Previous research has shown personalised nutrition feedback is more effective than generic onesize-fits-all nutrition advice(1). Using fruit and vegetable intakes from the MyPlanetDiet randomized controlled trial, this analysis will determine if different severity of personalised nutrition feedback delivers greater dietary change.

Participants were recruited from the general public and randomised to receive personalised feedback based on a more sustainable diet (intervention) or Healthy Eating Guidelines (control). Intervention participants received feedback on total fruit, total vegetables, dark green vegetables, and/or red/orange vegetables. Control participants received feedback on total fruit and vegetables, total vegetables, citrus fruits, and/or fruit juice. Participants completed dietary assessments (3x 24-hour recalls) at baseline (Week 0) and endpoint (Week 12) using Foodbook24, a validated online dietary assessment tool(2). Mean food group intakes and Healthy Eating Index scores were calculated. Personalised feedback messaging was assessed to measure the severity of fruit and vegetable feedback, ranging from zero messages (least severe) to four messages (most severe). Data are presented as mean±standard error. Data were analysed via two-way mixed analysis of covariance and univariate general linear models using IMB SPSS Statistics (Version 29).

Participants (n = 292) were 56% female and 42.3 ± 0.7 years old. Mean fruit and vegetable intake at baseline was 325.4 ± 183.3g. Almost all participants (97%) received feedback for at least one component of fruit and vegetable intake. Control participants were more likely to receive feedback on fruit (p<0.001) while intervention participants were more likely to receive vegetable feedback (p<0.001). There was a significant time*group interaction for fruit intake (p = 0.005) with larger increases in the control (+102.3g) than the intervention group (+38.6g). The intervention group had higher vegetable intakes (200.6 ± 7.9g) compared to control (164.2 ± 7.5g) at endpoint (p<0.001). Those receiving more severe fruit and vegetable feedback had significantly lower intakes of fruit and vegetables at baseline (p<0.001) but not endpoint (p = 0.80). There was a significant time*group interaction for fruit and vegetable intake (p<0.001) between severity groups. Those with least severe feedback decreased fruit and vegetable intake (-57.4g) while those in the most severe group increased intakes by 162.2g. However, mean fruit and vegetable intake in the least severe group was still higher (472.9 ± 31.8g) at endpoint than in the most severe group (397.2 ± 23.6g). There was a significant time (p<0.001) and time*group interaction (p = 0.039) in HEI scores with the smallest increase in the least severe group (+3.7) and the largest increase in the most severe feedback group (+9.6).

More personalised nutrition feedback was associated with greater behaviour change when using fruit and vegetable intake as an example. Differences in messaging between control and intervention groups led to corresponding differences in dietary change. Different severity of personalised nutrition feedback resulted in participants having comparable fruit and vegetable intakes at endpoint.

It is estimated that one-quarter of the world’s population has Metabolic Syndrome (MS)(1), a key driver of growth in healthcare expenditure. Traditional approaches to treating MS through the application of standard dietary recommendations and caloric restriction have had limited success. More recent evidence suggests that novel, anti-inflammatory approaches such as replacing refined carbohydrates and ultra-processed food with unprocessed or minimally processed, lower carbohydrate foods and adapting meal timing and frequency may be more effective(2). The aim of the study was twofold: 1) To determine the effectiveness of anti-inflammatory dietary strategies for long-term weight loss and improvement in metabolic health and 2) To examine the relationships between eating behaviours and long-term weight loss. Twelve-month audit data from a UK based 12-week lifestyle program that focuses the principles of consuming an anti-inflammatory diet was analysed using repeated-measures ANOVA to examine the effects of the program on changes in weight and waist circumference. A quantitative, survey-based research design was used to retrospectively identify relationships between eating behaviours and both anti-inflammatory and pro-inflammatory dietary patterns. Multivariate regression using stepwise method was used to examine differences in weight change based on eating patterns and behaviours. Six hundred and forty-two (N = 642) participants (age = 50.4 ± 12.5 years, female 63.6%, weight = 96.1 kg ± 22.1, BMI 35.2 kg/m2 ± 7.5) demonstrated a weight loss average of 4.49 kg ± 3.78 post-lifestyle program (12 weeks). Survey respondents (N = 64) reported a maximum long term weight loss of 13.9 kg ± 11.9. Weight loss and percentage weight loss after the program was significantly predicted by daily consumption of sweet drinks and grain-based foods. The model predicted one unit increase in daily serving consumption of these foods resulted in less weight lost [2.3 kg (4.5%)]. Seventy one percent of survey respondents had maintained most or all their weight loss for more than 6 months. The model predicted change in consumption of grain-based foods, TFEQ-emotional eating score, consumption of savoury ultra-processed foods, and following an alternative dietary approach after the program were statistically significant in predicting weight loss maintenance (R2 = 0.803, F(4, 20) = 20.376, p < 0.001). The preliminary findings suggest that anti-inflammatory dietary approaches are effective and sustainable for weight loss. Eating behaviour may both support and hinder long term changes in eating patterns and whilst there are significant relationships between eating behaviour and eating patterns, the extent to which dietary patterns drive eating behaviour remains unclear.

