Observational studies suggest that a healthy diet in combination with ample physical activity is associated with a lower prevalence of cancer-related fatigue. The SoFiT trial (SoFiT: Study on Fatigue: a lifestyle intervention among colorectal cancer survivors) will assess the effect of a personalised lifestyle programme on cancer-related fatigue in a randomised study. We designed a programme that aims to increase adherence to lifestyle recommendations on diet and physical activity. The programme was person-centred with regard to the lifestyle and personal characteristics of participants, to the determinants of behaviour of that participant, and to the preferences, opportunities and barriers of the participant. The effect of the programme was tested in the SoFiT trial: a two-armed, parallel, randomised controlled trial among adult stage I–III colorectal cancer survivors, who experience cancer-related fatigue after treatment completion; intended sample size n=184. Participants randomised to the intervention group received the personalised lifestyle programme. During 6 months, participants in the intervention group had individual sessions with a lifestyle coach of which four sessions were face-to-face and eight sessions were remote. After 6 months, participants randomised to the control group had access to two lifestyle coaching sessions and to the same materials that the intervention group also received. The primary endpoint of the trial is cancer-related fatigue. Secondary endpoints are sleep quality and duration, health-related quality of life, physical performance, depression and anxiety, skeletal muscle echo intensity and cross-sectional area, and gut microbiota composition. This trial will show the effects of a personalised lifestyle programme on cancer-related fatigue and on an extensive set of secondary outcomes. Clinicaltrials.gov: NCT05390398.

Diets low in vegetables are a main contributor to the health burden experienced by Australians living in rural communities. Given the ubiquity of smartphones and access to the Internet, digital interventions may offer an accessible delivery model for a dietary intervention in rural communities. However, no digital interventions to address low vegetable intake have been co-designed with adults living in rural areas(1). This research aims to describe the co-design of a digital intervention to improve vegetable intake with rural community members and research partners. Active participants in the co-design process were adults ≥18 years living in three rural Australian communities (total n = 57) and research partners (n = 4) representing three local rural governments and one peak non-government health organisation. An iterative co-design process(2) was undertaken to understand the needs (pre-design phase) and ideas (generative phase) of the target population through eight online workshops and a 21-item online community survey between July and December 2021. Prioritisation methods were used to help workshop participants identify the ‘Must-have, Should-have, Could-have, and Won’t-have or will not have right now’ (MoSCoW) features and functions of the digital intervention. Workshops were transcribed and inductively analysed using NVivo. Convergent and divergent themes were identified between the workshops and community survey to identify how to implement the digital intervention in the community. Consensus was reached on a concept for a digital intervention that addressed individual and food environment barriers to vegetable intake, specific to rural communities. Implementation recommendations centred on i) food literacy approaches to improve skills via access to vegetable-rich recipes and healthy eating resources, ii) access to personalisation options and behaviour change support, and iii) improving the community food environment by providing information on and access to local food initiatives. Rural-dwelling adults expressed preferences for personalised intervention features that can enhance food literacy and engagement with community food environments. This co-design process will inform the development of a prototype (evaluation phase) and feasibility testing (post-design phase) of this intervention. The resulting intervention is anticipated to reduce barriers and support enablers, across individual and community levels, to facilitate higher consumption of vegetables among rural Australians. These outcomes have the potential to contribute to improved wellbeing in the short term and reduced chronic disease risk in the long term, decreasing public health inequities.

Horse obesity is a growing concern that can result in negative welfare. The role horse owners play in horse weight management is not well understood. This study aimed to: (1) explore the attitudes, beliefs, and perceptions of owners with overweight or obese horses regarding their horses’ weight; and (2) understand the motivators and barriers for owners to implement, improve and maintain weight management-related strategies. A semi-structured interview guide based on the Theoretical Domains Framework was developed. Qualitative interviews were conducted with 24 owners in Prince Edward Island, Canada whose horse(s) were previously classified as overweight or obese by a veterinarian. Interviews were analysed using template analysis, organising patterns in the data into a codebook and overarching themes. Owners believed horse weight management was important, however, their perceived complexity of the issue made the implementation of the weight management practices difficult. Owners held conflicting perceptions, viewing overweight horses as well cared for, yet recognised these horses were at increased risk for negative health outcomes. Ultimately, participants felt emotionally torn about compromising their horse’s mental well-being to address weight issues. Owners considered the practicality of weight-management strategies, the strategies’ effectiveness, and whether recommended strategies aligned with their beliefs regarding good horse care practices. Knowledge was embedded into owners’ understanding of horse weight, however, some highlighted that traditional knowledge dominates the equine industry hindering systemic industry change. Increased understanding of the effectiveness and impacts of weight management strategies on horses and fostering a society that recognises and accepts horses within a healthy weight range are warranted.

Behavioural science has sought to promote pro-environmental behaviours including climate-friendly dietary change, and to reduce travel emissions and excessive wastes. Nevertheless, there is a debate about how effective behavioural interventions are, and in turn, about the real barriers to enduring pro-environmental behaviour change. In this context, we conceptualise brown sludge as multi-level impediment to pro-environmental behaviour change, which results in higher environmental costs shared by the broader society, rather than solely by the individual actor. We propose that brown sludge comprises an array of additional transaction costs, encompassing, but not restricted to, psychological, temporal, and uncertainty costs. Brown sludge can occur at the individual, social, institutional, and societal levels. Examples include confusing eco-information, delay and disinformation campaigns, and complicated systems and infrastructure leading to carbon lock-in.

