Diet is a modifiable risk factor for cardiometabolic diseases, yet establishing causality between diet and disease outcomes remains challenging(1). Most evidence in nutritional epidemiology stems from observational studies, which are susceptible to confounding and reverse causation, and many observational associations have failed to replicate in large-scale randomised controlled trials (RCTs). Although RCTs are considered the gold standard for causal inference, they often face practical barriers in nutrition research. Mendelian randomisation (MR) offers a complementary alternative by using genetic variants as instrumental variables (IVs) to proxy modifiable exposures such as diet(2). As genetic variants are randomly assorted at conception and remain fixed throughout life, MR can be thought of as nature’s RCTs to infer the long-term causal effect of an exposure. However, identifying valid IVs for dietary exposures remains difficult. Conventional significance-based approaches often select variants that exhibit pleiotropy, i.e. affecting multiple traits beyond the dietary exposure of interest. This violates a core MR assumption that IVs only affect the outcome through the exposure and may give misleading conclusions about the true effects of diet. To address this, we used genetic IVs related to taste and smell perception, which are biological drivers of food preferences and intake. Anchoring IVs in the sensory biology of dietary behaviours can minimise pleiotropic bias and improve the reliability of diet-related MR findings(3). MR was applied to assess the causal effects of four dietary patterns (DPs) (Unhealthy, Healthy, Meat-based, Pescatarian) from the UK Biobank (n = 258,758–449,210) on twelve cardiometabolic outcomes (n = 149,006–1,320,000), including body mass index, coronary artery disease (CAD), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, triglycerides (TG), systolic blood pressure, diastolic blood pressure, type 2 diabetes (T2D), haemoglobin A1c, fasting insulin, and fasting glucose (FG). Findings included robust evidence (Bonferroni-corrected p < 0.00185) that the Unhealthy DP causally increased risk of CAD (odds ratio [95% confidence interval] = 3.23 [1.89, 5.52] per SD increase in Unhealthy DP score, p = 1.86 × 105) and TG levels (beta = 0.45 ± 0.13 SD per SD increase in Unhealthy DP score, p = 5.23 × 104), supporting existing mechanistic understanding between diet and cardiovascular disease risk. Suggestive evidence (p < 0.05) was found for an Unhealthy DP increasing T2D risk, a Healthy DP lowering FG in individuals without T2D, and a Meat-based DP elevating CAD risk. Notably, our chemosensory IVs did not replicate implausible associations identified using conventional significance-based IVs, such as a Healthy DP increasing BMI, suggesting that these may reflect residual bias or pleiotropy. Overall, this study demonstrated the utility of MR in strengthening causal inference and triangulating evidence in nutritional epidemiology, while emphasising the crucial importance of using biologically informed IVs in MR studies on dietary exposures.

Diet strongly shapes the gut microbiome(1). Diets rich in fibre and plant-food sources promote bacteria that produce short-chain fatty acids (SCFAs), which support gut barrier integrity and reduce inflammation(1). In contrast, diets high in saturated fat and low in fibre can encourage pro-inflammatory or opportunistic microbes, altering microbial metabolism in ways that may harm health(1). Controlled feeding trials allow direct comparisons of microbiome responses to different dietary patterns and help reveal mechanisms linking diet quality to microbial changes. This study compared gut microbial diversity and species-level composition in response to a Healthy Australian Diet (HAD) versus a Typical Australian Diet (TAD) in a randomised, crossover-controlled feeding trial. Thirty-four healthy adults consumed each diet for two weeks, separated by a washout period, with all food provided. The HAD aligned with Australian Dietary Guidelines(2), while the TAD was based on national intake data(3). Stool samples were collected at baseline and after each diet (four visits per participant) and analysed by shotgun metagenomic sequencing. Alpha diversity was measured using Shannon and Simpson indices. Species present in ≥ 20% of samples were retained; relative abundances were arcsin-square root transformed. Linear mixed-effects models adjusted for diet, period, age, and sex, with participant ID as a random effect. False discovery rate (FDR) correction was applied (q < 0.05). Of 136 collected samples, three were excluded due to sequencing failure or contamination, leaving 133 for analysis. Alpha diversity was significantly higher after TAD compared with HAD. Within-diet changes (baseline to post-diet) showed 10 significant species shifts after FDR correction: six in HAD (five decreased, including Ruminococcus torques and Coprococcus comes, and one increased: unidentified Firmicutes species GGB9758_SGB15368) and four in TAD (three increased, including Lawsonibacter asaccharolyticus and Phocaeicola massiliensis, and one decreased). Between-diet comparisons found 13 species differing significantly, including Alistipes putredinis and Flavonifractor plautii, both higher in TAD. While greater diversity is often considered beneficial, enrichment of taxa following the TAD such as Ruminococcus torques, a mucin-degrading species linked to gut barrier thinning and inflammatory bowel disease(4), may indicate shifts towards less favourable microbiome states. Flavonifractor plautii, although capable of SCFA production and flavonoid degradation, has been associated in recent Indian colorectal cancer cohorts with the loss of protective flavonoids(5), suggesting context-dependent effects. The TAD increased microbial diversity but favoured taxa previously linked to adverse health outcomes, possibly reflecting a reduced intake of diverse, fibre-rich substrates. The HAD reduced several opportunistic species, supporting the concept that diet quality, not microbial diversity alone, may be critical in determining health-promoting gut microbiome. Future analyses should consider metagenomic data to investigate potential functional changes along with metabolites.