The consumption of healthy foods such as whole grains, vegetables, fruits, nuts, legumes, dairy, and fish is associated with decreased risk of cardiovascular disease (CVD). CVD is an inflammatory disease caused by atherosclerosis. Inflammation is measured clinically using hsCRP, however hsCRP is not specific to CVD. Novel pro-inflammatory markers, such as platelet-activating factor (PAF) and lipoprotein-associated phospholipase A2 (Lp-PLA2), have garnered attention due to their specific roles in endothelial dysfunction and CVD risk. During the COVID 19 outbreak research highlighted a potential interaction between PAF and Lp-PLA2 and the SARS COVID 19 virus(1-3) and related adenovirus-vector and mRNA vaccines.4 This cross-sectional study investigated the association between PAF, Lp-PLA2, hsCRP, and intake of healthy food groups including fruit, cruciferous and other vegetables, grains, meat and poultry, fish and seafood, nuts and legumes, and dairy in 100 adults (49 ± 13 years, 31% male) with variable CVD risk. Data were collected across four groups during May and July 2021 (Groups 1 and 2 - CVD risk factors) and January and April 2022 (Groups 3 and 4 - no CVD risk factors). Fasting PAF, Lp-PLA2 and hsCRP and usual dietary intake (food frequency questionnaire) were measured. Food intake was converted into serves and classified into food groups. Correlations and multiple regressions were performed. Contrary to expectations, mean PAF was lower for groups 1 and 2 (n = 46, mean PAF 3.31 ± 1.66 ng/mL) compared to groups 3 and 4 (n = 54, mean PAF 19.82 ± 12.95 ng/mL) p < 0.001 with a large effect size (eta squared 0.665). Cruciferous vegetables were associated with lower levels of PAF (β = -.27, CI [−0.41, −0.14], p < .001) with a one serve increase in cruciferous vegetables per day associated with an 24% reduction in PAF. Nuts and legumes were associated with lower levels of hsCRP (β = -.51, CI [−0.81, −0.22], p<.001) with an increase of one serve per day associated with a 40% reduction in hsCRP. There were small inverse associations between cheese and both PAF (β = -.15, CI [−0.27, −0.03], p = .017) and Lp-PLA2 (β = -.26, CI [−0.47, −0.04], p = .024), however these were not significant at the Bonferroni-adjusted P<.005 level. In conclusion, cruciferous vegetables and nut and legume consumption were associated with lower levels of inflammation. The lack of associations between PAF and Lp-PLA2 and other healthy foods may be due to confounding by COVID-19 infection and vaccination programs which prevents any firm conclusion on the relationship between PAF, Lp-PLA2 and food groups. Future research should aim to examine the relationship with these novel markers and healthy food groups in a non-pandemic setting.

Adhering to traditional diets could significantly contribute to enhancing health and promoting environmental sustainability (1). China reports the highest incidence of non-communicable disease related fatalities globally (1). There has been no consistent definition of the traditional Chinese diet (TCD). Findings on the association between TCD and health outcomes are also inconsistent (2). Therefore, it is critical to establish a consensus on the definition of the TCD, including food groups that are characteristic of this diet and their quantities. The Delphi method is widely accepted as an effective tool for consensus-building among experts (3). Hence, this study aimed to 1) establish an index for assessing adherence to the overall TCD, involving inviting nutrition experts to achieve a consensus on which food groups, food quantities, and food-related habits define the TCD; and 2) develop five indices that characterise regional TCDs (for the eastern, western, southern, northern, and central Chinese regions).

From October 2023 to February 2024, a three-round modified Delphi study was conducted via an online platform. The eligible participants were nutrition experts, working in various fields, including academic professors, registered dietitians, and clinical nutrition physicians. Participants were invited to complete online questionnaires, to establish the food groups and food-related habits that characterise TCD by using a mix of Likert scales, a list of responses, and yes/no questions. Openended and free-text questions were also used to collect detailed comments/suggestions. Consensus was assessed by using percentages of agreement; median values and interquartile ranges were used to illustrate the recommended consumption ranges for each food group to be included in the index. Statistical analyses were performed using SPSS and NVivo 12.

Fifty-eight nutrition experts (a minimum of ten experts from each region) were involved in the first Delphi round. Response rates for the second and third rounds were 87.9% and 93.1%, respectively. The resulting overall TCD index comprises 15 food groups plus one dietary habit, with scores ranging from 0 to 23 (minimum to maximum), where higher scores reflect higher adherence to TCD. Rice, various vegetables, fruits, eggs/egg products, wheat/wheat products (excluding wheat with filling), and starchy roots and tubers scored two points when meeting the consumption range. Wheat with filling, pork/pork products, fermented foods, deep-fried wheat, corn/coarse grains, legume products, beef/beef products, poultry and cooking by steaming and/or boiling were scored one point each when meeting the consumption criteria. Five regional TCD indices, including food groups and the range of quantities for each food group, were also developed.

This modified Delphi study achieved consensus for developing TCD index and five regional TCD indices for the first time. These indices can be utilised as essential instruments for future research on exploring adherence to TCD and its impacts on health outcomes and environmental sustainability.

Numerous disorders, including type 2 diabetes and even COVID-19, are linked to poor gut health and inflammation(1,2). In addition to impacting food digestion and absorption, gut inflammation worsens diabetes outcomes by causing gut microbial dysbiosis, disrupting tight junctions (allowing microbial metabolites to freely enter into circulation), and altering glucose absorption(3). ACE2 is a crucial regulator of gut health and has received much attention during the COVID-19 pandemic due to its role as a major viral entry protease. Studies have shown that the ACE2/Ang-(1-7)/Mas axis is important in managing inflammation and maintaining normal glucose metabolism(3). Dietary phytochemicals are plant bioactive compounds, with promising anti-inflammatory and anti-diabetic properties, and may affect these processes. In this work, we aimed to look at the link between inflammation, ACE2 and the glucose transporters, SGLT1 and GLUT2, and how phytochemicals could be used to normalise the changes brought about by inflammation in Caco-2/TC7 human intestinal epithelium cells. We first examined how gut inflammation, ACE2 and glucose transporters are related and proceeded to look at the effect of some chosen phytochemicals on regulating glucose transport via modulation of the ACE2/Ang(1-7)/Mas axis. This included genistein (an isoflavone from soyabeans), sulforaphane (an isothiocyanate found in Brassica, especially broccoli), apigenin (a flavone found in vegetables and herbs), and artemisinin (a sesquiterpene lactone used as a drug). The impact of phytochemicals on the SARS-CoV-2 viral entry receptors, ACE2 and TMPRSS2, was also examined as a secondary outcome. To induce inflammation, the Caco2/TC7 cells were co-stimulated with IL-1β (25 ng/mL) and TNF-α (50 ng/mL) for varying durations (24 h, 48 h, 72 h, 168 h) and changes in target gene expression (ACE2, SGLT1, GLUT2, TMPRSS2) were assessed by droplet digital PCR. IL-6 and IL-8 were assessed as markers of inflammation in the cell culture media by multiplex ELISA. Inflammation increased ACE2, TMPRSS2 and SGLT1 mRNA. ACE2 increased with cytokine exposure duration, coupled with an obvious decrease in IL-8, SGLT1 and TMPRSS2. Pearson correlation analysis revealed that the increase in ACE2 was strongly associated with decreases in SGLT1 (r = −0.99, p<0.01) and IL-8 (r = −0.959, p<0.05), implying ACE2 to play a crucial role in gut inflammation and postprandial glycaemia. After establishing the gut cell inflammation model, we compared the effect of the phytochemicals on our target genes in cells cultured in normal and pro-inflammatory environments. None of the tested phytochemicals were effective in reducing IL-8 secretion, while phytochemicals showed varying effects on the target genes. Genistein normalised the effects of inflammation on the target genes with less effect from the other tested phytochemicals. However, further research is required to assess the importance of genistein in vivo in the context of gut inflammation and type 2 diabetes.

