We aimed to compare the mean sodium content of New Zealand (NZ) packaged breads in 2013 and 2023 and assess compliance with the NZ Heart Foundation (HF) and World Health Organization (WHO) sodium reduction benchmarks. Sodium data were obtained from a supermarket food composition database. Mean differences between years were assessed using independent samples t-tests and chi-square tests. There was a significant reduction in the sodium content of all bread from 2013 (n=345) to 2023 (n=309) of 46 mg/100g (p<0.001). In 2013, 20% (n=70/345) of breads met the HF benchmarks, and 10% (33/345) met the WHO benchmarks; corresponding values for 2023 were 45% (n=138/309) and 18% (n=57/309) (p<0.001 for both). If continued, the modest reduction in sodium content and increase in the percentage of NZ breads meeting relevant sodium reduction benchmarks could positively affect public health, particularly if extended across the packaged food supply.

We investigated the coverage of childhood vitamin A supplementation (VAS) across India from 2005–2006 to 2019–2021 and further explored how it related to childhood mortality. Data collected from mothers through standard questionnaires during the latest three rounds of the National Family Health Survey (2005–2006, 2015–2016 and 2019–2021) were used. Information on VAS in children aged 9–35 months was available from 2015–2016 to 2019–2021. Information on VAS among children aged 9–59 months was available from 2005–2006 to 2015–2016. Childhood VAS coverage was determined nationally and subnationally (viz. individual states, geography, socio-demographic index and developmental groups). Nearly 40 % eligible children aged 9–59 months and 30 % eligible children aged 9–35 months missed VAS during recent times. But improvements in VAS coverage were noticed over the years: from 18·6 % (2005–2006) to 60·5 % (2015–2016) among children aged 9–59 months and from 64·5 % (2015–2016) to 71·2 % (2019–2021) among children aged 9–35 months. There were coverage disparities, with Western India documenting the highest and Northeastern India documenting the lowest coverage values. During simple linear regression analysis, childhood mortality between 1 and 5 years of age varied inversely as a function of VAS coverage among children aged 9–59 months, with the association being less pronounced in 2015–2016 (β = −0·47) than in 2005–2006 (β = −0·40). However, this relationship disappeared when we accounted for potential confounders (viz. childhood immunisation and socio-economic factors) through multivariate analysis, suggesting that the role of VAS in promoting childhood survival may be limited during present times.

Diet in the first years of life is a key determinant of lifelong disease risk and is highly affected by socio-economic status (SES). However, the specific relation between SES and food consumption in toddlers and preschoolers is poorly understood. This study assesses SES-related differences in food consumption in 1- to 5-year-olds in Germany using weighed food records (3 + 1 d) of a subsample of 887 children from the cross-sectional Children’s Nutrition Survey to Record Food Consumption (KiESEL) undertaken between 2014 and 2017. Children were categorised as having a low, medium or high SES depending on parental income, education and occupation. A two-step generalised linear model corrected for age and sex was applied to assess differences in food consumption, using bootstrapping to address unequal group sizes. Differences between SES groups were found for unfavourable foods (and the subgroups sugar-sweetened beverages and confectionary/desserts), fruit, bread/cereals and fats/oils (PBoot < 0·05). Mean daily consumption in the low-SES group as compared with the high-SES group was 84 g lower for total fruit, 22 g lower for bread/cereals and 3 g lower for fats/oils, while being 123 g higher for sugar-sweetened beverages and 158 g higher for unfavourable foods in total (based on bootstrap 95 % CI). In conclusion, this study suggests a social gradient in the diet of German toddlers and preschoolers, with lower SES linked to lower diet quality. To prevent adverse health trajectories, public health measures to improve early life nutrition should address all children, prioritising those of lower SES.

This meta-analysis assesses the relationship between vitamin D supplementation and incidence of major adverse cardiovascular events (MACE). PubMed, Web of science, Ovid, Cochrane Library and Clinical Trials were used to systematically search from their inception until July 2024. Hazard ratios (HR) and 95 % CI were employed to assess the association between vitamin D supplementation and MACE. This analysis included five randomised controlled trials (RCT). Pooled results showed no significant difference in the incidence of MACE (HR: 0·96; P = 0·77) and expanded MACE (HR: 0·96; P = 0·77) between the vitamin D intervention group and the control group. Further, the vitamin D intervention group had a lower incidence of myocardial infarction (MI), but the difference was not statistically significant (HR: 0·88, 95 % CI: 0·77, 1·01; P = 0·061); nevertheless, vitamin D supplementation had no effect on the reduced incidence of stroke (P = 0·675) or cardiovascular death (P = 0·422). Among males (P = 0·109) and females (P = 0·468), vitamin D supplementation had no effect on the reduced incidence of MACE. For participants with a BMI < 25 kg/m2, the difference was not statistically significant (P = 0·782); notably, the vitamin D intervention group had a lower incidence of MACE for those with BMI ≥ 25 kg/m2 (HR: 0·91, 95 % CI: 0·83, 1·00; P = 0·055). Vitamin D supplementation did not significantly contribute to the risk reduction of MACE, stroke and cardiovascular death in the general population, but may be helpful for MI. Notably, the effect of vitamin D supplementation for MACE was influenced by BMI. Overweight/obese people should be advised to take vitamin D to reduce the incidence of MACE.