Markers of oxidative stress have previously been found to be elevated in people with obesity(1) due to the generation of reactive oxidant species from multiple pathways and impairment of antioxidant defences(2). Weight loss, through dietary change and behaviour modification, is recommended to reduce the risk of health complications associated with obesity. Consumption of almonds, as a food rich in Vitamin E with antioxidant properties, may also reduce oxidative stress(3). This study aimed to determine whether biomarkers of oxidative stress change following consumption of energy-restricted diets containing almonds or carbohydrate rich snacks for 9 months. Adults with overweight or obesity (n = 140, BMI 30.7 ± 2.3 kg/m2, 47.5 ± 10.8 years) were randomly assigned to consume 15% of total daily energy from either almonds (n = 68, AED) or isocaloric carbohydrate-rich snacks (n = 72, CRD) in a dietary intervention that comprised 3 months (3M) weight loss (30% energy restriction) followed by 6 months (6M) of weight maintenance. At baseline (BL), 3M and 9M, dietary intake of vitamin E was captured from weighed 4-day food records (FoodWorks Nutritional Analysis Software) and biomarkers of oxidative stress (oxidized low-density lipoprotein (ox-LDL), the ratio of ox-LDL to LDL and F2-isoprostanes) were measured from blood and urine samples collected following an overnight fast. Intention to treat analyses were conducted using mixed effects modelling (fixed effects: group and time and participant ID as the random effect) with body mass index at BL as a covariate. Significance was set at p < 0.05 and data are presented as estimated marginal means and standard errors. Significantly greater increases in Vitamin E consumption occurred for AED compared to CRD (3M: 3.98 ± 0.72 mg/d vs. −4.10 ± 0.71 mg/d, 9M: 3.55 ± 0.75 mg/d vs. −0.52 ± 0.78 mg/d, p < 0.001 interaction effect). There was a significant difference in ox-LDL between groups (AED: 65.49 ± 2.10 U/L vs. CRD: 72.36 ± 2.09 U/L, p = 0.02, group effect) and significant reductions over time in all participants (3M: −5.79 ± 1.83 U/L, 9M: −4.36 ± 2.05 U/L, p = 0.005, time effect), but no group by time interaction. There were no significant changes in the ratio of ox-LDL to LDL, or plasma or urinary F2-isoprostane levels over time or differences between groups. Reduced energy consumption over 9 months reduced some markers of oxidative stress but the inclusion of almonds did not modify these effects despite increasing dietary intake of Vitamin E. The decrease in ox-LDL over time is likely due to a decrease in LDL cholesterol (previously reported)(4), rather than a reduction in LDL oxidation. Future studies should explore precision health approaches to manage oxidative stress and improve health outcomes.