Food poverty is an acknowledged social determinant of health and is associated with significant adverse health outcomes(1,2). It is a growing issue on the Island of Ireland, due to a number of factors, including, the COVID-19 pandemic, chain supply issues, inflation and external geo-political events. As news media play a key role in shaping policy discourse(3)and public attitudes(4) towards health and social issues, understanding how the issue of food poverty is framed on the island of Ireland may help health promoters develop alternate framings to better advocate for effective policy measures. The overall aim of this research was to investigate the discursive construction of food poverty in the news media, and to explore public, policy and key stakeholder perceptions of food poverty.

A series of interlinked studies were conducted, including analysis of policy documents, analysis of print and broadcast news media reporting on food poverty, and qualitative interviews with news media professionals, members of the public, third sector community organisations and policymakers. In analysing how the topic is framed, the research drew on Entman’s Framing Theory. An integrated knowledge translation approach was adopted throughout the research process.

Findings from analysis of policy documents (n = 48), print (n = 81) and broadcast (n = 91) news media, and qualitative interviews with key stakeholders (n = 44) across the island of Ireland revealed four core inter-linked and over-lapping discursive frames, including: political dysfunction, economic dysfunction, social dysfunction, and individual dysfunction. A key finding included differing opinions between participants in the North and the Republic on whether lifestyle (individual dysfunction) or structural (political dysfunction) factors were salient drivers of food poverty. Those who leaned more towards understandings of food poverty that included individual dysfunction showed greater endorsement of individual and community level interventions, while those who leaned more towards understandings that included political dysfunction showed greater endorsement of policy-led interventions. This coherence was not evident in news media reporting, where media discourse more prominently highlighted community-led responses (e.g. charitable food aid), despite acknowledgement of its upstream drivers. Another key finding was the absence of the voices of those experiencing food poverty from news media reporting on the issue. While news media professionals expressed a need for case studies, third sector service providers raised questions about the ethical engagement with vulnerable populations.

The research findings highlight that the problem of food poverty is largely depicted through the lens of charity, which precludes obligations for state actors and says nothing of the right to food. Re-framing discussions of food poverty as a health and human rights issue may be a fruitful strategy in addressing the problem. Health promotors, researchers and other stakeholders interested in food poverty should move towards adopting rights-based messaging when translating knowledge, including to policymakers and the media.

Blood pressure (BP) is influenced by both genetics and diet. Dietary management of hypertension includes increasing potassium-rich foods while reducing sodium intakes. Dietary sodium and potassium intakes can be measured objectively using urinary sodium and urinary potassium, with lower urinary sodium to potassium ratios associated with lower BP(1). Understanding the interplay between diet and genetics may be useful in treating hypertension and determining which individuals may receive an outsized benefit from lowering their sodium potassium ratio. This study aims to investigate whether identifying genetic risk for hypertension could be utilised to identify individuals who may benefit most from lowering sodium intake and increasing potassium intake. UK Biobank cohort participants (n = 296,475) with data on genotype, BP and spot urinary sodium and potassium data were used. Diet quality was assessed using Oxford WebQ. Biologically directed genetic scores for BP were constructed for pathways related to sodium/potassium biology (pharmagenic enrichment scores [PES]), as well as traditional polygenic risk scores (PRS). A gene-by-environment effect between urinary electrolytes, diet quality and PRS on BP were tested. Genetic risk, diet quality and urinary electrolytes independently correlated with BP. Urinary sodium had larger BP increasing effects amongst individuals who had high genetic risk in sodium/potassium pathways than those with comparatively lower genetic risk. Higher diet quality had a small effect on reducing BP in baseline PRS models, but this did not remain significant in the full model. Polygenic scores for BP personalised to individual sodium/potassium biology (PES) could be used to identify individuals who may receive an outsized benefit from a personalised sodium/potassium dietary intervention. These findings may inform future precision and personalised dietary advice for the management of hypertension.

Dysphagia is more common in older age and is present in up to 70% in long-term care facilities (LTCFs)(1). Thus, the demand for texture-modified diets (TMDs), required to ensure safe nutrition for residents, is high. Individuals with dysphagia are at greater risk of malnutrition, poorer health outcomes and quality of life(2). Moreover, TMDs are less energy- and nutrient-dense due to necessary processing(3). Consequently, TMDs require additional planning and fortification to meet nutrient requirements for this cohort. The International Dysphagia Diet Standardisation Initiative (IDDSI) framework describes drink thickness (level 0-4) and food textures (level 3-7; liquidisedregular), to ensure standard textural characteristics of foods and drinks, however, there is little guidance for food providers in Ireland on how to prepare TMDs to meet nutritional requirements. Whether TMDs in LTCFs meet nutrition standards for food provision in Ireland is unknown. Our aim was to conduct a clinical audit, evaluating adherence of TMDs in a LTCF in Cork, Ireland, to the BDA Nutrition and Hydration Digest(4).

Samples of the daily menu, i.e. all meals, snacks and drinks for IDDSI level 3,4,5 and 6 were weighed over a 2-day period, representing the maximum food and beverages available to residents. Recipes were confirmed with the catering department. Nutritional analysis was conducted using Nutritics©. Nutritional composition was compared to the nutrition standards of the BDA for food providers for nutritionally vulnerable individuals (total daily targets:1840-2772kcal, 79-92g protein; main courses: 800kcal, 27g protein).

