For a qualified nutritionist to obtain registration with the Nutrition Society of Australia they must first demonstrate that they meet a set of competencies relating to required nutrition knowledge and skills(1). However, theoretical knowledge and a technical skillset may not be enough to actively contribute to the workforce as a new graduate(2). Employers have previously expressed a desire for nutrition graduates to also develop employability skills in undergraduate studies to be better prepared for the workforce(3). Universities across Australia appear to have heterogeneous approaches to building nutrition students employability skills. To better understand student workforce readiness and employability skills, the research team undertook a mixed-methods study. A validated work-ready tool was used to survey undergraduate nutrition students self-perception of work readiness (n = 88) and semi-structed interviews of students pre/post nutrition industry placements (n = 18) were conducted to assess factors impacting student understanding and development of work readiness. Preliminary data from the survey showed higher levels of perceived ability related to higher age in, written communication (P<0.05), decision making (P<0.05), working unsupervised (P<0.05) and managing challenges (P<0.05). Lower age showed lower perceived ability in understanding how to apply skills (P<0.001). Lower levels of work experience showed lower perceived ability to work in a team (P<0.01), collaborate (P<0.01), work under pressure (P<0.05), and identify problems (P<0.01). Thematic analysis from interviews revealed themes related to improved confidence following a placement experience, communicating to stakeholders, the importance of translation skills, the benefits of networking and self-efficacy. The results suggest there are numerous identified gaps and significant room for improvement. To have a systematic approach to skill development, universities training nutrition students should consider developing a framework that builds understanding and scaffolds skill development across year levels. An employability framework has the potential to increase students employability skills and knowledge, enhance student confidence and increase graduate employment.

The challenge of meeting nutritional requirements for vitamin D because of low supply in the food system means that substantial proportions of the population have low vitamin D intakes and status(1). Naturally rich sources such as oily fish are consumed infrequently and foods such as eggs do not have sufficient quantities to meet Dietary Reference Values. Usually, fortification is voluntary and a premium price can be achieved for the fortified product. Hence, there may be a role for mandatory fortification to ensure equal access to healthy, fortified foods for all.

The aim of this study was to profile food product launches to the global market over the last 15 years to determine if product launches can potentially meet Vitamin D requirement. The GlobalData(2) is an industry specific intelligence planform that can be accessed to identify and analyse food product launches based on specific inputs such food-type, country, nutrients, health claim etc. This database was mined to retrieve and analyse all food products launched in the 15year period from January 2009 to March 2024 with at least 0.01ug of vitamin D listed in the nutritional content.

The search returned a database with a total of 2,203 products launches. From 2009, there was a steady increase in product launches until it peaked in 2012 with 320 products. Thereafter it decreased with a low in 2016 at 50 product launches. Although not exceeding the high in 2012, there has been a steady increase since 2016 with 150 launches reported for 2023. The top three countries for product launches were USA at 11.8% (n = 261) followed by UK at 7.2% (n = 159) and India at 6.6% (n = 146). The market is dominated by dairy foods with nearly half of all launches this category (47%). This was followed by drinks (15%), bakery and cereals (15%) and baby foods (10%).

Countries such as the USA and India have voluntary fortification strategies in place which may explain higher proportion of product launches seen in these countries(3,4). The implementation of a national vitamin D food fortification strategy may help to increase the launch/supply of fortified foods on the market to increase the potential to achieve recommended intakes. The dominance of vitamin D fortification within a small number of food categories such as dairy(5) highlights the opportunities and untapped potential for other food categories such as pasta and sauces to also undertake fortification. It is also important to accommodate the diversity of the diet and provide vitamin D fortified foods for non dairy consumers. Studies have shown that food fortification can increase vitamin D status(6) Therefore additional and more diverse food fortification should be considered to improve vitamin D intakes in the population.

Vitamin D-(bio)enriched meat products may complement current market offerings to produce value-added foods without altering consumer dietary habits(1). However, a paucity of information exists regarding consumer insights in relation to nutrition/health claims, animal welfare considerations and appropriate purchase price of vitamin D-(bio)enriched foods.The aim of this research was to assess consumer attention to front-of-pack labelling and market potential of vitamin D-(bio)enriched chicken goujons and pork sausages.

Two independent studies were conducted using a mixed-methods approach; eye tracking (study 1) and qualitative elicitation (study 2). Consenting adults aged 18-65 years were recruited for study 1 (n = 50) and study 2 (n = 32). In study 1, participants viewed n = 5 front-of-pack food labels of both vitamin D-enriched meat products in a random order (20s/label)(2) using a Tobii T60 eye tracker (Tobii Technology, Stockholm, Sweden). Images for each (bio)enriched product label included a variation of nutrition/health claims, animal welfare certification and various price points. Eight areas of interest (AOI) were defined on labels of both vitamin D-(bio)enriched meat products: product name, nutritional information, serving size, price, enriched with vitamin D, source of vitamin D, animal welfare and health claim. Total duration of fixations, number of fixations, time to first fixation and duration of first fixation (ms) were determined for each AOI(3). Statistical analysis was performed using IBM SPSS Statistics 29 for windows, Chicago, IL, USA one-way ANOVA with Tukey post-hoc test, p< 0.05 significant. In study 2, transcripts from focus groups (n = 7; total n = 32 participants) were analysed thematically(4) (NVivo version 12, Lumivero, Denver, CO, USA) to identify emerging ideas such as evaluation of product concept, attitudes to health/nutrition claims and willingness to purchase vitamin D-(bio)enriched meat products.

