University students are a unique population subgroup, who experience a life transition into adulthood, often marked by the establishment of unhealthy eating behaviours(1) which are associated with chronic disease risk factors, poor mental health and lower academic achievement(2). Data regarding the food skills/behaviours of university students is limited, but low cooking self- efficacy and food skills are potential barriers to healthy meal preparation(1). Nourished@Deakin is an online cooking program, co-designed by Deakin University students, that aims to inspire students to cook and eat healthier. It commenced in November 2021 and includes a series of blogs, recipes, and cooking videos, available to all Deakin students via a Deakin University blog site. To determine if accessing Nourished@Deakin improves food skill confidence, food intake, and nutrition knowledge, participants completed a short online survey before accessing Nourished@Deakin materials and then again four weeks after their first engagement. The survey included 31 questions regarding confidence related to a variety of food skills (eg. recipe following, reading food labels, meal planning); 2 questions regarding fruit/vegetable intake; 11 knowledge questions regarding the Australian Dietary Guidelines (ADGs); and 16 demographic questions. Pre/post surveys were compared using paired t tests (knowledge scores, fruit/veg serves) or McNemar extact test (proportions). A total of 108 students completed the pre-survey and 41 (mean (SD) age 27.0 (8.4) years; 63% female) also completed the post-survey. Of the 41 participants who completed both surveys, 42% were studying within the Faculty of Health and 16 (39%) were living in the family home with parents. Most (68%) were studying full time and 59% were employed part-time/casually. Three-quarters were domestic students, and 59% were undergraduate students. Following completion of Nourished@Deakin, there was a significant increase in the proportion of participants feeling confident in two of the 31 food skills (namely ‘meal planning’: 44% pre vs 63% post, P<0.05; and ‘growing fruit and/or vegetables at home’: 22% pre vs 44% post, P<0.05). Fruit intake increased from 1.6 serves/day pre-program to 1.9 serves/day post-program (P<0.05), but vegetable intake remained stable (2.5 serves/day pre and 2.6 serves/day post, P = 0.287). Before participating in Nourished@Deakin, 56% of participants correctly reported the recommended daily serves of fruit and 66% correctly reported it for vegetables. The mean ADG knowledge score was 8.2/9 and 49% of participants got all nine questions correct. There were no significant changes in any of the knowledge markers post-program. Over a relatively short period, Nourished@Deakin produced modest improvements in the self-reported confidence in some food skills and self-reported fruit intake. A revised program (incorporating a greater variety of recipes, additional blogs, and new videos) may encourage greater engagement and result in increased confidence and knowledge in other targeted areas.

The low fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) diet is recommended as a first line therapeutic management strategy for irritable bowel syndrome (IBS)(1). The low FODMAP diet is supported by meta-analytical evidence(2), and demonstrates acceptability and effectiveness for improving symptoms and quality of life (QoL) in 50-75% of individuals with IBS. However, a subset of individuals (25-50%) do not respond to the diet(3). The identification of individual-level predictors of treatment response across all three phases of the low FODMAP diet is currently lacking. The study aims were to assess psychological predictors of symptom and QoL response to the low FODMAP diet in patients with IBS. Adults with IBS underwent a three-phase low FODMAP diet, guided by individualised dietetic education. Predictor variables included levels of depressive, anxiety, and extraintestinal somatic symptoms, stress, treatment beliefs and expectations, behavioural avoidance, and illness perceptions. Symptom severity and QoL were the main outcomes. Questionnaires assessing psychological predictors, symptoms and QoL were administered at five points: pre-dietitian (week 0), post-dietitian, end of elimination (week 5), end of reintroduction (week 13), and end of personalisation (week 25) phases. Latent class growth analysis was used to identify classes of response trajectories for symptoms. Linear mixed models were used to test the effect of baseline psychological scores on symptoms and QoL over time. Cross lagged panel models determined the directional predictive relationship between psychological predictors and symptom severity. 112 participants (89% F) median age 30 ± 17 years were included. There were three classes of symptom response trajectories, including ‘non-improvers’ (21.3% of participants) with high initial symptom severity and minimal improvement, ‘improvers’ (22.5% of participants) with low initial symptom severity and significant improvement, and an ‘intermediate’ group (56.2% of participants) with moderate initial symptom severity and significant improvement. Higher treatment beliefs predicted a stronger initial symptom response (effect on linear slope p = 0.036). Lower gut-specific anxiety, as well as higher levels of personal and treatment control at baseline predicted a stronger reduction in IBS symptom severity and improved QoL from week 0 to week 25. Participants with higher levels of baseline psychological symptoms and negative illness perceptions (i.e., lower emotional representations) predicted a stronger initial and later QoL response (effect on linear (p = 0.006) and quadratic (p = 0.049) slopes). Increased cyclical time beliefs predicted poorer initial and later QoL response (effect on linear (p = 0.015) and quadratic (p = 0.029) slopes). Individuals experiencing lower to mid-range symptom severity at baseline had greater improvement with the low FODMAP diet. Lower anxiety, positive illness views and higher treatment beliefs predict better QoL and symptom response. Personalised strategies are crucial for optimising low FODMAP diet effectiveness in IBS.