The daily TMDs of the LTCF provided [mean (SD)] 1928 (334) kcal, 73 (0.0) g protein (level 3); 1646 (62) kcal, 52 (2.0) g protein (level 4); 1323 (91) kcal, 45 (3.0) g protein (level 5); 1506 (75) kcal, 53 (5.0) g protein (level 6). On analysis of main courses, lunch meals provided 534 (99) kcal, 20 (3.0) g protein (level 3); 436 (0.3) kcal, 16 (0.8) g protein (level 4); 399 (16) kcal, 12 (1.0) g protein (level 5); 353 (13) kcal, 14 (0.3) g protein (level 6), while evening meals provided 770 (58) kcal, 33 (7.0) g protein (level 3); 561 (33) kcal, 19 (0.4) g protein (level 4); 305 (39) kcal, 9 (0.4) g protein (level 5); 379 (52) kcal, 18 (6.0) g protein (level 6).

Across levels, there was poor adherence to energy and protein standards. Only level 3 provided sufficient daily energy and met protein targets for evening meal, potentially explained by the use of full fat milk as a dilutant to create the correct consistency. Guidance is needed for food providers of all LTCFs in Ireland on how to prepare TMDs for nutritionally vulnerable individuals. Future research should investigate actual food consumption, malnutrition risk, oral nutritional supplementation use and training of food providers in LTCFs.

Culinary nutrition (encompassing culinary medicine) is an emerging field that is gaining traction as potential means to mitigate the global disease burden linked to unhealthy dietary patterns, by fostering practical culinary and nutrition literacy among health professionals. Culinary nutrition programmes have shown promise in improving dietary behaviour, cooking confidence, and nutrition counselling skills among students and professionals(1). There is a recognised need for the development and evaluation of standardised culinary nutrition training for nutrition and dietetics (N&D) professionals and there is limited understanding regarding the preparedness of the next generation of nutritionists and dietitians in delivering effective culinary nutrition programmes(2). This study aimed to investigate the cooking and food practices of students of N&D in UK to assess their capabilities and to inform the requirements of future educational curricula.

Between May and June 2023, an online survey was circulated to all UK universities delivering AfN- or BDA-approved nutrition or dietetics programmes, for subsequent circulation to students. It contained validated questionnaires on cooking and food skills confidence, meal preparation frequency, food engagement, and completion of curriculum-based cooking sessions. King’s College London provided ethical approval. Kruskal-Wallis H tests and hierarchical multiple regression modelling with adjustment of relevant covariates were conducted using SPSS Statistics v29.0.2, with a significance threshold of p<0.05.

There were complete responses from 213 students of N&D from 27 UK universities. Respondents mean age was 28.1± 9.4 years, 194 (91.1%) were female, and 132 (62.1%) were white ethnicity. The cohort comprised 57 undergraduate and 95 postgraduate nutrition and 32 undergraduate and 29 postgraduate dietetic students. Students’ average confidence scores were 84.3± 14.7 (out of 98) for cooking skills and 112.0± 20.7 (out of 133) for food skills, with an average food engagement score of 40.2± 4.7 (out of 50). 95 (44.6%) students reported cooking a main meal daily, and 141 (66.2%) had completed an average of 14.2± 16.4 practical cooking session hours as part of their degree program. Undergraduate dietitians completed the least time of cooking sessions at 3.00h, versus undergraduate nutritionists at 9.00h (p = 0.044) and postgraduate nutritionists at 10.00h (p = 0.025). Hierarchical regression models accounted for 18.8% of the variance in cooking skills confidence and 27.7% in food skills confidence. Notably, meal preparation frequency and food engagement significantly contributed to the explained variance in the respective models (p<0.001), even after adjusting for demographic factors such as gender and ethnicity.

Students of N&D in the UK exhibit higher cooking and food skills confidence compared to the general population(3). Coupled with their inherent knowledge of nutritional science, they are wellpositioned to implement future culinary nutrition interventions that could enhance public dietary behaviour and health outcomes. However, to ensure the future workforce is ready, there is a need for curriculum consensus.

As the demand for plant-based meat analogues (PBMAs) continues to surge globally, understanding the marketing strategies that drive consumer choice becomes imperative(1). This research project, part of a larger study at Massey University, explores the design and packaging of vegan food products, specifically focusing on processed PBMAs and how this influences vegan diet consumption choices in New Zealand vegans. We examined the packaging of vegan processed food available in New Zealand supermarkets and those promoted online, with a focus on processed PBMAs. This informed the development of an online survey including: demographics, motivations for following a vegan diet, and questions related to perceptions and preferences about vegan diets and processed PBMA packaging. The survey was offered to individuals who had previously participated in vegan research at Massey University and followed a strict vegan diet. There were 235 participants of whom 198 completed the survey. This consisted of primarily females (n = 156, 74%) and individuals of New Zealand European descent (n = 159, 71%), aged 18 to 76 years (37.8 ± 12.3). The participants had varying durations of following a vegan diet, with the largest group (n = 87, 42%) adopting it for 5 to 10 years. The primary motivation for following a vegan diet was animal welfare (n = 205), followed by environmental concerns (n = 189) and health (n = 175). Participants were able to select more than one option, suggesting there are often multiple reasons for choosing to follow a vegan diet. Factors influencing purchase decisions for PBMAs included nutrient claims on packaging, with protein having the highest positive influence. Environmental concerns also played a significant role, with eco-friendly packaging and positive environmental claims being important. Packaging images, particularly of the final prepared product, had a significantly positive impact on purchasing decisions (4.12 ± 0.78) where 1 represented a negative influence and 5 represented a positive influence on a Likert Scale. The majority sometimes, or always checked the nutrition information panel (n = 167, 85%) and examined the ingredients (n = 191, 98%). Participants reported concern about the nutritional value of processed PBMAs (n = 94), and reported that they are aware that these foods are classified as ‘ultra-processed (n = 91). This research provides valuable insights into the reasons people choose vegan diets and what influences their choices when it comes to purchasing PBMAs. It highlights the significance of marketing strategies in the plant-based meat alternatives industry. However, to gain a more comprehensive understanding of this evolving market, further research is necessary. Future research should consider a wider range of demographics and regional distinctions to better understand how consumer preferences in plant-based diets are changing. This should also include looking at how the market is maturing, with buyers becoming more aware of things like nutrients and the processing of food, which can impact the sustainable food choices individuals make.