Dietary intakes of most young adults aged 18–35 living in Australia, fall short of national dietary guidelines, including low intake of fruits and vegetables and high consumption of highly processed foods. Coinciding with suboptimal diets are a rapid increase in cardiovascular risk factors. Over half of Australians enter their thirties with overweight or obesity and an accelerating burden of hypertension, dyslipidaemia and type 2 diabetes(1). Additionally, early-onset cardiovascular disease in adults under 40 is rising, suggesting decades of lost health and productivity(2). Despite this, young adults remain underserved, with limited public health or primary care programs explicitly targeting this age group. With high smartphone use and widespread engagement with social media, digital platforms offer a promising avenue to deliver scalable, accessible, and engaging tools to support healthy eating in this cohort(3). The Heart Foundation has identified young adulthood (18–35) as a critical window for long-term behaviour change and prevention of cardiovascular disease. Therefore, this project aims to inform the development of a digital food literacy and healthy eating tool that builds practical skills, knowledge, and motivation for heart healthy eating among young adults (18–35) living in Australia. A multi-method consumer research and participatory co-design process was conducted, including a literature review, an online representative sample survey (n = 1000), three online focus groups (n = 20), and a one-day in-person co-design workshop (n = 7). Findings of the literature review, survey and focus group discussions highlighted a range of behavioural, environmental, and psychosocial barriers to healthy eating, including time, cost, motivation, cooking confidence, access, and social influences. Young adults expressed a strong interest in simple, flexible, and practical nutrition support delivered through digital platforms. Tools that reduced decision fatigue, promoted time and money saving, and featured clear, visual content were especially valued. Trust in credible sources, such as the Heart Foundation, and receptiveness to personalisation, snackable content, and goal-driven features were consistent themes. These findings informed the co-design workshop, where participants completed a series of interactive activities to prioritise content, features, and delivery formats for a future digital tool. Outcomes of the co-design workshop confirmed the importance of simplicity, personalisation, and visual appeal, with mobile applications and social media identified as the preferred delivery platform for tailored food and nutrition information for young adults. These insights can inform the design of digital interventions, ensuring they reflect both current evidence and lived experience. Building new accessible tools that address the needs of young adults, empowers them with practical tools, and credible information that can help support healthy behaviours with long-term heart health benefits.

Social media is used daily by most Australians and there is a plethora of content online about food and nutrition, including on the platform Instagram(1). Among nutrition-related Instagram posts, the provision of recipes is common(1). Australians have reported that they use social media to source recipes and meal ideas(2), however, little is known about the healthfulness of recipes published on social media. Therefore, this study examined the nutrient and food group composition of recipes published by influential Australian Instagram accounts. A list of the top 1000 Australian health influencers was initially screened, and furthered via snowballing, to identify Instagram accounts with ≥ 100,000 followers who regularly posted a sufficient amount (25%+ within 1 month) of relevant content. All posts (September 2020–2021) for each account were downloaded and screened to identify nutrition-related posts, resulting in a sample of 10,964 (described qualitatively elsewhere(1)). A random subsample of posts (n = 1,199) was screened to identify recipes. Recipes were classified based on the type of meal and analysed in Foodworks to determine the amount of key nutrients and food groups per serve of each recipe. Statistical analysis was undertaken in Stata. In total, 119 recipes were included (n = 30 breakfast, n = 33 lunch/dinner, n = 23 snacks, n = 33 desserts and n = 11 beverages). Per serve, recipes had a median of 1441 ± 1572 kilojoules, 9.0 ± 21.4 grams of protein, 14.6 ± 18.7 grams of fat, 3.7 ± 7.2 grams of saturated fat, 32.5 ± 43.2 grams of carbohydrates, 3.9 ± 9.1 grams of added sugar, 4.9 ± 7.9 grams of fibre and 224.9 ± 446.3 milligrams of sodium. Overall, 46 (39%) recipes contained vegetables, 54 (45%) fruit, 68 (57%) grains, 32 (27%) wholegrains, 85 (71%) meat or meat alternatives, and 40 (34%) milk, cheese, yoghurt or alternatives. On average vegetable, wholegrain and meat/meat alternative content was highest per serve for lunch/dinner recipes (1.23, 1.40 and 0.64 serves, respectively), and fruit and dairy were highest per serve for beverages (1.83 and 0.56 serves, respectively). Recipes published by popular Australian Instagram accounts tended to be low in saturated fat, added sugars and contain moderate amounts of sodium and fibre per serve. Less than half the recipes analysed contained vegetables and the amount of vegetables per serve tended to be low. Overall, there was a large amount of variation in the energy density, nutrient and core food group composition of recipes and social media users should be selective about which recipes from Instagram they choose to prepare.

