The eight well-known food security indicators were developed in 1997 using a stepwise process that involved five focus group interviews (one Māori, one Pakeha, two Pacific, and one mixed ethnicity) of 8-16 people, all of whom were either on a low income or were government beneficiaries(1). As part of the development of the tools and methods for a future New Zealand National Nutrition Survey, these eight indicators were considered for inclusion. The Māori and Technical Advisory Groups convened for the development of the National Nutrition Survey foresaw issues with the interpretation of some of the questions given the changes in the food environment and sources of food assistance in the last 25 years and recommended that cognitive testing should be conducted to see if changes were required. Participants were recruited through two community organisations, a local marae, and community Facebook pages. Participants were given the option of participating in a one-on-one interview or as part of a focus group. During each session, participants were asked five (three original and two new) questions relating to food security (running out of basics, use of food assistance, household food preparation and storage resources). After each question, the participants were asked a series of additional probing questions to ascertain whether they had interpreted the question as intended. All interviews were audio recorded and transcribed, and a qualitative analysis was performed on the transcripts to determine areas of concern with each question. A total of 46 participants completed the cognitive testing of the food security questions, including 26 aged 18-64 years, and 20 aged 65+ years. Participants also spanned a range of ethnicities including 8 Māori, 15 Pasifika, 15 Asian, and 8 New Zealand European or Other. Just over half of the participants (n=24) reported themselves to be financially secure, 16 participants reported that their financial security was borderline, 1 participant reported that they were not at all financially secure, and 5 participants declined to answer. Variable interpretations of terms by participants were found in all questions that were tested. Therefore, answers to the food security questions may have not reflected the actual experience of participants. This study also identified other dimensions of food security not assessed by the current eight indicators (e.g., lack of time, poor accessibility). These findings indicate that the food security questions need to be improved to ensure they are interpreted as intended and that new questions are needed that considers all dimensions of food insecurity (i.e., access, availability, utilisation, and stability). These new and amended questions should be cognitively tested in groups that are more likely to be experiencing food insecurity.

The FAO states that the term food sovereignty focuses on food for the people by placing people’s need for food at the centre of policies and insists that food is more than just a commodity. Food Sovereignty also promotes knowledge and skills by building on traditional knowledge; using research to support and pass on this knowledge to future generations; and rejecting technologies that undermine local food systems. It is essentially a movement that “recognizes that control over the food system needs to remain in the hands of producers, and is clearly focused primarily on small-scale agriculture of a non-industrial nature, preferably organic”(1). In Māori terms, Kai Sovereignty is drawn first from the relationship of foods to our needs; it is expressed through whakapapa, and has an overarching contribution to food security. Traditional foods abound in Aotearoa. The relationships are longstanding, expressive and contribute to our wellbeing in various ways(2). But the true cultural value of traditional foods is diminishing as new foods, lifestyles and experiences succeed them. Kai sovereignty therefore is at risk of being relegated to historical discourse. The FAO acknowledgement of the intergenerational role of traditional knowledge to support food sovereignty aligns well to the Māori experience. This knowledge covers a myriad of food relationships including foraging, producing, harvesting, processing, cooking and manaakitanga. We are in a renaissance period that seeks to rediscover our relationship with the pātaka, the food store. So much knowledge has been lost, but much also remains. How we draw that together in a way that acknowledges the whakapapa or historical relationship alongside the present and future. The right to achieving kai sovereignty is yet to be properly understood within our communities. The first steps lie in the knowledge space; sharing and acknowledgement of our food traditions before they are lost or misinterpreted.

Supermarkets have been described as having unprecedented and disproportionate power in the food system, influencing population diets through the products they have for sale, their price, store layouts, and other marketing activities(1).There is growing evidence to suggest that changing the retail food environment to be more health-enabling via in-store interventions is possible. The purpose of this study was to review the available high-quality evidence reporting on the effectiveness of real-world supermarket-based interventions on improving the healthiness of consumer purchases and consumption. First, a systematic search across seven electronic databases was completed in April 2023 to identify reviews describing the effects of intervention strategies that aimed to improve the healthiness of consumer purchasing in supermarkets and grocery stores (overview of reviews). The methodological quality of reviews was assessed using the Risk of Bias In Systematic Reviews for systematic and scoping reviews, and the Scale for the Assessment of Narrative Review Articles for narrative reviews. Review findings were synthesised narratively. Next, high-quality, primary studies from these reviews were further inspected (review of primary studies). In-store interventions were categorised by strategy type(2), and outcome effects were coded as effective (positive/promising), ineffective or mixed/unclear(3). Results were synthesised narratively, and separately for population subgroups. Thirty-eight reviews published between 1989 and 2023 met the inclusion criteria. Most were systematic reviews (n = 29, 76%). The number of primary studies included in reviews ranged between eight and 211. Prompting (n = 19, 50%) and pricing (n = 15, 40%) were the most assessed strategy type, either alone or in combination with another strategy. From the overview of reviews, pricing strategies appeared to be the most promising at improving consumer purchasing. Twenty-three high-quality primary studies met the inclusion criteria for further review. In most studies (n = 21, 91%), the goal was to increase sales of healthy products, most commonly fruit and vegetables, or products with a higher nutritional ranking. Only two studies (9%) aimed to exclusively reduce sales of unhealthy/less healthy products. Promotion was the most assessed strategy type (n = 11, 48%), either alone or in combination with another strategy. Common promotion strategies included providing education to customers about the health benefits of selected products, offering samples of products and giving food demonstrations. From the review of primary studies, promotional strategies used in combination with another strategy appeared to be most successful in the general population, and pricing was successful in subgroups of the population, including socioeconomically disadvantaged individuals, and those living in regional/remote areas. Overall, the evidence reviewed shows that the implementation of health-promoting supermarket interventions are more likely to be successful if they include a substantial pricing initiative (particularly for some subgroups), or the inclusion of promotion in combination with another strategy.

