Nutrition is an important factor for an athlete’s overall performance and recovery. Previous research has demonstrated that sports nutrition knowledge is linked to balanced and healthy dietary practices(1,2). As coaches have an influential relationship with athletes, in relation to their dietary intake, understanding the nutritional knowledge of coaches is necessary in terms of supporting an athlete’s overall nutrition plan(3). The aim of this study was to investigate the nutrition knowledge of rugby coaches within the Irish Rugby and Football Union (IRFU) responsible for coaching young players.

An online questionnaire was distributed by the IRFU via email to National and Provencial coaches (n = 54) of 15-20 year old male and female players. The questionnaire consisted of two previously validated general and sports nutrition knowledge questionnaires(4,5). Ethical approval was provided by the ATU Sligo Department of Health and Nutritional Sciences Ethics Committee. Descriptive statistics were tabulated for coaches’ demographic data and their total and sub-category mean scores. An Independent samples t-test assessed the difference in mean nutrition knowledge score for coaches who gave advice and those who did not give advice on sports nutrition.

Twenty-eight coaches participated in the study, yielding a response rate of 55%. Nearly two thirds of participants (64.1%) were within the age range of 29 – 39 years; the length of time coaching was relatively balanced with 25% having 2 – 5 years’ experience, 35.7% had 5 – 15 years’ experience and 39.3% had over 15 years coaching experience. Coaches responded correctly to over half of all the questions asked (55.3%), which is below the minimum score of 75% set to determine adequate nutrition knowledge(6). There was no significant difference in nutrition knowledge score between coaches who reported having a formal nutrition training compared to coaches with no formal nutrition training. Fifty seven percent of coaches reported that they provided nutrition advice to their players.

In conclusion, the coaches that participated in this study did not have adequate nutrition knowledge. However, over half of the coaches reported giving nutrition advice to players, highlighting that coaches could benefit from a formal ongoing nutrition training program to improve their knowledge.

Snacking, namely, consuming food and beverages in-between main meals, especially snacks with a high fat, salt and/or sugar content, is a major contributor to excessive energy intake and long-term weight gain(1). There are many potential drivers of snacking behaviours, including physiological (e.g., hunger) as well as social, psychological, and emotional reasons(2). Individual differences, such as personality traits, have been linked to unhealthy snacking. Nevertheless, it is important to examine the potential explanatory pathways, such as motivations for snacking and habit strength, that may explain this relationship between personality and snacking. This cross-sectional study investigated the associations between personality traits, habit strength, motivations for snacking, and snacking behaviour, including choice and consumption. Participants were n = 230 Australian adults (female: n = 164; 71.3%) aged 18-77 years old (M = 34 years, SD = 13.4) who completed an online survey. The survey included assessments of personality traits (The Big Five Inventory 2), habit strength (the Self-Report Habit Index), motivations for snacking (The Eating Motivation Survey), momentary snack food choice (Snack Preference Task), and habitual snack food consumption (Snack Frequency Questionnaire). Overall, the most frequently selected motivations for snacking were ‘liking’, ‘convenience’, and ‘habit’. Correlation analyses were conducted to examine the relationship between motivations for snacking and snacking behaviour. We found that health motivation for snacking was negatively correlated with momentary choice (r = -.042, p <.01) and habitual consumption (r = -.033, p <.01) of unhealthy snack foods and beverages. Hierarchical multiple regression analyses were used to examine whether habit strength and the Big Five personality traits predicted both motivations for snacking and snacking behaviours after controlling for demographic variables. For health motivations for snacking, habit strength (beta = −0.15, p = .025), openness (beta = 0.50, p = .003, and conscientiousness (beta = 0.58, p = .001) were significant predictors. For momentary choice of unhealthy snacks, health motivation (beta = −4.35, p = .004), pleasure (beta = 3.53, p = .029), and visual appeal (beta = 5.29, p <.001) were significant predictors. For habitual consumption of unhealthy snacks, health motivation (beta = −5.39, p = .001), habit strength (beta = 2.89, p = .045) and neuroticism (beta = 5.16, p = .045) were significant predictors. These findings indicate that health motivation for snacking predicts both momentary snack preference and habitual snack food consumption. Moreover, personality traits may be linked with habitual unhealthy snacking behaviour via their association with specific motivations for snacking. Overall, these findings suggest that health promotion messages focusing on health motivation may be important for increasing healthier momentary and habitual snack choices to improve dietary intake and support weight management.

Depression and eating disorder (ED) risk are heightened during adolescence(1) and both were exacerbated during COVID-19 lockdowns. This analysis reports changes in self-reported symptoms of depression and eating disorders throughout the Fast Track to Health trial. Fast Track to Health was a 52-week multi-site randomised-controlled trial, conducted 2018-2023, comparing intermittent (IER) and continuous energy restriction (CER) in adolescents with obesity and ≥1 associated comorbidity(2). The Centre for Epidemiologic Studies Depression Scale-revised 10-item version for adolescents (CESDR) was used to assess symptoms of depression (no symptoms, sub-threshold, or possible, probable, major depressive episode). Eating Disorder Examination Questionnaire (EDE-Q) was used to assess ED risk; defined as global score ≥2.7, ≥2 episodes of binge eating with/without loss of control, or ≥1 episode of purging within the last 28-days. The Binge Eating Scale (BES) assessed severity of binge eating (no binge eating, mild/moderate, severe). Adolescents were monitored for disordered eating during dietetic consults. Linear mixed models, retaining all data consistent with intention-to-treat analysis, were used to estimate the change in outcomes from baseline to week-52. Descriptive statistics were used to describe the number of participants meeting screening criteria at baseline and week-52. One hundred and forty one adolescents were enrolled and 97 completed the trial, with median (IQR) EDE-Q score 2.28 (1.43 to 3.14), CESDR 9.00 (4.0 to 14.5) and BES 11.0 (5.0 to 17.0) at baseline. EDE-Q (change in estimated marginal means [SE], IER −0.63 [0.18], CER −0.56 [0.17]) and CESDR (IER −2.70 [1.15], CER −3.87 [1.07]) scores reduced between baseline and week-52 in both groups (p<0.05) with no difference between groups. There was a between group difference (p = 0.019) in change in BES. The IER group had a reduction between baseline and week-52 (−3.72 [1.27]) and the CER group had no change. At baseline, 31 (22%) adolescents were classified as having a possible/probable/major depressive episode, 110 (78%) met ≥1 ED criteria and 28 (21%) as mild/moderate or severe binge eating, reducing to 8 (9%), 56 (61%) and 15 (16%) respectively at week-52. A small sub-group of adolescents required additional support for disordered eating. Overall, treatment-seeking adolescents with obesity have symptoms of depression and ED. Although symptoms reduce for most, some required additional support. Screening and monitoring for depression and ED are important to ensure early intervention.