Nutrition knowledge (NK) has a positive significant relationship with dietary intake in athletes. Many studies have evaluated education tools or programs to improve nutrition knowledge in athletes. However, it is unclear if these tools/programs have developed education content based on established gaps in knowledge(1). Knowledge gaps within Australian university student-athletes at any level of competition have not been well explored previously(2). The aim of this study is to identify gaps in nutrition knowledge amongst university student-athletes. Cross-sectional study in athletes, aged 18+ years, enrolled in tertiary education and competing in sport at any level. Online surveys were used to collect demographics and nutrition knowledge scores (ANSKQ). Descriptive statistics were used to explore mean total, general, and sport NK scores, across the total group. NK gaps were identified by the frequency of incorrect response for each question and via proportion of incorrect responses within the following categories: macronutrients, micronutrients, alcohol, fuel for competition, hydration, supplementation, and recovery. Percentage of incorrect responses were calculated within each category. Ninety-one student-athletes completed the general NK questions; 83 also completed the sports NK questions. Overall median [IQR] scores were 51% [17.1] (total), 54% [18.2] (general), and 50% [20.8] (sport). Of the 35 included NK questions, 16 had 40% or more incorrect responses (five in general NK out of 11 questions, 11 in sport NK out of 24 questions). For each category, the percentage of incorrect responses were as follows: 39% macronutrients, 71%micronutrients, 50% alcohol, 38% fuel for competition, 74% hydration, 37% supplementation, and 37% recovery. These scores indicate the median NK level amongst student-athletes met the rating of average (50–64%, as categorised by the ANSKQ tool). These scores indicate that there are many topics that may be knowledge gaps for student-athletes. However, some topics have much higher numbers of items with incorrect responses. To improve the nutrition knowledge of this group of Australian university student-athletes, future nutrition education tools should focus on addressing knowledge gaps specific to this athlete group, including micronutrients, alcohol, and hydration.

Nutrition during pregnancy and postpartum is critical in maternal and infant health, with poor dietary intake during this period contributing to adverse outcomes and long-term health risks(1). Dietary intake is influenced by behavioural, physiological, and social factors(2), and understanding the patterns, and their determinants, can inform targeted nutrition interventions. This study aimed to assess changes in diet quality and food and nutrient intakes from pregnancy to one year postpartum in Australian women and compare to national nutrition recommendations. Associations between diet quality, sociodemographic and health characteristics were also investigated. This study was an analysis of data from the ORIGINS pregnancy cohort (2017–2022). Women were included if they had complete dietary data at both timepoints, were aged ≥ 19 years, and were not pregnant one year postpartum. Dietary intake was assessed via the Australian Eating Survey food frequency questionnaire and diet quality was assessed using the Australian Recommended Food Score (ARFS). Sociodemographic data were self-reported; clinical health data were extracted from hospital medical records. Paired sample t-tests analysed changes in diet quality and intake. Linear regression estimated associations between maternal characteristics and diet quality, with adjustment for covariates. Food group and nutrient intakes were compared to recommendations in the Australian Guide to Healthy Eating and Nutrient Reference Values. Among 337 women (33.1 (4.5) years, 49.9% Australian-born, 51.3% university educated), mean (95% CI) diet quality was suboptimal during pregnancy and one year postpartum (ARFS 34.0 (33.0, 35.0) vs. 34.8 (33.8, 35.8) points out of 73, p = 0.038). One year postpartum, participants reported consuming more vegetables, meat, protein, and retinol equivalents, but less fruit, dairy, carbohydrate, saturated fat, iodine, and folate (p < 0.05). Across both timepoints, alignment with recommendations was poor for all food groups, macronutrients and key micronutrients. None of the women met the daily intake targets for all five food groups during pregnancy, and only one woman met the targets one year postpartum. Lower diet quality during and after pregnancy was linked to not having had a university education, and a higher pre-pregnancy BMI. Postpartum, younger age and lower income was also associated with poorer diet quality and having a BMI in the overweight category before pregnancy (p < 0.05). Findings underscore persistent nutritional inadequacies and social disparities among pregnant and postpartum women in Australia and provide evidence to support updates to national dietary guidelines and the development of targeted nutrition interventions, particularly for women experiencing socioeconomic disadvantage.

