To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The World Health Organization (WHO) has a global initiative to eliminate industrially produced trans fatty acids (iTFAs) from the food supply (1). Formed via the partial hydrogenation of vegetable oils to create hardened vegetable fat, iTFAs can be found in processed foods including fried foods and baked goods. Even small amounts of iTFAs can increase the risk of coronary heart disease. These can be successfully eliminated from the food supply with the WHO recommending a ban on partially hydrogenated oils or to limit iTFA in food to a maximum of 2% of total fat (1). As of June 2024, over 50 countries had one of these regulatory measures in place. The trans-Tasman Food Regulation System is considering policy options to ensure iTFAs are eliminated or reduced as much as possible from the food supply in Australia and New Zealand. Up to date data on the presence of iTFAs in the New Zealand food supply is needed to inform this work as this was last measured in New Zealand in 2007/09 for packaged food and 2013 for fast food. The aim of this survey was to determine the presence and levels of iTFAs in the New Zealand food supply. Since it is not possible to analytically quantify iTFA separately from trans-fats that occur naturally in food products of ruminant origin, such as dairy, beef and lamb products, the sampling plan was designed to target products likely to contain predominately iTFA and adapted from the WHO global protocol for measuring trans fatty acid profiles of foods(2) to the New Zealand context. The survey analysed the trans-fat content of 627 products across national supermarkets (275 products), international supermarkets specialising in imported foods (149 products) and ready-to-eat food outlets (203 products from three regions). One hundred and six products (16.9%) contained trans-fat that exceeded 2% of total fat. Twenty-five (4%) of these products were likely to contain predominately iTFA. The 25 products predominately containing iTFA included eight products from national supermarkets (mostly bakery products), nine products from international supermarkets (mostly curry pastes and biscuits) and eight products from ready-to-eat food outlets (all fried foods). The median trans-fat content of these 25 products was 3.2% of total fat (assumed to be all iTFA). Over a third of these products contained more than double the recommended WHO limit, with five products containing over four times the limit and one product containing more than 16 times the WHO limit. The remaining 81 products may contain some iTFA, but we were unable to quantify the amount. The results from this survey will be used by New Zealand Food Safety to inform the consideration of regulatory options for reducing iTFAs in foods in New Zealand.
Although current estimates suggest that global food production is enough to meet nutritional needs, there are still significant challenges with equitable distribution(1). Tackling these disparities is essential for achieving global nutrition security now and in the future. This study uses the DELTA Model® to analyse global nutrient supply dynamics at national resolution and address nutritional shortfalls in specific countries(2). By examining the distribution of food commodities and nutrients in 2020, we project the future food and nutrient production needs for 2050 to ensure adequate global supply. Our findings indicate that while some nutrients are sufficiently supplied on a global scale, many countries face significant national deficiencies in essential nutrients such as vitamins A, B12, B2, potassium, and iron. Addressing these gaps will require substantial increases in nutrient supply or redistribution. For example, a 1% increase in global protein, targeted at countries with insufficient protein, could close the 2020 gaps. However, if current consumption patterns persist, the global food system will need a 26% increase in production by 2050 to accommodate population growth and changing consumption patterns. Our study developed a framework for exploring future production scenarios. This involves reducing surplus national nutrient supply linearly over decades while simultaneously increasing production of undersupplied nutrients. This framework provides a more practical assessment of future needs, transitioning from idealized production scenarios to realistic projections. Our study investigated a potential future for nutrient supply to meet minimum requirements by 2050. Calcium and vitamin E are crucial, and production must be increased to address significant gaps, given their severe deficiencies in 2020. Energy and fibre production will be required to peak between 2030 and 2040 before stabilizing back near 2020 levels. Predicted changes in nutrient supply from 2020 to 2050 vary: while calcium and vitamin E will need to increase, phosphorus, thiamine and the indispensable amino acids can decrease without compromising global nutrition with only minor redistribution. These results are essential for determining the food supply required to achieve adequate global nutrient supply in the future. Incorporating these insights into global food balance models will provide key stakeholders with evidence, refine future projections, and inform policy decisions aimed at promoting sustainable healthy diets worldwide.