Daily sodium intake in England is ∼3.3 g/day(1), with government and scientific advice to reduce intake for cardiovascular health purposes having varying success(2). Eccrine sweat is produced during exercise or exposure to warm environments to maintain body temperature through evaporative cooling. Sweat is primarily water, but also contains appreciable amounts of electrolytes, particularly sodium, meaning sweat sodium losses could reduce daily sodium balance without the need for dietary manipulation. However, the effects of sweat sodium losses on 24-h sodium balance are unclear.

Fourteen active participants (10 males, 4 females; 23±2 years, 45±9 mL/kg/min) completed a preliminary trial and two 24-h randomised, counterbalanced experimental trials. Participants arrived fasted for baseline (0-h) measures (blood/urine samples, blood pressure, nude body mass) followed by breakfast and low-intensity intermittent cycling in the heat (∼36⁰C, ∼50% humidity) to turnover ∼2.5% body mass in sweat (EX), or the same duration of room temperature seated rest (REST). Further blood samples were collected post-EX/REST (1.5-3 h post-baseline). During EX, sweat was collected from 5 sites and water consumed to fully replace sweat losses. During REST, participants drank 100 mL/h. Food intake was individually standardised over the 24-h, with bottled water available ad-libitum. Participants collected all urine produced over the 24-h and returned the following morning to repeat baseline measures fasted (24-h). Sodium balance was estimated over the 24-h using sweat/urine losses and dietary intake. Data were analysed using 2-way ANOVA followed by Shapiro-Wilk and paired t-tests/Wilcoxon signed-rank tests. Data are mean (standard deviation).

Dietary sodium intake was 2.3 (0.3) g and participants lost 2.8 (0.3) % body mass in sweat (containing 2.5 (0.9) g sodium). Sodium balance was lower for EX (-2.0 (1.6) g vs -1.0 (1.6) g; P = 0.022), despite lower 24-h urine sodium losses in EX (1.8 (1.2) g vs 3.3 (1.7) g; P = 0.001). PostEX/REST blood sodium concentration was lower in EX (137.6 (2.3) mmol/L vs 139.9 (1.0) mmol/L; P = 0.002) but did not differ at 0-h (P = 0.906) or 24-h (P = 0.118). There was no difference in plasma volume change (P = 0.423), urine specific gravity (P = 0.495), systolic (P = 0.324) or diastolic (P = 0.274) blood pressure between trials over the 24-h. Body mass change over 24-h was not different between trials (REST +0.25 (1.10) %; EX +0.40 (0.68) %; P = 0.663).

Sweat loss through low-intensity exercise resulted in a lower sodium balance compared to rest. Although urine sodium output reduced with EX, it was not sufficient to offset exercise-induced sodium losses. Despite this, body mass, plasma volume and blood sodium concentration were not different between trials, suggesting sodium may have been lost from non-osmotic sodium stores. This suggests sweat sodium losses could be used to reduce sodium balance, although longer studies are required to confirm this thesis.

Globally, a third of total anthropogenic greenhouse gas emissions (GHGE) are produced by the food system(1). Estimating the carbon footprint of current diets is therefore important to consumers, businesses, and policymakers. With most home-consumed food in the United Kingdom (UK) purchased from supermarkets(2), supermarket purchasing records represent a novel data source that can provide insights into dietary patterns(3). These data are particularly useful in an environmental sustainability context as they provide information on the amounts of foods and beverages purchased, not just the amounts consumed (as in traditional dietary assessments). We estimated GHGE of foods and beverages purchased in Yorkshire and the Humber region of the UK using supermarket transaction data from primary-shopper loyalty cards over 12 months in 2022.

We mapped a UK retailer’s food and beverage products to GHGE (kg CO2-eq/kg) using data on the environmental footprint of food commodities(4), and grouped the products according to the Living Costs and Food Survey (LCFS) categories. The sustainability mapping process was guided by product sales (i.e., prioritising the most sold products and categories) and involved three stages utilising mapping approaches with different complexity, resulting in 98.6% of >28,000 store products being mapped. We estimated total GHGE of each product by multiplying the final mapped GHGE by the product weight (as sold). We then used these product-level GHGE estimations (kg CO2-eq/item) in conjunction with the sales data (number of items sold) to estimate the contribution of each product, and subsequently each LCFS category, to total GHGE from all purchases.