This review aims to emphasise the impact of poor nutrition on children’s health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.

Reducing meat consumption is essential to curb further climate change and limit the catastrophic environmental degradation resulting from the current global food system. However, consumers in industrialised countries are hesitant to reduce their meat intake, often because they find plant-based foods less appealing. Despite the climate emergency, eating meat is still perceived as the norm, and recommended in most national dietary guidelines. To support the transition to more sustainable diets by providing insights for increasing the appeal of plant-based foods to mainstream consumers, this review presents recent research findings on how people think and communicate about meat-based and plant-based foods. The key findings we review include: (1) while vegans think about plant-based foods in terms of enjoyable eating experiences, omnivores think about plant-based foods in terms of health, vegan identity and other abstract information that does not motivate consumption in the moment. (2) Packages of ready-meals and social media posts on Instagram present plant-based foods with fewer references to enjoyable eating experiences than meat-based foods. (3) Presenting plant-based foods with language that references enjoyable eating experiences increases their appeal, especially for habitual meat eaters. This language includes words about sensory features of the food (e.g., crunchy, creamy), eating context (e.g. pub; with family) and immediate positive consequences of eating (e.g. comforting, delicious). In contrast, the term ‘vegan’ is strongly associated with negative stereotypes. Hence, rather than referring to being vegan, meat-free or healthy, the language used for plant-based foods should refer to sensory appeal, attractive eating situations and enjoyment.

In the few weight loss studies assessing diet quality, improvements have been minimal and recommended calculation methods have not been used. This secondary analysis of a parallel group randomised trial (regsitered: https://clinicaltrials.gov/ct2/show/NCT03367936) assessed whether self-monitoring with feedback (SM + FB) v. self-monitoring alone (SM) improved diet quality. Adults with overweight/obesity (randomised: SM n 251, SM + FB n 251; analysed SM n 170, SM + FB n 186) self-monitored diet, physical activity and weight. Real-time, personalised feedback, delivered via a study-specific app up to three times daily, was based on reported energy, fat and added sugar intake. Healthy Eating Index 2015 (HEI-2015) scores were calculated from 24-hour recalls. Higher scores represent better diet quality. Data were collected August 2018 to March 2021 and analysed spring 2022. The sample was mostly female (78·9 %) and white (85·4 %). At baseline, HEI-2015 total scores and bootstrapped 95 % CI were similar by treatment group (SM + FB: 63·11 (60·41, 65·24); SM: 61·02 (58·72, 62·81)) with similar minimal improvement observed at 6 months (SM + FB: 65·42 (63·30, 67·20); SM: 63·19 (61·22, 64·97)) and 12 months (SM + FB: 63·94 (61·40, 66·29); SM: 63·56 (60·81, 65·42)). Among those who lost ≥ 5 % of baseline weight, HEI-2015 scores improved (baseline: 62·00 (58·94, 64·12); 6 months: 68·02 (65·41, 71·23); 12 months: 65·93 (63·40, 68·61)). There was no effect of the intervention on diet quality change. Clinically meaningful weight loss was related to diet quality improvement. Feedback may need to incorporate more targeted nutritional content.

Mexico is going through an environmental and nutritional crisis related to unsustainable dietary behaviours. Sustainable diets could solve both problems together. This study protocol aims to develop a three-stage, 15-week mHealth randomised controlled trial of a sustainable-psycho-nutritional intervention programme to promote Mexican population adherence to a sustainable diet and to evaluate its effects on health and environmental outcomes. In stage 1, the programme will be designed using the sustainable diets, behaviour change wheel and capability, opportunity, motivation, and behaviour (COM-B) models. A sustainable food guide, recipes, meal plans and a mobile application will be developed. In stage 2, the intervention will be implemented for 7 weeks, and a 7-week follow-up period in a young Mexican adults (18–35 years) sample, randomly divided (1:1 ratio) into a control group (n 50) and an experimental group (n 50), will be divided into two arms at week 8. Outcomes will include health, nutrition, environment, behaviour and nutritional-sustainable knowledge. Additionally, socio-economics and culture will be considered. Thirteen behavioural objectives will be included using successive approaches in online workshops twice a week. The population will be monitored using the mobile application consisting of behavioural change techniques. In stage 3, the effects of the intervention will be assessed using mixed-effects models on dietary intake and quality, nutritional status, physical activity, metabolic biomarkers (serum glucose and lipid profile), gut microbiota composition and dietary water and carbon footprints of the evaluated population. Improvements in health outcomes and a decrease in dietary water and carbon footprints are expected.