Major depressive disorder (‘depression’) is significantly more prevalent amongst young adults in Australia relative to older ages. The inefficacy of current treatment options for many individuals(1) warrants investigation of additional approaches to alleviating the burden of this illness. Incidentally, diet often becomes unhealthier during the transition from adolescence to young adulthood(2). This can result in poorer micronutrient consumption, and there is a growing body of evidence indicating that an inverse relationship exists between intake of certain micronutrients and depressive symptoms(3). Given this, diet may be an important modifiable risk factor or adjunctive means of ameliorating depression for young adults. Young adult vegetarians in particular have an increased risk of some micronutrient deficiencies which have been implicated in depression(4). In combination, their age and dietary choice suggest they may be especially vulnerable to depression and therefore benefit from clear guidance to adequately meet their micronutrient requirements. The present study aimed to elucidate the need for such guidance by comparing the proportions of vegetarian and omnivorous young adult participants in the 2011-12 National Nutrition and Physical Activity Survey (NNPAS) who had inadequate intakes of micronutrients implicated in depression. The NNPAS collected the most recent nationally-representative data pertaining to the dietary intake (via two 24-h recalls) of Australians and included 2,397 young adults (18-34 years). Participants who were pregnant, lactating, or who mis-reported intakes according to Goldberg equation-derived cut-off values were excluded (n = 791). The dietary data were used to estimate usual intakes via the Multiple Source Method. Inadequate intakes were identified according to the Estimated Average Requirement (EAR) cut-point method for all micronutrients with an EAR except iron, for which the full-probability method was applied. Survey weights allocated for inference to the total Australian population were implemented throughout the analysis. The final sample was composed of 66 vegetarians (did not report any animal tissue consumption) and 1540 omnivores. The mean intake of long-chain omega-3 fatty acids (EPA, DPA, DHA) from both diet and supplementation was significantly lower in vegetarians compared to omnivores (96.3mg/day vs. 264.5mg/day, p<0.001). A significantly greater proportion of vegetarians compared to omnivores had inadequate total B12 (22.7% vs. 1.4%), iron (58.3% vs. 18.9%), selenium (30.8% vs. 3.5%) and zinc (58.8% vs. 33.3%) intakes (all p<0.05). These results suggest that young adult vegetarians are likely to have significantly lower consumption of long-chain omega-3 fatty acids and an increased risk of inadequately consuming vitamin B12, iron, selenium and zinc compared to their omnivorous counterparts. These findings support the notion that young adult vegetarians may have an increased risk of depression from a nutritional standpoint, and therefore stand to benefit from tailored dietary advice on a public and individual level designed to support their mental health.

Dietary assessment methods play a crucial role in evaluating individuals’ and communities’ dietary intake (1). Among these methods, Food Frequency Questionnaires (FFQs) are common in epidemiological dietary surveys. However, with the rapid advancement of technology and increased internet usage globally, innovative digital tools to assess dietary intake have emerged (2). Collaborative efforts between tool developers and dietitians are vital for leveraging technology effectively and advancing evidence-based nutrition practice. Thus, the aim of this study was to explore the: 1) perceived advantages and disadvantages of FFQs, 2) challenges and benefits associated with transitioning from traditional paper-based to web-based FFQs, and 3) opportunities and challenges of integrating a range of new technologies, from established digital tools such as web-based or smartphone applications to more futuristic options such as artificial intelligence and biosensors, into dietary assessment practices and research among researchfocused dietitians with PhD.

Seven dietitians from Turkey with extensive experience in using dietary assessment methods were selected using purposive sampling. One-to-one semi-structured interviews were conducted using a topic guide via Microsoft Teams and transcribed verbatim into text-based records. They examined advantages and challenges of paper-based and web-based FFQs, ranked a list of predefined features for FFQ development, and provided insights into technology integration, addressing both the benefits and challenges of incorporating new tools. Preliminary thematic analysis was conducted using NVivo12 software to identify common themes.

Participants had an average of 18 years (6-49 years) of experience in nutritional research. Common challenges identified by the group included the absence of validated FFQs in Turkish (n = 5), necessitating the use of FFQs alongside other methods like 24-hour recall (n = 4). General diet representation was commonly appreciated, while all participants deemed paper-based semiquantitative FFQs time-consuming. The top priorities for FFQ enhancement included a semiquantitative feature for nutrient intake calculation, inclusion of portion size photos, and evidencebased development using national diet survey data. None of the participants had employed any digital dietary assessment tools in their research endeavors. However, there was a consensus recognizing the potential benefits and drawbacks of using technology in dietary assessment. Participants highlighted the efficiency (n = 7), increased flexibility in data collection (n = 6), and heightened accuracy (n = 5) associated with technology-based assessment methods as significant advantages. Common concerns included users’ lack of proficiency with technology (n = 6), potential challenges related to the cost of research and development (n = 4), and considerations surrounding data privacy and ethical breaches (n = 3), particularly the unauthorized recording of sensitive information by artificial intelligence in camera-based technology.

The insights from Turkish dietitians highlight the necessity for validated Turkish web-based FFQs. While technology-based dietary assessment tools offer research benefits, addressing integration barriers is crucial. These findings will contribute to the development of web-based FFQs and more futuristic dietary assessment tools, advancing evidence-based nutrition practice.

The recent ONS survey reported that 92% of students had been affected by the cost-of-living crisis with 46% revealing their overall mental health and well-being had worsened(1). London Metropolitan University has a unique diverse student population: in 2020-21, 82% of students were mature, 64% of students identified as female, 55% of students were from a minoritised background and 13% had a known disability(2). Furthermore, at least 50% of our students, many of whom have caring responsibilities, reside in the most deprived wards of Islington or other impoverished London boroughs. It has been documented that those students with families, who come from a low income and a minority background are more vulnerable(3) and are more likely to be disproportionately affected by the cost-of-living crisis and at risk of food insecurity. We sought to ease the burden of the cost-of-living crisis with a recipe box scheme, BRITE Box (4) and evaluate its acceptance.