When incorporating sales, the LCFS categories with the highest contributions to total GHGE included ‘beef’ (19.6%), ‘milk’ (9.8%), ‘cheese and curd’ (8.6%), ‘ready meals’ (6.9%), and ‘poultry’ (5.5%). The LCFS categories among the lowest contributors to total GHGE included ‘confectionery products’ (0.2%), ‘pasta products’ (0.4%) and ‘soft drinks’ (0.5%). Although some LCFS categories had higher GHGE per kg for their products, they were sold in smaller quantities, and therefore, their contributions to total GHGE were lower in total. For example, ‘lamb’ was in the top five LCFS categories with the highest GHGE per kg (39.7 kg CO2-eq/kg) but contributed to 1.4.% of total estimated GHGE when incorporating sales information, which was less than ‘bread’ (2.2%) and ‘yoghurt’ (1.7%).

Our results highlight that although some foods might be very GHGE-intensive on a per weight basis, they have a lower overall GHGE impact if they are not frequently purchased in the population. These supermarket sales data are an important resource to understanding and subsequently tackling the environmental impact of the food system. Further research, including other environmental sustainability metrics (e.g., water and land use), is needed to provide a more comprehensive picture of the environmental footprint of foods and beverages purchased by UK consumers.

Associations between obesity and mental illness have been identified, but they are complex and bidirectional(1). Weight loss interventions have been proposed as a potential strategy to improve mental health in individuals with overweight or obesity, but the evidence remains inconclusive(2). Additionally, the role of specific foods in a weight loss diet and mental health outcomes is not well understood(3). This study aimed to explore the association between weight loss (with and without almonds) and self-administered psychological and sleep assessments, including the Profile of Mood States (POMS), the Perceived Stress Scale (PSS), the Zung Self-Rating Depression Scale (ZSDS), and the Pittsburgh Sleep Quality Index (PSQI). Participants (n = 140, 47.5 ± 10.8 years) with overweight or obesity (BMI: 30.7 ± 2.3 kg/m2) were randomised to an energy-controlled almond-enriched diet (AED) or nut-free diet (NFD). Psychological and sleep assessments were conducted at baseline, after 3 months of weight loss, and after 6 months of weight maintenance. Data were analysed using mixed-effects models and linear regression. For POMS, total mood disturbance score (TMDS) (60.2%, p = 0.01), fatigue-inertia (21.2%, p = 0.003), and vigor-activity (19.9%, p<0.001) improved over time (with no different between groups), with improvements associated with the magnitude of weight loss (TMDS: β = 0.059, p = 0.02; fatigue-inertia: β = 0.268, p = 0.016; vigor-activity: β=-0.194, p = 0.048). No significant changes were observed in tension-anxiety, depression-dejection, anger-hostility, or confusion-bewilderment. A significant group x time interaction (p = 0.048) was found for the PSS, which increased in the NFD group (10.1%) and decreased in the AED (1%) during the weight maintenance phase. No significant changes were observed for the ZSDS. The PSQI demonstrated significant improvement in both groups over time for sleep quality (11.3%, p<0.001), sleep latency (24.3%, p<0.001), sleep disturbance (39.2%, p = 0.04), and daytime dysfunction (290.4%, p<0.001), but not for sleep duration or habitual sleep efficiency. Summed scores, generating the global sleep score (GSS), demonstrated an overall significant improvement in both groups over time (33.5%, p<0.001), and these improvements were associated with weight loss (GSS: β = 0.863, p<0.001). The findings emphasise the importance of evaluating mental health outcomes in weight loss interventions and highlight the potential influence of weight management on mood and sleep quality. Further research is warranted to explore the impact of diet composition on perceived stress and other mental health outcomes.

The production and consumption of food has a significant impact on our environment, with 2030% of consumption impact on the environment relating directly to food and drink(1–3). One method of reducing this is to diversify protein intake e.g. reducing meat consumption in favour of more sustainable products. While the use of plant proteins is to be encouraged, on the island of Ireland this still has challenges(4). There is therefore a need to diversify protein intake on the island of Ireland through products which are both sustainable and local.

Using co-creation methods, this study aimed to understand what consumers want as sustainable and local plant-based products. Specifically, the study focused on oat, wheat, barley, rye, and pea. Co-creation puts consumers at the heart of product development, ensuring their ideas are understood from the beginning, thus leading to greater acceptance and potential for product success. Four workshops plus a follow-up workshop (n=38: 21 female, 17 male, age range 22-80 years old) were held across Belfast and Dublin to understand consumers’ wants for a sustainable and local alternative protein product. Workshops discussed factors influencing food purchasing, current sustainability issues, and strategies to shift to a sustainable diet. Key co-creation tasks included drawing a local and sustainable product based on any (or any combination) of the 5 specified ingredients. Discussions were transcribed and initial findings using content analysis are presented.

For products made by participants through co-creation, pea was a popular ingredient, with the top 3 highest rating products based on pea. Products containing oats and wheat were also popular. Product types varied and included main meals (plant-based burgers, pastas etc.), snacks (crackers, crisps etc.), and drinks (milks and meal replacements). While popular in the main workshops, consumers in the follow-up workshop who were tasked with reviewing the products created in the other workshops, largely rejected pea-based products due to taste. The highest rated products were a bolognese product made with pea and barley, porridge oats, and wheat and barley pasta.

These findings corroborate wider research findings that taste is vital in new product development. Basic products based on similar products already on the market ranked high, in line with findings that familiarity is a key driver of acceptance of alternative proteins. Future research should use these findings to gauge the popularity and acceptance of these products at a wider level.