This method abstract details the Green School Program, piloted across three schools in maritime Fijian islands, addresses critical issues faced by Fijian and Pacific Island communities. These encompass malnutrition, food security, health hazards, and the urgency of integrating traditional knowledge, governance, and social-ecological systems approaches into creating healthier school environments. Non communicable diseases have emerged as a pervasive concern within Pacific Island communities, creating a challenge for public health systems, driven greatly by dietary habits(1). This complex health landscape underscores the need to safeguard traditional knowledge and agri-food practices and develop neo-traditional approaches to local food systems(2). Furthermore, the Green School Program recognizes the essential role of schools as community hubs, enabling enhancing heathy school environments by embracing traditional wisdom and sustainable farming practices and foods, ultimately empowering communities to address these multifaceted challenges(3). Developing the school environment as a sustainable setting for governance framework led by women and the school administration, rooted in traditional knowledge and practices. Additionally, it aims to design facilities that support efficient organic farming while integrating these into school activities. Economic sustainability through the sale of surplus farm products, as well as the enhancement of sustainable land-use management, health, wellbeing, and cultural identity. The program unfolds within a distinctive community-based framework with the establishment of robust governance, with a notable emphasis on the leadership of women and mothers who play a pivotal role in steering the green school initiative and ensuring community ownership. Collaborative governance spans multiple stakeholders, including school management, community-based school committees, youth groups, women groups, and traditional leaders. This inclusive engagement ensures both shared responsibility in program design and ownership during implementation phases. Sustainable facilities are strategically designed to include biodigesters, water storage and irrigation systems, composting, organic fertilizers, and seedling nurseries, enhancing the program’s capacity to create healthier school food environments while embracing traditional practices and values. The program has witnessed the active engagement of women in governance roles, promoting community unity and ownership. Traditional knowledge integration has enhanced crop diversity and sustainability. Economic sustainability has been achieved through surplus farm product sales, reducing dependency on external funding sources. Health improvements are evident, with reduced exposure to indoor air pollution from open fires. Cultural identity preservation and increased student engagement are also notable outcomes. The Green School Program’s holistic approach, rooted in traditional knowledge and sustainable practices, has yielded positive outcomes in governance, agriculture, nutritional food security, health, and cultural identity preservation. The program’s success demonstrates the potential for community-based initiatives to address critical issues and empower remote island communities. These results provide valuable insights into sustainable development approaches that prioritize community wellbeing and cultural heritage preservation in similar contexts.