The Brazil nut tree Bertholletia excelsa is an icon of Amazon conservation through sustainable use. Moderate disturbance, such as that caused by swidden agriculture, favours this heliophilic species. Our systematic literature review of Bertholletia studies and historical records addresses the following questions: do slash-and-burn farming systems increase Bertholletia density and growth? What do historical records reveal about the links between Bertholletia life history and human occupation? And what policies and regulations shape the current context for harnessing this synergistic potential for sustainable use? Compared to mature forests, slash-and-burn fallow seedling/sapling densities (11–82 individuals ha–1, with a mean of 29 individuals ha–1) are greater and faster-growing. Extant Bertholletia trees that were cut and burned during swidden preparation resprout as forked individuals and supplement new seeds buried by Dasyprocta spp. The presence of large forked Bertholletia trees and the occurrence of anthropogenic soils, particularly brown soils associated with Brazil nut tree groves, provide evidence that extant Bertholletia groves may be islands of active and passive agroecological management by ancestral Indigenous populations and local communities. This supports the notion that conservation through sustainable use can maintain Amazonian megadiversity. Furthermore, fire has been used in the Amazon since the onset of crop cultivation (including Bertholletia) c. 4500 years ago, suggesting that a more effective approach than banning fires would be to implement a systematic and methodical fire and fuel management strategy, given the ineffectiveness of command-and-control policies in this regard. The 124 conservation units and Indigenous lands in the Amazon containing Brazil nut trees reinforce the importance of policies to create protected areas. Evidence suggests that the presence of an Amazonian biocultural forest – a phenomenon resulting from the interaction between human activities and natural processes – can be sustainably used to promote what might be termed ‘sociobiodiversity conservation’.
The nutrition workforce plays a vital role in disease prevention and health promotion, with expanding job opportunities shaped by factors like aging populations, climate change, global food systems, and advancing technologies(1,2). Preparing students for careers that require adaptability involves understanding the valuable skills they possess and identifying any gaps. This research aimed to identify the skills and knowledge valued by students who had recently completed work-based placements, and explore recent graduates’ experiences, challenges, and preparedness for employment. At the end of their work-based placements students give presentations sharing their experiences and learning. Permission was sought from ten students to analyse the recordings of these presentations. The presentations were selected to include a range of nutrition fields, including sports nutrition, public health, community nutrition, dietary counselling, food and industry, and nutrition communication. Additionally, a list of graduates (within four years of graduation) from various fields (as above) was compiled and they were invited to participate. Semi-structured interviews (n=10) were conducted online via Zoom and recorded. The interview guide included open-ended questions on employment experiences, challenges, preparedness, and required skills. The interviews, transcription and analyses were completed by two student researchers between November 2023 and February 2024. Thematic analysis using NVivo software was used to identify themes. The themes developed included the importance of skills relating to; i) communicating complex nutrition concepts to the public, ii) collaborating within diverse teams, iii) identifying and filling personal knowledge gaps. In addition Graduates felt practical experience from their University study boosted their preparedness for the workforce, though many struggled to apply their skills in non-traditional roles and expand their career scope. In summary, ongoing focus on team-based projects, communication with non-science audiences, and strategies for continuous learning using evidence-based sources are crucial for both undergraduate and postgraduate education.
Head and neck cancer (HNC), characterised by malignant neoplasms originating in the oral cavity, upper aerodigestive tract, the sinuses, salivary glands, bone, and soft tissues of the head and neck, is diagnosed in approximately 600 people annually in New Zealand. Although HNC is a less common cancer, it has a profound effect on almost all aspects of the lives of those affected, particularly the nutritional and social domains. This is due to the common treatment modality being surgery and/or radiotherapy, which can result in major structural and physiological changes in the affected areas, which in turn affects chewing, swallowing, and speaking(1). Specific nutrition impact symptoms (NIS) of HNC have been identified and are significant predictors of reduced dietary intake and malnutrition risk(2). We aimed to identify and describe the malnutrition risk, prevalence of NIS, and protein and energy intake of community living adult HNC survivors 6 months–3 years post treatment in New Zealand. Participants were recruited through virtual HNC support groups in New Zealand. A descriptive observational case series design was used. Malnutrition risk was determined using the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF). Malnutrition was defined as a PG-SGA SF score between 2 - 8 (mild/suspected - moderate malnutrition) or ≥9 (severely malnourished). NIS were obtained via a validated symptom checklist specific for HNC patients(3), and dietary data was collected using a four-day food record. Participants (N=7) are referred to as PTP1 – PTP7. PTP1 was well-nourished. PTP3 through PTP7 were categorised as mildly/suspected to moderately malnourished (scores ranged from 2-7), and PTP2 was severely malnourished (score of 16). NIS were experienced by all seven participants, with “difficulty chewing” and “difficulty swallowing” being the most selected and highest scored NIS that interfered with oral intake. PTP2 (severely malnourished) scored loss of appetite, difficulty chewing, and difficulty swallowing highly (interfering “a lot”), indicating a high degree of prevalence and impact. Despite being well-nourished, PTP1 had inadequate energy intake (85.5% of their estimated energy requirement (EER)). PTP2, 3, 6, and 7 also had inadequate energy intake (79.3%, 79.3%, 73.9%, and 99.3%, respectively, of their EER). All participants had adequate protein intake based on a range of 1.2-1.5 g/kg body weight per day. The prevalence of malnutrition and NIS in this case series indicates an urgent need for research to identify the true extent of malnutrition in community living HNC survivors post treatment.
