were hydrolyzed at 50°C for 30 min using Neutrase®, Umamizyme and Protease AN “Amano” 100SD at an enzyme-to-substrate ratio of 1%. Bitterness in the hydrolysates was assessed with 16 semi-trained participants using labeled magnitude scales (LMS) and by 44 participants using a ranking test. Both tests showed that the least bitter hydrolysates were those generated using Umamizyme and Protease AN “Amano” 100SD. These hydrolysates were used to develop protein-fortified tomato soup with 3% of protein powders, that were characterised by 38 naïve consumers using hybrid quantitative descriptive profiling.

ANOVA on the bitter taste revealed that soups containing hydrolysed MPC (regardless of the hydrolytic enzyme used) were significantly more bitter compared to the control unhydrolyzed protein-fortified tomato soup (p<0.001). Bitterness in the protein-fortified tomato soup was masked using various ingredients, applying the principle of taste-taste interactions. A ranking test with 43 naïve participants showed that a combination of tomato puree and sucrose successfully reduced bitterness.

Overall, the enzyme preparation used affected the bitterness of the MPC and PPI hydrolysates and consequently the taste of the protein-fortified tomato soup. The use of Umamizyme and Protease AN Amano resulted in less bitter protein hydrolysates (both PPI and MPC) compared to Neutrase (p<0.001). Taste-taste interactions resulting from a combination of ingredients could successfully be employed to reduce bitterness in the protein-fortified tomato soup. Since these soups are aimed to be consumed by older people, further work will aim to test their preference.

The increasing consumer interest in reduced-sugar, natural, sustainable options and healthier baked goods has prompted research into alternative non-caloric sweeteners of natural origin, like Stevia, as substitutes for conventional sugar in bakery items(1). However, the bitter aftertaste associated with stevia is a significant challenge in its application as a sugar substitute(2).

This study delves into innovative baking, focusing on developing health-conscious oat-quinoa cookies sweetened with Stevia to evaluate the possibility of using Inulin to enhance acceptability.

Three types of Cookies were formulated using oats and quinoa flour: sugar-based (SuC), steviabased (StC) and stevia+inulin-based (InStC). SuC served as the control. The optimised formulas were tested using physical, chemical, and sensory parameters.

After approval from the Ethics Committee Board, University of Limerick(06098S&E), sensory analysis was conducted to determine consumer preference (n = 89). A 9-point hedonic scale was used to evaluate odour, taste, colour, sweetness, aftertaste, texture, and overall impression(3). The fiber content of the cookies was calculated based on the nutritional information of the ingredients. After baking, water activity (aw) and texture were also measured on days one and five. Antioxidant activity (DPPH, TPC, FRAP and Total Monomeric Anthocyanins) was also evaluated.

All data was statistically evaluated using IBM SPSS Statistics (Version: 28.0.1.1 (14)). One-way ANOVA test- LSD post hoc test was carried out for sensory, antioxidant and aw assays.

Based on the sensory study results, there was no perceived difference between odour and colour for the three formulations. The average evaluation score for Overall Impression was 6.6>5.9>5.4 (p<0.001, p = 0.016) for SuC, InStC, and StC, respectively. For Texture, 7.0>6.3>5.5 (p = 0.818, (p<0.001) for SuC, InStC, StC, respectively. For the Taste attribute, it was 6.5>5.9>5.5 (p<0.001, p = 0.087) for SuC, InStC, and StC, respectively. A statistically significant difference was observed for both overall impression and texture between InStC and StC.

Regarding fibre content, InStC had a significantly higher fibre content, 7.02%, compared to StC 3.36% and SuC 3.11%. A statistically significant difference in aw was observed between the StC and InStC on day one and day 5 (p<0.05), with the StC having a higher aw. Texture analyser results correlated with the results of aw. No statistically significant difference was observed between the samples for the antioxidant activity (p>0.05).

These findings demonstrate the potential of incorporating functional ingredients such as inulin to improve stevia-sweetened baked goods’ sensory acceptability and physical properties, aligning with the growing consumer preference for healthier baked products.

The low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet is recommended as a first line therapeutic management strategy for irritable bowel syndrome (IBS)(1). The low FODMAP diet is supported by meta-analytical evidence(2), and demonstrates acceptability and effectiveness for improving symptoms and quality of life (QoL) in 50-75% of individuals with IBS. However, a subset of individuals (25-50%) do not respond to the diet(3). The identification of individual-level predictors of treatment response across all three phases of the low FODMAP diet is currently lacking. The study aims were to assess psychological predictors of symptom and QoL response to the low FODMAP diet in patients with IBS. Adults with IBS underwent a three-phase low FODMAP diet, guided by individualised dietetic education. Predictor variables included levels of depressive, anxiety, and extraintestinal somatic symptoms, stress, treatment beliefs and expectations, behavioural avoidance, and illness perceptions. Symptom severity and QoL were the main outcomes. Questionnaires assessing psychological predictors, symptoms and QoL were administered at five points: pre-dietitian (week 0), post-dietitian, end of elimination (week 5), end of reintroduction (week 13), and end of personalisation (week 25) phases. Latent class growth analysis was used to identify classes of response trajectories for symptoms. Linear mixed models were used to test the effect of baseline psychological scores on symptoms and QoL over time. Cross lagged panel models determined the directional predictive relationship between psychological predictors and symptom severity. 112 participants (89% F) median age 30 ± 17 years were included. There were three classes of symptom response trajectories, including ‘non-improvers’ (21.3% of participants) with high initial symptom severity and minimal improvement, ‘improvers’ (22.5% of participants) with low initial symptom severity and significant improvement, and an ‘intermediate’ group (56.2% of participants) with moderate initial symptom severity and significant improvement. Higher treatment beliefs predicted a stronger initial symptom response (effect on linear slope p = 0.036). Lower gut-specific anxiety, as well as higher levels of personal and treatment control at baseline predicted a stronger reduction in IBS symptom severity and improved QoL from week 0 to week 25. Participants with higher levels of baseline psychological symptoms and negative illness perceptions (i.e., lower emotional representations) predicted a stronger initial and later QoL response (effect on linear (p = 0.006) and quadratic (p = 0.049) slopes). Increased cyclical time beliefs predicted poorer initial and later QoL response (effect on linear (p = 0.015) and quadratic (p = 0.029) slopes). Individuals experiencing lower to mid-range symptom severity at baseline had greater improvement with the low FODMAP diet. Lower anxiety, positive illness views and higher treatment beliefs predict better QoL and symptom response. Personalised strategies are crucial for optimising low FODMAP diet effectiveness in IBS.

Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice for patients with medically-refractory ulcerative colitis (UC) and familial adenomatous polyposis (FAP). Whilst quality of life is generally good, as many as 83% of patients associate dietary factors with the onset of symptoms(1) and around two-thirds employ some form of dietary restriction post-pouch creation(2,3). There is growing interest to understand the role of diet (as a whole) on pouch function and how it can be used therapeutically. It is imperative that we know the dietary characteristics of pouch patients before attempting to introduce strategies altering their food choice. Since there is good rationale to assess overall diet quality to identify potential avenues for targeting dietary strategies, this study aimed to examine the frequency of perceived food intolerances and diet quality in patients with an ileoanal pouch and the relationship between these two indices. In this cross-sectional study, patients with an ileoanal pouch completed a food intolerance questionnaire and a validated 297-item semi-quantitative food frequency questionnaire (Monash Comprehensive Nutritional Assessment Questionnaire). Dietary data was used to score diet quality using the 2013 Dietary Guidelines Index (DGI), a scoring system which compares how closely an individual’s dietary intake aligns with the Australian Dietary Guidelines (ADG). The DGI also comprises of 11 subcomponents (scored out of 10 respectively) based on each of the ADG guidelines and provides a total score of 110, with higher scores reflecting greater compliance to the ADG. In order to determine if perceived dietary intolerances was negatively associated with the intake of specific dietary factors, univariable and multivariable linear regression analysis of the correlation of intolerance and diet quality was performed. Of the 58 (10 FAP and 48 UC) patients studied, 81% of UC and 80% of FAP patients reported dietary intolerances. Mean total DGI score was 78 (95% CI: 74-80) of 110 in the overall pouch cohort with no differences across pouch sub-groups. However, only 5% of patients achieved a full score for food variety. Both uni- [OR −0.94 (−1.7,-0.10); p = 0.02] and multivariable analysis (adjusting for age and sex) showed that only intolerances to dairy products were associated with reduced intake of lactose-containing dairy [OR −0.29 (−1.8,-0.08); p=0.03]. No other significant correlations were found for overall or subcomponents of DGI scores. High rates of perceived food intolerances were observed in patients with an ileoanal pouch. However, only those with perceived dairy intolerances restricted their intake of lactose-containing dairy products. Additionally, patients with ileoanal pouch scored highly for overall diet quality but specific gaps in achieving better diet quality, particularly for diet variety were observed. These results provide some starting points for targeted dietary counselling to optimise nutritional health and potentially to improve pouch function these patients.

This abstract was awarded the prize for best oral presentation.

Caffeine, a natural stimulant, is found in foods, beverages, and food supplements (FS). Excessive caffeine consumption has been associated with cardiovascular impairments, anxiousness and sleep disruptions1. The European Food Safety Authority (EFSA) estimated safe intake levels of caffeine: a single dose of up to 200mg and a daily intake of up to 400mg, are considered safe for the general population2. Regulation (EU)1169/2011 requires products containing caffeine to include additional labelling warnings, ‘Contains caffeine’ or ‘High caffeine content’3. In Ireland, all FS placed on the market must be notified to the Food Safety Authority of Ireland (FSAI) via the Food Notifications System (FNS)4.

The aims of this study were to: (1) Identify caffeine-containing FS notified to the FSAI from January 1st to December 31st 2023, (2) Investigate whether these FS comply with relevant labelling requirements, (3) Assess the safety of these products in line with the EFSA safe intake levels.

Data on caffeine-containing FS notified to the FSAI in 2023 was extracted from the FSAI FNS. Information extracted included product name, contains caffeine/high caffeine content statements, amount of caffeine, ingredients list and directions for use. Analysis was conducted using IBM SPSS (version 29.0.01).

There were 325 caffeine-containing FS notified to the FSAI in 2023. This study identified 8 categories of caffeine-containing FS, based on their function: pre-workout (n163), botanicals (n14), vitamin and minerals (n12), gaming (n7), before and/or during exercise (n45), fat burners (n57), general stimulants (n23) and energy drinks (n4).

Over 80% of these FS (n276) used “contains caffeine” and 9% (n30) used “high caffeine content” statements on their label. The remaining 5% (n19) used neither statement. Less than a fifth (14%) (n45) of notified FS did not comply with legislative labelling warnings (these products contained incorrect or no caffeine labelling statements) while the remaining 86% (n280) were deemed compliant.

Notified FS contained information on directions for use and were either to be consumed once-aday (n243) or multiple times throughout the day (n82). Over a quarter (n90) of the once-a-day FS exceeded EFSA’s safe single-dose intake of 200mg. Additionally n2 of the FS contained caffeine in amounts exceeding EFSA’s safe daily intake limit of 400mg.

This study identified FS on the Irish market with high caffeine content, exceeding both EFSA’s safe single-dose and daily intake levels, before additional dietary sources of caffeine are considered. Labelling compliance rates in this study are high. The FSAI will continue to monitor this category of FS, as the market of caffeine-containing FS grows.

Our diet and its impact on the human gut microbiota in terms of composition and function are key determinants of human health across the life-course(1). Fermented vegetables can have enhanced functional and nutritional properties through substrate transformation by microbes and production of biochemicals during the fermentation process(2). Kimchi is a traditional Korean vegetable ferment produced via spontaneous lactic acid bacteria fermentation. Plant nutrients and biochemicals, microbial metabolites and microbial cell components are present in kimchi(3). As live products, fermented vegetables present challenges to commercial producers who need shelf/ transport stability to deliver consistent products to consumers. We hypothesise that fermented vegetable health advantages will be preserved by freeze-drying, while enabling product stability, extended shelf and storage life, stable transportation and utility as food ingredients.

