Utilising local and traditional foods in schools presents a significant opportunity within our region to ensure food and nutritional security, support local livelihoods by driving markets and employment opportunities, increasing food literacy, and help students to understand the role of, and develop a preference for these foods. School meals programs (SMP) are increasingly touted as a strategy for food system transformation(1), however, are not widely used in the Pacific Islands(2). Yet, there is increasing interest and momentum towards understanding school food and nutrition environments and the use of SMP in this region, especially with models that support and promote the integration of local, traditional climate-resilient, nutrient rich foods. When a large scale SMP may not be possible, other school food and nutrition activities can be utilised to support nutritious food choice. Evidence collected over the last five years provides information on the current situation, activities, and capacity for providing food in schools across the Pacific Islands (2,3,4). Activities across the region vary from national SMP to gardening programs, nutrition education, providing canteens/tuckshops and other ad hoc activities, for example events for World Food Day. Some activities have a requirement for the use of local food, while some prioritise local foods in gardening programs and work with local farmers. Recently it has been shown that youth are exposed to, and have access to significant amounts of ultra-processed foods (UPF) around schools(3). Mapping of the foods available to students within a 400m radius of 88 schools in Fiji found that sugar sweetened beverages were available in 80%, and lollies/confectionary in just over 60% of outlets. Fresh fruit was available in just over 20% of outlets, while fresh vegetables were available in less than 20% of outlets(3). While there are many challenges to providing local, traditional, nutritious foods in schools, including access to financial, human, and physical resources, stakeholders have told us that one of the most significant is how modernisation and colonisation of food systems have resulted in a preference for hyperpalatable UPF and how this makes it more challenging to incorporate local produce in a way that is accepted by students. This provides an opportunity to further explore and share ways to integrate local, traditional, climate-resilient, nutrient rich foods in schools to support children and adolescents to value, utilise, prefer, and advocate for these foods. There is a need to support the utilisation of traditional, local foods in schools by advocating for policy (at various levels, right from a school level upwards) that drives the use of these foods and creates more supportive school food environments.

Access to adequate food is one of the Human Rights set out in international law and hence its delivery (through policy) is the role of government. ‘Food policy’ cannot be the role of a single government department, however, since regulations must take care of public goods (e.g. public health and protecting the natural environment) while also creating an economic environment attractive to private sector participation. From the mid-20th century, much of food policy was driven by a need to encourage the production base, but more recently the importance of considering food policy through the lens of nutritional requirements is increasingly recognised, alongside the importance of minimising environmental damage. This review paper draws on experience of working with policymakers (in particular the Scottish Government) and of active participation in an EC-commissioned project. It highlights the need for the research community to invest time and resources in understanding what evidence policymakers are asking for and to consider that alongside evidence from those who will be impacted by the policy (stakeholders). Examples of effective ways of engaging stakeholders and policy communities simultaneously are outlined and the paper provides some thoughts on the boundaries between the science and policy communities and how to bridge them. The Case Study also highlights the importance of evidence to inform prioritisation and consultation at a local level when aiming to meet multiple policy goals nationally.

There is significant evidence that an unhealthy diet greatly increases the risk of complications during pregnancy and predisposes offspring to metabolic dysfunction and obesity. While fat intake is typically associated with the onset of obesity and its comorbidities, there is increasing evidence linking sugar, particularly high fructose corn syrup, to the global rise in obesity rates. Furthermore, the detrimental effects of added sugar intake during pregnancy on mother and child have been clearly outlined. Guidelines advising pregnant women to avoid food and beverages with high fat and sugar have led to an increase in consumption of ‘diet’ or ‘light’ options. Examination of some human birth cohort studies shows that heavy consumption (at least one beverage a day) of non-nutritive sweetener (NNS) containing beverages has been associated with increased risk of preterm birth and increased weight/BMI in male offspring independent of maternal weight, which appears to be offset by breastfeeding for 6 months. Rodent models have shown that NNS exposure during pregnancy can impact maternal metabolic health, adipose tissue function, gut microbiome profiles and taste preference. However, the mechanisms underlying these effects are multifaceted and further research, particularly in a translational setting is required to fully understand the effects of NNS on maternal and infant health during pregnancy. Therefore, this review examines maternal sweetener intakes and their influence on fertility, maternal health outcomes and offspring outcomes in human cohort studies and rodent models.