Gold kiwifruit consumption and increased vitamin C intake have been associated with improved mood, vitality, and wellbeing in healthy individuals(1,2). However, to date, no studies have focussed exclusively on the efficacy of gold kiwifruit for improving such outcomes in participants with disturbed mood. A randomised crossover trial was undertaken to examine the efficacy of ZespriTM SunGoldTM kiwifruit for improving psychological wellbeing and vitamin C concentrations in adults with sub-clinical levels of mood disturbance. In a two-period, non-blinded crossover trial, N = 26 adults aged 21 to 60 years (M = 36.1, SD = 11.0) with mild to moderate mood disturbance were randomised to a counter-balanced sequence. Participants consumed 2x SunGold kiwifruit daily or their typical diet for four weeks, with a two-week washout between periods. The primary outcome was change in mood disturbance, with secondary outcomes including plasma vitamin C, wellbeing, vitality and gut health. Results indicated a significant time x treatment interaction effect for mood disturbance (F(2,107.3) = 6.19, p = ,003) with significant improvements in mood disturbance scores between baseline and post-intervention during the SunGold kiwifruit period. A significant time x treatment interaction effect for blood plasma vitamin C (F(2,98.5) = 3.65, p = ,029) also demonstrated increased vitamin C concentrations during the SunGold kiwifruit period. A significant time x treatment interaction effect for wellbeing (F(2,104.7) = 4.5, p = ,013) was evident with wellbeing significantly improved between baseline and post-intervention during the SunGold kiwifruit period. The time x treatment interaction for vitality approached significance (F(2,104.7) = 2.89, p = ,06) with increases in vitality following SunGold kiwifruit consumption. These results provide preliminary evidence that SunGold kiwifruit consumption improves psychological wellbeing in mood-disturbed adults, which corresponds to increased plasma vitamin C concentrations. Future research is required to replicate this effect and to further demonstrate the potential benefit of whole-food interventions for treating mood-disturbance.

Hospital placement is essential training for medical interns, involving shift work and high-pressure environments. This can increase physiological and psychological stress, which may be mediated by metabolites of microbial digestion(1). Nutrients of interest include those accessible to microbial digestion and associated with altered signalling within the microbiota-gut-brain axis (MGBA)(1). Fibre is fermented by gut microbes to produce short-chain fatty acids(2) and is associated with improved psychological outcomes(3). Tryptophan, a precursor to gut-derived serotonin(2), has been negatively associated with anxiety(4). Processed foods contain food additives, excess sugars, and saturated fats that may disrupt gut homeostasis(1) and impact psychological well-being(4). Lastly, total energy intake may determine the level of substrate available for microbial fermentation(2). Therefore, this research explores how microbiota-accessible food components interact with physical and psychological well-being in a cohort of medical interns undertaking their first-year of hospital placement. Participants were healthy medical interns, during first-year hospital placement (n = 21) from the Hunter New England Local Health District, NSW, Australia. Participants completed diet and wellbeing surveys at baseline and every 2 months over a 10-month period. 24-hour diet diaries were self-recorded from participants using a mobile application (Easy Diet Diary) and analysed using AusNut and the NOVA classification system of ultra-processed foods (ULP). Wellbeing surveys include depression, anxiety, stress scale (DASS), and PROMIS survey for mental (M), physical (P), and sleep well-being. Current data represents an ‘in-progress’ of the longitudinal data collection. This study utilised Spearman correlation and Tukey’s post hoc test for mixed methods analysis. From baseline to timepoint 3 (T3, 4 months) daily energy intake was consistent with cohort estimated energy requirements (EER). However, consumption ranged from 37% to 167% of EER, indicating a large variation of intakes. Energy consumed from ULP ranged from 30% to 34% (p = 0.6875). Baseline tryptophan intake (x¯ = 1139mg) was within the suggested target, whilst fibre intake (x¯ = 23g) was below the recommended intake. Neither saw significant changes from baseline to T3. Fibre intake was positively correlated with mental and physical well-being at baseline (x¯ = 23.1g, M: r = 0.474, p = 0.04, P: r = 0.608, p = 0.007), and timepoint 2 (x¯ = 31.5g, M: r = 0.647,p = 0.026, P: r = 0.780, p = 0.004) but not at T3. In addition, baseline consumption of sugar (x¯ = 18g) and poly-unsaturated fats (x¯ = 15g) were both negatively correlated with mental and physical well-being. Overall, no significant dietary changes were evident from baseline to mid-year collection in a first-year medical intern cohort during hospital placements. Fibre was significantly associated with mental and physical well-being, building on current understanding of fibre’s role in the MGBA. Planned metabolite analysis will explore the mechanisms of proposed microbiome-accessible nutrients alongside diet, well-being, and microbiota data. Findings from this study will identify how diet-microbiome interactions change under stress, with wider positive implications on intense workplace environments with the aim to preserve individual wellbeing.