Utilising existing kimchi physiochemical data, we identified kimchi biochemicals (KBs) (benefit health but not essential to it) and kimchi nutrients (KNs) (essential to health). We quantified these components in 3-day old fresh kimchi (T3) and in 3-day old fresh kimchi that had been freeze-dried and powdered (T3 FDP). We sampled technical triplicates and calculated P values using an unpaired 2 tailed t-test.

The hypothesis that KBs and KNs in T3 FDP are preserved at levels not statistically significantly different to those in (T3) (P > 0.005) was disproved. Components of kimchi were affected differently by the FDP process, with decreases in some and increases in others. As a result, the overall profile of KBs and KNs in T3 FDP was different to T3. Based on a daily portion of fresh kimchi being ∼50 g, there was 2.64 g KBs and KNs in 50 g T3 and 2.28 g KBs and KNs in equivalent portion T3 FDP (7.5 g), a reduction of 13.64% after FDP in KBs and KNs combined. Unexpectedly, soluble fibre and iron were significantly lower in equivalent sample T3 FDP compared to T3 (P=0.003 and P < 0.0001 respectively) and vitamin B9 was significantly higher in T3 FDP compared to T3 (P < 0.0001). For KBs, acetic acid and lactic acid were significantly lower in T3 FDP (P=0.020 and P=0.046 respectively), but propionic acid was undetectable in T3 and the equivalent sample T3 FDP contained 1.44 g. Capsaicinoids were not detectable in T3, but were notably present in T3 FDP.

This study represents a critical first step in understanding the extent to which the functionality of fresh kimchi is preserved in its freeze dried and powdered form (termed a FermentceuticalTM). Improving health through fermented foods is a critical concept for consumers, food manufacturers and healthcare professionals, alike.

An acute increase in intestinal epithelium permeability is induced by prolonged exertion in the heat, resulting in the translocation of pathogenic bacteria and endotoxins from the lumen into the circulation, causing a systemic inflammatory response and debilitating symptoms(1). Acute exercise-induced gastrointestinal syndrome mimics chronic health conditions with which an impaired intestinal barrier function is associated, including coeliac disease, inflammatory bowel disease, diabetes, Alzheimer’s and liver diseases(2). Intestinal epithelium permeability is typically assessed using a dual sugar absorption test, by administering a drink containing non-metabolisable sugars (e.g. lactulose [L] and L-rhamnose [R]) that can enter the circulation by paracellular translocation when the epithelium is compromised, and are subsequently excreted and measured cumulatively in the urine(3). We aimed to demonstrate that our recently developed ion chromatography protocol(4) can be used to accurately quantify L/R ratio in the plasma of participants exercising in hot ambient conditions and to determine the impact of nutritional intervention on intestinal epithelium permeability. Further, we hypothesised that measuring L/R in plasma collected at intervals during the post-exercise recovery period would reveal more information about intestinal permeability compared to previously published cumulative urine L/R data(3). Endurance-trained participants completed a set of randomised crossover studies, consisting of 2 h running at 60% V˙O2max in temperate, warm and hot ambient conditions (n = 8) and/or in the heat while consuming water, carbohydrate or protein (n = 9). The dual sugar solution was ingested at 90 min of exercise and blood was sampled at 0, 1, 2 and 4 h post-exercise. Plasma sugars were quantified by high-performance anion exchange chromatography with pulsed amperometric detection (HPAEC-PAD) and L/R ratios were compared by two-way repeated measures ANOVA with Tukey’s multiple comparisons. Plasma L/R increased immediately post-exercise in the heat (0.15 ± 0.11) compared with temperate (0.06 ± 0.04, p<0.001) and warm (0.09 ± 0.08, p<0.01) conditions, while consuming glucose before and during exercise alleviated this (0.02 ± 0.02, p<0.001), and this novel information was otherwise missed when measuring urine L/R. Consuming glucose or whey protein hydrolysate during exercise attenuated intestinal permeability from exertional heat stress throughout recovery, with the mean plasma L/R over 4 h reduced from 0.11 ± 0.05 to 0.04 ± 0.03 (p<0.001) and 0.06 ± 0.04 (p<0.01) with glucose and protein, respectively. We recommend using the dual sugar test with quantification of plasma sugars at intervals by HPAEC-PAD to maximise intestinal permeability data collection in exercise gastroenterology research and beyond, as this gives additional acute response information compared to urinary measurements. Our approach can be employed to investigate and develop personalised nutrition strategies that prevent intestinal hyperpermeability during exertional heat stress. This has implications for athlete performance and safety, and can also build upon occupational health and safety practices and inform chronic disease management.

Regulation (EC) No 1924/2006 outlines the rules for nutrition and health claims (NHCs), permitted in the European Union (EU)(1). Previously, the Food Safety Authority of Ireland (FSAI) completed work on the compliance of NHCs with Regulation 1924/2006 on yoghurts(2). Potential noncompliant rates of 1.5% for nutrition claims and 74% for health claims were reported. The study highlighted further research in this area was needed to understand the overall rates of NHCs compliance of food products on the Irish market. Therefore, the aim of this study was to assess the compliance of NHCs made on delicatessen meats and similar (DM) and bread products (BP) on the Irish market.

Food product label and composition information was collected from the Irish market in 2021 as part of the EU Joint Action Best-ReMaP project. The inclusion criteria for this study were the presence of an Irish address and NHCs on the product label. Based on these criteria, 14.6% of DM and 47.9% of BP were eligible for inclusion in this study. A representative sample of 100 products per category were randomly selected, using the RAND Excel function, and compliance was assessed against Regulation 1924/2006. NHCs were considered either compliant, non-compliant or potentially non-compliant. Where definitive compliance could not be established using the Regulation, a claim was deemed potentially non-compliant. Analysis was conducted using Microsoft Excel.