Eye tracking results in study 1 demonstrated that product name, serving size and nutrition information gained the greatest consumer attention across both vitamin D-(bio)enriched meat products. Nutrition claim ‘source of vitamin D’ showed greater (mean±SD) total duration of fixations compared to ‘enriched with vitamin D’ for pork sausages, (1185.6±1098.2 vs 677.0±685.9, p < 0.05). There was no difference in gaze fixation parameters between nutrition claims for chicken goujons. Consumer attention also indicated that health claims, animal welfare and price may influence consumer purchasing decisions of vitamin D-(bio)enriched meat products. Study 2 reported that consumers cited a preference for ‘naturally enriched’ opposed to ‘enriched’ nutrition claim. In addition, stronger preferences were apparent for the 'immune function’ health claim compared to 'muscle function'. Furthermore, approximately half of consumers were willing to pay a premium for the products.

Overall, consumers had a positive attitude to vitamin D-(bio)enriched meat products, suggesting market potential within the agri-food industry to help address low vitamin D status.

Mentoring is an established method of promoting networking, professional growth and learning, and career development in many health professions(1). For a non-vocational profession such as nutrition with a diverse scope of practice, the impact of mentoring remains unclear. In 2020, the Nutrition Society of Australia (NSA) developed and implemented a mentoring program for registered nutritionists. The individually matched mentoring facilitates a 12-month relationship between nutritionists who opted-in to the program. This qualitative case study research aimed to understand the conceptualisation and development of the NSA mentoring program and explore the experience from the viewpoints of both mentors and mentees in the program. First, a 60-minute focus group was conducted with the NSA program organising committee to explore the initial conceptualisation, objectives of the program, expected outcomes, and related training provided to mentors and mentees. Then, a 34-item questionnaire was sent to 63 participants from the first three program cohorts to collect their demographic information as well as expectations, perception and experience of the mentoring. Twenty-one questionnaire responses from 10 mentors and 11 mentees were collected. Participants were from a range of nutrition professions across NSW, VIC, QLD, and WA. Ten questionnaire participants (four mentors and six mentees) further participated in in-depth interviews to provide narratives of their experience. Thematic analysis was conducted with employment of theory-building structure within the case study(2). Our findings indicated that despite an explicit discussion of mentoring focus on employability skills, e.g. communication, professionalism, advocacy, etc., many mentees perceived mentoring as a gateway to employment and career pathway development. The perceived benefits of mentoring were highly dependent on matching of mentor/mentee, which was complicated by the diversity of practice within the profession, and unstated expectations of individual mentees. Regardless of the perceived quality of their mentoring experience, participants reported that the NSA mentoring program added value to the society’s membership and were supportive of program continuity. In conclusion, the NSA mentoring program was a value-adding strategy to the society membership and it could play an important role in career pathway support into the diverse areas of practice in the nutrition profession. More explicit discussion of expectations between mentors and mentees at the beginning of mentoring could enhance the mentoring experience.

Vitamin D deficiency is a cause for concern among the UK population, with many failing to achieve the recommended daily amount of 10µg/day(1). Sunlight exposure is not sufficient in the UK to maintain year-round vitamin D status so therefore the population rely heavily on dietary sources, including fortified foods(2). In the absence of standardised and/or mandatory vitamin D fortification policies in many countries(3), such products often contain variable amounts of vitamin D(4), however this has not been investigated to-date on a global scale. Therefore, the aim of this study was to explore the vitamin D content of newly launched products worldwide over a 5-year period.

Data were extracted from Mintel’s Global New Product Database across all regions. Search criteria were filtered by nutrient and/or ingredient, to only include products launched from December 2018 to December 2023, and containing >0.1µg vitamin D per 100g/ml. Of the total 2,963 products identified, 608 were excluded owing to missing data, resulting in 2,355 products included in the final dataset for analysis. Vitamin D content was quantified as µg per100g/ml (µg=IU/40, when required). Data were compared by food category (n = 12) and between branded vs private label (own-brand) products, using ANOVA (with Tukey post-hoc tests) and independent samples t-tests, respectively.

The overall mean±SD vitamin D content of newly launched products was 12.5±71.2 µg per 100g/ml (range: 0.01-2380 µg per100g/ml). By category, the mean±SD vitamin D content of products (µg per100g/ml) were as follows: baby food (7.1±20.3), bakery (210.4±683.3), breakfast cereals (9.4±21.2), chocolate confectionary (134.4±135.1), dairy (6.0±23.7), desserts and ice cream (1.8±2.1), rice and noodles (4.4±0.1), processed meat and fish (20.9±39.0), sauces and seasonings (39.3±123.5), snacks (6.7±9.3), sugar confectionary (101.4±90.9) and sweet spreads (56.7±95.5). Products in the bakery, chocolate confectionary and sugar and gum confectionary categories had a significantly higher vitamin D content per 100g/ml, compared to all other categories. In the total dataset, branded products (n = 2832; 96%) had a significantly higher vitamin D content than private label products (n = 131; 4%) (12.7±72.5 vs. 6.1±11.3 µg per 100g/ml, respectively; P<0.001).

This preliminary analysis has demonstrated a wide range in the vitamin D content of newly launched products worldwide, which varies significantly between food categories and is higher in branded compared to private label products. Future research using this dataset will explore changes over time, as well as regional differences in the vitamin D content of new products, both between and within the different categories. Such evidence may help to inform future new product development opportunities and vitamin D fortification policies.

Private practice is the fastest growing employment sector for dietitians in Australia, including for new graduates(1). There is an anecdotal concern that current graduate cohorts are not adequately prepared for private practice. The present study aims to assess the existing literature relevant to workforce development specific to private practice dietetics, including areas such as workforce size, distribution, competency, practices and global challenges. The secondary aim is to identify gaps in the literature to inform future priority areas and to inform private practice dietetics workforce development research. Five databases were systematically searched from inception to August 2023 and grey-literature was searched using the Google search engine using key search terms to identify studies for inclusion. Of the 2361 peer-reviewed publications and 1800 grey literature, eighty were included. Directed content analysis and qualitative constant comparison technique were used to deductively extract data from eligible private practice literature. Intelligence sources covering the following themes proved to be limited: workforce size, distribution, attributes, demography, supply/preparation, competencies, continued professional development and challenges. However, clear structural issues present workforce challenges for private practice dietitians. There is an overwhelming paucity of comprehensive literature on the private practice dietetics workforce across the world. Private practice dietetics workforce development research is warranted to address current research gaps in a coordinated, collaborative approach to ensure this rapidly expanding workforce is well supported.