As developmental science expands globally, its theories and methods must rise to the challenge. Children worldwide develop within caregiving ecologies that often differ from traditional family models. Understanding how infants adapt within these contexts reveals general principles of human development. Achieving this requires structural change: consensus-building, open methods, and theories grounded in the environments where most children actually grow up.

Food insecurity remains a critical challenge in Nigeria, contributing to poor health, malnutrition, and reduced productivity, while disproportionately affecting key populations. This study examined the prevalence of food insecurity among women compared to men in Nigeria, including how this differs by age and geographic location. Data for this study were from the 2021 UNICEF Multiple Indicator Cluster Survey (MICS 6), using the Food Insecurity Experience Scale (FIES) to measure household food insecurity for female and male-headed households (FHHs and MHHs). Rasch modelling was used to assess the validity of the scale in Nigeria, and results were calibrated to the global FIES reference scale(1). Logistic regression models were used to explore how food insecurity levels varied by gender of household head, with interaction terms included for age, region, and geopolitical zone. Overall, food insecurity was widespread, with 71.8% of households experiencing moderate and 27.6% experiencing severe food insecurity. The prevalence of severe food insecurity was significantly greater for FHHs (45.9%) compared to MHH (42.3%). Conversely, the prevalence of moderate food insecurity was significantly greater for MHHs (34.9%) compared to FHHs (33.0%). Age-specific analysis revealed that younger FHHs (15–49 years) had 1.4 times the odds of food insecurity (moderate and severe combined) compared to older FHHs (50+) (95% CIs 80.3, 84.9; p =< 0.001). Interaction terms were not significant for region and geopolitical zone when food insecurity was analysed as a binary variable (food secure vs. food insecure). However, significant interaction terms for geopolitical zone were observed when food insecurity was analysed as moderate and severe separately. That is, only severe food insecurity was more prevalent among FHHs compared to MHHs in several geopolitical zones, notably North East, North West, South East, and South South zones (all p < 0.010). This study highlights the unequal burden of food insecurity among FHHs in Nigeria, especially among younger FHHs of reproductive age. These findings underscore the need for targeted, gender transformative, and region-specific policies to effectively address food insecurity and its structural determinants.

High sodium consumption increases the risk of hypertension and cardiovascular disease(1). Although food remains the primary source of intake, elevated sodium levels in drinking water can further contribute to excessive intake, particularly in populations already exceeding recommendations(2). A review of sodium limits in national standards for unbottled drinking water in 197 countries was conducted to inform discussion on the need for enforceable, health-based sodium limits. National standards for unbottled drinking water were identified using the WHO 2021 review of drinking water guidelines(3), the FAOLEX country database(4), and targeted internet and AI searches. For each country, data were extracted for the document name, year, regulatory body, regulation type, sodium limit (if stated), and rationale. Socio-geographic data were sourced from World Bank Open Data(5). A descriptive analysis was conducted using Microsoft Excel. Drinking water standards were identified for 164 countries. Of these, 20% (n = 32), representing 30% of the global population, had no sodium limit. Of the 132 countries with a sodium limit, 92% (n = 121) adopted the WHO’s palatability-based guideline of 200 mg/L. Upper limits ranged from 50 to 400 mg/L. Only twelve countries (9%) cited health as a rationale for setting sodium limits in drinking water. Three countries—Australia, Canada, and the United States—provided a separate recommendation for at-risk populations to consume water with sodium levels below 20 mg/L. This review highlighted that globally, drinking water standards give inadequate attention to sodium’s health risks. Most standards either lack sodium limits or rely on palatability thresholds that are too high to protect health. Updating national and international standards to reflect current evidence is essential to support sodium reduction efforts. Health-based sodium limits would empower communities to better advocate for safe water. Amid rising water salinity, such reforms must form part of a broader global strategy to ensure universal and equitable access to safe, affordable drinking water as a basic human right.