There were 205 claims identified on the 100 DM products. The compliance rate of these claims was 85.4% (n = 175) and the non-compliance rate was 14.6% (n = 30). Of the 30 non-compliant claims observed across 9 DM products, 28 of these were non-compliant as the amount of the claimed nutrient was not labelled. The other 2 non-compliant claims were general health claims which were not linked to an authorised health claim. There were 293 claims on the 100 BP with a compliance rate of 85.3% (n = 250), a non-compliance rate of 12.9% (n = 38) and a potentially non-compliant rate of 1.7% (n = 5). The 43 non-compliant and potentially non-compliant claims were observed across 23 products. Most (n = 24) of which were due to non-compliant general health claims. The overall compliance of products was 91% (n = 91) for DM and 77% (n = 77) for BP.

Overall, this study demonstrates that there is a high rate of compliance for nutrition claims on DM and BP while identifying some key areas of non-compliance in health claims. This work provides important information for the FSAI as it identifies the issues faced by businesses in complying with the legislation and assists in understanding what compliance building resources are needed. Future work in this area is needed to assess the level of compliance of NHCs on other food categories on the Irish market.

Diet is implicated in the development of Inflammatory Bowel Disease (IBD). However, the role of diet in reducing inflammation and managing prevalent disease is unclear (1–3). Previous studies have analysed the relationship between dietary patterns and occurrence of flares or symptoms, but not disease activity or inflammation (4–5). It is important to explore the role of habitual diet in management of IBD to provide targeted dietary recommendations. We explored the relationship between dietary intake with disease activity and inflammation in an Australian adult cohort with and without IBD. We analysed dietary and clinical data from the Australian IBD Microbiome (AIM) study. AIM is a prospective longitudinal cohort study of adults and children with Crohn’s Disease (CD), Ulcerative colitis (UC) and healthy controls (HC). Habitual dietary intake of food groups, fibre, polyphenols and fermented foods was collected by merging dietary data from 3-day food records and food frequency questionnaires with PhenolExplorer and the Australian Fibre Categories Database. Dietary patterns were explored using Principal Component Analysis (PCA) and cluster analysis (CA) in IBM SPSS Statistics (V29). Associations between dietary intake, clinical disease activity categorised as remission or active, and faecal calprotectin (FCAL) were explored in adult participants. A total of 412 participants (IBD = 223, HC = 189) were included. FCAL data was available for 211 participants (HC = 100, CD = 49, UC = 62). Median (IQR) FCAL at baseline was 20 (20) mg/kg for HC and 33 (127) mg/kg for IBD, indicating clinically irrelevant inflammation (FCAL >50mg/kg = clinical inflammation). PCA identified 7 distinct dietary patterns for adults with IBD. A dietary pattern of high plant diversity was associated with active CD. In the total IBD cohort, low association to a 'Prudent’ pattern was positively associated with low FCAL, and high association to a 'Meat-eaters’ dietary pattern was positively associated with moderate FCAL. CA revealed 3 distinct clusters amongst participants with IBD. No significant difference between diet cluster and disease activity or FCAL was seen. There were no significant differences in intake of fibre or polyphenols between remission vs active disease in participants with IBD. A significant difference between total, soluble and insoluble fibre and FCAL categories was seen with a higher fibre intake associated with lower FCAL. Higher plant-diversity and 'Prudent’ dietary patterns are associated with active disease and higher FCAL in Australian adults with IBD. Reverse causality cannot be ruled out, with analysis of larger cohorts and clinical trial data needed to clarify this.

Patients with inflammatory bowel disease (IBD) have higher risk of developing cardiometabolic diseases due to chronic gut and systemic inflammation which promotes atherogenesis. Adopting healthy lifestyle habits can prevent development of cardiometabolic diseases, but can be challenging for people with IBD. The IBD exercise and diet (IBDeat) habits study describes the lifestyle habits and cardiometabolic disease risk factors of adults with IBD in Aotearoa, New Zealand (NZ).

This is a cross-sectional study including adult NZ IBD patients recruited online via Crohn’s and Colitis NZ and Dunedin hospital from 2021 to 2022. An online questionnaire collected demographics, smoking status, comorbidities, medications, disease severity scores, quality of life, physical activity, and dietary intake. The Dunedin cohort had physical measurements taken including anthropometrics, handgrip strength, blood pressure, body composition (bioelectrical impedance), blood nutritional markers, and faecal calprotectin. Data were compared to established reference values and linear regression analysis investigated associations between lifestyle habits and cardiometabolic risk factors. The study received University of Otago ethical approval (reference: H21/135). A total of 213 adults with IBD (54% Crohn’s disease; 46% ulcerative colitis) completed the online questionnaire and a subset of 102 from Dunedin provided physical measurements. Participants characteristics were: median age 37 (IQR 25, 51) years, 71% female, 82% NZ European, 4% smokers, and 1.4% had active IBD. Thirty-five percent of participants had at least one comorbidity and 34% of participants had poor quality of life. Known dietary risk factors associated with cardiometabolic diseases were common: low intakes of vegetables (77%), fruit (51%), fibre (35%) and high intakes of total fat (84%) and saturated fat (98%). Physical activity recommendations were met by 61% of participants and 63% reported barriers to being more active from fatigue (63%) and joint pain (54%). Other cardiometabolic risk factors were common in the Dunedin cohort: high LDL (79%) and total cholesterol (76%), central adiposity (64%), high body fat percentage (44%), high blood pressure (26%), and low handgrip strength (25%). Regression analysis showed that vegetable (per serve) and carbohydrate (per 5% of total daily energy intake (TE)) were associated with 0.22 mmol/L (95%CI 0.43, 0.013) and 0.20 mmol/L (95%CI 0.34, 0.057) lower LDL cholesterol. Discretionary food items were associated with higher LDL cholesterol, 0.11 mmol/L per daily serve (95%CI 0.028, 0.19). A 5% difference in TE intake from carbohydrate was associated with 1.11% (95%CI 2.22%, 0.0038%) lower body fat percentage while protein was associated with 3.1% (95%CI 0.81%, 5.39%) higher body fat percentage. Physical activity had weak associations with cardiometabolic disease risk factors. Adults with IBD have multiple modifiable risk factors for cardiometabolic diseases. Vegetable and carbohydrate intake were associated with lower LDL cholesterol concentration while discretionary food items showed otherwise. Protein intake was associated with higher body fat percentage.