BRITE Box provides a complete set of pre-weighed ingredients for a healthy nutritious meal with an easy-to-follow recipe guide. Each box typically contains two servings of vegetables, meat, bread and dairy, as well as spices, dried and tinned goods to feed a family of five people. We distributed 300 boxes over a period of five months to students primarily with families who had accessed the university hardship fund. Student volunteers and the academic staff pre-weighed the ingredients, prepared and distributed the boxes. The scheme was advertised through Student Services who administer the hardship fund, the Student Union and the intranet. The recipients of the boxes were provided with a QR code linking to a 20-item online survey on demographic characteristics, number of children, acceptability of the box and perceived advantages and disadvantages of the scheme. Ethics was approved by London Metropolitan University.

Thirty-three participants completed the survey, 42% of the recipients identified as female, 55% were from a minority background and 30% had children. The responses showed that students agreed and strongly agreed that the recipe box introduced them to new flavours (52%), and new foods (42%). The majority followed the recipe and will use again (67%). Most importantly, 73% students agreed and or strongly agreed that it helped with the food budget and helped foster a sense of belonging to the university (85%).

The scheme has proved to be popular among the students: “a really cool concept”, “it helped me cook”, “the box provided food for 3 days” and created a buzz around campus on distribution days. It has enhanced the feeling of community and belonging within the university, whilst also alleviating food insecurity and tackling the cost-of-living crisis.

University students are a unique population subgroup, who experience a life transition into adulthood, often marked by the establishment of unhealthy eating behaviours(1) which are associated with chronic disease risk factors, poor mental health and lower academic achievement(2). Data regarding the food skills/behaviours of university students is limited, but low cooking self- efficacy and food skills are potential barriers to healthy meal preparation(1). Nourished@Deakin is an online cooking program, co-designed by Deakin University students, that aims to inspire students to cook and eat healthier. It commenced in November 2021 and includes a series of blogs, recipes, and cooking videos, available to all Deakin students via a Deakin University blog site. To determine if accessing Nourished@Deakin improves food skill confidence, food intake, and nutrition knowledge, participants completed a short online survey before accessing Nourished@Deakin materials and then again four weeks after their first engagement. The survey included 31 questions regarding confidence related to a variety of food skills (eg. recipe following, reading food labels, meal planning); 2 questions regarding fruit/vegetable intake; 11 knowledge questions regarding the Australian Dietary Guidelines (ADGs); and 16 demographic questions. Pre/post surveys were compared using paired t tests (knowledge scores, fruit/veg serves) or McNemar extact test (proportions). A total of 108 students completed the pre-survey and 41 (mean (SD) age 27.0 (8.4) years; 63% female) also completed the post-survey. Of the 41 participants who completed both surveys, 42% were studying within the Faculty of Health and 16 (39%) were living in the family home with parents. Most (68%) were studying full time and 59% were employed part-time/casually. Three-quarters were domestic students, and 59% were undergraduate students. Following completion of Nourished@Deakin, there was a significant increase in the proportion of participants feeling confident in two of the 31 food skills (namely ‘meal planning’: 44% pre vs 63% post, P<0.05; and ‘growing fruit and/or vegetables at home’: 22% pre vs 44% post, P<0.05). Fruit intake increased from 1.6 serves/day pre-program to 1.9 serves/day post-program (P<0.05), but vegetable intake remained stable (2.5 serves/day pre and 2.6 serves/day post, P = 0.287). Before participating in Nourished@Deakin, 56% of participants correctly reported the recommended daily serves of fruit and 66% correctly reported it for vegetables. The mean ADG knowledge score was 8.2/9 and 49% of participants got all nine questions correct. There were no significant changes in any of the knowledge markers post-program. Over a relatively short period, Nourished@Deakin produced modest improvements in the self-reported confidence in some food skills and self-reported fruit intake. A revised program (incorporating a greater variety of recipes, additional blogs, and new videos) may encourage greater engagement and result in increased confidence and knowledge in other targeted areas.

Type 1 diabetes (T1D) is a chronic autoimmune disease characterised by a deficiency in insulin production and consequent hyperglycaemia. A glycated haemoglobin (HbA1c) value < 53 mmol/mol (< 7%) is recommended to reduce the risk for diabetes-specific complications(1). However, most adolescents and young adults (AYAs) have an HbA1c above the target(2). Dietary behaviours, including a routine meal plan with snacks, play a significant role in self-management(3). Snacks without an insulin bolus, grazing or snacking to cope with stress contribute to out-of-target glucose levels. Although modifying AYAs’ snacking behaviours could be a low-cost, equitable, and effective approach to improving glycaemic control, there is a dearth of evidence to inform effective snacking interventions. Importantly, no brief, validated tool exists to assess snacking behaviour among individuals with T1D. This research explored the acceptability and feasibility of validating a snacking questionnaire adapted for AYAs with T1D; a crucial step before a larger validation study. Twenty-five AYAs (aged 13-20 years) with T1D and receiving diabetes care through Te Whatu Ora Southern were invited to participate in a feasibility study. Purposive sampling was used for maximum variability in participants’ demographic characteristics. All study procedures were completed remotely, with electronic questionnaires administered in the morning via a secure web platform. On days 1 and 8 of the 8-day study, participants completed a 30-item snacking questionnaire that assessed the timing and frequency of snacking and types of food or drinks consumed as a snack in the past seven days. The snacking questionnaire was adapted from questionnaires previously used in population-level surveys. An experienced diabetes dietitian ensured that items reflected foods commonly consumed by AYAs with T1D. Before recruitment, two diabetes dietitians and a young adult with T1D critically reviewed the adapted snacking questionnaire. On days 2-8, participants recalled their snacking behaviour (timing, frequency, food/drink consumed) over the previous day. The proportion of completed snacking questionnaires assessed feasibility, defined as a response rate ≥ 80%. The ease of completing the snacking questionnaires was self-reported on a Likert-type scale (1-completely agree, 5-completely disagree) to assess acceptability, defined as ≤ 20% of participants reporting the questionnaires were not easy to complete. Participants (n = 10) were aged 16.2 ± 1.69 years, 60% male, and 90% self-identified as New Zealand or Other European. All participants completed the proposed validation study. Most (95%) of the snacking questionnaires were completed. All (100%) daily snacking behaviour questionnaires were completed. All participants (100%) agreed that the questionnaires were easy to complete. The snacking behaviours questionnaire validation procedures are feasible and acceptable to New Zealand and Other European AYAs with T1D. Feasibility and acceptability must be explored among ethnically diverse AYAs before conducting a larger rigorous validation study.