In New Zealand, Māori and Pasifika have the lowest foodborne illness notification rates (per 100,000 people) for most foodborne illnesses(1); with underreporting of illness and differing food safety practices as possible factors. New Zealand Food Safety (NZFS) is responsible for regulating the New Zealand food safety system to make sure food is safe and suitable for all New Zealanders. Supporting consumers to make informed food choices and understand safe food preparation practices is a key priority for NZFS(2). As part of this, NZFS communicates food safety advice through various traditional channels including published material and campaigns.To better understand consumer attitudes, knowledge and behaviours around food safety and suitability, NZFS conducted an online survey of 1602 New Zealanders 15 years and over between 24 November and 17 December 2023. The survey used a quota sampling method and included booster samples for Māori and Pasifika. The margin of error was ±2.9% at a 95% confidence interval. The survey was available in English and Te Reo Māori.(3). The study highlighted key insights into food safety practices for Māori and Pasifika. For example, NZFS advises consumers not to wash raw chicken due to the potential for cross-contamination during food preparation. In the survey(3), we found that 67% of consumers who prepare chicken said they washed it either sometimes or always; further, 79% of consumers who prepare chicken believe they should. The most common reason for washing raw chicken was because of hygiene (23%). Even though NZFS messaging is clear to not wash raw chicken, it is concerning that the advice is not adhered to, and the risks are not recognised. In the survey, Pasifika who prepare chicken were more likely to say they wash raw chicken either sometimes or always (79% of Pasifika). As a food safety regulator, it is important to understand our Māori and Pasifika consumers and their perceptions, knowledge and behaviours around food safety practices, but also to consider how we can communicate effectively with them. For example, of the food safety information sources most trusted, Māori were more likely to trust friends, family and or whanau (49%), and Pasifika were most likely to trust health professionals (53%)(3). With a view of trying to better understand our Māori and Pasifika consumers models such as Te Whare Tapa Wha(4) (the Māori Health Model) provide an important and holistic view of health-based concepts of taha whanau (family and social wellbeing), taha tinana (physical wellbeing), taha hinengaro (mental and emotional wellbeing) and taha wairua (spiritual wellbeing). There are opportunities for NZFS to reflect on and use Te Whare Tapa Wha throughout the survey development and implementation process, through to the delivery of targeted food safety messages.
‘I just don’t know what to eat!’ is a frequent statement from people seeking nutrition support. With a magnitude of information available, confusion and limited confidence is a common complaint. People face myriad challenges in their attempts to have a healthy diet, including cost and time constraints, challenging food environments, and limited knowledge and skills(1). Challenges about eating well are often raised, yet enablers to eating well are not as readily discussed. Intention for healthy behaviours, self-efficacy and social support are examples of favourable elements which support healthy diets(1,2). As such, existing knowledge, skills, and positive influences should also be considered. As part of a wider qualitative study, and using an interpretive description approach, we sought to identify enablers to healthy eating perceived by people engaged with Green Prescription (GRx) and Active Families programmes. Nineteen clients aged 18 years and over, engaged with six GRx services were interviewed between May and October 2023. Eighteen whānau (family) members, (19-53 years) attending Active Families sessions facilitated in the Waitematā area participated in focus group discussions during May-August 2024. Participants were asked in these discussions (kōrero) to share what helps them and their whānau to eat well. Braun and Clarke’s(3) thematic analysis approach was used to analyse responses from these kōrero through data familiarisation, coding, and cyclical review of thematic relationships. Several themes were identified in this analysis: ‘confidence in personal skills,’ ‘supportive environments’, and ‘being open and willing’. Personal skills such as planning meals, managing household budget and efforts to procure ‘good’ food were identified as strengths. These wider food skills have been suggested as potentially more important to enhancing dietary behaviours than cooking skills(4). Participants relayed experiences of developing skills that improved their confidence in eating well including growing, gathering and preserving food, experimenting with recipes, and knowing where to find affordable, nutritious food. Environments where people learned food and cooking skills and household members supported their endeavours to eat well were described as influential to encourage people in their efforts. Participants also expressed that being open to trying new foods and ways of eating led to inspiration and new knowledge. This attitude resulted in increased variety in the diet and further enhanced confidence to seek recipes and food information and spurred on efforts to make changes. People who have sought nutrition advice have often expressed challenges and uncertainty impacting their efforts to eat well. Nevertheless, there are also strengths which have meaningful impact on their eating. In nutrition advice provision, it would be beneficial to thoroughly explore the strengths people exhibit to support healthy eating. Identifying these insights may powerfully effect people’s confidence to eat well and identify more effective support and information provision.