Regional One Health antimicrobial stewardship networks require coordinated, adaptive strategies across sectors. This conceptual article combines strategic fit theory with the Ansoff matrix to identify key determinants of sustainable network performance and proposes strategic development pathways to strengthen governance, data integration, cross-sectoral collaboration and long-term network development.

The architectural history of Iran began in the early 1900s with the orientalist approaches prevalent at that time and continued for a long time, with minor changes, under the influence of these approaches. From the mid-1990s, the situation changed slowly, and between 1995 and 2005, also known as the “reform era,” a profound transformation took place in this field. The holding of the first Congress on the History of Architecture and Urban Planning of Iran (1995) was the starting point of this transformation. Then, a series of events, including changes in existing institutions, the establishment of new institutions, the establishment of specialized journals, the holding of related conferences and scientific events, and finally the establishment of the field of Iranian architectural studies, were the milestones that led to the transformation of this field. The article examines the general aspects of this development.

Increased consumption of foods with pulses (e.g., lentils or chickpeas), which are a source of protein, is recommended due to their lower environmental impact than animal-sourced foods(1). However, data for the environmental and nutritional trade-offs for such a dietary shift has been lacking in the Australian context, and nutritional implications for specific population groups not considered. The diets of Australian adolescents are particularly poor, yet this age is critical for developing healthy lifestyle behaviour that can persist into adulthood. We aimed to assess the nutritional and environmental impact of increase pulse consumption, through a case study of a dietary shift of Australian adolescents from a ham sandwich to hummus sandwich. Nutritional analysis was undertaken using the Nutrient Rich Food index for adequate intake (NRF-ai) to evaluate nutritional value, weighted to reflect the proportion of the Australian adolescent population with inadequate/excessive intakes of 22 key nutrients(2). Environmental impact of each sandwich was assessed using Life Cycle Assessment methodology across five impact categories: global warming potential, eutrophication, acidification, freshwater ecotoxicity and water scarcity. A sensitivity analysis was undertaken to test the influence of key variables for ham (imported from Europe or Australian) and hummus (commercial, or homemade with either canned or dried chickpeas). The NRF-ai score was also used as a functional unit to determine the nutritional ecoefficiency of each type of sandwich (environmental impact per NRF-ai). Nutritional affordability (NRF-ai per dollar cost to the consumer) was also calculated. Based on an equivalent nutritional value (one unit NRF-ai), a hummus sandwich has a lower impact on the environment than a ham sandwich, across all environmental impact categories. For example, considering adolescent boys’ diets, the global warming potential (GHGE) from a ham sandwich (using imported ham) is 10 times that of a hummus sandwich (using commercially made hummus). Per serve, a hummus sandwich has a much lower environmental impact, greater nutritional benefit, and is more affordable than a ham sandwich. The biggest contributors to environmental impact of the ham sandwich is feed and on-farm production (e.g., emissions from manure). The growing of pulses has environmental benefits reducing acidification and eutrophication. Consumer choice can make a substantial difference to environmental and nutritional outcomes of the food system. If 50% of Australian adolescents consumed a hummus sandwich once a week for a year, instead of a ham sandwich, the reduction in GHGE would be equivalent to a person flying from Paris to Brisbane 3358 times (15,450,000 kg CO2eq). Strategies are needed to support consumer decisions to choose foods with environmental and nutritional benefits, such as pulses, through increasing access to healthy and appealing pulse based foods, and increasing consumer’s knowledge and skills to purchase, prepare and consume pulses.

This article argues that the formation of a topological structure in the Luso-American postal system from 1800 to 1820 produced a form of spacetime compression: a temporal acceleration in communications achieved by the shrinking of distances and intensification of flows. This acceleration was closely tied to a revolutionary context that heightened the urgency of political communications. In particular, reforms prompted by the Portuguese throne’s migration to America instigated significant changes in postal networks. Drawing on a range of legal and administrative documents, letters, almanacs, and newspapers, the study highlights the expansion, diversification, and regularization of the network. It further underlines the links between communication infrastructure and social experiences of space and time, suggesting that a comprehensive postal network fostered a global experience of accelerated time. Using digital cartography alongside other sources, the article contends that the spatial dimension of modern accelerated temporality is rooted in topological space.