Minerals and trace elements are essential for human health and wellness. Fruits can be an important dietary source of these micronutrients. For centuries, native Australian fruits have been a vital source of nutrition and well-being for the Indigenous Communities(1). However, comprehensive information on the mineral and trace element composition of these native fruits, including broad-leaved Geebung (Persoonia stradbrokensis), is lacking. Therefore, the aim of the present study was to determine the mineral and trace element composition of broad-leaved Geebung, an important but still underutilised native Australian fruit, at different maturity stages. Inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma-optical emission spectroscopy (ICP-OES) were used to analyse the fruit. Statistical analysis was performed using one-way ANOVA and the means (n = 3) were compared by Tukey’s multiple comparison post hoc test with p < 0.05 as significant. Calcium and potassium could be identified as the main minerals, and iron, zinc and manganese as the main trace elements. The calcium content in broad-leaved Geebung was lower than Australian desert lime, kakadu plum, and riberry, respectively (35.7-271.5 vs. 384.2 vs. 282.5 vs. 307.7 mg/100g dry weight (DW))(2). Potassium has a vital role in the prevention of bone loss and is essential for the heart, kidney, and blood pressure. The potassium content of broad-leaved Geebung fruit was lower than Australian desert lime, kakadu plum, lemon aspen, quandong and riberry (average 516.4 vs. 1287.8 vs. 1905.5 vs. 1512.9 vs. 3456.2 vs. 1715.7 mg/100g DW)(2), which contributes to approximately 15% recommended dietary allowance (RDA). Iron is the main element in the production of hemoglobin and is important for maintaining healthy blood. Iron content in the fruit ranged from 0.8-2.6 mg/100g DW, which was higher than that of Davidson’s plum (1.2 mg/100g DW), but lower than the Green Plum, Australian desert lime, and kakadu plum (3.8 vs. 4.7 vs. 4.0 mg/100g DW) (2,3). Besides, the manganese levels were relatively high in broad-leaved Geebung fruit and considerably higher than in other native Australian fruits such as Kakadu plums, Desert limes and Quandongs (11.2-26.4 vs. 3.5 vs. 0.9 vs. 0.3 mg/100 g DW)(2). Interestingly, the mineral and trace element content decreased (p < 0.05) during fruit maturity. In general, broad-leaved Geebung fruit can provide considerable amounts of essential minerals and trace elements and its potential as a healthy “snack” alternative should be investigated further.

Nut consumption in Australia does not meet recommended levels, and concern regarding the impact of nuts on body weight is a reported barrier to regular intake, due to their high energy content(1). Nut intake is not associated with higher body weight(2), which may be explained by their lower metabolisable energy(3). Hence, total energy intake may be overestimated among nut consumers. Nut consumption patterns in Australia are also unknown. This study aimed to describe the metabolisable energy from nuts, and nut consumption patterns of the Australian population. A previously developed nut-specific database was expanded to include the metabolisable energy of nuts based on nut type and form, and applied to the 2011-12 National Nutrition and Physical Activity Survey (NNPAS). Mean metabolisable energy was compared to mean energy intake determined using Atwater factors for nut consumers. Additionally, nut consumption patterns were also explored, including the proportion of nuts consumed at meals and snacks, proportion of nuts consumed alone or combined with other foods, and timing of nut intake. Among nut consumers, the mean metabolisable energy from nuts, based only on nut type, was 241.24 (95% CI: 232.00, 250.49) kJ/day. The mean metabolisable energy when considering both nut type and form was 260.69 (95% CI: 250.18, 271.21) kJ/day, while energy from nuts using Atwater factors was 317.60 (95% CI: 304.85, 330.35) kJ/day. Nuts were more likely to be consumed as snacks, with approximately 63% of all nut intake (in grams) occurring as a snack. Nuts were frequently consumed with other foods and beverages, with only 27% of nuts consumed alone or with plain water. Furthermore, nuts were most often consumed after midday (68% of intake) rather than in the morning (32% of intake). Application of metabolisable energy data to the 2011-12 NNPAS has a significant impact on the calculation of energy intake from nuts. Nut consumption patterns identify most nut consumption occurring as snacks and two-thirds of nut intake occurring in the afternoon and evening. These findings may inform strategies to promote nut consumption in Australia.