Modal concord refers to the phenomenon where the co-occurrence of two modal elements with the same flavor and force (e.g. may possibly, must certainly) gives rise to the interpretation of single modality. Given their (arguably) equivalent semantics, constructions with modal concord and single modal (e.g. may, must) can function as alternative choices in different contexts of use – how do speakers choose between them, and how is the choice perceived? In this article, we take a ‘Register’ approach and report an experimental study of MC in US English, addressing their linguistic and social meanings with versus without situational context. The results show that (i) modal concord constructions differ from single modal ones in linguistic meanings, which casts doubt on the concord assumption, and (ii) modal concord has distinct social meanings from those of single modal constructions. Our findings suggest a correlation between the meaning strength of a linguistic expression and the social perception about the speaker. Context, manipulated via the single situational parameter of interlocutor relation (close vs. distant), did not interact with the linguistic or social meaning of modal concord constructions, the implications of which are discussed in relation to the multidimensional nature of conversational situations and the method applied.
FODMAPs (Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols) are indigestible, short-chain carbohydrates fermented in the large intestine, causing discomfort in patients with irritable bowel syndrome (IBS). FODMAPs, specifically fructans, galacto-oligosaccharides (GOS), lactose, fructose in excess of glucose, and polyols, are found in fruits, vegetables, grains, milk and their processed products. The aim of this project was to identify the major sources of FODMAPs in the New Zealand diet to guide research into reducing FODMAPs in those major sources. FODMAP data were collected from the New Zealand Food Composition Database(1), in-house data and published sources(2-5). NZ food consumption data were sourced from multiple published sources. Estimated potential dietary intake of FODMAPs in NZ was calculated in grams per capita per annum. Foods and beverages were ranked to ascertain major FODMAP sources within each food group. Without replicated data for individual foods, inferential statistical analysis was not possible. NZ food consumption data on a per capita per annum basis is limited, therefore consumption data were calculated based on serving size and serves per day per capita for some foods. Comprehensive FODMAP data are not available for NZ foods and beverages. In terms of FODMAP data, the New Zealand Food Composition Database(1) contains only fructose and glucose data (to calculate excess fructose) and lactose data. The main cereal and grain source of FODMAPs is wheat flour (763–831 g fructan) and the main cereal-based product sources are breads (55–1194 g fructan, up to 121 g excess fructose and 55–159 g GOS) and breakfast cereals (60–525 g fructan, up to 99 g excess fructose, up to 159 g GOS, and 2409 g lactose if consumed with cow’s milk). The main fruit source of FODMAPs is apples, providing up to 456 g excess fructose and 68–81 g sorbitol. The main vegetable sources are onion bulb (134–662 g fructan), cauliflower (131 g mannitol) and mushroom (53 g mannitol). Consumption data for garlic were unavailable. Cow’s milk is the main source of lactose (4516–5259 g), followed by ice cream (415–937 g), cheeses and butter. The main beverage sources are milk and milk-based café-style coffee (1407–4220 g lactose) and apple-based fruit juices (486–836 g excess fructose). Little data exist for sweeteners and confectionery. Honey and pear juice (containing excess fructose) are sources, as are artificial sweeteners such as erythritol, maltitol and xylitol (i.e. polyols), commonly found in chewing gum, diabetic and low-carb food products. Milk chocolate contributes to lactose consumption. More comprehensive New Zealand food consumption data (on a per capita per annum basis) are required to obtain a more accurate picture of dietary FODMAP intake. Adding oligosaccharide and polyol data to the New Zealand Food Composition Database would be beneficial to provide complete FODMAP data of New Zealand foods.
New Zealand ranks among the highest globally for childhood obesity(1). One of the main platforms to maximize the prevention of child excess adiposity is the establishment of healthy diets in early life(2,3). Despite this recommendation, Aotearoa has limited information on children’s whole diet quality and its associations with child healthy weight. This study explored the associations between dietary patterns and indicators of excess adiposity among 4.5-year-olds within the Growing Up in New Zealand birth cohort study (n= 6,048, 98.2% of the children who took part of the 4.5-year data collection wave). At 4.5 years, two dietary patterns were previously derived and described: “Refined, high in sugar, sodium and fat” and “Fruit and vegetables”(4). The indicators of excess adiposity examined at 4.5 years were body-mass-index-for-age (BMI/A) (>+2 z-score) and waist-to-height ratio (WtHR) > 90th percentile. Information on child and maternal sociodemographic and maternal health behaviour characteristics was sourced from the antenatal and the 4.5-year-interviews. Children’s scores in both dietary patterns were ranked in tertiles. Multiple Poisson regressions with robust variance were performed to examine the associations between the dependent variables (BMI/A z-score >+2 and WtHR >90th percentile) and the independent variables (dietary patterns), adjusted by child and mother characteristics (IBM SPSS software). Sensitivity analyses excluding children with outliers for BMI/A (<-5 z-score or >+5 z-score) was also performed. Findings were reported as adjusted risk ratio (RR) and 95% confidence intervals (CIs). Children in the highest tertile of the “Refined high in sugar, salt and fat” dietary pattern were more likely to be overweight/obese (BMI/A) compared to children in the lowest tertile (RR:1.51; 95% CI: 1.20-1.90; p<0.001). This significant association was confirmed in the sensitivity analyses (RR:1.49; 95% CI: 1.18-1.89; p <0.001). There were no significant associations between this dietary pattern and WtHR > 90th percentile nor between the “Fruit and vegetables” dietary pattern and the indicators of child excess adiposity. This study provided nationally generalizable information that poor diet quality in early life is associated with child excess adiposity. National strategies to prevent childhood obesity need to encompass approaches to reduce the availability and intake of refined foods and those high in sodium, sugar and unhealthy fats in children.