A high intake of fruit and vegetables (FV) has consistently been associated with a reduced risk of a number of non-communicable diseases. This evidence base is largely from prospective cohort studies, with meta-analyses demonstrating an association between increased FV intake and reduced risk of both CHD and stroke, although the evidence is less certain for cancer and diabetes. Controlled intervention trials examining either clinical or intermediate risk factor endpoints are more scarce. Therefore, evidence that FV consumption reduces the risk of disease is so far largely confined to observational epidemiology, which is hampered by some methodological uncertainties. Although increased FV intake is promoted across all dietary guidelines, national surveys confirm that dietary intakes are suboptimal and are not increasing over time. A range of barriers to increasing FV intake exist, including economic, physical and behavioural barriers that must be considered when exploring potential opportunities to change this, considering the feasibility of different approaches to encourage increased FV consumption. Such interventions must include consideration of context, for example, challenges and uncertainties which exist with the whole food system.

The process of driving improvement in animal welfare has three stages: 1) assessment of animal welfare, 2) identification of the risk factors potentially leading to a compromise in animal welfare, and 3) interventions, in response to the risk factors, to bring about improvement in animal welfare. This process is applicable to animals farmed in commercial situations and for individual animals kept or worked in isolated environments. An impressive weight of knowledge has accumulated in the science of animal welfare assessment and this needs to be counterbalanced by development of mechanisms to actively improve welfare. In the case of animal welfare, interventions have to motivate the animal owner or carer to make changes to their own behaviour on behalf of a third party; the animal. This is a different situation from that described in the human health literature where interventions encourage people to take steps to improve their own well-being, thus benefiting themselves directly. The development of strategies to improve animal welfare require a multi-disciplinary approach including social scientists, psychologists and economists, however, the skills of animal welfare scientists are essential to ensure that interventions truly achieve improvements in animal welfare.

Food decisions are driven by differences in value of choice alternatives such that high value items are preferred over low value items. However, recent research has demonstrated that by implementing the Cue-Approach Training (CAT) the odds of choosing low value items over high value items can be increased. This effect was explained by increased attention to the low value items induced by CAT. Our goal was to replicate the original findings and to address the question of the underlying mechanism by employing eye-tracking during participants’ choice making. During CAT participants were presented with images of food items and were instructed to quickly respond to some of them when an auditory cue was presented (cued items), and not without this cue (uncued items). Next, participants made choices between two food items that differed on whether they were cued during CAT (cued versus uncued) and in pre-training value (high versus low). As predicted, results showed participants were more likely to select a low value food item over a high value food item for consumption when the low value food item had been cued compared to when the low value item had not been cued. Important, and against our hypothesis, there was no significant increase in gaze time for low value cued items compared to low value uncued items. Participants did spend more time fixating on the chosen item compared to the unchosen alternative, thus replicating previous work in this domain. The present research thus establishes the robustness of CAT as means of facilitating choices for low value over high value food but could not demonstrate that this increased preference was due to increased attention for cued low value items. The present research thus raises the question how CAT may increase choices for low value options.

Traditionally, assessment of animal welfare generally focused on physiological signs of health with less consideration of psychological well-being. More recently, the Five Domains model highlighted the concept of all aspects of an animal's life influencing their affective state. In equestrianism, however, there is a lack of awareness of the Five Domains model and, specifically, how different factors may affect the mental well-being of horses (Equus caballus). This divide between scientific research and lay horse owners could compromise equine welfare by failing to recognise horses as sentient beings with species-specific needs. The present study therefore aimed to explore how evidence-based information can be effectively communicated to equestrians (n = 259) through an online survey and whether increased knowledge of equine welfare needs has any impact on horse caregivers’ assessment of their own horses’ quality of life. Results showed that a simple educational infographic based on the Five Domains model had a significant impact on equestrians’ assessment of equine welfare, although longitudinal, empirical studies are needed. Scores on a Likert scale for health, behaviour/human interactions and overall welfare were significantly lower following the intervention but scores for emotional well-being were significantly higher. This may suggest that, whilst the infographic increased participant awareness of the importance of emotional state and the factors affecting welfare, there were difficulties or inconsistencies in objectively assessing these emotions. This highlights the need for equine welfare science to be communicated more proactively to horse owners in an accessible, engaging format.

The inactive lifestyle of urban Indians has increased their risk of non-communicable diseases (NCDs). A qualitative study was designed to explore barriers and facilitators related to exercise participation among urban Indians. Underpinned by the developmental life course theory, nine focus group discussions (FGDs) were conducted with 29 women and 26 men residing in Mumbai, India. Focus groups were gender and age stratified. Both thematic analysis and content analysis techniques were used to analyse the data. While the lack of time was mentioned as a barrier by all groups, an unstructured schedule was mentioned specifically by women and awareness of physical health benefits emerged as the most popular facilitator for recreational physical activity. Based on the results of the FGDs, a pilot exercise intervention for sedentary women (N = 6) was conducted which consisted of a morning walk six days a week for 10 weeks. Post-intervention, an FGD was conducted to explore participants’ perspectives on their experience in the intervention. The participants reported that the intervention enhanced exercise self-efficacy and well-being. Exercise as relaxation, spousal support, and need for peers to exercise with emerged as primary themes during the follow-up FGD. These findings can inform the development of age and gender-specific as well as culturally appropriate interventions to facilitate active living.