Parkinson’s disease (PD) is the second most prevalent neurodegenerative disease globally(1) whereby there is a loss of dopaminergic neurons in the brain and a deficiency of dopamine. PD is characterised by dyskinesia, rigidity, tremor and postural instability, and non-motor symptoms which include neuropsychiatric, sleep and autonomic dysfunction which often occur before motor symptoms(2). Several of these motor and non-motor symptoms can adversely affect nutritional status(3) and a significant number of people with PD are at risk of malnutrition(4). Observational studies have examined the relationship between dietary intake, symptoms and disease progression yet there is a lack of randomised controlled trials of dietary interventions. This presentation will examine the evidence base and suggest future directions for nutrition research in this important area.

The estimated global preterm birth rate in 2020(1) was more than 10% of livebirths or 13.4 million infants. Despite the importance of neonatal nutrition in optimising growth, neurodevelopment, and later metabolic disease risk, there is inconsistency in nutrition recommendations for preterm infants(2). Incomplete or inconsistent reporting of outcomes in nutrition intervention studies is part of the reason for the lack of consensus on optimal nutrition. To reduce uncertainty in measuring or reporting nutritional intake and growth outcomes in preterm studies, a consensus process is needed to identify relevant measures for patients, parents/caregivers, researchers, and health professionals. We aimed to develop a minimum reporting set (MRS) for measures of nutritional intake and growth in preterm nutrition studies. We collaborated with a group of international researchers from 13 countries and registered this study at the COMET initiative (registration number 3185). The target population was individuals born preterm at any gestational age and study location whose nutritional intake was assessed before first hospital discharge and whose growth was assessed at any age. Measures reported in preterm nutrition studies were systematically reviewed and used to develop the real-time Delphi survey(3) using Surveylet (Calibrum) software, including 13 questions about nutritional intake and 14 about growth outcomes. We used a snowball process to recruit participants from the consumer, healthcare provider, and researcher stakeholder groups with expertise in preterm infants, nutrition, and growth to rate the importance of each measure on a 9-point Likert scale. Participants initially rated the survey items without seeing other participants’ responses, saved and refreshed the page to see the anonymous responses of other participants, and had the option to change their rating and provide reasons for their answers. Participants’ final scores for each item will be used to identify the consensus criteria for that item(3). To date, we have recruited 246 participants from 31 countries across 5 continents, including 58 (24%) consumers, 156 (63%) healthcare professionals, and 26 (11%) researchers. Preliminary findings indicate that 12 measures of nutritional intake and 4 of growth have met the criteria for inclusion in the MRS. However, participant recruitment and survey responses are ongoing. A final consensus meeting is planned for November 2024 to confirm the MRS.

As many as 1 in 12 people in residential care are likely to have a pressure injury at any time(1). Our pragmatic intervention, consented by both patients and their Enduring Power of Attorney, provided 20g whey protein concentrate (WPC) in 200ml whole milk to be consumed by the resident in the morning with breakfast or morning tea, to compensate for the likely lowest protein meal of the day(2), and increase total protein intake. WPC has a number of beneficial substances that support wound healing, such as arginine, and glutamine(3), plus the branch chain amino acids(4). The intervention was uncomplicated, well tolerated and resulted in wound healing, as evidenced by the pictures of the three initial cases. We need further trials to show that this is better than usual interventions. However, we believe this is a useful protocol to address a recognised problem of poor protein intake for those who need extra to heal wounds

The objective of the food safety system is to provide safe and suitable food in New Zealand(1). This is of particular importance for our youngest members– infants and young children. During the first 2000 days of life, food and nutrition have crucial roles. Nutrient requirements are high, and children often have an increased vulnerability to hazards associated with chemical and microbiological contamination. Foods targeted to this age group typically have strict regulations, as the quality and safety of foods for infants and young children is of great concern to caregivers, public health authorities and regulatory bodies worldwide. The recent First Foods New Zealand Study (FFNZ) and Young Foods New Zealand (YFNZ) Study have provided important data into what, and how, we feed our infants and young children under four years of age(2). Insights from the dietary intakes and health of 925 infants and young children from these studies are being used by NZFS to inform its work on food monitoring surveillance and food policy. Currently New Zealand Food Safety (NZFS) is conducting the 2024 New Zealand Total Diet Study (NZTDS) (Infants and Toddlers)(3). The NZTDS is a food monitoring and surveillance programme which aims to evaluate the risk to New Zealanders from exposure to certain chemicals such as agricultural chemicals, contaminants (including from food packaging), and nutrients. The 2024 NZTDS will, for the first time, focus exclusively on infants and young children. The FFNZ and YFNZ studies informed the selection of 117 foods to be tested from four New Zealand regions throughout 2024/2025. The dietary intake data will then be used to estimate the dietary exposure to each of the 362 chemicals analysed. This monitoring programme informs policy decision-making and food standard setting and provides assurance on the safety of our food supply. Concerns around the nutrient quality and labelling of some commercial products for infants and young children have been identified in Australia and New Zealand. Within the joint food regulatory system, consultation is underway to consider regulatory and non-regulatory options for improving commercial foods for infants and young children(4). This presentation will discuss NZFS’s role in monitoring foods and diets of infants and young children in Aotearoa New Zealand, the importance of, and application of evidence to inform policy, food safety, and potential regulatory and non-regulatory options to ensure that the food safety system continues to deliver safe and suitable food in New Zealand.