Polycystic Ovary Syndrome (PCOS) is a complex condition characterized by reproductive, metabolic and psychological features(1). The most recent iteration of the International PCOS guidelines recommend a healthy lifestyle for effective management(2). Following a healthy diet is considered one of the first line management strategies for mitigating long-term health risks in PCOS. However, there is little evidence to support one superior dietary approach. As such, current guidelines recommend a dietary pattern consistent with population-based dietary guidelines(2). However, many women with PCOS have expressed the desire for more tailored and individualised dietary recommendations. In populations with similar health vulnerabilities, there is evidence that adherence to a Mediterranean diet (MedDiet) is inversely associated with cardiometabolic disease risk, independent of caloric restriction(3). However, the feasibility of a MedDiet in PCOS is unknown. Therefore, this study explored the feasibility of a pilot ad libitum MedDiet intervention on metabolic, hormonal and anthropometric outcomes in women with PCOS and a BMI ≥ 25 kg/m². Women with PCOS and a BMI ≥ 25 kg/m2, aged 18–45 years, were randomized to either an ad libitum MedDiet or a Healthy Eating (HE) control, consistent with the Australian Dietary Guidelines. The 12-week intervention incorporated fortnightly, personalized dietary consultations and tailored resources. Primary outcomes were measures of feasibility, and included items such as recruitment metrics, data collection methods, and intervention adherence. Acceptability was examined using semi-structured interviews and surveys. Independent samples t-tests were used to assess between group differences. Qualitative data from audio-recorded interviews were transcribed verbatim and analysed using framework analysis. Feasibility outcomes were reported narratively. Study promotion resulted in n = 380 interested individuals; a total of n = 26 were randomised to either a MedDiet (n = 12) or HE (n = 14) control. Data collection was mostly appropriate as demonstrated by the collection of 100% of anthropometric and biochemical data; however, only 69% of 4-day food records were returned. Participants reported the intervention as acceptable, and adherence was enhanced through individualized counselling and the provision of practical resources. At week 12, adherence was significantly greater in the MedDiet group compared to the HE control (8.1 ± 2.4 vs. 4.6 ± 1.0; p = 0.002). Adherence significantly improved from baseline to week 12 for both groups (MedDiet; Baseline: 3.67 ± 1.32; Week 12: 8.11 ± 2.37; p < 0.001; HE; Baseline: 3.57 ± 1.27; Week 12: 4.57 ± 0.98; p = 0.02). Our study provides valuable knowledge and preliminary evidence related to the acceptability and feasibility of a MedDiet intervention in PCOS. However, larger and adequately powered clinical trials are needed to inform clinical practice guidelines, which also consider feasibility issues identified in the present study, including participant recruitment and the collection of dietary intake data.

Evidence-based medicine (EBM) has become the dominant mode of validation in health research, with the randomized control trial (RCT) the gold standard tool for treatment evaluation. This article traces the slow but certain rise of the RCT in Britain since 1948, where evidence was inextricably linked with management of the National Health Service, socialized and free at the point of use. It uses the 1971 publication and reception of epidemiologist Archie Cochrane’s book Effectiveness and Efficiency: Random Reflections on the Health Service as a lens through which to understand the political and clinical motivations for applying EBM in the health service, reducing clinical autonomy in order to ensure cost efficiency. Cochrane’s work had a direct causal link to the establishment, in 1998 under New Labour, of the National Institute for Clinical Excellence (NICE), a body that used a mixture of RCT evidence, stakeholder engagement and cost–benefit analysis to determine treatment approval, and which was made possible by 1990s innovations in information technology and library science. The article argues that there was a strong connection between evidence-based medicine based on RCTs and socialist medical thought in Britain, in relation to validation, the regulation of market interests and restriction of consumer choice, in order to maintain the economic feasibility of a socialized health service.