Irritable bowel syndrome (IBS) is a chronic and relapsing gastrointestinal condition which negatively impacts quality of life(1). Dietary triggers are common and dietary management is central to the IBS treatment pathway with dietitians being the main education providers for patients(2). The aim of this study was to explore the perceptions of dietitians towards current practices in IBS services in clinical settings across the UK.

Qualitative semi-structured interviews were undertaken to explore current practices, barriers, and facilitators to dietetic practice and expected treatment outcomes. Eligible participants were dietitians specialising in IBS and working in the National Health System (NHS) in the UK. Interviews were held virtually. Audio was recorded and transcribed following intelligent transcription. Data were analysed using template analysis (3).

Thirteen dietitians (n=12 female) specialising in gastroenterology consented to participate in the study. Dietitians were working in various NHS Trusts across the country (Southeast England n=3; Southwest England n=3; Northwest England n=2; Northeast England n=1; West Midlands n=1; Southwest Wales n=1 and Southcentral Scotland n=2). Ten out of 13 dietitians had more than five years of experience in IBS management. Three main themes emerged: 1) Dietetic services as part of IBS referral pathways; 2) Practices in relation to dietetic services and 3) Implications of services on patients’ expectations and feelings. Each main theme had subthemes to facilitate the description and interpretation of data. The increasing number of IBS referrals to dietitians and the need for accurate and timely IBS diagnosis and specialist IBS dietitians was reported, alongside the use of digital innovation to facilitate practice and access to dietetic care. The use of Internet as a source of (mis)information by patients and the limited time available for educating patients were identified as potential barriers to dietetic practice. Dietitians follow a patient-centred approach to dietary counselling and recognise the negative implications of perceived IBS-related stigma by patients on their feelings and treatment expectations.

The study identified areas and practices which can facilitate access to dietetic services and patient- centred care in IBS management as outlined in guidelines (4).

The increasing rates of obesity among children and adolescents are significant issues worldwide and in the Pacific Island Nations(1). An energy imbalance between calorie intake and expenditure is linked to overweight and obesity for children and adolescents. Epidemiological, nutritional, and technological changes are linked to altered eating habits, including an increase in energy consumption. Conversely, technological advancements and market globalization are responsible for declines in physical activity (PA)(2). During COVID-19 outbreak a more sedentary lifestyle than before the outbreak has been adopted by children and adolescents as a result of lockdown measures, which include shutting of schools, restrictive travel outside the home, and limiting social interactions has made the issue worse(3). Studies have shown that 40% to 70 % of obese children become obese adults(4). Since children spend a large portion of their day in school and eat their main meals there, school settings are suitable for interventions aimed at preventing childhood obesity. Additionally, school environments will reduce the number of dropouts brought on by problems with accessibility or transit(5). The selection of primary school children is important for interventions as the dietary and physical activity habits acquired at this age are ingrained in children and continue into adulthood. So, it is important to have a robust nutrition and physical activity curriculum in all the primary schools. There are many challenges faced by the governments in implementing such curriculum which includes lack of trained in country staff, limited infrastructures in schools for physical activity, culturally relevant information which can be easily understood by local populations, proper monitoring, and evaluation of the existing guidelines. Community engagement and partnership with local health ministries and departments are crucial for the success of these curriculum (6). To fill this gap robust evidence on effectiveness and implementation of school-based wellness intervention programs in primary schools are in dire needs in Pacific Island nations. Given this, the project titled “Healthy Child Promising Future-Promoting health in primary school settings was conducted in all schools in Wallis & Futuna and piloted in one urban school in Fiji. A knowledge, attitude, practice (KAP) questionnaire was used to evaluate the effectiveness of the intervention which was conducted for all the children (7-9 years) and their care takers. Intervention was conducted on 15 pre identified themes by face-to-face sessions every week and 30 minutes physical activity session was conducted every day in all the schools for children. For caretakers intervention was conducted around 5 themes. In both the countries the intervention had shown significant improvement in KAP scores both for caretakers and children related to the healthy diet consumption and promotion of physical activity. The results indicate that the developed intervention package had a positive impact on KAP.

The number of clinical studies assessing the effects of time-restricted eating (TRE) has increased in recent years(1). The results of the studies conducted on humans demonstrate some health benefits, however, there is still a need to design larger and longer randomized clinical trials to prove the effectiveness and long-term benefits of these types of interventions(2). However, to ensure these health benefits, individuals need to be able to integrate its principles into their daily routines. This work aimed to associate daily habits with the potential adherence to different TRE protocols and to determine the factors that predict adherence to these protocols.