New Zealand and Australian governments rely heavily on voluntary industry initiatives to improve population nutrition, such as voluntary front-of-pack nutrition labelling (Health Star Rating [HSR]), industry-led food advertising standards, and optional food reformulation programmes. Research in both countries has shown that food companies vary considerably in their policies and practices on nutrition(1). We aimed to determine if a tailored nutrition support programme for food companies improved their nutrition policies and practices compared with control companies who were not offered the programme. REFORM was a 24-month, two-country, cluster-randomised controlled trial. 132 major packaged food/drink manufacturers (n=96) and fast-food companies (n=36) were randomly assigned (2:1 ratio) to receive a 12-month tailored support programme or to the control group (no intervention). The intervention group was offered a programme designed and delivered by public health academics comprising regular meetings, tailored company reports, and recommendations and resources to improve product composition (e.g., reducing nutrients of concern through reformulation), nutrition labelling (e.g., adoption of HSR labels), marketing to children (reducing the exposure of children to unhealthy products and brands) and improved nutrition policy and corporate sustainability reporting. The primary outcome was the nutrient profile (measured using HSR) of company food and drink products at 24 months. Secondary outcomes were the nutrient content (energy, sodium, total sugar, and saturated fat) of company products, display of HSR labels on packaged products, company nutrition-related policies and commitments, and engagement with the intervention. Eighty-eight eligible intervention companies (9,235 products at baseline) were invited to participate, of whom 21 accepted and were enrolled in the REFORM programme (delivered between September 2021 and December 2022). Forty-four companies (3,551 products at baseline) were randomised to the control arm. At 24 months, the model-adjusted mean HSR of intervention company products was 2.58 compared to 2.68 for control companies, with no significant difference between groups (mean difference -0.10, 95% CI -0.40 to 0.21, p-value 0.53). A per protocol analysis of intervention companies who enrolled in the programme compared to control companies with no major protocol violation also found no significant difference (2.93 vs 2.64, mean difference 0.29, 95% CI -0.13 to 0.72, p-value 0.18). We found no significant differences between the intervention and control groups in any secondary outcome, except in total sugar (g/100g) where the sugar content of intervention company products was higher than that of control companies (12.32 vs 6.98, mean difference 5.34, 95% CI 1.73 to 8.96, p-value 0.004). The per-protocol analysis for sugar did not show a significant difference (10.47 vs 7.44, mean difference 3.03, 95% CI -0.48 to 6.53, p-value 0.09).In conclusion, a 12-month tailored nutrition support for food companies did not improve the nutrient profile of company products.

Gut health is a 50-billion-dollar (US) industry that is forecast to continue growing. This growth is attributed to our increased understanding and interest in the gut microbiome and its association with many chronic diseases, mental health and gut and autoimmune disorders. In 2024, “dysbiosis”, “gut microbiome” and “gut probiotics” were some of the most commonly google searched words but, what constitutes “good gut health”? There is no exact definition but in clinical practice we may use symptoms as a proxy for gut health, for example normal gastrointestinal function and the absence of chronic gastrointestinal symptoms that negatively impact on our quality of life. Consumer research found that consumers regard gut health as well-being and are interested in latest science but that does not inform their purchasing behaviours(1). Interestingly, symptoms of suboptimal gut health, which may include abdominal bloating, diarrhoea, constipation, excessive flatulence, were most likely to influence consumer behaviours.1 In this presentation, I review the latest scientific evidence about foods and dietary patterns that are associated with markers of gut health. I also provide examples of how we can practically educate and advise New Zealanders on implementation of dietary changes that may support sustainable gut health.