Global consumption of sugar-sweetened foods (SSF) is high, despite being linked with obesity(1). Motivations to eat SSF may contribute to high sugar intakes(2). The herb Gymnema sylvestre (GS) may reduce SSF consumption(3), but its effects on motivations to eat SSF are unknown. This study aimed to investigate effects of GS on adult’s motivations to eat SSF. The study used a placebo-controlled randomised cross-over method, of which seven participants (mean age of 34 ± 13.8 years; two males, five females) who self-identified as having a sweet tooth agreed to interview. A placebo mint was tested three times daily in-between meals (i.e., PLAC-SYS) for 14 days, before random allocation to one of two GS treatments for a second 14-day period, crossing over GS treatments in a final 14-day period. The GS treatments were identical GS-containing mints, administered systematically three times daily in-between meals (i.e., GS-SYS); or ad-libitum up to six times daily (i.e., GS-ADLIB). Each participant completed four 30-minute interviews – at baseline and after each 14-day testing period – to capture perspectives on changes in motivations, and the effects of treatments on SSF intake. Interviews occurred on Zoom software or in person, according to participant preference. Interview transcripts were uploaded to NVivo, and themes regarding motivations to eat SSF were identified and explored to ascertain effects on participant’s behaviour during each treatment, and what influenced their motivations. Baseline motivations to eat or to avoid SSF were categorised in psychological, external, habitual, hedonistic and physiological themes (except none habitually avoided SSF). Baseline motivations to eat and avoid SSF were influenced by deliberate decisions to change lifestyles and external factors (e.g., occupations). During testing of PLAC-SYS, GS-SYS and GS-ADLIB, participants’ motivations were affected by each treatment and external factors. At all stages participants were still motivated hedonistically to eat SSF. Compared to PLAC-SYS, both GS treatments were more effective because they reduced pleasure derived from SSF more and enhanced mindful eating. Four participants preferred GS-SYS to GS-ADLIB because of taste preference, and because it was more effective at changing behaviours around eating SSF. Participants also reported self-control of SSF intake changed because of GS-ADLIB (but not GS-SYS or PLAC-SYS) and external factors. Overall, reported self-control levels varied during the study, mostly because of external factors rather than the effects of GS-ADLIB. Compared to PLAC-SYS, both GS treatments may increase motivations to avoid SSF. The herb may be useful in interventions already utilising mindful eating by increasing the time between initial motivations to eat, and actually eating SSF. External factors also affect how in control individuals feel over SSF intake; GS-ADLIB may enhance self-control. Interventions supporting navigation of changing external factors, combined with GS, could be particularly effective in reducing SSF intake.

Olfaction, the sense of smell, is under recognised and underappreciated despite being vital in wellbeing. It confers a major influence on the feeding process being the major contributor of flavour and has a direct involvement in the cephalic phase responses. Along with its influence on food and nutrition, olfaction is directly associated with cognitive function and impacts social communication and safety(1). Loss of olfactory acuity, commonly occurring in aging and frailty, significantly influences dietary behaviour and food selection(2). Unlike the senses of vision and audition, interventions are lacking. We propose in a proof-of-concept that crossmodal integration of olfaction and audition could inhibit olfactory decline in lifelong musicians through encouraging neuroplasticity of the olfactory brain centres. Ethical approval was obtained from The University of Adelaide Human Research Ethics Committee. Male musicians with a lifetime experience of music (ME) and naïve non-musicians (NM) aged 55 years and over were recruited through music organisations and controls through the Australian Men’s Shed network. The initial target sample size was twenty per cohort. Olfactory acuity was assessed with Sniffin’ sticks® (Odofin, Groningen, The Netherlands), a well validated system of a battery of three tests regimes. Sniffin’ sticks represent ‘felt tipped pens’ impregnated with odourants presented 20mm below the nose of participants who were then prompted to ‘sniff’. Assays determined participant ‘Threshold’, ‘Discrimination’ and ‘Identification’ of test odours (3). Measurement of Threshold and Discrimination were undertaken in triplet fifteen seconds apart with eyes closed; measurement of Threshold being conducted in an ascending ‘staircase’ to detect lowest odour concentration detectable, whereas measurement of Discrimination selected the ‘odd-man-out’ of a triplet comprising two identical and one different odour. Measurement of Identification, with eyes open, selected the odour of a single ‘pen’ from a prompt list of four. All tests demanded selection. Each of the test batteries were scored out of sixteen along with total aggregate of Threshold, Discrimination, and Identification (TDI). Twenty-six participants completed the study (18 ME and 8 NM); numbers were limited owing to active COVID-19. Mean and standard deviations (SD) of Threshold, Discrimination, Identification and TDI were derived and compared between groups using ‘t’-test. For ME, Threshold, Discrimination, and Identification values were 6.2 (SD ± 3.7), 10.6 (SD ± 1.9), and 12.9 (SD ± 1.6). The respective values for NM were 5.0 (SD ± 2.3), 8.8(SD ± 2.9), and 10.8 (SD ± 2.5). The ME group showed a significantly higher Discrimination (p = 0.164). Significant differences were not seen for Threshold, Identification, and overall TDI scores, however the small sample size may have accounted for this. Based on this proof-of-concept, further exploration of music is warranted as an intervention to enhance olfactory acuity to potentially improve the intake of food and nutrition, and enrich pleasure of eating and drinking, and quality of life.

Dietary guidelines have emerged as a key tool with the potential to inform the transformation of food systems not only towards better nutrition but also towards sustainability(1). In the last few years, some countries have integrated different aspects of sustainability into dietary guidelines. However, there is lack of clarity on what this means or on how countries go about this integration. While there are multiple suggested approaches(2)(3), there is no agreed methodology on how to do it.The aim was to investigate countries’ conceptual understanding and practices for integrating sustainability into the dietary guidelines’ development process.

Using the FAO/WHO sustainable healthy diets guiding principles(4) as a conceptual framework, FAO surveyed the 27 countries that had reported, into the FAO online repository, integrating at least one aspect of sustainability. The responses were coded, and common themes identified by two different researchers and reviewed by a third. The statistical methods used for analysis consisted of means and frequency distributions.