In Aotearoa New Zealand, approximately 1 in 3 adults and 1 in 8 children are classified as obese, with Māori and Pacific communities disproportionately affected(1). While maternal nutrition has been extensively studied, paternal impacts and the combined effect of both parents’ obesogenic environments on offspring health remain underexplored(2). The primary objective of this study is to characterise the metabolic phenotype of parent rats fed a High Fat High Sugar (HFHS) diet and investigate the birth characteristics of their offspring, from a factorial mating design.Eighty female and 40 male Sprague-Dawley rats were randomised to a standard chow diet (SD) (24% protein, 18% fat, 58% carbohydrates) or HFHS diet (Specialty Feeds SF23-120: 16% protein, 41% fat, 43% carbohydrates) for five weeks prior to mating. Females were then continued on their respective diets throughout pregnancy and lactation. Four mating combinations were established: SDmum-SDdad, SDmum-HFHSdad, HFHSmum-SDdad, and HFHSmum-HFHSdad. A subset of parents (n=38) underwent body composition assessments using dual-energy X-ray absorptiometry (DEXA). Additionally, a subgroup (n=23) was evaluated for metabolic profiles using Prometheon metabolic cages. Offspring birth weights and body lengths were recorded. The HFHS diet’s efficacy was confirmed in both male and female rats, with HFHS groups showing higher body weight (females: 327.1 g ± 19.7 vs. 288.2 g ± 20.1; males: 575.8 g ± 39.8 vs. 532.6 g ± 50.3; p < 0.05), greater fat percentage (females: 46.8% ± 5.6 vs. 29.2% ± 5.6; males: 40.5% ± 7.2 vs. 28.7% ± 6.8; p < 0.001), and a lower respiratory exchange ratio (RER) (females: 0.8108 ± 0.0275 vs. 0.8679 ± 0.0288; males: 0.8257 ± 0.0304 vs. 0.8759 ± 0.0266; p < 0.05) compared to the SD group. In male offspring, birth weights in HFHSmum-SDdad (6.3 g ± 0.9) and HFHSmum-HFHSdad (6.0 g ± 0.9) groups were significantly lower (p < 0.0001) than in SDmum-SDdad (6.980 g ± 0.7753) and SDmum-HFHSdad (7.0 g ± 0.7) groups. Birth weights were further reduced in HFHSmum-HFHSdad versus HFHSmum-SDdad (Mean Diff. = 0.3g; p < 0.05).Body lengths in HFHSmum-HFHSdad males were shorter (43.1 mm ± 3.2; p < 0.0001) compared to other groups (≥ 45.3 mm). Female offspring birth weights were lower in the HFHSmum-SDdad (5.8g ± 0.8) and HFHSmum-HFHSdad groups (5.8 g ± 0.9; p<0.0001) compared to the other groups (means ≥ 6.4g) but paternal HFHS diet had no additional effect on birth weight. As with males, body lengths in the HFHSmum-HFHSdad female offspring were significantly shorter (4 mm ± 3; p<0.0001) compared to all other groups (≥44mm). Parental HFHS diets synergistically reduce offspring birth length and weight, with stronger effects in males. These findings underscore the importance of inclusive dietary guidelines for both parents to reduce intergenerational obesity risk and support long-term health.