Cardiometabolic diseases, including type 2 diabetes (T2DM) and cardiovascular disease (CVD), are common. Approximately one in three deaths annually are caused by CVD in Aotearoa New Zealand (AoNZ)(1). The Mediterranean dietary pattern is associated with a reduced risk of cardiometabolic disease in epidemiological and interventional studies(2,3). However, implementing the Mediterranean diet into non-Mediterranean populations can be challenging(4). Some of these challeanges include facilitating consumption of unfamiliar foods and the cultural and social context of food consumption. AoNZ produces a rich source of high-quality foods consistent with a Mediterranean dietary pattern. He Rourou Whai Painga is collaborative project combining contributions from food industry partners into a Mediterranean Diet pattern and providing foods, recipes and other support to whole household/whānau. The aim was to test if a New Zealand food-based Mediterranean diet (NZMedDiet) with behavioural intervention improves cardiometabolic health and wellbeing in individuals at risk. This presentation will review the background to the research, the process of forming a collaboration between researchers and the food industry, the design and implementation of a complex study design (see protocol paper)(5), with results from the initial randomised controlled trial. We conducted several pilot studies(6,7,8) to inform the final design of the research, which was a combination of two randomised controlled trials (RCT 1 and 2) and a longitudinal cohort study. RCT-1 compared 12-weeks of the NZMedDiet to usual diet in participants with increased cardiometabolic risk (metabolic syndrome severity score (MetSSS) >0.35). The intervention group were provided with food and recipes to meet 75% of their energy requirements, supported by a behavioural intervention to improve adherence. The primary outcome measure was MetSSS after 12 weeks. Two hundred individuals with mean (SD) age 49.9 (10.9)yrs with 62% women were enrolled with their household/whānau. After 12 weeks, the mean (SD) MetSSS was 1.0 (0.7) in the control (n = 98) and 0.8 (0.5) in the intervention (n = 102) group; estimated difference (95% CI) of -0.05 (-0.16 to 0.06), p=0.35. A Mediterranean diet score (PyrMDS) was greater in the intervention group 1.6 (1.1 to 2.1), p<0.001, consistent with a change to a more Mediterranean dietary pattern. Weight reduced in the NZMedDiet group compared with control (-1.9 kg (-2.0 to -0.34)), p=0.006 and wellbeing, assessed by the SF-36 quality of life questionnaire, improved across all domains p<0.001. In participants with increased cardiometabolic risk, food provision with a Mediterranean dietary pattern and a behavioural intervention did not improve a metabolic risk score but was associated with reduced weight and improved quality of life.

Masters athletes tend to have higher intakes of calcium, magnesium, iron, and zinc when compared to Australian national population data from similar age groups(1). However, little is known about the diets of New Zealand Olympians as they get older. This study aimed to describe the micronutrient intakes of New Zealand Olympic and Commonwealth Games athletes over the age of 60 years and make comparisons with National Nutrition Survey data. Thirty-three individuals (mean age 76±8 years, n=27 male) who had represented New Zealand at an Olympic or Commonwealth Games participated in this study. Dietary intake was assessed using three 24-h diet recalls. The first recall was conducted face to face in the participant’s home and the second and third were completed over a voice or video call on non-consecutive days following this. All recalls were performed using a multiple-pass technique and entered into FoodWorks dietary analysis software (Version 9, Xyris Software Ltd., Brisbane, Australia). Mean intakes across the three recalls were used to represent the intake of each individual.This study was approved by the University of Otago Ethics Committee (Health; H23/054, April 2023).The mean intakes of iron (males 13.3±5.1 mg, females 9.9±1.9 mg) and zinc (males 10.7±4.0 mg, females 9.6±1.9 mg) in Olympians were similar to those reported in those over 70 y in the 2008/09 New Zealand Adult Nutrition Survey, but more than 60% of Olympians had intakes below the estimated average requirements for these nutrients. Intakes of calcium (males 1048±474 mg, females 810±139 mg) and selenium (males 66.7±49.1 µg, females 48.4±17.7 µg) were higher in Olympians when compared to the 2008/09 New Zealand Adult Nutrition Survey data, however 39% and 61% of Olympians still had intakes below the estimated average requirements, respectively. While this group of older New Zealand Olympians did have higher intakes of some nutrients than a representative sample of their peers, a marked number are still at risk of inadequate intakes and may benefit from a nutrition intervention to improve the overall quality and adequacy of their diet.

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 co-morbidities of autoimmune thyroid disorders (AITD), including Hashimoto’s disease and Graves’ disease 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 of a GFD are controversial. This study aims to explore the causal relationship between CeD and AITD, particularly with Hashimoto’s disease, and to determine whether a GFD is beneficial for AITD. We performed a two-sample Mendelian randomisation analysis on data from the largest meta-analysis summary statistics of AITD, CeD and GFD. Genetic instrumental variables were established by pinpointing SNP 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. Hashimoto’s disease 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 randomisation study does not support genetic liability related to CeD with Graves’ disease and GFD with AITD. This study supports the positive correlation between Hashimoto’s disease 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.