So far, 16 countries have responded to the survey (59% response rate), however, among these, 3 skipped most of the questions (48% effective response rate). Preliminary results show that, for environmental sustainability, greenhouse gas emissions (GHGE) (54%) and food losses and waste (FLW) (54%) were the most common aspects included. For sociocultural sustainability, the most common aspects were local food culture (92%), followed by consumption patterns (85%) and local culinary practices (77%). Affordability was included by 61.5% of respondents. Some methods used by countries to integrate these different aspects included consideration of additional evidence and including additional data when performing linear programming for optimizing diets. Methods varied significantly among countries, the need for additional guidance is evident.

These results reaffirmed the need for guidance that was expressed in a 2018 survey (FAO, forthcoming) on how to successfully integrate sustainability considerations into dietary guidelines. FAO is introducing a new methodology to develop, implement and use dietary guidelines with a food systems approach. Developed with inputs from multiple experts and stakeholders, it provides “step-by-step” guidance to countries on integrating the different aspects of sustainability across environmental, economic, and social dimensions. Several countries have already started using the Food systems-based dietary guidelines (FSBDG) methodology.(5)

Poor menstrual health literacy is a factor that contributes to females not seeking medical help for abnormal menstrual symptoms that may impact their mental, social, and physical health(1). Few studies have focused on testing baseline functional knowledge of the menstrual cycle (MC) outside the context of pregnancy and menopause. The primary objective of this study was to investigate MC knowledge levels of physically active females residing in New Zealand. A secondary objective was to understand where females get their MC information from, what sources they consider to be trustworthy and what information on the MC they would like to know more about. A MC knowledge questionnaire was developed by the research team (n = 3), and reviewed by academics (n = 4), medical experts (n = 4), sporting organisation staff (n = 5), and target population (n = 10) to ensure content validity. Active females (n = 203) between the ages of 16-40 years completed an online questionnaire. The questionnaire included a total of 25 knowledge questions and was split into four categories: menstrual cycle (Q = 9), menstruation (Q = 7), symptoms (Q = 5), and health outcomes (Q = 6). Responses (single and multiple answer multi-choice questions) were analysed using descriptive statistics which were presented as mean, SD and frequency (%). The overall knowledge score was 51.8% (22.8 ± 3.4). The highest knowledge scores were noted for symptoms (80.5%), followed by menstruation (79.8%), and the menstrual cycle (64.2%). Females scored poorly when asked about health outcomes related to the MC (20.4%). 61.5% of participants (n = 123) identified the internet as their main source of MC information. Friends (n = 82, 41%), school sex education (n = 73, 36.5%) and social media (n = 73, 36.5%) were the next most common sources of MC information. The most trustworthy sources of information were doctors/GPs (n = 96, 48%) and healthcare professionals (n = 70, 35%). The most common topics that females wanted to know more about were diet and the MC (n = 115, 57.5%), training and the MC (n = 115, 57.5%), MC tracking (n = 78, 39%), MC and mood (n = 75, 37.5%) and RED-S/LEA/Female athlete triad (n = 71, 35.5%). Overall functional knowledge levels of the MC and associated health outcomes is low in active females. Healthcare professionals and doctors are the most trustworthy sources of information; however, they are not the most common sources of information that females will engage with. Developing online educational resources on the MC, associated health outcomes and lifestyle factors (diet, physical activity) with medical and healthcare professionals may be considered in future female health education.

Life Cycle Assessment (LCA) databases allow for the environmental impacts of food production and consumption to be quantified, thereby informing sustainable dietary choices(1). In the foodservice sector, LCA data is considered key to assessing environmental performance, accelerating sustainable practices, reducing impacts, and supporting sustainability managers in decision-making processes(2). As nutrition research increasingly emphasises the importance of considering sustainability in dietary patterns(3), developing guidelines for the food service sector and increasing understanding around LCA’s are key to the transition towards sustainable practices. Nutritics developed 'Foodprint’ a carbon and water grading system using data from LCA’s(4). The aim of this study was to analyse carbon and water Foodprint values, and to assess whether results were consistent across different LCA databases.

This study provides a quantitative analysis of data points on 6,614 foods across 11 open-access, peer-reviewed LCA databases. Analysis was conducted to examine the relationship between the carbon and water footprint values for foods and 13 food categories, accounting for differences in country of production (CP) and LCA databases. Foods were assigned a Foodprint carbon (A to E) and water grade (1 to 10) using Nutritics software. Descriptive statistics including univariate analysis of variance (ANOVA) were used to assess the relationship between CP and LCA database when analysing the carbon and water footprints of foods. Scheffe Post-hoc tests were used to identify specific differences between groups when results were significant. Statistical analysis was conducted using Microsoft Excel 2019 and IBM Statistical Package for Social Science Version 28 (SPSS).

LCA data was available for 6,614 foods across 14 master categories and 160 regional categories.

87% of items had carbon footprint values (n 5,755) and 23% had water footprint values (n 1,522). Significant differences were observed between food categories in terms of their carbon and water footprints (P <.001). There was no significant difference between LCA databases for the carbon and water footprint of food categories (P >.001). The category ‘Animal Products’ had the highest carbon footprint (μ 15.23 co2eq/kg) and the ‘Cereals and Grain’ category had the highest water footprint (μ 16247.37L/kg). Across all LCA databases, the highest variation in carbon grades was seen for ‘Potatoes’, ‘Soups’, ‘Cakes & Desserts’, ‘Vegetables-General’ and ‘Grains’, and the least variation was seen for ‘Creams - Dairy’ and ‘Lamb’.

The findings suggest that the LCA databases provide consistent results on the carbon and water footprint of foods, and that certain food categories have the highest environmental impact regardless of the LCA database selected. Further research should analyse additional LCA databases that are not open-access, and assess the impact of using primary level product data on outcomes. Additional environmental impacts should also be assessed.