A cross-sectional study was conducted using an online questionnaire based on a previous study(3), to assess the dietary and sleeping habits, daily routines and willingness to adhere to different windows of time-restricted eating in a sample of Portuguese adults. To analyze the associations between variables, the Spearman correlation coefficient and the Chi-Square test were calculated, and multiple linear regression was performed to identify the predictive factors. Statistical analysis was conducted on IBM SPSS Statistics version 29.0.

130 responses were obtained (26% men, 74% women) with a mean age of 37.9±13.59 years old. On workdays, 60.0% of participants reported a daily eating window (the period between the first and last caloric intake) of 12h-14h, while on free days the highest percentage (41.5%) was between 10h12h. An inverse correlation was observed between age and willingness to adhere to a TRE protocol if there were health benefits (r=-0.356, p<0.001). Moderate correlations were also found between the availability to follow a TRE protocol on work days (r=0.538) and free days (r=0.598) and the potential health benefits of this type of intervention (p<0.001)). Associations were found between sex and potential adherence to the TRE protocol (χ2=10.644, df=2, p=0.005), with a tendency for more men not to adhere to a TRE protocol. There was also an association between body weight management and reducing the eating window by 1h-2h (χ² =24.883, df=12, p=0.015) and 2h-3h (χ²=22.367, df=12, p=0.034). The living situation, motivation for change, income, weight management, cooking knowledge, and working schedule were among the main factors predicting the willingness to adhere to TRE protocols (p<0.05).

People’s willingness and motivation to adhere to TRE protocols outside the controlled environment of a clinical study depends on several factors. The results presented herein provide information that may be central when considering the translation of study results into nutritional practice and counselling.

The focus of nutritionists is on improvement of the health impact of current diets. Therefore, it is important to ask the question whether healthy diets are more sustainable. This review provides an overview on the research on synergies between health and sustainability. Synergies are found from shifts from animal-based to plant-based diets, from ultra-processed foods to fresh and whole foods and from reduction of food waste. The importance of looking at sustainability of the present diets has led to steps made in Europe to incorporate sustainability into food-based dietary guidelines. Examples from UK, Nordics, Belgium and the Netherlands are given. World Wildlife Fund has summarised the insides in a future-proof diet: the planet-based diet within planetary boundaries.

Children’s cooking programs have been linked to increased cooking frequency and positive dietary outcomes (1,2). A systematic review on children’s cooking interventions with a control group, in a variety of settings, on all age groups has not yet been conducted. Thus, we aimed to examine the effects of children’s participation in published cooking interventions on their cooking skills, food acceptance, and dietary behaviors; and the quality of the scientific evidence.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two independent electronic searches across six databases were conducted to identify cooking-focused interventions with comparison groups among participants aged up to 18 years old, published in English, between 2017 and 2022. Studies were assessed on quality using the Academy of Nutrition and Dietetics Evidence Analysis Library quality criteria checklist.

Among 1104 articles identified, 23 met inclusion criteria and described main results for distinct interventions. Interventions varied in participant age, settings, cooking sessions and program length. Knowledge of cooking skills, self-efficacy and involvement were the most frequent positive outcomes; improvements in dietary intake were rarely achieved. Seven studies were highly rated for research quality.

Lack of assessment standardization, variability in program characteristics, and insufficient intervention description made it difficult to discern best practices for children’s cooking programs.

Improvements in intervention development and measurement instruments are needed.

Interventions that include hands-on cooking lessons seem promising in improving knowledge and self-efficacy, however, further exploration is needed on the factors that make cooking programs successful long-term, while considering age and gender.

Thailand suffers from the double burden of malnutrition due to the nutrition transition(1). Shifts in eating patterns from traditional foods to more processed foods, an increase in snacking and urbanisation are associated with the nutrition transition(2). We aimed to explore eating, feeding, and snacking behaviours in children aged 3-5 living in urban and rural areas of Thailand’s Southernmost Border Provinces (SBPs).