Ebstein anomaly is frequently associated with accessory pathways, including Mahaim atriofascicular fibres. We herein illustrate successful Mahaim fibre ablation in Ebstein anomaly by targeting the ventricular insertion site below the tricuspid ridge.

It is estimated that one-quarter of the world’s population has Metabolic Syndrome (MS)(1), a key driver of growth in healthcare expenditure. Traditional approaches to treating MS through the application of standard dietary recommendations and caloric restriction have had limited success. More recent evidence suggests that novel, anti-inflammatory approaches such as replacing refined carbohydrates and ultra-processed food with unprocessed or minimally processed, lower carbohydrate foods and adapting meal timing and frequency may be more effective(2). The aim of the study was twofold: 1) To determine the effectiveness of anti-inflammatory dietary strategies for long-term weight loss and improvement in metabolic health and 2) To examine the relationships between eating behaviours and long-term weight loss. Twelve-month audit data from a UK based 12-week lifestyle program that focuses the principles of consuming an anti-inflammatory diet was analysed using repeated-measures ANOVA to examine the effects of the program on changes in weight and waist circumference. A quantitative, survey-based research design was used to retrospectively identify relationships between eating behaviours and both anti-inflammatory and pro-inflammatory dietary patterns. Multivariate regression using stepwise method was used to examine differences in weight change based on eating patterns and behaviours. Six hundred and forty-two (N = 642) participants (age = 50.4 ± 12.5 years, female 63.6%, weight = 96.1 kg ± 22.1, BMI 35.2 kg/m2 ± 7.5) demonstrated a weight loss average of 4.49 kg ± 3.78 post-lifestyle program (12 weeks). Survey respondents (N = 64) reported a maximum long term weight loss of 13.9 kg ± 11.9. Weight loss and percentage weight loss after the program was significantly predicted by daily consumption of sweet drinks and grain-based foods. The model predicted one unit increase in daily serving consumption of these foods resulted in less weight lost [2.3 kg (4.5%)]. Seventy one percent of survey respondents had maintained most or all their weight loss for more than 6 months. The model predicted change in consumption of grain-based foods, TFEQ-emotional eating score, consumption of savoury ultra-processed foods, and following an alternative dietary approach after the program were statistically significant in predicting weight loss maintenance (R2 = 0.803, F(4, 20) = 20.376, p < 0.001). The preliminary findings suggest that anti-inflammatory dietary approaches are effective and sustainable for weight loss. Eating behaviour may both support and hinder long term changes in eating patterns and whilst there are significant relationships between eating behaviour and eating patterns, the extent to which dietary patterns drive eating behaviour remains unclear.

Chronic pain affects 20-30% of people worldwide(1). While the impact of nutrition and dietary patterns on bodily pain has gained attention in recent years, the underlying linking mechanisms remain poorly understood; it is possible that body weight, specifically adiposity, may be a mediating factor(2). Thus, the primary aim of this study was to explore whether adiposity mediates the relationship between diet quality and bodily pain. This cross-sectional analysis included 654 adults (57% women, mean age 50.4 ± 1.1 years, BMI 29.0 ± 6.2 kg/m2) with complete diet, adiposity, and pain measures from the Whyalla Intergenerational Study of Health (2008-09). Diet quality was calculated using the Dietary Guideline Index (DGI total score, core and non-core scores)(3), and pain assessed via the Short Form-36 bodily pain scale (SF36-BPS) transformed percent score. Adiposity was determined from body mass index (BMI), waist circumference (WC), and body fat percent (BF, via dual energy x-ray absorptiometry). Mediation analyses determined the role of adiposity in the direct and indirect relationships between diet quality and pain in the whole population, then stratified by sex (self-report). There were no significant indirect or direct effects between DGI total scores and SF36-BPS, for any measure of adiposity. Direct effects were observed for DGI core-food scores on SF36-BPS for each measure of adiposity (BMI, β = 0.258, 95% CI 0.048, 0.467; WC β = 0.246, 95% CI 0.037, 0.455; BF β = 0.247, 95% CI 0.040, 0.454; all p<0.05). Each measure of adiposity accounted for <10% of the relationship between diet quality and pain, with a better-quality diet associated with less bodily pain (higher SF36-BPS). Relationships differed by sex; with no direct or indirect effects seen between DGI scores and SF36-BPS for men while, in women, there was non-mediation with direct positive effects between DGI total score and SF36-BPS for each measure of adiposity (BMI, β = 0.362, 95% CI 0.132, 0.591; WC β = 0.345, 95% CI 0.116, 0.574; BF β = 0.357, 95% CI 0.130, 0.584; all p<0.05). Also in women, body fat mediated 85% of the relationship between DGI non-core scores on bodily pain (indirect effect β=-0.242, 95% CI −0.358, −0.126, p <0.05). While adiposity did not mediate the relationship between diet quality and pain, this study highlights that diet quality plays a role in the pain experience with higher consumption of core foods showing direct associations with lower levels of bodily pain. Moreover, sex differences were observed, with less bodily pain in women associated with higher overall diet quality. Interestingly, body fat drove the relationship between higher pain scores and greater consumption of non-core foods (discretionary), but body fat alone was associated with consumption of fewer discretionary foods. This anomaly requires further investigation.