Community cafés are non-profit setups seeking to address food insecurity (FI) locally and equitably usually using a pay-as-you-feel model and surplus foods(1). Concerns about rising levels of FI(2) and food waste(3) frequently drive this model. Started in 2023, the Kitchen Roots Café (KRC) aims to provide healthy, sustainable, affordable meals without proof of need or referral. Open once a week during lunch it offers hot meals, primarily using surplus foods. Clients can pay as much or little as they wish and can pay a meal forward. A mixed methods evaluation of KRC was carried out which aimed to identify who KRC clients were and their reasons for attending, in addition to its social and nutritional impact.

Qualitative and quantitative data were gathered using bespoke questionnaires and optional interviews. In all, 32 individuals completed questionnaires, the majority in-person at KRC (91%), the remainder online. Four client telephone interviews were also held. Thematic analysis of qualitative data was carried out to identify recurring themes, while descriptive statistics were generated for quantitative data.

KRC clients were largely vulnerable. The majority were at least middle-aged (28.1% aged ≥60; 25.0% aged 50-59 years) and out of full-time employment (62.5% worked <1 day a week while 9.3% worked part-time). Self-reported disability was common (43.8% overall; 50.0% of all men). Several lived in supported housing (e.g. YMCA, accommodation for women victims of domestic violence). One reported homelessness due to their immigration status. High levels of FI were evident: over half (54.8%) used other, often multiple, food support services, including food banks, community fridges and church lunches.

The majority made use of the KRC primarily in response to FI, indicating as their main reason for visiting support with food cost and/or the cost of living (46.9%). For this group using the service was tightly linked with their ability to access a healthy hot meal and to save money; 85.7% agreed or strongly agreed with this.

Many added the social aspect of the KRC experience as a second main reason for visiting (50.0% of those who gave multiple reason). Additionally, support the local community and enjoy delicious food were highlighted. Ninety-six % of participants agreed or strongly agreed that coming to the KRC had improved their wellbeing, while 65.6% agreed or strongly agreed that it had made them feel more valued, like they ‘belonged’ to the community.

While concern about food waste was not their primary reason for coming, 90.6% of participants thought that eating surplus food offered at KRC benefitted the environment.

For this vulnerable group, local community café provision offered a safe space with affordable healthy food. This, plus feeling welcomed and included, benefitted their feelings of wellbeing and belonging.

An increasing body of evidence has emerged suggesting that lifestyle behaviours, including diet quality, may be an important modifiable risk factor for mental health disorders. The Mediterranean diet (MedDiet), which is often heralded as an anti-inflammatory diet, has been widely investigated and promoted as one of the ‘healthiest’ dietary patterns for reducing chronic disease risk and promoting healthy ageing(1). Greater adherence to a MedDiet and/or anti-inflammatory diet is inversely associated with the risk of depression or depressive symptoms in younger and middle-aged adults(2). However, these findings have been inconsistent, particularly in older adults. We therefore explored the independent associations between adherence to a MedDiet and severity of symptoms related to depression, anxiety and stress in community-dwelling older adults from Australia. We conducted a cross-sectional study of older Australians aged ≥ 60 years. Older adults who were permanent residents of Australia, free from dementia or cognitive decline and could independently complete an anonymous online survey in English were invited to participate. A 75-item self-administered questionnaire was used to assess the relationship between adherence to a MedDiet and severity of symptoms related to depression, anxiety, and stress. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS)(3) and the Depression, Anxiety and Stress Scale (DASS-21)(4) was used to assess the severity of negative emotional symptoms. Multivariable linear regression analysis (and 95% CI) was used to investigate the independent association between adherence to a MedDiet and severity of symptoms related depression, anxiety and stress using one unadjusted and six adjusted predictor models. A total of n = 294 participants were included in the final analyses (70.4 ± 6.2 years; Females, n = 201; Males, n = 91; n = 2 unspecified). Adherence to a MedDiet was inversely associated with severity of anxiety symptoms (β = −0.118; CI: −0.761, −0.012; P = 0.043) independent of age, gender, BMI, physical activity, sleep, cognitive risk and ability to perform activities of daily living. Furthermore, MedDiet adherence was inversely associated with symptoms of stress (β = −0.151; CI: −0.680, −0.073; P = 0.015) independent of age, gender, BMI, physical activity and sleep. However, no relationship between MedDiet adherence and depressive symptoms was observed. We showed that adherence to a MedDiet is inversely associated with severity of symptoms related to anxiety and stress but not for depression. Exploration of these findings using longitudinal analyses and robust clinical trials are needed to better elucidate these findings in older adults.

Morbidity and mortality from preventable diseases among ethnic minority groups are higher when compared with white population group in the UK(1). Diet is a major modifiable disease risk factor and depends on several factors, including the affordability and availability of foods commonly consumed by these communities. With families now bearing the burden of inflation with an increase in the price of food, and with people adapting to this by adjusting their spending, the widening of health inequality is reported(2).

Understanding of the impact of the cost-of-living crisis (COLC) on the dietary practice and health of ethnic minority populations is limited(2). This study explored the impact of dietary choices in the immigrant Nigerian community living in the UK, within the context of a COLC.

Using hermeneutic phenomenological design and with the aid of purposive sampling, community networks, and snowballing were leveraged to assist in recruiting participants from the Nigerian population in Manchester and London based on age, gender, and socio-economic factors. Utilising an informed consent process, fifteen one-to-one telephone semi-structured interviews were undertaken, and detailed information about culture, dietary choices, and the cost-of-living crisis was collected.