A cross-sectional survey was conducted among 279 parent-child dyads recruited from one urban (n=135) and three rural schools (n=144) in the SBPs. The International Eating and Feeding Tool (ICFET)(3) was used to collect sociodemographic data, feeding frequency, food and snack consumption. Weight and height were measured to calculate WHZ (weight- for-height z score) and HAZ (heigh-for-age z score) scores. The frequency of consumption for groups and types of food were summed to give a monthly frequency. A 24-hour recall of intake of plated foods and drinks during five potential eating occasions was taken. Carers rated the applicability of statements regarding their use and control of snacks. Descriptive statistics and Mann-Whitney U test for comparisons between urban and rural areas were analysed using SPSS V28.

Socioeconomic disparities between caregivers from urban and rural areas were observed. Onefourth (22%) of rural caregivers reported senior high school education and no income (16%) compared to 0.7%, (P<0.001) and 1% respectively in urban caregivers (P<0.001). Child stunting was more prevalent in rural areas (24% vs 6% urban, P<0.001). No difference in wasting was observed between the two settings (7% rural vs 9% urban, P<0.423). Monthly food frequencies (times) (Median, IQR) were higher in urban compared to rural areas for milk and dairy products (30, 15-45) urban vs (15, 15-30) rural (P<0.001) and fruits and vegetables (Mean, SD) (53, 31) urban vs (43, 29) rural, (P=0.008). Half the children (56%) had three between-meals snacks and dry finger foods (mean, SD) (1.7, 0.5) times daily. Rural parents described higher scores of snack control (Median, IQR) (16, 15-18) rural vs (15, 13-16) urban, (P<0.001), and felt children were more likely to seek snacks in response to hunger compared to urban children (5, 2-5) rural vs (4, 2-5) urban, (P<0.001). Surprisingly, more snack foods were consumed in rural areas (50, 33-75) rural vs (45, 33-60) urban, (P=0.042).

Eating snacks between meals is common in Thai children living in SBPs. Snack foods are widely eaten, even more in rural than urban children. Despite the substantial differences in socioeconomic characteristics and levels of stunting, there was little variation between urban and rural areas in the commonness of snacking.

Childhood obesity and overweight rates in New Zealand are considerably higher than that globally with one in three children aged between 2-14 years being overweight or obese(1). Children’s dietary knowledge and food preferences are influenced by various factors including the food environment. Schools are an excellent setting to influence children’s dietary behaviours since they have the potential to reach almost all children during the first two decades of their lives. However, previous analyses indicate many school canteens and food providers do not supply foods that promote healthy eating and nutrition behaviours (2,3). The Ministry of Health (MoH) recently implemented a ‘Food and Drink Guidance for Schools’ which utilises a traffic-light framework dividing foods into three categories: ‘green’, ‘amber’, and ‘red’(4). The aim of this study was to assess primary school canteen food menus against the newly implemented MoH Guidance. A convenience sample of 133 primary school canteen menus were collected in 2020 as part of the baseline evaluation of the Healthy Active Learning initiative across New Zealand. Four researchers (three nutritionists and one dietitian) developed a menu analysis toolkit to undertake the analysis of all menus collected. The toolkit provided a breakdown of commonly packaged foods and meals/menu items available to purchase within schools based on Health Star Ratings, ingredients, and/or standard recipes. Assumptions were created for menu items requiring additional detail to be categorised according to the guidance through consensus by all four researchers. Primary school menus were coded by two researchers, and intercoder reliability was ensured by independent coding and cross-checking of 10% of menus. Descriptive and inferential analyses were conducted using IBM SPSS and P<0.05 denoted significance. Analyses of canteen menus revealed that most menu items belonged to the less healthy amber (41.0%) and red (40%) food categories. Low decile schools had a lower percentage of green food items (8.6%) and a higher percentage of red food items (48.3%) compared to high decile schools (p = 0.028). Similarly, schools in low deprivation areas had a significantly higher percentage of green food items (14.2%) compared to high deprivation areas (8.6%) (p = 0.031). Sandwiches, filled rolls, and wraps were the most commonly available items (86%) followed by baked foods and foods with pastry (71%). Sugar-sweetened beverages were just as prevalent as water on school food menus (54% each). Over half of in-house catered canteen menu items were classified as 'red’ foods (55.3%). This study highlights that most school canteens were not meeting the guidelines for healthy food and drink provision outlined by the MoH. Improving school food availability for children in socioeconomically deprived areas needs to be prioritised to reduce inequities. Findings suggest the need for more robust national policies and mandated school guidance to improve the food environments in New Zealand schools.