Evidence suggests that low carbohydrate eating patterns are effective for rapid weight loss 1, however, little is known about their long-term effects on the risk of chronic diseases. We assessed the association of a low carbohydrate diet score (LCD) with the incidence of type 2 diabetes using Melbourne Collaborative Cohort Study (MCCS) data. Between 1990 and 1994, the MCCS recruited 41,513 people aged 40 to 69 years. The first and second follow-ups were conducted in 1994-1998 and 2003-2007, respectively2. We analysed data from 39,185 participants. LCD at baseline was calculated as the percentage of energy from carbohydrate, fat, and protein. The higher the score the less carbohydrate contributed to energy intake. The association of LCD quintiles with the incidence of diabetes was assessed using modified Poisson regression, adjusted for lifestyle, obesity, socioeconomic and other confounders. LCD was positively associated with diabetes risk. Higher LCD score (p for trend = 0.001) was associated with increased risk of type 2 diabetes. Quintile 5 (38% energy from carbohydrates) versus quintile 1 (55% energy from carbohydrates) showed a 20% increased diabetes risk (incidence risk ratio (IRR) = 1.20 (95% CI: 1.05-1.37)). A further adjustment for BMI and WHR eliminated the association. Mediation analysis demonstrated that BMI attributed 76% of the LCD & diabetes association. Consuming a low carbohydrate diet, reflected as a high LCD score, may increase the risk of type 2 diabetes which is largely explained by obesity. Results imply the need for further studies, including clinical trials investigating the effects of a low carbohydrate diet in type 2 diabetes.

Childhood obesity has been a public health concern worldwide(1). Parents are a crucial part of the weight monitoring of children(2). But effects of parental perception of children’s weight on children’s weight change remain inconclusive. This systematic review and meta-analysis aimed to evaluate the effects. A systematic search of six databases was conducted from inception to March 2023 based on Cochrane guidelines. Longitudinal studies were included. Data were synthesised using a semi-quantitative approach and meta-analysis. Finally, nine studies with a total of 25,475 respondents were included in the systematic review and meta-analysis. The pooled results showed that compared to children perceived as normal weight, children who were perceived as overweight or obese by their parents had a statistically significantly greater weight gain (pooled coefficient β = 0.43, 95% confidence interval (CI): 0.1, 0.76, p<0.05) during follow-up. Conversely, children perceived as underweight presented less weight gain (β=-0.16, 95%CI: −0.3,-0.02, p<0.05) during follow-up compared to children perceived as normal weight. However, parental misperception of their children’s weight was not statistically significantly associated with children’s weight change (underestimation: β = 0.04, 95% CI:-0.37, 0.44, p>0.05; overestimation: β=-0.09, 95% CI:-0.06, 0.23, p>0.05). We found that parental perception of children’s weight, not parental misperception, might influence children’s subsequent weight change. Longitudinal and intervention studies using validated measurements and including potential confounders and mediators are needed to confirm the causalities.

Utilising local and traditional foods in schools presents a significant opportunity within our region to ensure food and nutritional security, support local livelihoods by driving markets and employment opportunities, increasing food literacy, and help students to understand the role of, and develop a preference for these foods. School meals programs (SMP) are increasingly touted as a strategy for food system transformation(1), however, are not widely used in the Pacific Islands(2). Yet, there is increasing interest and momentum towards understanding school food and nutrition environments and the use of SMP in this region, especially with models that support and promote the integration of local, traditional climate-resilient, nutrient rich foods. When a large scale SMP may not be possible, other school food and nutrition activities can be utilised to support nutritious food choice. Evidence collected over the last five years provides information on the current situation, activities, and capacity for providing food in schools across the Pacific Islands (2,3,4). Activities across the region vary from national SMP to gardening programs, nutrition education, providing canteens/tuckshops and other ad hoc activities, for example events for World Food Day. Some activities have a requirement for the use of local food, while some prioritise local foods in gardening programs and work with local farmers. Recently it has been shown that youth are exposed to, and have access to significant amounts of ultra-processed foods (UPF) around schools(3). Mapping of the foods available to students within a 400m radius of 88 schools in Fiji found that sugar sweetened beverages were available in 80%, and lollies/confectionary in just over 60% of outlets. Fresh fruit was available in just over 20% of outlets, while fresh vegetables were available in less than 20% of outlets(3). While there are many challenges to providing local, traditional, nutritious foods in schools, including access to financial, human, and physical resources, stakeholders have told us that one of the most significant is how modernisation and colonisation of food systems have resulted in a preference for hyperpalatable UPF and how this makes it more challenging to incorporate local produce in a way that is accepted by students. This provides an opportunity to further explore and share ways to integrate local, traditional, climate-resilient, nutrient rich foods in schools to support children and adolescents to value, utilise, prefer, and advocate for these foods. There is a need to support the utilisation of traditional, local foods in schools by advocating for policy (at various levels, right from a school level upwards) that drives the use of these foods and creates more supportive school food environments.