This study examined whether supplementation with collagen peptides (CP) affects appetite and post-exercise energy intake in healthy active females. In this randomised, double-blind cross-over study, fifteen healthy females (23 (sd 3) years) consumed 15 g/d of CP or a taste matched non-energy control (CON) for 7 d. On day 7, participants cycled for 45 min at ∼55 % Wmax, before consuming the final supplement. Sixty-min post supplementation an ad libitum meal was provided, and energy intake recorded. Subjective appetite sensations were measured daily for 6 d (pre- and 30 min post-supplement) and pre (0 min) to 280 min post-exercise on day 7. Blood glucose and hormone concentrations (total ghrelin, glucagon-like peptide-1 (GLP-1), and peptide YY (PYY), cholecystokinin (CCK), dipeptidyl peptidase-4 (sDPP-4), leptin, and insulin) were measured fasted at baseline (day 0), then pre-breakfast (0 min), post-exercise (100 min), post-supplement (115, 130, 145, 160 min) and post-meal (220, 280 min) on day 7. Ad libitum energy intake was ∼10 % (∼41 kcal) lower in the CP trial (P = 0·037). There was no difference in gastrointestinal symptoms or subjective appetite sensations throughout the trial (P ≥ 0·412). Total plasma GLP-1 (AUC, CON: 6369 (sd 2330); CP: 9064 (sd 3021) pmol/l; P < 0·001) and insulin (+80 % at peak) were higher after CP (P < 0·001). Plasma ghrelin and leptin were lower in CP (condition effect; P ≤ 0·032). PYY, CCK and glucose were not different between CP and placebo (P ≥ 0·100). CP supplementation following exercise increased GLP-1 and insulin concentrations and reduced ad libitum energy intake at a subsequent meal in physically active females.

Previous studies have reported comorbidities of autoimmune thyroid disorders (AITD), including Hashimoto’s disease (HT) and Graves’ disease (GD), and celiac disease (CeD), as well as the possible beneficial effects of a gluten-free diet (GFD) on AITD. Nonetheless, it remains uncertain whether there is a genetic causal relationship between AITD and CeD, while the beneficial effects on a GFD are controversial. This study aim to explore the causal relationship between CeD and AITD, particularly with HT, and to determine whether a GFD is beneficial for AITD. We performed a two-sample Mendelian Randomization (MR) analysis on data from the largest meta-analysis summary statistics of AITD, CeD and GFD. Genetic instrumental variables were established by pinpointing single nucleotide polymorphisms (SNPs) that relate to corresponding factors. In assessing sensitivity and heterogeneity, we conducted examinations of MR Egger, weighted median, simple mode, weighted mode, and MR Egger intercept tests. HT was found to play a pathogenic role in increasing the risk of CeD (ORIVW = 1.544 [95%CI 1.153-2.068], p = 0.00355), and our Mendelian randomization study does not support genetic liability related to CeD with GD (Graves’ disease) and GFD with AITD. This study supports the positive correlation between HT risk and CeD risk, while GFD has no protective effect on AITD and may exert its effect through other mechanisms. These findings provide valuable insights into potential targets for disease intervention and treatment at the genetic level.

Femoral neck bone mineral density (FNBMD) is a high risk factor for femoral head fractures, and coffee intake affects bone mineral density, but the effect on FNBMD remains to be explored. First, we conducted an observational study in the National Health and Nutrition Examination Survey and collected data on coffee intake, FNBMD, and sixteen covariates. Weight linear regression was used to explore the association of coffee intake with FNBMD. Then, Mendelian randomisation (MR) was used to explore the causal relationship between coffee intake and FNBMD, the exposure factor was coffee intake, and the outcome factor was FNBMD. The inverse variance weighting (IVW) method was used for the analysis, while heterogeneity tests, sensitivity, and pleiotropy analysis were performed. A total of 5 915 people were included in the cross-sectional study, including 3 178 men and 2 737 women. In the completely adjusted model, no coffee was used as a reference. The ORs for the overall population at ‘< 1’, ‘1–<2’, ‘2–<4’, and ‘4+’ (95% CI) were 0.02 (–0.01, 0.04), 0.00 (–0.01, 0.02), –0.01 (–0.02, 0.00), and 0.00 (–0.01, 0.02), respectively. The male and female population showed no statistically significant differences in both univariate and multivariate linear regressions. In the MR study, the IVW results showed an OR (95% CI) of 1.06 (0.88–1.27), a P-value of 0.55, and an overall F-value of 80.31. The heterogeneity, sensitivity analyses, and pleiotropy had no statistical significance. Our study used cross-sectional studies and MR to demonstrate that there is no correlation or causal relationship between coffee intake and FNBMD.