Sports-related concussions (SRC) may impact athletes at all levels, from recreational to professional. SRC disrupts brain function, initiating various transient, and subjective symptoms(1). Due to the gut-brain axis, gastrointestinal (GI) function is affected and may cause nausea, vomiting, and abdominal pain. Post-concussion GI symptoms may hinder digestion, nutrient absorption, and energy availability to the brain(1), and their prevalence among Irish athletes is unknown. This study aimed to investigate gastrointestinal disturbances experienced by Irish athletes post-concussion.

In January 2024, following ethical approval, an online survey was distributed to athletes and their support teams (coaches, nutritionists, physiotherapists, etc.) via social media, email, posters, and word of mouth. Eligible athletes had experienced a concussion/ mTBI. The survey included sections on general and GI-specific symptomology, demographics, injury history, digestive function, and gut health. Questions were retrospective and specific to the Time of Participation (ToP). Quantitative data analysis was performed using Excel.

This research presents preliminary data on fifty-three Irish athletes, (43% female) between 18 and 40 years (median = 25). Athletes participated in a variety of sports, including Gaelic football (60%), rugby (53%), soccer (49%), hurling/camogie (30%), running (19%), equestrian (15%), field hockey (9%), athletics (11%), martial arts (11%), either at elite, recreational, or competitive levels. Athletes had sustained 1 to 6 concussions (median = 2), between 10 days (February 2024) to 180 months (2009) before study participation (median = 18 months).

Their ToP bowel function ranged from moving once (57%), 2-3 times (23%), 4-6 times (9%) daily, or once every 2-3 days to once a week (12%). Using the Bristol Stool Form (BSF) scale (4) at ToP, 45% were type 3 or 4, and 10% were type 2 (3). Acutely post-concussion participants’ bowel function became more frequent, with 43% moving once daily, 30% 2-3 times, 6% 4-6, and 2% moving 7 times or more daily. 19% had experienced a reduction in bowel movements to once every 2-3 days, 4-6 days, or once a week post-concussion. Their stool forms ranged from hard, lumpy (type 1, 2), sausage-shaped (type 3, 4) to watery (type 5, 6, 7) on BSF (3). All participants identified prevalence of GI symptoms. Rating tiredness (55%), loss of/poor appetite (54%), and nausea/vomiting (47%) as most severe. Increased bloating, flatulence, urgency to open bowels, stomach gurgling, pain/discomfort, constipation, incomplete evacuation, diarrhoea, indigestion, reflux, heartburn, and increased cravings were also reported.

Athletes experienced increased bowel movements, irregularities, and constipation, alongside varying symptoms of appetite changes, nausea, vomiting, flatulence, and sensitivities, which resolved as most athletes began to recover.

Irish athletes encountered diverse GI disturbances post-concussion. Athletes and their professional support teams need to be mindful that head injuries affect GI function, causing symptoms such as a loss of appetite, vomiting, and changes in bowel habits.

Dietary therapies have revolutionised treatment for irritable bowel syndrome (IBS). However, response rates to the diet with the highest evidence of efficacy (the low FODMAP diet) remain at 50-75%, suggesting other potential drivers of symptom onset. A low food chemical elimination-rechallenge diet targeting bioactive food chemicals (including salicylates, amines, glutamate and other additives), is commonly applied in Australia in patients exhibiting both gastrointestinal and extra-intestinal symptoms. One key food chemical, salicylate, has been shown to elicit symptoms in IBS patients with aspirin-sensitivity(1), and 77% of IBS patients have reported amine-rich foods trigger symptoms(2). However, data supporting the full low chemical diet is scant, and safety concerns exist due to its restrictive nature potentially causing nutritional deficiencies and disordered eating. This cross-sectional survey aimed to evaluate the frequency of co-existing extra-intestinal symptoms, as well as explore patient perceptions and use of the low chemical diet in those with IBS and healthy controls. Participants with IBS (IBS-Severity Scoring System (IBS-SSS) >75), and healthy controls (not meeting Rome IV and IBS-SSS ≤75) were recruited via online advertisement. Validated questionnaires were used to assess gastrointestinal symptoms (IBS-SSS), extraintestinal symptoms (extended PHQ-12), nutrient (Comprehensive Nutritional Assessment Tool) and food additive intake (IBD-Food additive questionnaire). Additional questionnaires assessed use of dietary therapies with specific focus on food chemicals. Data was analysed using independent samples t-test and chi-square test. 204 IBS (Total IBS-SSS, 277 ± 79) and 22 healthy controls (36 ± 28, p<0.01) completed the study. IBS participants were more likely to report extra-intestinal symptoms including headaches (p<0.01), migraines (p = 0.03), fatigue (p<0.01), difficulty sleeping (p = 0.03), rhinitis (p = 0.02), urticaria (p = 0.04) and mood disturbance (p<0.01). IBS participants were more likely to report at least one food chemical as a trigger for gastrointestinal (38% vs 13%, p = 0.03) and/or extra-intestinal (30% vs 9%, p = 0.04) symptoms. In the IBS group, the most common suspected dietary triggers for gastrointestinal symptoms were salicylates (19%) followed by MSG (17%) and artificial colours (14%); while for extra-intestinal symptoms, MSG (15%) was most common, followed by amines (14%), and sulphites (12%). There was no significant difference in consumption of ultra-processed, additive containing foods. Twenty-one (10%) IBS participants were following a low chemical diet, with dietary advice provided by a dietitian (n = 13), general practitioner (n = 6), gastroenterologist (n = 6), naturopath (n = 3), family/friend (n = 4) and/or the diet was self-initiated (n = 7). Fourteen of the 21 (67%) reported following both a low food chemical and low FODMAP diet. Patients with IBS are more likely to report extra-intestinal symptoms compared to healthy controls. Despite limited evidence, a low food chemical diet is utilised to manage both gastrointestinal and extra-intestinal symptoms. Of concern, many respondents following a low food chemical diet reported also following a low FODMAP diet, which may have implications for nutritional adequacy.