Optimal vitamin D status is important for growth and development during childhood(1). Children with a circulating concentration of 25-hydroxyvitamin D [25(OH)D] below 25 nmol/L are at increased risk of rickets. In order to maintain 25(OH)D > 25nmol/L, a dietary intake of 10µg/d vitamin D is recommended for children aged 4 years and above(2,3). The aim of this study was to determine vitamin D status in healthy children and to investigate associations between 25(OH)D concentrations and muscle health, cognitive function, and parental knowledge of vitamin D, vitamin D habits, perceptions, and practices.

A cross-sectional study of healthy children aged 4 – 11 years conducted between 2019 – 2023 examined vitamin D status by measuring plasma 25(OH)D via the gold standard liquid chromatography tandem mass spectrometry and parathyroid hormone concentrations. Muscle strength (hand grip and balance) was determined by dynamometer, single and tandem stance balancing whilst cognitive function was assessed using the Cambridge Neuropsychological Test Automated Battery. Parents completed questionnaires to assess vitamin D knowledge, and perceptions, habits, and attitude towards vitamin D.

A total of 192 children (91 boys; 101 girls) with an average age of 8.2 years were recruited. Plasma 25(OH)D concentrations were 61.10±18.75 nmol/L (n = 190), with 68.4% of children defined as vitamin D sufficient (25(OH)D>50nmol/L). When stratified by winter months, only 58% of children were vitamin D sufficient. In single linear regression, plasma 25(OH)D concentrations were positively associated with dominant hand grip strength, single leg balance and the cognitive test ‘5choice movement time’ (p<0.05). Overall, there was a reported mean score of 41.9% for parental vitamin D knowledge and 68% of parents thought there was no harm in giving their child vitamin D fortified foods.

Approximately 70% of this sample of children were vitamin D sufficient, however insufficiency was prevalent in almost half of the cohort during the winter months. Benefits of optimal vitamin D for muscle and cognitive function were evident. These results support the promotion of the existing vitamin D dietary recommendations during the winter months for optimal child growth and development.

As the global population continues to age, strategies that promote health and wellbeing among older adults are urgently required. This demographic faces an increasing burden of chronic diseases linked to inflammation(1), often associated with diets that are energy dense and nutrient poor(2). Importantly, the impact of these conditions can be minimised by adopting an anti-inflammatory dietary pattern, such as the Mediterranean diet(3). While there are numerous predictors of behaviour and an individual’s capacity for behaviour change, nutrition knowledge is a fundamental influencer of eating behaviours(4). However, knowledge of anti-inflammatory diets generally and the Mediterranean diet specifically is lacking among older adults(5), highlighting the need for effective educational programs targeting this group. Digital health technologies have the potential to provide cost-effective and accessible nutrition education, however, few technologies have been developed to meet older adults unique needs and preferences. To address this gap, this study aimed to explore the specific needs and design preferences of older adults for an online nutrition education resource. A total of 20 adults aged 55 years and older participated in one of four 2-hour participatory design workshops, where prompted discussion questions were used to explore their use of technology and scope their needs and preferences for an online nutrition education resource. All participants were regularly using a range of different devices (e.g., smartphones, tablets, and computers) and reported being comfortable doing so. Participants wanted a website that could be accessed across devices (i.e., desktop and mobile friendly) that provided practical nutrition advice, recipes, and information on the link between diet and disease. A number of design principles were identified as essential to optimise the user experience, including large and simple fonts, use of dark type on a light background, and clear categories for easy navigation. To enhance engagement, participants sought a personalised resource that could be adjusted to suit their needs, provided up-to-date information, and allowed for easy content sharing with others, such as by exporting information as a PDF. Participatory design methods offer new knowledge for developing and refining existing and future digital health technologies that are appropriate and useful for the target audience. Specifically, the older adult participants were motivated to access a user-friendly web-based nutrition resource provided it was able to be personalised to their health and nutrition needs, offered practical solutions such as adaptations to portion size or in relation to cost, and was easily shareable with others. Given the limited availability of online, self-directed and evidence-based nutrition education resources for older adults, these findings provide valuable insights to shape digital health resources that cater to the needs and preferences of this population and have the potential to support healthy eating habits and contribute to reducing diet-related chronic disease burden.

Older adults in aged care homes account for 30% of the population burden of hip fractures(1). Nutritional interventions to correct protein and calcium inadequacies reduce these and other debilitating fractures, perhaps partly by reducing falls and slowing deterioration in bone morphology. We aimed to determine whether a nutritional approach to fracture risk reduction in aged care homes is cost-effective. Costing was estimated based on results of a prospective two-year cluster-randomised controlled trial involving 3313 residents in 27 aged care homes (intervention using high dairy menus), 3911 residents in 29 aged care homes (controls consuming from normal menus) and cost of ambulance, hospital, rehabilitation, and residential care incurred after fracture. The incremental cost-effectiveness ratios per fracture averted within a 2-year time horizon were estimated from the Australian healthcare perspective applying a 5% discount rate on costs after the first year. Intervention resulted in a total of 3.5 servings of milk, yoghurt and/or cheese daily, achieving 1,142mg calcium and 69g protein versus usual daily intakes of 700mg calcium and 58g protein consumed by controls. This intervention reduced all fractures by 33% at a daily cost of AU$0.66 per resident. The base-case results showed that intervention was cost-saving per fracture averted, with robust results in a variety of sensitivity and scenario analyses. Scaling the benefits of intervention to the Australian community equated to a saving of AU$66,780,000 annually in Australia and remained cost saving up to a daily food expenditure of AU$1.07 per aged care resident. Averting hip and other non-vertebral fractures in older adults in aged care homes by restoring nutritional inadequacies of protein and calcium is cost saving and supports the wide-spread implementation of this type of nutritional intervention in similar settings.