The Tohu Manawa Ora | Healthy Heart Award programme helps early learning services across Aotearoa create an environment that promotes nutritional health and physical activity. It achieves a sustainable change to the environment by using a ‘whole-service’ approach, through governance and management, learning and teaching, collaboration and professional development. The programme aims to foster happy tamariki with awareness of how to have hearts fit for life, ensuring healthier futures for whānau across Aotearoa New Zealand. To evaluate and understand the impact and social value of the Tohu Manawa Ora | Healthy Heart Award programme on fostering healthy habits and creating supportive environments in early learning settings across Aotearoa New Zealand the Heart Foundation undertook this evaluation with ImpactLab. Two hundred and fifteen early learning services and 33,717 tamariki across Aotearoa New Zealand, who were enrolled in or had achieved a Tohu Manawa Ora | Healthy Heart Award, were used to determine the impact and social value of the programme. This was achieved through using a social value calculation which integrates multiple data sources and analytical methods. Firstly, impact values derived from the programme were combined with evidence from global literature on the effectiveness of similar health promotion programmes. Secondly, the size of the opportunity for participants—early learning services across Aotearoa New Zealand—to achieve more positive health outcomes was assessed. Thirdly, the number of people supported by the programme was considered. Every year, the Tohu Manawa Ora | Healthy Heart Award programme delivers $6,163,581 of measurable good to society in New Zealand. Outcomes for tamariki of improved oral health, physical activity and reduced diabetes and improved physical activity for whānau directly contribute to the social value. Improved health equity, nutrition, increased food exposure and physical activity, promotion of lifelong wellbeing and positive health behaviours, reduced cardiovascular disease and sugar consumption indirectly contributed to the social value. This means that every dollar invested in the Tohu Manawa Ora | Healthy Heart Award programme delivers $4.50 of measurable good to New Zealand. The Tohu Manawa Ora | Healthy Heart Award programme delivers significant measurable social value to Aotearoa New Zealand. Growth, development and continued funding of the programme should continue to further positively impact the future of tamariki and their whānau in Aotearoa New Zealand.
We assessed whether the motor component of the Glasgow Coma Scale (GCSm) is independently associated with unfavorable outcomes in aggressively treated poor-grade subarachnoid hemorrhage (SAH) patients.
Methods:
Retrospective cohort of poor-grade SAH patients (World Federation of Neurosurgical Societies (WFNS) grades IV and V). The best GCSm score achieved within 24 h of admission was stratified into four categories (<4, 4, 5 or 6). Outcomes were classified as favorable [modified Rankin Scale (mRS) ≤ 2] or unfavorable (mRS ≥ 3). Multivariable logistic regression was performed to identify independent predictors of unfavorable outcome.
Results:
A total of 179 patients were admitted during the study period (mean age 55.9 ± 12.1; 68.2% female). Thirty-three patients (33/179 – 18%) died before aneurysm treatment, one patient had missing GCSm data at 24 h and sixteen patients (16/179; 9%) were lost to follow-up. One hundred and twenty-nine patients (129/179 – 72%) were included in the final analysis. No patient with GCSm < 4 had a favorable outcome (sensitivity 22.4%, specificity 100%, positive predictive value 100% and negative predictive value 67.8% for unfavorable outcome). Delayed cerebral ischemia-related cerebral infarction (odds ratio (OR) 4.06; 1.56−11.11 95% CI, p = 0.004) and the best GCSm score were independently associated with unfavorable outcome. There was a stepwise decrease in the rate of unfavorable outcome from GCSm < 4 to GCSm = 6 (<4 = 100%; 4 = 80%; 5 = 46% and 6 = 20%). Each one-point decrease in GCSm score was associated with an OR of 3.52 (1.77−7.92 95% CI, p = < 0.001) for unfavorable outcome.
Conclusion:
The GCSm score was independently associated with unfavorable outcome. All patients with a GCSm score < 4 experienced an unfavorable outcome.
Dietary protein provides amino acids, nine of which are indispensable (IAAs) as they are not synthesised within the body. Adoption of a vegan diet has shown an increased trend in several Western countries.(1) Past assessments of total protein intake of vegan populations were found to be low but not necessarily below daily requirements.(2) However, plant-sourced proteins generally have lower quantities of digestible IAAs as compared to animal-sourced proteins.(3) Simply accounting for protein intake without considering amino acid profile and digestibility could overestimate protein adequacy among vegans. This study aims to quantify protein intake and protein quality (digestible IAAs) among a cohort of NZ vegans as compared to individual requirements. Dietary intake data was obtained through a four-day recall from 193 individuals participating in a cross-sectional study of adult vegans (above 18 years) residing in New Zealand who have followed a vegan diet for at least two years. Ethical approval was granted (HDEC 2022 EXP 12312). Anthropometric data was collected at Massey University, Auckland. Protein and IAA composition of all foods were derived by comparing dietary data to food composition data from New Zealand FoodFiles and the US Department of Agriculture. Mean values for protein and IAA were adjusted for true ileal digestibility and body weight (kg).(4,5) Mean protein intakes for males and females were 0.99 and 0.81 g/kg of body weight/day, respectively. Overall, 78.8% of males and 74.5% of females met the Estimated Average Requirement (EAR) for daily protein. Plant-sourced proteins in the vegan diet provided 52.9 mg of leucine/g of protein and 35.7 mg of lysine/g of protein, which were below the reference scoring patterns (leucine: 59mg/g, lysine: 45mg/g).(5) When adjusted to individual body weight, average IAA intakes were above daily requirements, but lysine just met requirements at 31.2 mg/kg of body weight/day (reference: 30 mg/kg/d). The importance of adjusting for digestibility is noted as the percentage of vegans meeting adequacy for protein and IAAs decreased as compared to using only IAA compositions without this adjustment. In contrast to grains and pasta, legumes and pulses were the foods that contributed most to overall protein and lysine intake while providing lower energy intake. Lysine followed by leucine were the two most limiting IAAs in the diet of this NZ vegan cohort. Increased proportion of legumes and pulses, and decreased proportion of grains and pasta within the diet can potentially increase leucine and lysine intake but must be considered in the context of the whole diet.