Chronic inflammation is linked with several deleterious diseases, including cardiovascular disease, obesity, diabetes mellitus, irritable bowel disease, and osteoporosis (1,2). Post-menopausal women are at a heightened risk of developing these diseases due to the remission of oestrogen, further amplifying a pro-inflammatory state (3,4). This study aimed to critically examine the combined effect of pre- and probiotic supplementation (synbiotics) and exercise in the form of ≥7,000 steps per day on inflammatory markers hs- CRP, IL-1β, IL-6, IL-8, IL-10, INF-γ and TNF- α in sedentary post-menopausal women. Eighty-seven healthy post-menopausal women were allocated to receive either a synbiotic supplement or placebo for 12 weeks. Participants’ demographics and physical activity levels were determined using questionnaires, and their diet was assessed using self-reported 3-day diet records. Body composition measures of height, weight and BMI were measured at baseline, while total body mass, lean body mass, total fat mass and total body fat percentage at baseline and week 12 using dual-energy X-ray absorptiometry. Fasted venous blood samples were collected to analyse inflammatory status before and after the intervention. Statistical analysis was performed using SPSS version 24, where outcome variables with multiple time points, were analysed using repeated measures ANOVA with the model, including time (baseline vs 12 weeks), intervention group (placebo vs synbiotic), and their interaction as fixed effects. The results showed no significant differences between the intervention group’s demographics, physical activity levels, and dietary intake (p > 0.05). The 12-week study duration (time) was found to have had a statistically significant effect on lowering hs-CRP (p <0.018), IL-8 (p <0.001), IFN-γ (p <0.001), TNF-α (p <0.001) and increasing IL-6 (p <0.001) and IL-10 (p <0.001) in both groups. However, the observed decrease in IL-1β (p <0.348) over time was not significant. The intervention type (synbiotic or placebo) significantly impacted IL-10 (p < 0.003). No significant interactions between time and group were observed across all other inflammatory markers (p > 0.05). The study duration increased total lean body mass (p <0.015) and decreased total body fat percentage (p <0.022) in both the placebo and synbiotic groups. At the same time, the intervention type (synbiotic or placebo) had no effect on total lean body mass, total fat mass, total body mass and percentage body fat in both groups (p > 0.05). The current study showed no notable differences between the placebo and synbiotic groups suggesting synbiotic supplementation is likely ineffective at reducing chronic inflammation in overweight, sedentary post-menopausal women living in New Zealand. However, future studies are needed to confirm these findings. Additionally, studies should investigate the effects of exercise and synbiotic supplementation separately in this population.

Increasing food insecurity (FI) in the UK has led to increased food bank usage(1). This underrepresents true levels of need, since many with FI utilise alternative coping strategies(2). Food banks are designed to provide emergency food for a limited time, requiring referral with proof of need. They have been critiqued for this and their limited food choices(3), which add to the stigma experienced by many clients(4). Their nutritional quality has also been criticised(3). The UN Sustainable Development Goals (SDG) require action to address socioeconomic drivers of inequity. Several are nutrition-related including SDG2 (zero hunger) and SDG12 (responsible production and consumption)(5). Part of SDG12 aims to halve per capita levels of food waste by 2030(5). Surplus food is often used to feed those with FI through community support schemes like social supermarkets, alternatives to food banks. This study evaluated social supermarkets to identify client experiences and perceptions of surplus food, food waste and stigma.

Bespoke questionnaires were administered in two social supermarkets in Sussex on three site visits (n = 111). Additional optional telephone interviews (n = 25) were conducted. Ethics approval was obtained from Kingston University London. Of particular interest were client views on quality and choice of food available, and implications of this for SDG12. Thematic analysis of qualitative data was carried out to identify key themes, while quantitative data were statistically analysed to explore impact of demographics using Kruskal Wallis tests with posthoc Dunn’s and Bonferroni correction.

Of particular interest were client views on the quality and choice of food available, and the implications of this for SDG 12. The majority (n = 102; 91.9%) agreed or strongly agreed that choosing what they ate rather than being given no choice mattered to them, while 76.6% (n = 85) agreed or strongly agreed that the social supermarket helped them to reduce food waste. Interviews revealed these were linked, and the impact on food waste was not solely due to the use of surplus food but to offering food choice with clients choosing what they and their families liked and would eat; being given no choice increased the likelihood of foods being wasted.

[Social supermarket client quote] ‘I think [choice] is important, I hate, absolutely hate waste, I don’t agree with it, I don’t agree with throwing things away that you could eat. And if someone made that choice for you, you might not be able to eat it and want to eat it’.

Food choice therefore increased client agency, reducing the potential for stigma and trauma. Using surplus food to feed those dealing with FI is problematic. Nonetheless, offering food choice represents a more client dignified experience with potential to reduce food waste, thereby arguably helping to achieve SDG12.

Polycystic Ovary Syndrome PCOS is an endocrine disorder affecting 8 to 13% of reproductive aged women(1). Dietary and physical activity changes are the first-line therapy to assist with symptom and weight management and to reduce the risk of reproductive, metabolic and psychological comorbidities(2). However, women with PCOS have a higher weight, experience weight gain, and a higher prevalence of living in a larger body. Health care professionals (HCPs) play a crucial role in delivering diet and physical activity advice for people with PCOS. Thus, the aim of this systematic review is to understand the barriers, facilitators, experiences, and perceptions of engagement and compliance with diet and physical activity modifications in people with PCOS and in HCPs providing or referring people with PCOS to diet and physical activity modifications. A mixed-method systematic review was conducted with quantitative studies narratively synthesised and all studies thematically analysed. There were 68 eligible papers, including n = 59 (n = 5198) people with PCOS and n = 17 (n = 2,622) HCPs. Several themes were identified as impacting people with PCOS’ ability to make diet and physical activity changes. HCP education on PCOS management through diet and physical activity was viewed by HCPs and people with PCOS to be inadequate, further impacting the quality of care and health outcomes. Dietary and physical activity advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. Both people with PCOS and HCPs agreed that there was a need for individualised and PCOS-specific diet and physical activity advice. However, HCPs viewed that there was limited evidence supporting these recommendations and a lack of time to deliver this care. Weight stigma was identified as impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self-perception and mental health. People with PCOS perceived that diet and physical activity are overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including receiving diet and physical activity advice that meet the individual’s needs, are necessary for leading to long-term sustainable changes and improvements in health outcomes. A multidisciplinary team approach and an overhaul of HCPs’ perceptions and mentality of weight and weight-centric care for those with PCOS are essential in delivering effective diet and physical activity advice.