The number of people following a plant-based (PB) diet has increased in recent years. This has led to concerns regarding vitamin D intake, as natural dietary sources of vitamin D are primarily animal based(1) and cross-sectional studies have reported lower intakes amongst vegetarians and vegans(2). Some PB foods, primarily dairy alternatives, are now fortified with vitamin D. Whilst vitamin D is synthesised in the skin following exposure to UV light, this does not happen in the autumn and winter months in areas of northern latitude (such as the UK). Hence, dietary supply of vitamin D becomes particularly important. This study aimed to investigate whether it is possible to maintain dietary vitamin D intake when transitioning to a PB diet, through careful choice of PB alternatives.

A subset of 4-day diet diaries, from 81 women (72 Caucasian and 9 South Asian, mean age 52 ± 12y) living in South East England, was randomly selected from those collected for the D-FINES study (Vitamin D, Food Intake, Nutrition and Exposure to Sunlight in Southern England, 2006–2007; FSA funded Project N05064, NHS REC 06/Q1909/1)(3)and analysed for vitamin D intake. No subjects followed an entirely PB diet at baseline. Data modelling was carried out to substitute animal-based foods with equivalent amounts of PB alternatives. For dairy products, the equivalent fortified PB alternatives were chosen. Meat, fish and eggs were replaced with equivalent amounts of protein from PB sources, such as lentils and tofu, as no fortified direct alternatives were found. The diaries were then re-analysed. Pre- and post-substitution intakes were compared by paired t test, and ethnic groups by independent t test.

There were no differences in Vitamin D intake between ethnicities either at baseline (p = 0.087) or post-substitution (p = 0.361). Vitamin D intake increased in the South Asian group post-substitution (from 2.4 ± 1.3 to 4.3 ± 1.8 µg/day, p = 0.002), with no change observed in the Caucasian group (3.6 ± 2.0 to 3.7 ± 1.8 µg/day, p = 0.660). There was no difference between vitamin D intake pre- and post-substitution overall (3.5 ± 2.0 and 3.8 ± 1.8 µg/day respectively, p = 0.222). Twenty cases decreased by ≥1 µg/day, all in the Caucasian group, with the largest decrease being from 9.6 to 2.2 µg/day.

This study demonstrates that it is possible to move to a PB diet, whilst maintaining existing dietary patterns, without a reduction in vitamin D intake, but it is largely dependent on dairy intake in the original diet, as no meat/fish substitutes in the UK are currently fortified. It also requires care when choosing PB dairy substitutions as many, including organic options, are not fortified. Mean daily intakes, both pre- and post-substitution, were substantially below the recommended intake of 10 µg/day(4), suggesting that supplementation may be necessary, particularly during winter months.

Centenarians represent a phenomenon of successful aging, yet little is known about their lifestyle and health practices, including diet/nutrition, medication use, and health conditions. A protocol for this systematic review was registered previously(1). We systematically searched Medline, CINAHL, Scopus, and grey literature from 2000 to 2022, limited to quantitative studies published in English among adults aged 95 years or above. Two reviewers independently screened 3,392 records and identified and extracted data from 34 eligible studies. Additionally, they independently assessed the study quality using the Modified Newcastle-Ottawa Scale (mNOS)(2). Any disagreement was discussed and resolved with a third reviewer. In analysis, pooled prevalence was provided for categorical variables on demographics, lifestyles, medications, and diseases using % (95%CI); mean or median was provided for continuous variables. Due to study heterogeneity, we conducted a narrative synthesis for the associations between the exposures and outcomes. Over 70% of the included studies met 6/8 criteria based on the mNOS; nearly half did not mention or control for confounders in statistical analyses. The age ranged from 95-118y (32 studies: 100y+; 2 studies: mean age 97-98 y); the majority were females (75%; 95%CI: 71%,78%). Most centenarians did not smoke or drink [current smokers: 7% (5%, 9%); former smokers:16% (12%, 19%); daily drinkers: 27% (20%, 34%); former drinkers:21% (13%, 30%)]. Most centenarians were physically inactive (23%; 20%, 26%). Over 50% had normal weight (52%; 42%, 61%), 33% (14%, 52%) underweight, and 14% (8%, 20%) overweight. Regarding nutrition, the narrative synthesis suggests that centenarians had normal levels of albumin (3.8g/dL), total triglycerides (111mg/dL), total (188mg/dL), and HDL cholesterol (54mg/dL) but high levels of LDL cholesterol (109mg/dL). Regarding medications, nearly 50% took antihypertensive medications (49%; 14%, 84%) or other cardiovascular drugs (48%; 24%, 71%); they took a median of 5 (range: 2-7) drugs. Common conditions included impairment of basic activities of daily living (ADL) (54%; 33%, 74%), hypertension (43%; 21%, 65%), and diabetes (22%; 9%, 52%). In regression analyses among centenarians, high dietary diversity, lower salt preference, and weight status were significant factors for more independence in basic ADL, lower mortality, and greater longevity. For example, a high dietary diversity score was associated with a low mortality risk [0.93 (0.92, 0.94) per unit increase]; those who preferred salty food versus those who did not had a 3.6-fold risk of impaired ADL [adj.OR: 3.59 (1.14, 11.25)]. Being overweight vs. normal weight reduced the risk of ADL impairment [adj.OR: 0.84 (0.78, 0.91] while underweight increased this risk [adj.OR:1.34 (1.28, 1.41)]. Also, overweight [adj.OR: 0.92 (0.90, 0.94)] or abdominal obesity [adj.OR: 0.72 (0.52, 0.996)] reduced the likelihood of longevity per kg increase. This systematic review suggests a healthy lifestyle, good nutrition, and normal body weight may contribute to extreme longevity. Interpreting these summary findings should be cautious due to potential recall bias and heterogeneity of the included studies.