The significance of human milk in an infant’s diet is well-established, yet accurately measuring human milk intake remains challenging. Current methods are either unsuitable for large-scale studies, such as the dose-to-mother stable isotope technique, or rely on set amounts of human milk, regardless of known variability in individual intake(1). There is a paucity of data on how much infants consume, particularly in later infancy (>6 months) when complementary foods have been introduced. This research aimed to estimate human milk intakes and total infant milk intakes (including infant formula) in New Zealand infants aged 7-10 months, explore factors that predict these intakes, and develop and validate equations to predict human milk intake using simple measures. Human milk intake data were obtained using the dose-to-mother stable isotope technique in infants aged 7-10 months and their mothers as part of the First Foods New Zealand study (FFNZ)(2). Predictive equations were developed using questionnaire and anthropometric data (Model 1) and additional dietary data from diet recalls (Model 2)(3). The validity of existing methods to estimate human milk intake (NHANES and ALSPAC studies) was compared against the dose-to-mother results. FFNZ included 625 infants, with 157 mother-infant dyads providing complete data for determining human milk volume. Using the dose-to-mother data, the measured mean (SD) human milk intake was 785 (264) g/day. Older infants had lower human milk and total milk intakes, male infants consumed more total milk. The strongest predictors of human milk intake were infant age, infant body mass index, number of breastfeeds a day, infant formula consumption, and energy from complementary food intake. When the predictive equations were tested, mean (95% CI) differences in predicted versus measured human milk intake (mean, [SD]: 762 [257] mL/day) were 0.0 mL/day (-26, 26) for Model 1 and 0.5 mL/day (-21, 22) for Model 2. In contrast, the NHANES and ALSPAC methods underestimated intake by 197 mL/day (-233, -161) and 175 mL/day (-216, -134), respectively. The predictive equations are presented as the Human Milk Intake Level Calculations (HuMILC) tool, designed for use in large-scale studies to more accurately estimate human milk intakes of infants. The use of objective quantifiable assessment methods enhances our understanding of infant human milk intakes, improving our ability to accurately assess nutritional adequacy in infants.
Food security constitutes a worldwide concern closely correlated with population growth. By 2050, the global population is expected to reach 9.3 billion(1). The rising population, along with increasing life expectancy and shifts toward Western dietary patterns, is expected to drive higher food demand and contribute to a rise in metabolic conditions(2). In this context, looking for alternative and sustainable food and protein sources is imperative. Pasture legumes including lucerne (Medicago sativa) and red clover (Trifolium pratense) are becoming popular as they can be used as an alternative protein and functional food source. Both crops play an important role in New Zealand’s agriculture. Their seeds can be used in human nutrition as alternative food and protein options; however, the presence of anti-nutritional factors (ANF) and their distinct taste make them less favourable for human consumption. Fermentation can be used as a possible strategy to mitigate these limitations. Lactobacillus fermentation was conducted using Lactocillus plantarum, Lactobacillus. acidophilus and Lactobacillus. casei. Proximate composition and mineral content were determined following Association of Official Analytical Chemists (AOAC) methods. Total phenol content (TPC), total flavonoid content (TFC) and antioxidant activity (2,2-Diphenyl-1-picrylhydrazyl and 2,2′-azino-bis-(3-ethylbenzothiazoline-6-sulfonic) acid) and ANF including phytic acid, trypsin, and chymotrypsin inhibition were assessed using colourimetric techniques. For the enzyme inhibition assays, enzyme-substrate reactions were performed with sample extracts before measurement. All the experiments were replicated three times, and the results were expressed as mean ± SD. A factorial analysis of variance (ANOVA) was conducted (4 legume seed samples × 3 LAB cultures) with a Tukey’s post-hoc test for mean comparison at P < 0.05 using IBM SPSS Statistics 29.0. All the legume seeds demonstrated high nutritional content, with crude protein and fibre levels around 40 and 16% respectively. The seeds were also rich in minerals, particularly magnesium, phosphorus, iron and zinc. In addition, fermentation led to an increase (P < 0.05) in TPC, TFC and antioxidant activity, while significantly reducing ANF. For instance, fermentation led to an increase in TPC (18.8 to 47.1% increase), TFC (9.6 to 34.5% increase) and AOA via DPPH and ABTS. Lactobacillus fermentation has proven to be an effective processing technique to enhance the nutritional value of lucerne and red clover seeds. These findings support the potential of using fermentation to develop novel and sustainable protein sources, contributing to improved dietary quality and nutrition. Moreover, further work to study the effect of fermentation on the nutrient digestibility of lucerne and red clover seeds is warranted.