Simultaneously improving diet quality and minimising dietary environmental impacts are central to the development of sustainable healthy diets. Altering dietary patterns to increase the proportion of plant-based foods and reduce animal-source foods has the potential to reduce dietary greenhouse gas emissions (GHGEs) and other environmental indicators(1). However, data evaluating the impacts of these dietary changes on micronutrient intakes are scarce(2).

The MyPlanetDiet randomised controlled trial (RCT) was conducted in healthy adults across the island of Ireland [NCT05253547]. Participants were randomly assigned to follow a diet with reduced GHGEs (intervention group), or a diet based on national dietary guidelines (control group), for 12 weeks. Otherwise, all study procedures were identical. Dietary intake was assessed at baseline and endpoint using three non-consecutive 24-hour recalls, collected remotely using the Foodbook24 web-based dietary assessment tool(3). Dietary GHGEs and micronutrient intakes were calculated from food sources only. Data were analysed using paired t-tests to assess for withingroup differences between baseline and week 12, and one-way analysis of covariance (ANCOVA) to test for differences between groups at week 12, whilst controlling for baseline intakes.

Here, we present data from one of three sites (University College Cork). Of the 127 participants enrolled, 108 completed the trial (n = 57, intervention group; n = 51, control group). The mean (SD) age of participants was 42.2 (11.9) years and 59% were female. Ninety-three percent of participants were white and 88% completed third-level education. At baseline, mean (SD) GHGEs were 7.3 (3.1) kg CO2 equivalents/day. GHGEs reduced significantly in the intervention group (p<0.001), and GHGEs were significantly lower in the intervention group compared to the control group at week 12 (4.6 (1.5) vs. 6.8 (2.9) kg CO2equivalents/day, p<0.001).

In the control group, intakes of carotene, vitamins B12 and C increased significantly from baseline (p<0.05), whereas vitamin E reduced significantly (p = 0.005). In the intervention group, intakes of retinol, riboflavin, niacin equivalents, vitamins B6 and B12, biotin, pantothenate, calcium, phosphorous, zinc, and potassium reduced significantly (p<0.05).

Compared to the control group at week 12, the intervention group had significantly higher intakes of vitamin E (p = 0.015) and significantly lower intakes of retinol, thiamin, riboflavin, niacin equivalents, vitamins B6 and B12, biotin, pantothenate, calcium, phosphorous, zinc and potassium (p<0.05). There were no differences in carotene, retinol equivalents, total folates, vitamin C, magnesium, iron, copper, or selenium.

Micronutrient intakes generally remained similar or improved in the healthy control group, whereas the low-GHGE diet resulted in reductions in some key micronutrients. Further analysis of dietary composition, the prevalence of inadequate intakes, and biomarkers of nutritional status will enable a more comprehensive understanding of the impacts of such a dietary transition on nutritional status.

Excluding all animal-sourced foods may be associated with increased risks of nutrient deficiencies. As indispensable amino acids (IAAs) cannot be stored or endogenously produced, consistent protein consumption throughout the day is important to improve protein quality for optimal metabolic function(1). Assessment of protein adequacy needs to be undertaken at the meal rather than daily intake level because food combinations within each meal can be complementary and influence the overall amino acid profile of the meal(2).

Outcomes of our previous review found that among plant-sourced foods, soy, legumes, nuts and seeds provide greater protein content and quality(3). We hypothesise that variation in protein intake will exist both between vegan individuals and between observation days for the same individuals. Previous investigations of the relationship between meals and nutrient intake based on specified time windows for eating may have been subject to researcher bias in the definition of these windows. The main outcome of this study is to utilise time series clustering to determine the impact of dietary patterns on protein distribution, across the day.

Intake data was obtained using a four-day food diary from a cross-sectional survey of 193 New Zealand vegans (Ethical approval: HDEC 2022 EXP 12312). The inclusion criteria required participants to have followed an exclusive vegan diet for at least two years. A kernel density contour estimation was used to visualise protein distribution across eating occasions for all participants over four days. Dynamic Time Warping (DTW) was then used to align two temporal sequences (time series) to compute an output of distance(4) which was used for hierarchical clustering using the Ward.D2 method. An optimal cluster of 3 was identified using silhouette coefficient and domain knowledge.

Participants had a mean age of 39.4 years (SD=12.3), with 90.1% having attained a tertiary-level education or higher. Overall, mean protein intake was 1.11 g/kg/d (SD=0.39), with 8.29% of participants below the Estimated Average Requirements (EAR) and 24.3% of participants below the Recommended Dietary Allowance (RDA) for adults. The mean Acceptable Macronutrient Distribution Range (AMDR) for protein is 15.5% (SD=4.16), with 96.9% of participants within the recommended AMDR range (10-35%). Peak protein consumption was observed at 1230 and 1900. Sequential colour scale representing density found higher distribution of data points representing protein intake of less than 10g per eating occasion. Time series similar in shape and amplitude were assigned to the same cluster. Preliminary findings identified three different protein intake profiles across the day.