Sufficient vitamin D status is required in childhood for normal skeletal health and the development of muscle and motor function(1). Vitamin D primarily acts through the promotion of calcium absorption from the gut and mobilisation from bone tissue(2). Childrens’ vitamin D dietary intakes are currently below the recommended guidelines within the UK and Ireland suggesting a need for vitamin D3 supplementation to prevent the risk of developing vitamin D deficiency(3). The aim of this study was to examine the effect of 12 weeks’ supplementation with 10µg/d vitamin D3 vs placebo control on vitamin D status and to determine if improved vitamin D status impacted muscle function and cognition in children aged 4-11 years.

In the D-VinCHI randomised, double-blind, placebo-controlled trial, healthy children (n = 118; mean age 8.1±1.8 y; 51% girls) were randomly assigned to either placebo or 10µg/day of vitamin D3 for 12 weeks (year-round). Baseline and endpoint measures included anthropometric measures, hand grip strength, balance, and cognitive assessment. Blood samples were analysed for plasma 25hydroxyvitamin D [25(OH)D], and parathyroid hormone. Vitamin D consumption from food sources was assessed via a 13-item food frequency questionnaire.

Following the 12-week intervention vitamin D status [25(OH)D concentration] increased in the treatment group from 66.31 ± 17.25 nmol/L to 69.04 ± 16.92 nmol/L. Change in status was significantly different compared to the placebo group within which a decrease in 25(OH)D was observed from 63.67 ± 19.48 to 56.29 ± 18.58 nmol/L, p<0.001. Supplementation with vitamin D3 prevented deficiency of plasma 25(OH)D during the winter months. Vitamin D3supplementation had a positive effect on cognitive function, improving simple movement time from 707±380 to 599±207 milliseconds, compared to the placebo group within which time increased from 680±284 to 728±372 milliseconds, p = 0.017. Vitamin D mean dietary intake from food sources alone was 2.68µg/day. There was no effect of supplementation on muscle function.

Vitamin D3 supplementation maintained year-round sufficiency in children and importantly, prevented deficiency during the extended winter months. Vitamin D supplementation may enhance cognitive function via improvements in attention and psychomotor speed. The reported intakes of vitamin D food sources were low and were well below the current dietary reference value for this age group. Further health promotion policies and (bio)fortification strategies should be considered within this age group to maximise vitamin D status for optimal growth and development.

Serum 25(OH)D (vitamin D) plays an important role in skeletal and muscle function(1). Menopausal women are at an increased risk of reduced bone mineral density (BMD) and fracture due to a decline in oestrogen levels(2). A low circulating 25-hydroxyvitamin D (25(OH)D) level during menopause is a common problem and has been associated with changes in dietary intake and body composition(3). While vitamin D supplementation has been shown to increase serum 25(OH)D levels, its isolated effects on bone health in menopausal women is largely misunderstood. A systematic review was conducted to identify, appraise, and synthesise available studies to assess the impact of vitamin D supplements and bone health in menopausal women.

Four electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) were searched from inception to 8 December 2023. Only randomised controlled trials (RCTs) examining the efficacy of vitamin D supplementation in menopausal and/or post-menopausal women were included. Studies published in English and measuring BMD, fracture risk, calcium absorption, or serum 25(OH)D levels were eligible. Animal/lab trials, studies involving pharmaceutical co-treatments or vitamin K and/or calcium supplements were excluded. Two researchers independently extracted data according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines(4) and assessed possible bias using the Cochrane risk of bias tool v2. A narrative approach was used to synthesise the data.

In total, 243 studies were retrieved through initial database searches. Following the elimination of duplicates and screening stages, six RCTs involving 696 menopausal women met the eligibility criteria. The studies varied in intervention length (range 4 wks-4 yrs) and were conducted across four different countries including: Brazil, Bangladesh, Japan, and the USA. Study samples ranged from 38 to 230 participants. A variety of vitamin D supplements (dosages/frequencies) were used across the included studies. Despite heterogeneity in study methods and vitamin D dosages, significant improvements were observed in BMD, risk of falls, and calcium absorption following vitamin D supplementation. Results also found that vitamin D supplementation may improve postural balance and muscle function, improving mobility for menopausal women.

This systematic review demonstrates that vitamin D supplementation can enhance BMD, calcium absorption, reduce the risk of falls, and improve postural balance in menopausal women. However, the optimal dosage of vitamin D has not been determined. Limitations include methodological heterogeneity and lack of long-term follow-up, highlighting the need for further large-scale RCTs with rigorous methodology. These findings underscore the importance of ongoing research to better understand the role of vitamin D supplementation and bone health in menopausal women.