The extraction of salt from seawater is one of the most direct ways of exploiting the marine environment. In the historic period, the production of salt formed an important component of the global economy. In temperate locations such as Ireland, archaeological evidence of extracting salt from seawater comprises a range of expressions and locations dictated by the energy resource required. This article presents the results of the first archaeological excavations of a saltworks complex in Ireland, at two sites that produced salt from the seventeenth to the nineteenth centuries. Partial excavation of a seventeenth-century complex at Ballyreagh Lower revealed a crude structure that was not capable of supplying all of the area’s needs. By contrast, the eighteenth- and nineteenth-century pan site at Broughanlea shows a step-change in scale, efficiency, and infrastructure that reflects new economic networks in a country predominantly relying on agricultural produce.
Food waste is a global problem, with estimates of a third of all food produced going to waste(1). In 2015, the United Nations set Sustainable Development Goal (SDG) Target 12.3, to halve food waste by 2030(2). To reach this goal, following the Target-Measure-Act approach is considered best practice(3). At the University of Otago, in Dunedin, Aotearoa New Zealand, approximately 3,500 students live across 14 fully catered residential colleges. The University of Otago has formally committed to pursuing the SDGs, and therefore reducing food waste. To track progress towards SDG 12.3, baseline measurements of food waste at the residential colleges are required. This research aimed to quantify food waste from the residential colleges, as well as to qualitatively discuss reasons for the waste and potential ideas to reduce waste. On three days at each of the 14 residential colleges, preparation, servery, and plate waste were measured from breakfast, lunch, and dinner, following a protocol developed from the Waste and Resources Action Programme Food Loss and Waste Standard. Additionally, five focus groups were conducted across three residential colleges, with students and staff, to discuss food waste at the residential colleges. An average of 172 g (95% CI 154 g to 191 g) of food waste were produced per student per day, with approximately 50% being plate waste, 35% being servery waste, and 15% being preparation waste. Reinforcing the quantitative data, in the focus groups staff voiced that the plate waste was a concern to them. Ways to reduce plate waste were discussed and included increasing awareness through making the waste more visible, as well as improving communication between kitchen staff and students particularly regarding serving sizes and preferred menu items. Servery waste was also considered, with more consistent forecasting of meal attendance across the residential colleges and a range of solutions for leftovers, such as a fridge for students or donation to other organisations, being suggested. With these baseline measurements of quantities of food waste produced at the University of Otago’s residential colleges, actions taken to reduce and mitigate food waste can be measured for effectiveness, and steps can be taken towards achieving SDG 12.3 collaboratively across the tertiary education sector.
Breastfeeding is the recommended way to feed infants. However, a safe and nutritious substitute for human milk is needed for infants when breastfeeding is not possible. As infants are a vulnerable population group, infant formula products are regulated by prescriptive provisions for composition and labelling. Any changes to the composition of these products must be established as safe prior to being permitted. As our knowledge of human milk expands, infant formula ingredients are developed to better replicate it. Food Standards Australia New Zealand (FSANZ) has assessed the addition of ingredients for the addition to infant formula products including human identical milk oligosaccharides (HiMOs) isolated using precision fermentation methodology. These ingredients are considered to be nutritive substances as their addition to food is intended to achieve specific nutritional purposes. In accordance with the Ministerial Policy Guidelines, FSANZ must assess both the safety and the health effect of nutritive substances for their use in infant formula. FSANZ risk assessments are undertaken by a multidisciplinary team covering toxicological and nutritional considerations using the best available scientific evidence. FSANZ assessments of the health effects concluded that the use of HiMOs in infant formula products would have a beneficial outcome for infants and align with the equivalent role of these substances in human milk(1,2). The weight of evidence supports health effects through an increase in the abundance of Bifidobacterium spp. in the infant gut microbiota, anti-pathogenic effects, inflammatory suppression and facilitation of appropriate immune responses and antigenic memory. FSANZ safety and technical assessments concluded that there are no public health and safety concerns associated with adding HiMOs to infant formula products(1, 2). The permitted levels are comparable to levels in human milk and are chemically and structurally identical to the naturally occurring forms. Food Standards Australia New Zealand, Canberra, 2606, Australia Based on the available evidence and intended purpose, a number of HiMOs have been permitted for use in infant formula products including 2′- fucosyllactose, lacto-N-neotetraose, difucosyllactose, lacto-N-tetraose, 3'-sialyllactose sodium salt, 6'-sialyllactose sodium salt. Evidence continues to emerge on the beneficial effects of HiMOs on infant health.