A small percentage of participants has protein intake below the daily requirements for adults. More occasions with lower protein intake per eating moment was observed. This approach classifies dietary patterns objectively for analysis of daily protein and IAA intake.

People with polycystic ovary syndrome (PCOS) have higher weight gain and psychological distress compared to those without PCOS(1). While COVID-19 restrictions led to population level adverse changes in lifestyle, weight gain and psychological distress(2), their impact on people with PCOS is unclear. The aim of this study was to investigate the impact the 2020 COVID-19 restrictions had on weight, physical activity, diet and psychological distress for Australians with PCOS. Australian reproductive-aged women participated in an online survey with assessment of weight, physical activity, diet and psychological distress. Multivariable logistic and linear regression were used to examine associations between PCOS and residential location with health outcomes. On adjusted analysis, those with PCOS gained more weight (2.9%; 95% CI; 0.027–3.020; p = 0.046), were less likely to meet physical activity recommendations (OR 0.50; 95% CI; 0.32–0.79; p = 0.003) and had higher sugar-sweetened beverage intake (OR 1.74; 95% CI 1.10–2.75; p = 0.019) but no differences in psychological distress compared to women without PCOS. People with PCOS were more adversely affected by COVID-19 restrictions, which may worsen their clinical features and disease burden. Additional health care support may be necessary to assist people with PCOS to meet dietary and physical activity recommendations.

Dietary intake assessment is an essential part of nutrition research and practice, with the use of digital technology now well established(1) and artificial intelligence (AI) in the form of image recognition readily available in research and commercial settings(2). Recent advances in large language models (LLMs), such as ChatGPT, allow computers to converse in a human-like way providing text responses to typed queries. No studies, however, have utilised both the LLM and image recognition components of ChatGPT-4 to evaluate its accuracy to estimate nutritional content of meals.

The aim of this study was to evaluate the accuracy of the ChatGPT-4 LLM and image recognition model in estimating the nutritional content of meals.

Thirty-eight meal photographs with known nutritional content (from McCance and Widdowson’s Composition of Foods) were uploaded to ChatGPT, and it was asked to provide point estimates for each of the meals for each of the following: energy (kcal), protein (g), total carbohydrate (g), dietary fibre (g), total sugar (g), total fat (g), saturated fat (g), monounsaturated fat (g), polyunsaturated fat (g), calcium (mg), iron (mg), sodium (mg), potassium (mg), vitamin D (mcg), folate (mcg), and vitamin C (mg). Comparisons were made between ChatGPT estimates and those from McCance and Widdowson using the Wilcoxon signed rank test, percent difference, Spearman’s correlation, and cross-classification of quartiles. Interpretation of statistical measures was based on Lombard et al.(3).

For estimating the content of meals, differences (p < 0.05) existed between the methods for 11 of the 16 nutrients, and 12 nutrients had a percent difference of >10%, indicating poor agreement for most nutrients. ChatGPT underestimated 15 of the 16 nutrients. Conversely, when considering the ranking of meals, all nutrients had correlation coefficients which indicated good (rs ≥ 0.50)(11 of 16) or acceptable (0.20 < rs < 0.49)(5 of 16) agreement. In the cross-classification of quartiles, ≥50% of meals were classified into the same quartile by both methods for 9 nutrients and 10% of meals were classified into opposite quartiles for 14 nutrients, indicating good agreement. ChatGPT also provided caveats regarding its estimations such as “the caloric estimate assumes the butter is spread thinly” and “cornflakes can often be fortified with vitamins and minerals […] and exact content could also vary based on the brand of cornflakes”.

ChatGPT showed poor agreement for estimating the nutritional composition of meal photographs for most nutrients, but the correlation and cross-classification of quartiles indicate good ability to rank meal photographs according to nutritional composition. Further research is required with a wider range of meals and in real-world settings. Future work should consider the training of language models using high-quality nutrition data to improve accuracy and maximise the potential for their use in dietary assessment.

Preconception diet is a proposed modifiable risk factor for infertility(1). However, there is no official guidance for women in the preconception period as to which dietary approaches may improve fertility. A comprehensive synthesis of the relevant evidence is key to determine the potentially effective dietary patterns and components as well as evidence gaps, and to provide information for nutritional recommendations for couples planning a pregnancy. In this systematic scoping review, four electronic databases (Medline and EMBASE via Ovid processing, CAB Direct, and CINAHL via EBSCO) were searched for observational studies (prospective and retrospective cohort, cross-sectional, and case–control studies) from inception to 27 September 2021. Eligible studies included women of reproductive age during the preconception period, and evaluated exposures related to preconception diet and outcomes related to fertility. Results were synthesised using a descriptive approach. A total of 36 studies were eligible for inclusion (31 prospective, 3 cross-sectional, and 2 case–control studies) and were published between 2007 and 2022. Of the assessed dietary exposures, increased adherence to the Mediterranean diet displayed the strongest and most consistent association with improved clinical pregnancy rates. Reducing trans fatty acids (TFAs), saturated fatty acids, and discretionary food intake (fast food and sugar-sweetened beverages) were associated with improvements in live birth, clinical pregnancy rates, and related ART outcomes. The dietary components of seafood, dairy, and soy demonstrated inconsistent findings across the few included studies. Due to heterogeneity and the limited available literature on most exposures, there is insufficient evidence to support any specific dietary approach for improving fertility. However, following some of the dietary approaches outlined in this review (anti-inflammatory diets, reducing TFA, and discretionary food intake) are consistent with broad healthy eating guidelines, have little to no associated risk, and offer a plausible set of possible benefits. This warrants further exploration in randomised controlled trials.