The interplay between selenoproteins, oxidative stress, and cell death pathways holds promise in unravelling novel therapeutic targets for Alzheimer’s disease (AD) in the future. Nonetheless, further comprehensive investigations are warranted to fully comprehend the precise contributions of selenoproteins in the aetiology and potential therapeutic strategies for Alzheimer’s disease. Previous work into gene expression networks in AD has included analysis of the entire transcriptome and, as of yet, has not yielded consistent insight into pathological pathways.1 Despite the comprehensive assessment of the transcriptome enabled by current technologies, one drawback of the whole transcriptome analysis is the risk of overlooking subtle yet significant variations in metabolic pathways.2 Thus, we aimed to assess gene expression of known selenoprotein and selenium-containing pathways in two different brain regions (dorsolateral prefrontal cortex (DPC) and posterior cingulate cortex (PCC)) across the AD spectrum. We used RNA sequencing data from The Rush University’s Religious Orders Study and Memory and Aging Project (ROSMAP) cohort available in the AD Knowledge Portal (https://www.synapse.org/).3 This study included data available for a total of 889 DPC and 647 PCC samples. Four pathological phenotypes were determined based on pathology (CERAD) and clinical (CDR) status: AD ([(+) pathology, (+) clinical], prodromal disease, corresponding to donors that have not received a clinical diagnosis despite the presence of pathological alterations ([(+) pathology, (−) clinical], controls ([(−) pathology, (−) clinical] and non-AD dementia [(+) pathology, (+) clinical]. This last group was excluded from the analysis as it is assumed they may have been misdiagnosed or presented with non-AD dementia. Six selenium or AD-related pathways were assessed, accounting for 421 unique genes. Group comparisons were performed using linear mixed modelling adjusted for age, sex, APOEe4 status and batch via DESeq2 package with Benjamini-Hochberg adjustment for multiple testing. A total of 18 genes significantly differed between AD and controls in both brain areas (same direction in both brain areas; P < 0.05), including eight selenoprotein genes or genes directly associated with selenoprotein synthesis. Fifteen of them were also different (same direction) in PCC (seven selenoprotein/selenoprotein synthesis genes), and four were different in DPC (four selenoprotein/selenoprotein synthesis genes) between AD and prodromal. Only three genes significantly differed between prodromal and control samples (DPC), including the selenoprotein DIO3 and the transcription factor SP3. Our findings indicate a progressive change in gene expression across the different stages of AD. These findings shed light on critical genes involved in selenoprotein synthesis that play a role in AD pathogenesis. Restricting the analysis to a subset of pathways enabled the detection of smaller alterations between groups, which is particularly appropriate in trace element homeostasis, where small alterations may have significant downstream effects.

Vitamin D deficiency and insufficiency have been associated with increased risk and severity of SARS-CoV-2 infection.(1) These conditions are prevalent among older adults, Asian and Black populations, and in individuals with high body mass index (BMI),(2) all of whom comprised a significant proportion of critically ill patients with SARS-CoV-2 infection in the UK.(3) This study investigated vitamin D status and its relation to BMI, ethnicity, sex, and in a hospital patients.

This study investigated vitamin D status by measuring serum 25-hydroxyvitamin D (25(OH)D) concentrations and its relation to BMI, ethnicity, sex, and laboratory data in a large sample (N = 17,628) from St Thomas’ Hospital, London, UK, collected close to the start of the COVID-19 pandemic between January and June 2020. We also identified 485 patients positive for SARSCoV-2 RNA/IgG between March 2020 and January 2021 from those 17,628 patients.

The prevalence of vitamin D deficiency (25(OH)D <25 nmol/L) was 25% in Black, 21% in Asian, and 17% in White patients. Vitamin D insufficiency (25(OH)D 25-50 nmol/L) was observed in 36%, 34%, and 33% of these groups, respectively. The lowest concentrations of 25(OH)D were observed in individuals aged 17-21 years across all ethnicities, with levels increasing with age and stabilising after 60 years. The highest prevalence of vitamin D insufficiency was in overweight (33%, BMI 25.0-29.9) and obese individuals (35%, BMI 30.0-34.9). The deficiency rates were 18.5% for females and 22.4% for males. Notable disparities in BMI and age were observed among Black patients but not in Asian and White groups. Differences in 25(OH)D concentrations were also observed between sexes across different ethnicities, with the exception of South Asian individuals (Bangladeshis, Indians, Sri Lankans). SARS-CoV-2 RNA/IgG screening indicated 485 patients had previously been infected with SARS-CoV-2. Of these patients, the median 25(OH)D concentration was 42 nmol/L (IQR 25-66 nmol/L); 24.1% were vitamin D deficient, and 36.7% were insufficient (total 60.8% deficient/insufficient). Of those with deficiency, 40% were Black and 43% were White. It is well documented that vitamin D negatively regulates pro-inflammatory cytokines such as TNF-α,(4) which are involved in the pathogenesis of SARS-CoV-2 infection.(5) In a subset of the SARS-CoV-2 infected patient cohort (N = 45), we found a significant negative correlation between 25(OH)D concentration and TNF-α levels (Pearson’s r = −0.395, P <0.01).

In conclusion, this study highlights a high prevalence of vitamin D deficiency among individuals of Black ethnicity, young adults (17-21 years), males, and those with obesity during the early part of the COVID-19 pandemic in south-east London. Vitamin D deficiency may be a preventable risk factor for SARS-CoV-2 infection and linked to hyperinflammation. Because TNF-α is known to be elevated in obesity,(6) further analysis of this pro-inflammatory cytokine and vitamin D in patients with SARS-CoV-2 infection and concomitant obesity is warranted.