Non-communicable diseases (NCDs) are the predominant cause of death in the UK(1) and place an economic burden on societies(2). An unhealthy diet is one of the four main behavioural risk factors for NCDs(3) and thus, interventions targeting dietary behaviour are of particular interest in the prevention of NCDs. The workplace may be a valuable setting for these interventions as employees represent a large proportion of the population in the UK(4). In the male population, NCDs and several risk factors typically manifest at a younger age(5) and, additionally, males participate less in health-promoting activities(6).

The aim of this scoping review was to identify and characterise the evidence base to determine if a future full systematic review on nutrition interventions in the workplace to improve health and well- being in males is feasible.

The review was conducted adhering to the PRISMA guideline for Scoping Reviews(7). Three electronic databases (Ovid, PubMed, and The Cochrane Library) were systematically searched for relevant publications responding to the research question from inception. No restrictions were made in the search and all study types were eligible. Articles that were not available in English were excluded from the review. Eligible studies were reviewed using a pre-defined data extraction form and references hand-searched for relevant publications. Data synthesis was focused on describing application-oriented aspects and outcome analyses were reduced to anthropometric outcomes.

Of the 1,224 publications from the initial database search, 46 were included in the review, with an additional 15 studies identified from hand-searching, resulting in 61 included reports on 57 interventions. Four main approaches to nutrition interventions at the workplace were identified; educational, environmental, individual counselling, and meal provision/replacement. Most interventions used multicomponent approaches. One of the 61 included reports followed a qualitative design. Anthropometric outcomes were reported in the majority (83.6%) of studies, followed by bioclinical outcomes (45.9%), other outcomes were food (34.4%) and nutrient intake (22.9%), smoking habits (14.8%) and, one study reported on Quality of Life. Of the studies reporting anthropometric outcomes 69% reported to be effective in improving body weight, 47.8% BMI and 54.5% waist circumference. No determinants of successful interventions such as type, duration, workplace participation were identified.

This review suggests that nutrition interventions at the workplace are effective in improving several anthropometric outcomes. A future full systematic review is feasible but should consider narrowing the research question to account for limitations in the current evidence base as differences in reporting of design, population, intervention, and outcomes severely limited data analyses. Furthermore, to enable high-quality research, the development of a reporting tool, such as the TIDieR checklist (8) is recommended.

The school food and drink environment offers opportunities to improve pupils’ food and drink choices, with school food accounting for up to 30% of pupils’ dietary intake(1). School canteens are often overcrowded and chaotic, which may lead to pupils choosing less healthy but quicker options. Interventions aiming to improve adolescents’ dietary behaviours have been conducted but usually lack adolescent involvement and can have limited impact on pupils’ dietary choices(2). Pupil involvement in design and development may lead to more acceptable interventions(3). The aim was to explore potential interventions with secondary school-aged pupils focused on key areas of the school food and drink environment.

A total of three North East England secondary schools were recruited based on pupil eligibility for free school meals and index of multiple deprivation. Approximately eight pupils (aged 12 – 13) were recruited per school to participate in three focus groups. Consent was collected from parents and pupils. In focus group one, pupils prioritised areas within the school food and drink environment for potential interventions. In focus group two, pupils explored what these interventions might comprise. Finally, pupils reviewed the acceptability, sustainability, and feasibility of their interventions. Thematic analysis using a coding framework was used to analyse data.

Ethical approval was granted by Newcastle University Ethics Committee, reference number: 2402/24272/2021.

Across the three schools, twenty-two (m=9; f=13) pupils participated in the focus groups. Preliminary analysis revealed the inability for pupils to eat their school lunch outside was a key area for improvement. Pupils felt that with dedicated areas to eat outside, they would have more time to eat and not rely on convenient options. Incorrect menus in the canteen also meant pupils did not know what they could select and instead chose the same, often less healthy options. Pupils wanted posters in the canteen to promote the available healthier options previously used in nudge-based interventions. School food and drink were usually considered poor value for money due to high prices and perceived poor quality of school food compared to what is available outside of school. Pupils felt that introducing meal deals or food-based rewards for healthier options would encourage higher consumption due to them being perceived as better value for money.

Prioritised areas and interventions within the school food and drink environment were schoolspecific. Before interventions are conducted in schools, further understanding of the school context and whether interventions are appropriate are needed. Further work exploring continued project development, including further pupil and school staff input to explore intervention feasibility is required.