Ultra-endurance running (UER) events are defined based upon duration, exceeding 4-6 hours, or distance, surpassing the 26.3-mile marathon(1). Oftentimes event courses comprise of extreme environmental conditions, altitudes, temperatures, terrains, or a combination. UER poses significant short- and long- term health implications. UER athletes’ risk chronic maladaptation of various systems, namely the cardiovascular, immune, and digestive(2). Research suggests that exercise-associated gastrointestinal symptoms (Ex-GIS) are among the leading cause of underperformance in distance running. Altered mesenteric blood flow, gastric emptying, and peristaltic activity from exercise are exacerbated by the conditions accompanying many ultraevents, impairing performance and recovery. Though Ex-GIS are generally temporary, there remains the potential for long-term medical conditions to arise, such as ischemic bowel disease and haemorrhagic gastritis. Ample nutritional planning and intake throughout training and racing is critical to enhance performance and recovery while minimizing Ex-GIS and its associated chronic conditions(3).

The aim of this research was to investigate the nutrition beliefs, and practices of ultra-endurance runners in Ireland.

An adapted electronic version of a validated questionnaire by Scrivin at al.(4) was used. A recruitment infographic of eligibility criteria (≥18 years old, healthy, no diagnosed health conditions except for irritable bowel syndrome, and training for/ competing in running events exceeding 4 hours) was distributed online and at events (Connemarathon, Kerry 50K ultra). Individuals that contacted the researchers and were deemed eligible for inclusion were directed to a Microsoft Forms page, where they gave consent and completed the questionnaire. Data were analysed using IBM SPSS Statistics version 28 (IBM Corporation New Orchard Road Armonk, NY 10504-1722, United States).

Sixty-eight (n = 68) individuals completed the questionnaire with one excluded due to medical diagnosis. Remaining participants (n = 46 males, n = 21 females) ranged from 25-66 with one over 66 years old. Previous experience was the main factor influencing nutrition practices (N = 30, 45.5%). N = 3 (4.5%) sourced information from qualified professionals. N = 42 (59.4%) experienced Ex-GIS, usually evenly throughout training and competition. Many had not implemented dietary or nondietary strategies to manage Ex-GIS. Supplementing with nitrates (N = 9) and probiotics (N = 4) were the most common dietary practices to alleviate Ex-GIS, while other (N = 14) and portion control (N = 13) were the most reported non-dietary practice.

This research cohort reflects the broader UER community, with 81% being >35 years old “masters” athletes, and male. This study suggests that Ex-GIS are commonplace throughout. Similarly, this research highlights the range of symptoms experienced. The absence in dietary and non-dietary practices employed for Ex-GIS management suggests a shortfall in the availability of nutrition information specific to this problem. Further research is required to understand the mechanisms behind UER Ex-GIS, its management, and best practices for communicating these to the target audience.

Food choice determinants in the general population are influenced by sociocultural, sensory, nutritional, and economic factors, among others(1). For athletes, these choices are further complicated by additional sporting and nutritional demands(2). The objective of this study is to conduct the first large-scale analysis of the determinants of food choice in athletes and active individuals, and to conduct comparison of these determinants across competition levels and sporting categories.

Participants, aged over 18, residing in Ireland, and engaged in competitive sport or structured physical activity at least twice weekly, completed an online survey via Qualtrics. The survey included the previously validated Athlete Food Choice Questionnaire (AFCQ)(3,4). The AFCQ comprises of 32 statements divided into 9 categories where athletes rate the frequency that their food choice is affected by various factors. Data were collected in February 2024, analysed using SPSS V28.0, with statistical significance set at P<0.05.

A total of 1,148 athletes (38% male, 62% female), median [IQR] age 26 years [21-40 years], reported participating in 7 hours [5-10 hours] of structured physical activity per week, spanning 32 sports. Participation levels ranged from non-competitive (32%) to those involved in international competitions (6%). Sensory appeal was highlighted as the most influential factor on food choices (P<0.01), followed by food and health awareness (P<0.01)—encompassing cooking ability, nutrition knowledge, and food planning. Performance-related factors were joint second most influential, with no significant difference with food and health awareness (P = 0.30). This included statements related to choosing food that enhances fuelling for competition, recovery and feeling energetic during training.

Ordinal logistic regressions showed variables such as age, gender, education level, and sporting variables such as competition level, sport type and average hours of exercise per week showed distinct impacts on food choice. For example, the nutritional attributes of a food impacts choice more as participants got older (Odds Ratio (OR) 1.02, 95% CI [1.01, 1.04], P = 0.01). However, the nutritional attributes had less influence if the participant was born in the USA (OR 0.37, 95% CI [0.16, 0.86], P = 0.02) or the rest of the world (OR 0.38, 95% CI [0.18, 0.81], P = 0.01) compared with those born in Ireland, and if the participant was a team sport athlete rather than an endurance athlete (OR 0.55, 95% CI [0.37, 0.81], P<0.01).

The determinants of food choice for athletes are multifaceted and more complex than those of the general population, attributed to additional exercise-related factors. Despite this complexity, sensory appeal remains the predominant influence across all sport types and competition levels. Understanding the dynamics of this food choice matrix in athletes allows for more personalised nutrition advice and identification of those at risk of poor dietary practices that may negatively impact upon their performance and health.