The role of protein in decreasing the risk of cardiometabolic diseases has been proposed, yet the findings are inconsistent, possibly due to how protein intake was expressed(1). This study aimed to examine how different ways of expressing protein intake may influence its relationships with diet quality and obesity. This study used data from the Australian National Nutrition and Physical Activity Survey (NNPAS) 2011-12, focusing on adults aged ≥19 years, excluding those who were pregnant or lactating, and had both anthropometric and dietary data (n = 7637). Total protein intake was assessed by up to two 24-hour dietary recalls and reported in two measurement units, namely g/day and % of energy intake. Usual protein (g) and energy intakes (kJ) were modelled using the Multiple Source Method(2). Diet quality was assessed using the Dietary Guidelines Index (DGI)(3). Body mass index (BMI) and waist circumference were used as measures of obesity. Multiple linear regressions were performed stratified by sex, and adjusting for age, country of birth, Socio-economic Indexes for Areas, physical activity level, energy misreporting, usual energy intake (for diet quality), and non-protein energy intake (for obesity). Positive associations between protein intake and diet quality were confirmed across measurement units. Protein intake expressed in % of energy intake (β-coefficient: men = 0.97; women = 1.21, p<0.001) had a higher β-coefficient than those reported in g/day (β-coefficient: men = 0.19; women = 0.30, p<0.001). Linear regression models showed a positive association between protein intake and BMI for men and women, either expressed in g/day (β-coefficient: men = 0.02, p<0.001; women = 0.03, p = 0.001) or % of energy intake (β-coefficient: men = 0.14, p<0.001; women = 0.12, p = 0.002). The relationship between protein intake expressed in g/day and waist circumference was also statistically significant (β-coefficient: men = 0.04, p = 0.004; women = 0.05, p = 0.035). However, protein intake expressed as % of energy intake was correlated with waist circumference for men only (β-coefficient: men = 0.26, p = 0.001; women = 0.19, p = 0.075). The consistent findings across measurement units suggested that the unit of g/day and % of energy intake can be used for examining associations between protein intake and diet quality. However, associations between protein intake and measures of obesity varied between protein units and sex. These findings suggest that the selection of protein measurement units in relation to obesity outcomes might need to consider the characteristics of study population (e.g., sex, energy intake). Overall, the outcomes of this study suggest that how protein is expressed may impact the associations between protein intake, diet quality, and obesity, and therefore require further considerations when examining the role of protein in cardiometabolic health.

Chronic pain affects 20-30% of people worldwide(1). While the impact of nutrition and dietary patterns on bodily pain has gained attention in recent years, the underlying linking mechanisms remain poorly understood; it is possible that body weight, specifically adiposity, may be a mediating factor(2). Thus, the primary aim of this study was to explore whether adiposity mediates the relationship between diet quality and bodily pain. This cross-sectional analysis included 654 adults (57% women, mean age 50.4 ± 1.1 years, BMI 29.0 ± 6.2 kg/m2) with complete diet, adiposity, and pain measures from the Whyalla Intergenerational Study of Health (2008-09). Diet quality was calculated using the Dietary Guideline Index (DGI total score, core and non-core scores)(3), and pain assessed via the Short Form-36 bodily pain scale (SF36-BPS) transformed percent score. Adiposity was determined from body mass index (BMI), waist circumference (WC), and body fat percent (BF, via dual energy x-ray absorptiometry). Mediation analyses determined the role of adiposity in the direct and indirect relationships between diet quality and pain in the whole population, then stratified by sex (self-report). There were no significant indirect or direct effects between DGI total scores and SF36-BPS, for any measure of adiposity. Direct effects were observed for DGI core-food scores on SF36-BPS for each measure of adiposity (BMI, β = 0.258, 95% CI 0.048, 0.467; WC β = 0.246, 95% CI 0.037, 0.455; BF β = 0.247, 95% CI 0.040, 0.454; all p<0.05). Each measure of adiposity accounted for <10% of the relationship between diet quality and pain, with a better-quality diet associated with less bodily pain (higher SF36-BPS). Relationships differed by sex; with no direct or indirect effects seen between DGI scores and SF36-BPS for men while, in women, there was non-mediation with direct positive effects between DGI total score and SF36-BPS for each measure of adiposity (BMI, β = 0.362, 95% CI 0.132, 0.591; WC β = 0.345, 95% CI 0.116, 0.574; BF β = 0.357, 95% CI 0.130, 0.584; all p<0.05). Also in women, body fat mediated 85% of the relationship between DGI non-core scores on bodily pain (indirect effect β=-0.242, 95% CI −0.358, −0.126, p <0.05). While adiposity did not mediate the relationship between diet quality and pain, this study highlights that diet quality plays a role in the pain experience with higher consumption of core foods showing direct associations with lower levels of bodily pain. Moreover, sex differences were observed, with less bodily pain in women associated with higher overall diet quality. Interestingly, body fat drove the relationship between higher pain scores and greater consumption of non-core foods (discretionary), but body fat alone was associated with consumption of fewer discretionary foods. This anomaly requires further investigation.

Cystic fibrosis (CF) is an autosomal-recessive condition that is caused by a mutation in the CFTR gene(1). As CF patients’ prognoses are improving due to highly effective modulator therapy, (HEMT) managing comorbidities such as bone disease is pertinent. This could be exacerbated by vitamin D insufficiency which has been estimated to be as high as 98% in adults with CF(1). This systematic review aimed to evaluate the efficacy and safety of high-dose cholecalciferol (vitamin D3) supplementation in correcting inadequate serum 25-hydroxyvitamin D (serum 25(OH)D) concentration in adults with CF.

The systematic search included studies that examined the impact of high-dose cholecalciferol on serum 25(OH)D concentration. Eligible RCTs included study designs that involved adults with CF and a high-dose cholecalciferol supplementation protocol (defined as any dose above basal) compared with basal doses (800IU-1000IU/day)/no supplementation. A systematic search was conducted and a meta-analysis of RCTs was produced to calculate the change in serum 25(OH)D concentration in the intervention group in comparison to control as the primary outcome measure.

The systematic search yielded five RCTs that were collated and analysed. The results of the metaanalysis demonstrated that the high-dose cholecalciferol group and control group achieved a serum 25(OH)D concentration of 40.19ng/ml± 10.21ng/ml and 28.50ng/ml± 7.35ng/ml respectively (p<0.01), indicating that high-dose cholecalciferol is an effective intervention to achieve optimal serum 25(OH)D concentration (>30ng/ml). A high heterogeneity was observed across the studies (I2=87%)(2,3). Doses varied from daily supplementation of 1,700IU to a 250,000IU single dose. There were minimal adverse effects reported in the RCTs from high-dose cholecalciferol and there were no instances of hypervitaminosis D or hypercalcaemia reported(3).