Pregnant women who develop pre-eclampsia (PE) and/or intra-uterine growth restriction (IUGR) have reduced polyunsaturated fatty acid (PUFA) status compared to healthy pregnancy(1). It is unknown if pregnant women diagnosed with Gestational Diabetes Mellitus (GDM), and their offspring, also have compromised PUFA status. To determine if women with GDM, and their offspring, have altered PUFA status compared to healthy pregnancy. Pregnant women were recruited from Glasgow Scotland, and Brisbane, Australia from antenatal clinics for this cross sectional study. Third trimester maternal blood samples were collected after an overnight fast and cord blood samples were collected at delivery. Plasma fatty acids were analysed using gas chromatography from women with GDM (n = 37) and healthy pregnancies (n = 27) and their respective offspring (n = 31, from women with GDM, and n = 27 from healthy women). T-tests were used to determine significant differences between maternal with GDM and healthy pregnancy, as well as for their offspring and significance was set at p<0.05. Previously, erythrocyte fatty acids were analysed from women with PE (n = 21), IUGR (n = 13) and healthy pregnancies (n = 86)(1). All results were expressed as mol percent of total fatty acids. There were no differences in maternal plasma arachidonic acid (4.51 ± 1.23 vs. 4.72 ± 0.64, p = 0.39) and plasma EPA & DHA (2.33 ± 0.74 vs 2.69 ± 1.04, p = 0.14) in women with GDM and healthy pregnancies, respectively. There were no differences in fetal plasma arachidonic acid (11.58 ± 2.26 vs. 12.63 ± 1.69, p = 0.08) and plasma EPA & DHA (4.44 ± 1.17 vs. 4.44 ± 1.00, p = 0.89) in offspring from women with GDM and healthy pregnancies, respectively. Women with PE and IUGR had approximately 25% lower erythrocyte EPA & DHA and 35% lower erythrocyte arachidonic acid compared to healthy pregnant(1). Offspring from women with PE and IUGR had approximately 25% lower erythrocyte EPA & DHA and 22% lower erythrocyte arachidonic acid compared to healthy pregnancy(1).Women with PE and IUGR had lower PUFA status likely due to reduced PUFA synthesis(1) and offspring from women with PE and IUGR had reduced PUFA status likely due to ectopic fat in placenta tissue(2). Women with GDM do not have compromised PUFA status suggesting there is no reduced synthesis and transport of PUFA. Offspring from women with GDM do not have reduced PUFA status suggesting there is no problem with PUFA transport across the placenta, unlike offspring from women with PE and/or IUGR. Women with GDM, and their offspring, do not have compromised plasma PUFA status compared to healthy pregnancy.

The United Nations’ Agenda 2030 provides a framework of 17 Sustainable Development Goals (SDGs) to achieve peace and prosperity for people and planet, now and into the future(1). The United Nations Decade of Action on Nutrition emphasises that food and nutrition are key levers for optimising both human and planetary health and that individuals working in food, nutrition and health play an essential role in contributing to the SDGs(2,3). This project aimed to (i) map the work being done by staff and higher degree students at Monash University’s Department of Nutrition, Dietetics and Food and its alignment with the SDGs, and (ii) assess the impact of this process on workforce capacity to embed the SDGs in future work activities. Three mapping workshops; one pilot, one in-person and one online, were conducted (n = 28), beginning with a short expert-led seminar about the SDGs before participants engaged in an interactive activity to record their work activities (research, education or engagement) relating to the SDGs. Mapping data were analysed to determine which SDGs were being prioritised and in what type of activities. To determine the impact on workforce capacity, participants completed pre- and post-workshop surveys that assessed their knowledge of and confidence regarding the SDGs. From the three workshops, 129 work activities were described, each linked to one or more of the SDGs. Of those, 41% were education, 36% were research, and 23% were engagement activities. Work activities spanned all 17 of the SDGs, with the most commonly aligned being Goal 3 Good Health and Wellbeing (53% of work activities), Goal 10 Reduced Inequalities (37% of work activities), Goal 4 Quality Education (36% of work activities), Goal 12 Responsible Consumption and Production (34% of work activities), and Goal 17 Partnerships for the Goals (27% of work activities). The pre- and post-workshop surveys indicated increased staff knowledge and confidence related to the SDGs. The percentage of participants that could correctly identify the number of SDGs increased from 43% to 96%, and the percentage of participants that recognised the correct aim of the SDGs increased from 43% to 86%. Regarding confidence in talking about the SDGs, the percentage of staff who indicated that they ‘avoid talking about them’ or are ‘not confident’ decreased from 39% to 4%, and the number of staff who were confident talking about the SDGs ‘in general terms’ increased from 39% to 75%. Nutrition professionals are well-placed to support progress towards each of the SDGs. Workshops such as these provide an opportunity to increase workforce capacity to discuss, share and relate their work to the SDGs and provide a periodic pulse-check to identify opportunities for greater contribution to this urgent, global Agenda.