With the growing global population and climate change, achieving food security is a pressing challenge(1). Vertical farming has the potential to support local food production and security. In the UK population females and younger adults appear to be particularly vulnerable to micronutrient shortfalls from food sources alone. Levels of micronutrient intakes including zinc and iron are below the recommended daily intake(2). As a Total Controlled Environment Agriculture (TCEA) system, vertical farming employs hydroponics using a nutrient solution which offers opportunities to modulate nutrient uptake, and thus influence plant mineral and vitamin composition(3).

In this study we aimed to determine the suitability of different crop types for soilless agronomic biofortification with zinc and iron to achieve biofortified crops.

In this study, we investigated the effect of the addition of 20ppm (+20 mg L−1) of zinc (ZnSO4) or iron (Fe-EDTA) to the nutrient solution on the growth and nutritional components in pea microgreens, kale microgreens and kale baby leaf plants. The growth conditions were kept identical throughout the treatments with photoperiod 18 h d-1, temperature 20-22°C and relative humidity at 70-80%. Plant growth, mineral composition, glucosinolate content and protein content were evaluated. Results were analysed using ANOVA (p<0.05, Tukey’s test).

It was determined that higher amounts of zinc in the nutrient solution resulted in significantly higher levels of zinc in all three crops (p<0.05), with increases of 205% in pea microgreens, 264% in babyleaf kale and 217% in kale microgreens compared to the control plants. Higher amounts of iron in the nutrient solution resulted in significantly higher levels of iron only in pea microgreens, with an increase of 38% (p<0.05). Neither dosing regimen negatively influenced the overall crop performance.

These results suggest that the three different crops are suitable for soilless biofortification with zinc and iron, although pea microgreens were the only crop that had a significant increase in iron upon iron-dosing.

Shifting dietary protein intakes from animal to plant-based sources is suggested as a path to sustain the world’s food consumption and maintain planetary resources (1). However, to facilitate change, it is important to characterise baseline dietary protein patterns. This study aimed to examine dietary protein intakes on the island of Ireland in order to determine population characteristics and food sources influencing protein intake.

Analyses were performed on the Northern Ireland sub cohort of the UK National Dietary Nutrition Survey (NDNS 2016-2019) (2) and the Irish National Adult Nutrition Survey (2008-2010) (3). Both surveys used a four-day food diary and a final sample of 1484 adults, aged 18-64 years was extracted (NANS; n =1274 and NI NDNS; n=210). Mean daily intakes for protein (MDI; % total energy, TE) for the total population were calculated and the population was divided into three tertile groups based on low, medium and high protein intake (%TE). Differences in population characteristics, energy MDI, key nutrients (%TE or per 10MJ) and contributing food sources were examined across these tertiles, using chi-square and one-way ANOVA with covariates (age and BMI) and correcting for multiple comparisons as appropriate (P<0.005).

Overall, 17.1% of TE was obtained from protein and 77% of participants met their protein DRV based on EFSA recommendations of 0.83g/kg/body weight (4). The difference in protein intakes between the highest and lowest tertiles was 7.8% TE (21.2 % TE vs 13.4% TE) with high protein consumers reporting lower energy intakes (1734 ±564kcal) compared to low consumers (2185± 661 kcal). High protein consumers were older (42.5 ± 12.8 years) and had a higher BMI (27.7 ± 6.0 kg/m2). They also had higher MDI of dietary fibre, calcium, zinc, sodium, iron, folate and vitamins A, C, D and B12 (per 10MJ) (p<0.001) and lower MDI of carbohydrates, fat, saturated fat (%TE) in comparison to low consumers (p<0.001). The % contribution of ‘chicken, turkey and dishes’ (18.3%), ‘beef, veal and dishes’ (12.8%) and ‘fish and fish products (7.0%) to protein intakes were significantly higher in the high versus the low consumption group (10%, 7.4%, 4.4% TE respectively; P<0.001). In contrast, those in the lowest protein intake group had a significantly higher intakes of protein coming from dietary sources including ‘burgers, sausages and meat products (9.9 vs 5.9%), ‘white bread and rolls’ (6.9 vs 3.9%), ‘potatoes (including chips)’ (4.1 vs 2.9 %) and ‘cakes, pastries, buns and fruit pies’ (1.7 vs 0.8%) compared to high consumers.

In general, animal protein sources contributed more to total daily protein intakes than plant sources, however, the pattern of protein foods differed according to level of protein intake. These findings will aid in the development of strategies to diversify protein intakes on the Island of Ireland.