The six-step guide Braun & Clark’s Reflexive thematic analysis of verbatim transcribed data from the audio-recorded interviews revealed adaptive and coping strategies have been adopted(3). Participants report what they now eat, and activities adopted to support eating. This includes purchasing cheap, low-quality, and reduced quantities of food, reducing wastage of food through preservation of any excess, bulk cooking, or preparation to minimise energy usage. Other cost savings are being made through, cutting down on social engagements (e.g. eating out and nightlife), A focus on food ‘’needs’’ and not ‘’wants’’, a reliance on social networks for support and assistance, the use of food banks, and skipping meals is also reported. One participant: ‘’This has affected our diet. So, it’s been very challenging. I mean generally, everywhere the cost of things is high’’. (GregM61). Another said, “I just cook enough for two days so that I can save some energy and reduce my energy bills”. (KhadijatF45). Illustrating the impact on health one participant suggested: ‘’When you have a cheap cost of meat and a cheap cost of carbohydrates, then you are eating badly’’. (EkongM51).

These findings cause concern since cheap and low-quality diets eaten by ethnic minority communities are known to be unhealthy and are high-risk factors for chronic diseases(4). The need for long-term support for individuals or groups most at risk of the COLC, and an ongoing need to develop culturally appropriate strategies to support healthy eating on a budget for this ethnic group are paramount to prevent poor health outcomes in this group.

In the 12-month period leading up to March 2023, inflation in the UK increased by 8.9%(1). Notably, the annual inflation rate for food and non-alcoholic beverages reached a peak of 19.2% in March 2023, marking a 45-year high(1). Concurrently, research conducted between October 2022 and January 2023, revealed that 25% of adult respondents were classified as food insecure(2). Food insecurity disproportionately affects young families, ethnic minorities, and individuals with disabilities, and correlates with poorer mental health, higher rates of obesity, and lower dietary quality. However, improving skills in cooking, meal planning, and budget shopping may alleviate some of the adverse health consequences associated with food insecurity. This primary research aimed to investigate the relationships between food insecurity, mental wellbeing, dietary quality, and food behaviours among a nationally representative sample of UK adults and was pre-registered (https://doi.org/10.17605/OSF.IO/ZFMHD).

A nationally representative cross-sectional survey was conducted in April 2023. Participants were recruited using a market research company (Dynata, UK) and quota-controlled sampling ( ± 5%) for age, gender, region and socioeconomic status. Data on food insecurity, mental wellbeing, diet quality and food behaviours, were collected, using validated measures where available. Ethical approval was received from King’s College London (Ref: LRS/DP-22/23-35412). Data analysis consisted of chi-square tests of homogeneity, Kruskal-Wallis H tests and hierarchical multiple regression modelling with adjustment of relevant covariates, using SPSS Statistics v29.0.2. The significance threshold was set at p<0.05.

1493 UK adults participated. Within the sample, 49.9% were male, mean age was 44.7 years (SD 16.3), 35.9% were classified into groups of either low (22.2%) or very low (13.7%) food security(3). Analyses revealed significantly higher proportions of females, individuals with lower income, and those of non-white ethnicity in the low or very low food security groups compared to groups with higher levels of food security (p<0.05). Participants in the low or very low food security groups exhibited lower mental wellbeing scores and consumed fewer fruits and vegetables per day compared to those with higher food security (p<0.05). Hierarchical regression models explained 28.5% of the variance in mental wellbeing scores and 16.4% in daily fruit and vegetable intake. Notably, variables related to food behaviour, such as food engagement and cooking skills confidence, significantly added to the variance explained by the models (p<0.001), even after controlling for factors such as food insecurity score and income, respectively.

This study reveals the substantial prevalence of food insecurity among UK adults, whilst also highlighting its associations with mental wellbeing and dietary quality, particularly among higher risk groups. The findings emphasise the urgent need for targeted interventions. Implementing programs focused on enhancing cooking skills and wider food behaviours could serve to mitigate some of the adverse health consequences associated with food insecurity, leading to improvements in overall wellbeing.

University students have high risk of food insecurity (FI)(1). Largely comprising young adults, they often have poor diets(2), important given the potential for this life stage to embed healthful eating behaviours(3). Having established high levels of concern about their food security among students at a post-92 university(4), the KingsGate Student Pantry was established in November 2023 as a partnership between university staff and student volunteers, a local food charity and a local church. It includes a weekly social space with free refreshments to encourage belonging, signposting to support, cookery demonstrations and access to a range of food, household and personal hygiene items, including bread, fresh fruit and vegetables. For a weekly payment of £5, customers receive £20-35 of items (estimated). An evaluation of the Pantry to understand its impact on customers and volunteers was carried out.

Bespoke questionnaires for each group collected qualitative & quantitative data about experiences of FI, reasons for coming (or volunteering) and impact of the Pantry on nutrition and belonging. These were administered at the Pantry using QR codes. Optional telephone interviews were held. Qualitative data were analysed using thematic analysis to identify key themes, while quantitative data were used to generate descriptive statistics. The impact of demographics on responses was explored using Kruskal Wallis tests.

This ongoing evaluation currently includes 112 customer and 14 volunteer questionnaires, as well as 3 customer and 5 volunteer interviews. Preliminary results suggest that finances and social reasons are major drivers for customer attendance. Key food items required at the Pantry are vegetables and fruit; cereals, pasta and rice; and milk and dairy products – basic staple foods now expensive largely due to cost-of-living pressures. High levels of satisfaction among both customers and volunteers are apparent, not limited to the goods on offer although levels of satisfaction with these are high. Goods are largely surplus, supplemented with additional items specifically purchased using the £5 weekly customer fee. This ensures a high quality offer in addition to contributing to sustainability of the Pantry. Satisfaction also extends to opportunities to build relationships, including between community and university volunteers and customers, groups otherwise unlikely to meet. The social space and welcome received are highly valued:

‘Doesn’t feel like support, feels like going out shopping with friends’ [customer interview]

‘Happy place to be’ [volunteer interview]

The Pantry therefore represents a pathway to developing a shared understanding of the meaning of community between diverse groups, to their shared benefit. Built using existing relationships and partnerships, it exemplifies how universities can utilise the skills and expertise of their community stakeholders to mutual benefit.