Snacking is a common eating behaviour among adolescents accounting for more than a quarter of their total energy intake but the relationship between snacks and overall diet quality remains unclear(1). Hence, the aim of this study was to examine characteristics of snacks among Australian adolescents (12-18 years) according to their level of diet quality. This secondary analysis uses one day of 24-hour dietary recall data from the 2011 - 2012 National Nutrition and Physical Activity Survey (n = 935). Snacks were defined based on participant-identified eating occasions(2). The Dietary Guideline Index for Children and Adolescents (DGI-CA) was used to assessed adherence to the Australian Dietary Guidelines(3), with the highest tertile of the DGI-CA score indicating high adherence. The means (95% confidence intervals [CI]) for daily snack frequency and snack energy density (ED; kJ/g) were estimated for boys and girls, using linear regression, adjusted for age, area-level disadvantage, and energy misreporting. The differences in means and proportions across tertiles of DGI-CA scores were tested by using F- and Chi square-tests, respectively. The results show no significant differences in the mean frequency of snacks across tertiles of DGI-CA scores in either boys (lowest tertile mean = 2.2, 95% CI [2.0, 2.4] snacks/day, highest tertile = 2.1 [1.9, 2.3]) or girls (lowest tertile = 1.9 [1.7, 2.1] snacks/day, highest tertile = 2.2 [1.9, 2.4]). The mean ED of snacks decreased as DGI-CA scores increased in both boys (lowest tertile = 8.42, 95% CI [7.1, 10] kJ/g, highest tertile = 6.32 [5.4, 7.4] kJ/g) and girls (lowest tertile = 8.99 [7.8, 10.3] kJ/g, highest tertile = 5.92 [5.1, 6.9] kJ/g). As DGI-CA scores increased, the proportion of both boys and girls consuming discretionary foods at snacks (such as soft drinks) decreased, while foods from the five food groups (such as apples) increased (p-values < 0.05). In conclusion, snack ED, but not frequency, and the types of foods consumed by adolescents at snacks varied by a level of diet quality. Snack ED decreased with increasing diet quality and adolescents with higher diet quality had higher intakes of foods from the five food groups and lower intakes of discretionary foods at snacks. Encouraging the consumption of lower-ED foods from the five food groups at snacks presents an opportunity to enhance adolescent diet quality. Future studies should explore snack-specific strategies to improve overall diet quality of adolescents.

Encompassing global cooling, the spread of grasslands, and biogeographic interchanges, the Hemphillian North American Land Mammal Age is an important interval for understanding the factors driving ecological and evolutionary change through time. McKay Reservoir near Pendleton, Oregon is a natural laboratory for analyses of these factors. It is remarkable for its small vertebrate fauna including rodents, bats, turtles, and lagomorphs, but also for its larger mammal fossils like camelids, rhinocerotids, canids, and felids. Despite the importance of the site, few revisions to its faunal list have been published since its original description. We expand on this description by identifying taxa not previously known from McKay Reservoir based on specimens collected during fieldwork and through reidentification of previously collected fossils. Newly identified taxa include the borophagine canid Borophagus secundus (Matthew and Cook, 1909), the camelids Megatylopus Matthew and Cook, 1909 and Pleiolama Webb and Meachen, 2004, a dromomerycid, and the equids Cormohipparion Skinner and MacFadden, 1977 and Pseudhipparion Ameghino, 1904. Specimens previously assigned to Neohipparion Gidley, 1903 and Hipparion de Christol, 1832 lack the features necessary to diagnose these genera, which are therefore removed from the site's faunal list. The presence of Borophagus secundus, Cormohipparion, and Pseudhipparion is especially important, because each occurrence represents a major geographic range extension. This refined understanding of the fauna lays the foundation for future studies of taphonomy, taxonomy, functional morphology, and paleoecology—potentially at the population, community, or ecosystem levels—at this paleobiologically significant Miocene locality.

A ‘Blackout Rage Gallon’ (borg) is a dangerous new alcohol consumption trend popular with young people. It involves creating a customised, individual alcoholic beverage by replacing half the water in a four litre (gallon) jug with alcohol (usually spirits), flavourings, electrolytes and caffeinated energy drinks or caffeine supplements. The most prevalent ‘recipe’ calls for the addition of 750ml of alcohol. The ‘blackout’ part of the name refers to the intent of one person to consume the borg in one session, thereby encouraging risky alcohol use. Indeed, there have been reports in popular media of multiple hospitalisations attributed to consumption of borgs at college events in the United States. Part of the attraction of the trend is to label the borg with a clever name, usually incorporating the term ‘borg’. The trend has gained traction recently on TikTok, which has become an important, yet unregulated, source of information for the public including young people(1). We investigated TikTok videos associated with the hashtag #borg to better understand this dangerous new phenomenon. We identified and analysed highly viewed TikTok videos (n = 105) for engagement, techniques, characteristics of featured individuals, and the portrayal of alcohol and risky drinking behaviours. Alcohol was visible in three quarters of the videos analysed (n = 78), and consumed in one third (n = 34). The average amount of alcohol present was well in excess of safe drinking guidelines (865ml) One quarter of videos (n = 25) promoted alleged benefits such as control of volume of consumption, protection from drink spiking, and mitigation of side effects due to addition of electrolytes and water. Alarmingly, only 9 videos included a warning about potential harms of the borg or alcohol in general. Indeed, videos discussing potential harms and benefits tended to encourage the use of borg, for example ‘I’m on board with the borg’. Our study found the borg TikTok trend encourages risky drinking in a fun and entertaining way, supporting previous studies where the majority of content was positively portraying a product or behaviour(2). As there is an association between viewing alcohol-related content on social media and alcohol use(3), there is an urgent need for social media content restrictions to limit the visibility of risky alcohol consumption, particularly to underage users.