The results infer the effectiveness of high-dose cholecalciferol in correcting low serum 25(OH)D concentration in adults with CF. The most effective regimen identified was a single weekly dose of 50,000IU for 12 weeks, which achieved serum 25(OH)D concentration of 45.91ng/ml± 11.24ng/ml (control: 23.61ng/ml± 4.37ng/ml) (p<0.01) after a 12-week intervention(2).

The key findings suggest that annual monitoring of serum 25(OH)D concentration would be beneficial with a tailored high-dose cholecalciferol protocol. A high level of heterogeneity was observed across the studies, with small sample sizes, meaning a larger multi-centre, multi-nation RCT study that considers the context of advances in HEMT should be conducted to corroborate the results before implementation into clinical guidelines.

High-dose cholecalciferol supplementation is an effective and safe method to increase serum 25(OH)D concentration in adults with CF that may lead to improved bone health outcomes. More studies are required before revising current vitamin D supplementation guidelines. Future research should focus on establishing dosing guidelines to optimise vitamin D status, exploring the longterm health outcomes of sustained adequate serum 25(OH)D concentration.

Vegan diet consumption is gaining popularity globally and in New Zealand. However, plant foods provide absent or limited quantities of important micronutrients such as vitamin B12, iron, zinc, and omega-three fatty acids(1). A restrictive and unplanned vegan diet may thus increase risks of nutrient deficiencies especially during pregnancy and early life if the nutrient demands are not fulfilled. Health professionals who provide primary support for pregnant women and their children are important figures in monitoring the nutritional statuses during the antenatal and postnatal periods(2). (Being knowledgeable about the nutritional risks of poorly-planned vegan diets, and having access to appropriate educational resources would support vegan mothers and children to achieve a well-balanced diet. Currently, there are insufficient studies investigating the perspectives of New Zealand’s health professionals within the realm of vegan diets during pregnancy and early life. The aim of the research is to utilise a mixed-methods approach to explore these concerns, attitudes, and experiences. Healthcare professionals, including dietitians, nurses, general practitioners and midwives were invited to participate in the study. Knowledge and attitude scores were collected with an online questionnaire and scores were recorded as a proportion of the participants. Subsequently, descriptions of experiences, concerns, and perspectives about the adoption of vegan diets during pregnancy and early life were collected with semi-structured interviews. A total of 14 health professionals completed the study. All health professionals showed positive attitudes towards the adoption of vegan diets during pregnancy but some exhibited greater concern about their restrictive nature especially in early childhood. Achieving intake adequacy and subjecting young children to intensive assessments for nutrient adequacy were among the concerns raised. More than 90% of health professionals were concerned about iron and vitamin B12 deficiencies while less than 50% were concerned about deficiencies in protein, omega-three fatty acids, iodine, zinc and vitamin D. Less than 50% of participants were aware that plant foods do not provide sufficient vitamin B12. More than 50% disagreed that sufficient information about vegan diets during pregnancy and early life is available. Insufficient evidence-based consensus and government guidelines, and limited access and referrals to dietitians for guidance on vegan diets were highlighted as challenges that reduce the overall knowledge and confidence. Hence, continual professional education and updated evidence-based resources would be important steps to support health professionals in providing guidance to individuals on vegan diets.

Menopause, as signified by 12 months of amenorrhea, marks the end of female fertility(1). The perimenopausal stage preceding this event, is frequently symptomatic, with previous research suggesting that a higher body mass index (BMI) may be associated with more severe menopausal symptoms(2). Changes to body composition have also previously been linked to the decline in hormones that accompany this midlife transition(3). This cross-sectional, observational study aimed to shed light on this underexplored area in Ireland.

Approval was granted by the Technological University of the Shannon Research Ethics Committee. A convenience sample of perimenopausal women (>40 years old) were recruited via social media and workplaces. Participants self-reported their symptom severity using the previously validated Menopause Rating Scale (MRS)(4). Psychological, somatic, and urogenital symptom categories were rated from 0 (no symptoms) to 4 (very severe symptoms), with a potential maximum score of 44. An overall score and a sub-score for each of the 3 symptom categories was generated. Participants self-identified their perimenopausal stage (early or late) based on descriptions of the STRAW+10 criterion(5). A range of anthropometric measurements were taken including height, weight, waist circumference (WC) and body fat (BF) percentage (using TANITA MC-580 tetrapolar bioelectrical impedance scales). Following descriptive analysis, Spearman’s correlation coefficient was utilised to test the relationship between MRS and anthropometric measurements.

Participants (N = 112) had a mean age of 48.05±3.48 years, a mean WC of 95.2±16.9cm, a mean BF percentage of 34.9±7.3. Prevalence of healthy, overweight, and obesity BMI amongst participants was 29%, 36% and 36% respectively, with a mean of 29.0±6.6kg/m2amongst the sample. Overall mean MRS symptom score was 15.3±6.9. There was a positive correlation between participant’s overall symptom rating and, their BF percentage (r =0.30, P = 0.001), WC (r = 0.30, P = 0.002), and BMI (r = 0.31, P = 0.001). This relationship was also observed in the symptom sub-score categories. Somatic sub-score positively correlated with BF percentage (r = 0.24, P = 0.010), WC (r = 0.31, P<0.001) and BMI (r = 0.31, P<0.001). Urogenital sub-score was similarly positively correlated to all 3 anthropometric measurements, BF percentage (r = 0.24, P = .010), WC (r = 0.24, P = 0.011), and BMI (r = 0.23, P = 0.014). Psychological sub-score was correlated positively with BF percentage (r = 0.23, P = 0.015) and BMI (r = 0.21, P = 0.026), but not WC.

The findings from this study suggest that a higher BF percentage, WC and BMI may be associated with a more symptomatic perimenopausal stage. Further studies are warranted to further explore this, and how to target interventions.