This study explored whether lifestyle therapy that promoted adherence to a Mediterranean-style diet as a treatment for depression led to environmental co-benefits. Participants (n 75 complete case) were Australian adults in the Curbing Anxiety and Depression using Lifestyle Medicine non-inferiority, randomised controlled trial, which showed that lifestyle therapy was non-inferior to psychotherapy in reducing depressive symptoms, when delivered in group format via video conferencing over an 8-week treatment period. In this secondary analysis, we hypothesised that the lifestyle arm would be superior to the psychotherapy arm in reducing the environmental impact of self-reported diet over time. Dietary intake derived from FFQ at baseline and 8 weeks was transformed into environmental impact scores by calculating global warming potential (GWP)*. GWP* was calculated for total dietary intake and distinct food groups (Australian Dietary Guidelines and NOVA classifications). Within-arm changes in GWP* over time were calculated using the median difference. Neither arm showed significant changes. Between-arm differences in percentage change in GWP* scores over time were analysed using generalised estimating equations models. No between-arm difference for total GWP* score was found (β = 11·06 (–7·04, 29·15)). When examining distinct food groups, results were mixed. These novel findings contribute to the sparse evidence base that has measured the environmental impact of diets in a clinical trial context. Whilst lifestyle therapy that reduced depressive symptoms did not have clear environmental benefits relative to psychotherapy, nutritional counselling that focuses on the environmental impact of food choices may drive more pronounced planetary co-benefits.

Overconsumption of unhealthy, discretionary, foods and beverages are associated with an increased risk of weight gain and non-communicable diseases, including diabetes, heart disease, and cancer. This cross-sectional study explored preferences for setting goals to reduce discretionary food and beverage consumption. The online survey included items about discretionary food and beverage intake, goal setting preferences to reduce intake, habit strength, personality traits, and demographic characteristics. A total of 2664 Australian adults completed the survey. The sample was mostly female (65.9%), half (52.8%) were aged between 30–49 years, and the median intake of discretionary food and beverages was 4.9 (IQR: 3.6 to 7.2) serves per day. Multinomial logistic regression and ordinal logistic regression models were used to explore demographic and psychological predictors of the helpfulness of long-term and short-term goals, elimination and gradual goals, specific food goals, specific eating occasion and food goals, self-set goals, collaboratively set goals, and assigned goals. The results showed participants with higher habit strength had greater odds of finding short-term (OR 1.40, 95% CI 1.06–1.86), gradual (OR 1.14, 95% CI 1.01–1.29), specific (OR 1.35, 95% CI 0.84–1.76), assigned (OR 1.38, 95% CI 1.14–1.66) and collaborative goals (OR 1.24, 95% CI 1.01–1.53) helpful. The results also indicated that age and gender were important predictors of goal setting preferences, particularly for long-term goals, elimination goals, broad goals, and collaborative goals. Interventions to reduce discretionary food and beverage intake are needed and consideration of goal setting preferences could be a novel way to developing more tailored and effective dietary interventions.

Nutrition education is crucial for improving nutritional knowledge. This study aims to evaluate the impact of healthy nutrition education on hedonic hunger, adherence to the Mediterranean diet and self-efficacy for healthy eating among early adolescence. This one-group, pre-test-post-test, quasi-experimental study included 202 middle-school students. Data were collected using a researcher-designed survey that included demographic variables, the Children’s Power of Food Scale, the Self-Efficacy for Healthy Eating Scale, the Mediterranean Diet Score and the Brief Nutritional Knowledge Assessment Form. Anthropometric measurements (weight, height, waist circumference, hip circumference and neck circumference) were also taken. After the pre-test, each student received 2 h of healthy nutrition education. A follow-up survey was administered 4 weeks later. The study revealed that most early adolescents exhibited unhealthy dietary habits, such as skipping main meals (15·3 % all the time and 60·2 % occasionally), snacking on sweet treats (33·3 %) and having irregular eating patterns (47·4 %). Additionally, the early adolescents had higher weights, BMI, neck circumferences and heights compared with reference values (P < 0·01). Significant changes were observed post-intervention: lower hedonic hunger scores (beginning: 2·90 (sd 0·68), follow-up: 2·70 (sd 0·76), P < 0·01), decreased self-efficacy for healthy eating (beginning: 5·41 (sd 3·50), follow-up: 4·33 (sd 3·61), P < 0·01) and increased knowledge about healthy nutrition (beginning: 67·23 (sd 14·39), follow-up: 80·00 (sd 17·22), P < 0·01). This study highlighted that healthy nutrition education enhances nutritional knowledge and decreases hedonic dietary tendencies among early adolescents. Continued nutrition education may further improve children’s preferences for healthy foods.