The high prevalence of obesity, combined with the wide availability of large serving sizes of energy-dense and nutrient-poor discretionary foods, highlights the need for effective interventions. Emerging evidence has demonstrated the impacts of on-pack visual cues on portion size selection and subsequent food intake(1). For instance, transparent packaging and on-pack food imagery are powerful cues that attract consumers’ attention and drive purchase intentions(2). Exaggerated on-pack food images, larger than the suggested serving size stated on the nutrition information panel, have been associated with increased consumption(3). Partitioning and resealability show promise in supporting better portion control(4). However, there is limited research assessing the presence of visual cues on discretionary food packaging. This audit study aimed to identify on-pack visual cues that serve as portion size indicators in share-packs of discretionary snack foods in Australian supermarkets. On-pack nutritional information and visual cues were collected for six categories of common snack foods, including ice-cream, chocolate, lollies, sweet biscuits, savoury biscuits, and crisps. Data were collected from major Australian supermarket chains via online website search and in-person visits between 2022 and 2024. Visual cues of interest were classified into two groups; ‘indicators promoting intake’ (including exaggerated front-of-pack images and package transparency), and ‘indicators supporting portion control’ (including the presence of front-of-pack serving size suggestions, resealability, and partitioning). A total of 1372 share-packs were recorded and analysed. The majority of share-packs included a front-of-pack image (84%) with these images being exaggerated in approximately half of these products, predominantly in lollies (71%) and chocolate (61%). Package transparency was featured on one-fifth of share-packs and more frequently observed in lollies (54%) and savoury biscuits (34%). In contrast, indicators supporting portion control were minimal, with front-of-pack serving size suggestions present on 16% of packs. Resealability and partitioning were present in few food categories; for example, 60% of chocolates featured resealable packaging or partitioning. These features were less common in lollies, sweet biscuits, and crisps (< 15%). In conclusion, the findings indicated that visual cues on discretionary food packaging were more commonly used to promote intake rather than to support portion control. Future efforts should focus on developing consistent, practical on-pack visual cues, and establishing clear guidance to promote appropriate portion size selection of discretionary foods.

Inclusive global theories of child development require local researchers who spearhead research within their own communities. This means creating pathways for researchers from underrepresented contexts to lead projects, define priorities, and collaborate as equal partners, rather than merely act as data collectors. This capacity-building holds the promise of generating more accurate and equitable developmental science research.

Greenhouse gas (GHG) emissions significantly affect the environment, public health, and socioeconomic systems. Many countries and organizations have launched sustainable strategies to ease damaging consequences caused by the global climate change. Food services contribute greatly to greenhouse gas emissions. Service factors involved are food waste, the type of food service provided, and the use of single-use plastic products. For example, a single-use plastic food container related greenhouse gas emissions ranges from 0.16 to 0.48 kg CO2e. We have encouraged staffs to use reusable food containers since July 2024, and we shared the related information with all of staffs via emails and official website. This study aimed to evaluate the impact of sustainability initiatives—particularly the promotion of reusable food containers and a variable price buffet system. In our staff restaurant, 3 types of food services were in place: (i) variable price buffet service, (ii) fixed price canteen service, and (iii) fixed price box lunch. Data were first collected from July 2023 to December 2024, and then analysed according to the following 4 aspects: (i) the average number of lunches consumed each day, (ii) the amount of reusable food containers used, (iii) the reduction of greenhouse gas emissions, and (iv) an observation of food waste in food services. Statistical analysis was carried out using the SPSS software, version 22. We found that in 2024, the restaurant provided 1,200 to 1,800 meals/day during lunch time. Within these meals, 37.1% were from variable price buffets, 18.8% were from fixed price canteen, and 44.1% were from fixed price box lunches. First, in 2024, the use of reusable food containers in the variable price buffet averaged at 50% (47.9% to 56.3% on a monthly basis). In comparison to the period July to December 2023, our results show a significant increase in use of reusable food containers from July to December in 2024 (p < 0.05). Second, from July to December 2024, an estimated GHG emission reduction of 15,387–46,163 kg CO2e. Finally, based on the observation of food waste in different types of food services, there was almost no food waste in variable-price buffet service. In the literature, Matzembacher et al. have reported that the variable-price buffet service generates 116% less avoidable food wastes when compared with the fixed price canteen service(1). With the increasing public awareness of sustainable practices aimed at environmental protection, the adoption of reusable food containers and a variable-price buffet model effectively reduced plastic waste and GHG emissions. These initiatives included the implementation of a variable price buffet service to reduce food wastes and minimizing single-use plastic items and carbon footprints.