Eggs are highly digestible, nutrient-rich and are a valuable source of protein and choline, thereby promoting a range of health benefits. Several studies have found an association between protein intake and gastrointestinal microbial diversity(1), while bacterial fermentation of undigested protein in the large bowel can produce short-chain fatty acids, such as butyrate, positively influencing host metabolic health, gut integrity and immune function(2). On the other hand, dietary choline stimulates gastrointestinal bacterial production of trimethylamine and the prothrombotic compound trimethylamine-N-oxide (TMAO)(3). Despite these established links, limited studies have explored the effects of whole egg intake on indices of gastrointestinal health. This systematic literature review aimed to synthesise research that has investigated the impact of egg-supplemented diets or egg consumption on markers of gastrointestinal health including microbiome, function and symptoms. This review was conducted in accordance with PRISMA guidelines. Five databases (Ovid Medline, Embase, CINAHL Plus, SCOPUS, and PsychInfo), and reference lists of relevant papers, were searched from inception until April 2023. Studies were included if they examined the link between whole chicken egg consumption and gastrointestinal health in healthy adults (aged>16). Indices of gastrointestinal health were defined as any outcomes related to gastrointestinal factors, including symptoms, microbiome, inflammation, colonic fermentation and TMAO. Reviews and case studies were excluded. All studies underwent risk of bias assessment. Overall, 548 studies were identified and 19 studies were included after screening. Eight of these were randomised controlled trials (RCTs), 8 cross-sectional and 3 prospective cohort studies. Participants ranged in number between 20-32,166 and in age between 18–84 years. Study periods varied between 3–14 weeks for RCTs and 6 months–12.5 years for prospective cohort studies. RCTs examined intakes between 1–4 eggs/day, with the majority examining 3 eggs/day (n = 6). The primary outcome across 15 articles was TMAO levels, with most reporting no significant associations (n = 13). Five studies examined inflammation with inconsistent findings ranging from no alterations (in TNF-α, IL-8, CRP), increases (in anti-inflammatory marker LTB5, TNF-α), and decreases (in IL-6, CRP). Lastly, 7 studies explored alterations in microbiome. Two RCTs and 2 cross-sectional trials reported no alterations in microbial diversity in response to eggs. Meanwhile, 2 cross-sectional and 1 prospective study linked specific bacteria to consistent egg intake. Eggs were associated with species that produce butyrate (E.rectale, F.prausnitzii, M.smithii, and R.bromii), and protect against metabolic syndrome (A.muciniphila). This systematic review found that egg consumption did not increase levels of the undesirable biomarker TMAO and were associated with butyrate-producing bacteria. Evidence regarding the effect of egg intake on inflammation was inconsistent. This review revealed the general lack of available research investigating whole eggs and gastrointestinal health. Future carefully designed RCTs are required to improve understanding of how eggs may influence the gastrointestinal microbiome and colonic fermentation.

Adequate dietary fibre (DF) intake is recommended to relieve constipation and improve gut health(1). It is often assumed that individuals with constipation have relatively low DF intake and do not meet the recommended adequate intake of 25 g and 30 g for females and males, respectively. The 2008/09 New Zealand Adult Nutrition Survey confirmed that the mean DF was 17.9 grams (g) per day for females and 22.8 g per day for males, which was well below the recommended adequate intake(2). With the continuous shift of dietary patterns over time, we sought to compare the current usual DF intake of two cohorts of New Zealand adults: those who have constipation with those without constipation but with relatively low DF intake. We report baseline dietary data from two randomised controlled dietary studies (Kiwifruit Ingestion to Normalise Gut Symptoms (KINGS) (ACTRN12621000621819) and Bread Related Effects on microbiAl Distribution (BREAD) (ACTRN12622000884707)) conducted in Christchurch, New Zealand in 2021 and 2022, respectively. The KINGS study included adults with either functional constipation or constipation-predominant irritable bowel syndrome to consume either two green kiwifruit or maltodextrin for four weeks. The BREAD study is a crossover study and included healthy adults without constipation but with relatively low DF intake (<18 g for females, <22 g for males) to consume two types of bread with different DF content, each bread for four weeks separated by a two-week washout period. All participants completed a non-consecutive three-day food diary at baseline. Dietary data were entered into FoodWorks Online Professional (Xyris Software Australia, 2021) to assess mean daily DF intake. Fifty-six adults from the KINGS study (n = 48 females, n= 8 males; mean age ± standard deviation: 42.8 ± 12.6 years) and BREAD study (n = 33 females, n= 23 males; mean age: 40.4 ± 13.4 years) completed a baseline food diary. In the KINGS study, females with constipation had a daily mean DF intake of 25.0 ± 9.4 g whilst male participants consumed 26.9 ± 5.0 g per day. In the BREAD study, females without constipation had a mean daily DF intake of 19.4 ± 5.8 g, whereas males had 22.6 ± 8.5 g per day. There was a statistically significant difference in the mean daily DF intake between females with constipation and those without constipation (p < 0.001) but not between males (p = 0.19). These two studies found that DF intakes among females with constipation were not as relatively low as previously assumed, as they met their adequate intake of 25 g. Further data analysis from the KINGS and BREAD studies will reveal the effects of using diet to manage constipation and promote better gut health in these two cohorts of New Zealand adults.

Chronic low protein intake can negatively affect human growth, cardiovascular function, metabolic profiles, immunity and exacerbate deficiencies of other nutrients including iron(1). It’s widely accepted that athletes and active individuals have an increased requirement for dietary protein, however to date little is known about the prevalence of low protein intake or protein supplementation practices within this population in Ireland.

This study aimed to examine the following in an Irish population of athletes and active adults: (i) the prevalence, frequency, and reasons for using protein supplements and protein-fortified foods; and (ii) the proportion of those at risk of consuming less than 1.0g of protein/kilogram bodyweight/day.

Participants, aged ≥18 years, residing in Ireland, and engaging in competitive sport or structured physical activities at least twice weekly, completed a self-administered, web-based questionnaire. A validated protein intake screening tool(2) was included to estimate the risk of low protein intake based on self-reported food consumption over the previous 4-weeks. Data collection occurred in April 2024 and descriptives and Chi-squared tests were performed (IBM SPSS v29).