Food literacy is a valuable life skill, and developing these skills early in life is shown to have a positive association with cooking attitude and behaviours, health and diet quality in later life(1,2). There is a plethora of food messaging available for children and adolescents but little evidence on which strategies are effective and why(1,2). As part of a larger research programme funded by safefood, the current study explored the experiences, perceptions and attitudes of children (411yr) and adolescents (12-18yr) on existing models and approaches on food and nutrition education, and food messaging on the island of Ireland.

This research was based on qualitative methodology with friendship pairs with children and focus groups with adolescents to obtain their experiences, perceptions, and attitudes on existing models and approaches on food messaging. Data were collected to reflect different groups in terms of social class, age, region and rural/urban. Recruitment and data collection were completed in schools on the island of Ireland. Data were analysed using thematic analysis(3). Ethical approval was obtained.

Using data from 12 friendship pairs (n = 10 males, n = 14 females; mean age 8 (SD2.0)yr) and 6 focus groups (n = 16 males, n = 30 females, mean age 15 (SD1.6)yr), three overarching themes were identified, namely (1) “Food messages that made the most impact”, (2) “Food messaging through surveillance and monitoring”, and (3) “Ideas to improve food messaging”. Overall, children and adolescents reported mixed experiences, perceptions and attitudes to food and nutrition education, and food messaging. They recalled food messages from social media, schools, sports coaches and family, with the most impact included an element of fun and practical components, such as cooking, tasting and gardening, being most memorable. They had an awareness and a basic knowledge of nutrition and food messaging, such as “you need to drink more water if you are exercising”,“eat vegetables with this meal as you’ve had enough pizza this week”, “that’s too much sugar”, and “we only have treats in our lunch boxes on Fridays”. There was an indication that social media such as YouTube, Instagram and TikTok, presents both potential harms and potential benefits on the attitudes to and knowledge of nutrition, and subsequent dietary behaviours among children and adolescents.

This study found that children and adolescents had mixed experiences, perceptions and attitudes to food and nutrition education, and food messaging. Although children and adolescents may be aware of the heathy eating guidelines, there appears to be a misconnect in translating into practical everyday use. Food and nutrition education, and food messaging for children and adolescents needs to be communicated with simple clear messages, consistently with repetition using practical and fun methods in partnership with schools, and families, taking account of the harm/benefit potential of social media.

Human nutrition is a key component of the definitions of both sustainable food systems and sustainable healthy diets, and features prominently in the Sustainable Development Goals. However, progress towards complete nutrition and food security for the entire global population is poor, and the burden of malnutrition and food insecurity is felt in countries of all income levels, including in Oceania. While countries like Australia and New Zealand (NZ) are widely perceived as sources of high-quality food exported overseas due to great surpluses above national requirement, this hides domestic issues. The international nutrition community recognises and are demanding that our food systems must be sustainable, which is not yet the case anywhere in Oceania. Food insecurity at the household level is not uncommon, nor are nutrient deficiencies. It is often presumed that, should the inequitable distribution of food be balanced, these challenges would disappear. However, food supply and trade data show that even at the national and regional levels, insufficient food and nutrient supplies to meet population requirements are the established norm. For example, it has been demonstrated that domestic vegetable production falls short of NZ dietary recommendations, with imports making a negligible difference other than via energy dense crops(1). Likewise, after consideration of trade, NZ has undersupplies of calcium, potassium, vitamins C and E, and dietary fibre compared to population requirements(2). A wealth of data exists quantifying food production, trade, and availability and various scales. Increasingly, researchers are matching these to human requirements, whether at the food or nutrient level, to identify gaps(3). Insights generated from these data-driven approaches are being directed at trade policy, enabling decisions that can realise aspirational goals to reduce food insecurity through international trade. Making this data accessible to all via interactive user interfaces promotes wider engagement, understanding, and dissemination of findings. It also allows stakeholders in various countries to identify their own vulnerabilities, both as a result of current undersupplies, and due to high reliance on trading partners for food and nutrition security. Trade data can also be connected to environmental measures to identify scenarios where trade can be leveraged to the benefit of both nutrition and broader sustainability goals(4). High level, data driven approaches are not a substitute for individual-based studies on nutrition, but are a useful complement to them. With regionally or nationally deficient food and nutrient supplies, complete nutrition for individuals cannot be attained. A holistic, system-wide understanding is necessary for any policy decisions to advance nutrition.