Establishing healthy lifelong eating habits in young people is important for short and long-term health(1). Schools are ideal setting to improve diet. However, research shows that many school food environments are unhealthy(2). In New Zealand (NZ), the canteen is a popular food provision, particularly in secondary schools. This research aimed to explore the barriers and enablers to providing healthy food and beverages in NZ secondary school canteens. In 2022, 6 secondary schools were purposively selected to participate in semi-structured interviews about foods and beverages sold in schools’ canteens and the factors that influenced this. In total, 11 stakeholders representing six schools and one staff member of an external catering company completed interviews. The interviews were transcribed and analysed using a reflexive thematic analysis approach(3). Four themes were developed. Theme 1 Action-oriented school policies that are based on healthy eating principles can facilitate healthier canteens highlighted the use and characteristics of policies. The subtheme highlighted that Mandatory policies are more enforceable. Theme 2 Multiple component opt-in programs or interventions facilitate a healthier school food provision shows that opt-in government interventions (e.g. Ka Ora, Ka Ako, the NZ free school lunch initiative) with funding, monitoring, and incentives can improve food provision. The subtheme Health-enhancing changes in the school environment has flow-on effect to canteens showed that these changes can affect the entire school food environment. Theme 3 Healthy canteens get lost in the “pecking order” of what’s important highlights that while schools and key stakeholders may believe healthy eating is important, other factors related to well-being and education were more important to prioritise within the school’s limited resources. Theme 4 People’s values, attitudes and beliefs may help and hinder the healthiness of canteens and explores the role champions have in influencing the healthiness of the canteen. Champions were those with a positive, proactive attitude, value healthy eating and are capable. Subtheme 1 Meet student preferences while providing healthy food was a common barrier many champions worked hard to overcome. The final subtheme identified how A collaborative approach within schools and their communities can overcome barriers to healthy canteens. Government mandates and interventions can positively impact the canteen and other food provisions. This research supports a recommendation for schools to create and implement school policies around food encompassing a whole-school approach.

Depression and eating disorder (ED) risk are heightened during adolescence(1) and both were exacerbated during COVID-19 lockdowns. This analysis reports changes in self-reported symptoms of depression and eating disorders throughout the Fast Track to Health trial. Fast Track to Health was a 52-week multi-site randomised-controlled trial, conducted 2018-2023, comparing intermittent (IER) and continuous energy restriction (CER) in adolescents with obesity and ≥1 associated comorbidity(2). The Centre for Epidemiologic Studies Depression Scale-revised 10-item version for adolescents (CESDR) was used to assess symptoms of depression (no symptoms, sub-threshold, or possible, probable, major depressive episode). Eating Disorder Examination Questionnaire (EDE-Q) was used to assess ED risk; defined as global score ≥2.7, ≥2 episodes of binge eating with/without loss of control, or ≥1 episode of purging within the last 28-days. The Binge Eating Scale (BES) assessed severity of binge eating (no binge eating, mild/moderate, severe). Adolescents were monitored for disordered eating during dietetic consults. Linear mixed models, retaining all data consistent with intention-to-treat analysis, were used to estimate the change in outcomes from baseline to week-52. Descriptive statistics were used to describe the number of participants meeting screening criteria at baseline and week-52. One hundred and forty one adolescents were enrolled and 97 completed the trial, with median (IQR) EDE-Q score 2.28 (1.43 to 3.14), CESDR 9.00 (4.0 to 14.5) and BES 11.0 (5.0 to 17.0) at baseline. EDE-Q (change in estimated marginal means [SE], IER −0.63 [0.18], CER −0.56 [0.17]) and CESDR (IER −2.70 [1.15], CER −3.87 [1.07]) scores reduced between baseline and week-52 in both groups (p<0.05) with no difference between groups. There was a between group difference (p = 0.019) in change in BES. The IER group had a reduction between baseline and week-52 (−3.72 [1.27]) and the CER group had no change. At baseline, 31 (22%) adolescents were classified as having a possible/probable/major depressive episode, 110 (78%) met ≥1 ED criteria and 28 (21%) as mild/moderate or severe binge eating, reducing to 8 (9%), 56 (61%) and 15 (16%) respectively at week-52. A small sub-group of adolescents required additional support for disordered eating. Overall, treatment-seeking adolescents with obesity have symptoms of depression and ED. Although symptoms reduce for most, some required additional support. Screening and monitoring for depression and ED are important to ensure early intervention.