The questionnaire yielded 885 (median age=40yrs, range=18-77yrs; 57.6% female) completed responses. More than half (54.5%) of this population were athletes competing at either local (34.3%), regional (24.3%), national (25.8%) or international (15.4%) level, while the remaining 45.5% engaged in regular exercise only. Overall, 50.2% of this population used protein supplements, with a greater prevalence among men (55.5% vs 46.3%, P<0.01) than women. There was no difference in the use of protein supplementation between athletes (55.5%) and active adults (53.7%, P = 0.595). The main reasons participants provided for using protein supplements were: 1) they found it difficult to meet daily protein requirements through diet alone (59.4%), 2) their training goals required higher intakes (47.7%), and 3) convenience (41.1%). Based on data from the protein intake screening tool, 36.5% of this population were at risk of low protein intakes from food alone, with no difference between athletes and active individuals (P = 0.909), but a higher risk among men (47.7% vs 28.2%, P<0.01) than women. Those who were at risk of low protein intakes were no more likely to use protein supplements (P =0.972) or protein-fortified foods (P = 0.956) than those not at risk. Of those at risk, 49.1% and 4.5% did not consume any protein supplements or protein-fortified foods respectively, while only 14.4% took protein supplements daily and 7.7% consumed proteinfortified foods daily.

Up to a third of this population may not consume adequate protein through their diet alone. While protein-fortified foods and supplements may be helpful, athletes and active adults should attempt to meet their daily protein requirements through a balanced whole food diet, where possible.

Female athletes are increasingly participating in sport during pregnancy and returning postpartum. However, similar to the Sex Data Gap in sport and exercise research(1), there is limited evidence to support athletes during this life stage(2) especially as it relates to nutrition. Therefore, as optimal nutrition is essential for long-term maternal and child health, the aim of this study was to investigate specific wants, needs and behaviours in relation to nutrition during pregnancy and postpartum return to sport in athletes.

King’s College London provided ethical approval (Ref: LRU/DP-23/24-41676) and the study was pre-registered (https://doi.org/10.17605/OSF.IO/NCSZK). An exploratory cross-sectional online survey is being conducted and dissemination is occurring during April and May 2024. Primary variables are assessed using researcher developed and validated measures and included pregnancy and postpartum nutritional support needs, supplement use, athlete level, performance changes and sociodemographic characteristics. Residents of the UK or ROI, ≥ 18 years old, trained and/or competed as an athlete prior to and/or during pregnancy within the last eight years are eligible. All data was summarised using IBM SPSS Statistics. Due to the exploratory nature of the survey, preliminary descriptive evidence is shown and comparisons between groups (e.g. athlete level, region, number of pregnancies) will be presented.

35 eligible athletes (UK: 24 (68.6%); ROI: 11 (31.4%)) from 14 team and individual sports have completed the survey. Average age of participants was 34.2±3.2 and 32 (91.4%) had ≥1 child. 9 participants (25.7%) were currently pregnant, and 7 (20%) had retired due to pregnancy. Only 9 participants (25.7%) received any nutrition advice during pregnancy, and, of the postpartum participants, one participant (3.8%) received nutrition advice during the postpartum period. During pregnancy, participants reported wanting to receive advice from NHS Midwives, Obstetricians and Gynaecologists (37.7%) and fellow athletes who’ve previously experienced pregnancy (21%).

Whereas postpartum advice was preferable from NHS Midwives, Obstetricians and Gynaecologists (37.1%), sports-specific nutritionist/dietitian (37.1%) and general

nutritionist/dietitian (37.1%). During pregnancy, 28 participants (80%) reported wanting athletespecific nutrition advice related training needs during pregnancy and 19 participants (54.3%) reported wanting more information about pregnancy-specific supplement intake (e.g. folic acid). Postpartum, 22 participants (62.9%) reported wanting athlete-specific nutrition advice related training needs during postpartum and returning to sport and 20 participants (57.1%) reported wanting more information about breast or mixed feeding. The top listed challenges to returning to sport postpartum were childcare provisions (94.3%), infant feeding practices (85.7%) and sleep (82.9%).

The preliminary findings revealed that pregnant/postpartum athletes want further advice in areas such as nutrition advice specific to being an athlete and training during pregnancy and postpartum, pregnancy supplement intake, and infant feeding practices. These areas require further investigation so pregnant and postpartum athlete needs can be better met.

Depression is the largest global contributor to non-fatal disease burden(1). A growing body of evidence suggests that dietary behaviours, such as higher fruit and vegetable intake, may be protective against the risk of depression(2). However, this evidence is primarily from high-income countries, despite over 80% of the burden of depression being experienced in low- and middle-income countries(1). There are also limited studies to date focusing on older adults. The aim of this study was to prospectively examine the associations between baseline fruit and vegetable intake and incidence of depression in adults aged 45-years and older from 10 cohorts across six continents, including four cohorts from low and middle-income countries. The association between baseline fruit and vegetable intake and incident depression over a 3–6-year follow-up period was examined using Cox proportional hazard regression after controlling for a range of potential confounders. Participants were 7771 community-based adults aged 45+ years from 10 diverse cohorts. All cohorts were members of the Cohort Studies of Memory in an International Consortium collaboration(3). Fruit intake (excluding juice) and vegetable intake was collected using either a comprehensive food frequency questionnaire, short food questionnaire or diet history. Depressive symptoms were assessed using validated depression measures, and depression was defined as a score greater than or equal to a validated cut-off. Prior to analysis all data were harmonised. Analysis was performed by cohort and then cohort results were combined using meta-analysis. Subgroup analysis was performed by sex, age (45 – 64 versus 65+ years) and income level of country (high income countries versus low- and middle-income countries). There were 1537 incident cases of depression over 32,420 person-years of follow-up. Mean daily intakes of fruit were 1.7 ± 1.5 serves and vegetables 1.9 ± 1.4. serves. We found no association between fruit and vegetable intakes and risk of incident depression in any of the analyses, and this was consistent across the subgroup analyses. The low intake of fruit and vegetables of participants, diverse measures used across the different cohorts, and modest sample size of our study compared with prior studies in the literature, may have prevented an association being detected. Further investigation using standardised measures in larger cohorts of older adults from low- to middle-income countries is needed. Future research should consider the potential relationship between different types of fruits and vegetables and depression.