Healthy eating is a struggle for many families in New Zealand when they cannot adequately afford food. Statistics New Zealand has shown that the food price index rose 12.5 percent over the past year with an increase of 22 percent for fruit and vegetables prices(1). Food prices now rate as the number one concern for New Zealanders(2). To understand the changes households are making in response to increasing food prices 109 main household shoppers were surveyed. The survey was administered via Qualtrics in May/June 2023. Participants were recruited via social media and by direct email from researchers and Heart Foundation staff. Survey participants were asked about food prices, shopping behaviours and changes within specific food categories. Two thirds of the participants were female. The predominant age groups were 20-29 years (29%) and 60 and above (28%). The major ethnicities were European (53%), Pasifika (20%) and Māori (8%). Around 46% of people lived in Auckland with the next highest area being Nelson (and wider Tasman). The results showed 85% of participants expected food prices to get worse over the next year. To manage rising food prices 70% people had changed where they shopped or how they accessed food, 90% changed what they buy and 67% had changed the way they eat (e.g., cooking more at home). The most substantial changes were in the fruit and vegetable category where people changed the types purchased (73%) and purchased less (63%). In many food categories buying cheaper brands, in bulk and when foods were on special were common responses. Rationing or going without was a consistent theme highlighted with meat/poultry, eggs, fish, alcohol and more expensive snack foods. The implications for the Heart Foundation’s work include (1) reinforcing the importance of fruits and vegetables in the diet and to provide tips and tools around ingredient substitution, (2) promote alternative protein sources (e.g., beans and legumes) as an affordable ingredient and recipes to support their use and (3) supporting companies to improve the composition of cheaper brands through food reformulation. With this being a small sample size, it may not be fully generalisable to the entire population however given the survey found a high percentage of people making changes it does indicate the important role health agencies can play providing information, and advice to support people to manage high food prices.

Dietary strategies for weight loss typically place an emphasis on achieving a prescribed energy intake. Depending on the approach taken, this may be achieved by restricting certain nutrients or food groups, which may lower overall diet quality. Various studies have shown that a higher quality diet is associated with better cardiovascular (CV) health outcomes1. This study aimed to evaluate the effect of an energy restricted diet on diet quality, and associated changes in cardiovascular risk factors. One hundred and forty adults (42 M:98 F, 47.5 ± 10.8 years, BMI 30.7 ± 2.3 kg/m2) underwent an energy restricted diet (30% reduction) with dietary counselling for 3 months, followed by 6 months of weight maintenance. Four-day weighed food diaries captured dietary data at baseline, 3 and 9 months and were analysed using a novel algorithm to score diet quality (based on the Dietary Guideline Index, DGI)2. Total DGI scores ranged from 0-120, with sub scores for consumption of core (0-70) and non-core foods (0-50). For all scores, a higher score or increase reflects better diet quality. The CV risk factors assessed included blood pressure (SBP and DBP) and fasting lipids (total (TC), high and low-density lipoprotein cholesterol (HDL-C, LDL-C) and triglycerides (TAG). Mixed model analyses were used to determine changes over time (reported as mean ± standard error), and Spearman rho (rs) evaluated associations between DGI score and CV risk factors. Dietary energy intake was significantly restricted at 3 months (−3222 ± 159 kJ, P<0.001, n = 114) and 9 months (−2410 ± 167 kJ, P<0.001, n = 100) resulting in significant weight loss (3 months −7.0 ± 0.4 kg, P<0.001; 9 months −8.2 ± 0.4 kg, P<0.001). Clinically meaningful weight loss (>5% body mass) was achieved by 81% of participants by 3 months. Diet quality scores were low at baseline (scoring 49.2 ± 1.5), but improved significantly by 3 months (74.7 ± 1.6, P<0.000) primarily due to reductions in the consumption of non-core i.e. discretionary foods (Core sub-score +4.0. ± 0.7, Non-core sub-score +21.3.1 ± 1.6, both P<0.001). These improvements were maintained at 9 months (Total score 71.6 ± 1.7, P<0.000; Core sub-score +4.4 ± 0.7 from baseline, P<0.000; Non-core sub-score +17.9 ± 1.6 from baseline, P<0.000). There were significant inverse relationships between changes in Total DGI score and changes in DBP (rs = −0.268, P = 0.009), TC (rs = −0.298, P = 0.004), LDL-C (rs = −0.224, P = 0.032) and HDL-C (rs = −0.299, P = 0.004) but not SBP and TG at 3 months. These data emphasise the importance of including diet quality as a key component when planning energy restricted diets. Automated approaches will enable researchers to evaluate subtle changes in diet quality and their effect on health outcomes.

Diet is a large influencer of the gut microbiota composition and function across the lifespan. However, information on whether and how diet can affect the brain via bidirectional communication between the gut and the central nervous system (the microbiota-gut-brain axis) is emerging. Immune, endocrine, humoral, and neural connections between the gastrointestinal tract and the central nervous system are important to this axis. The gut microbiota can produce cytokines, neurotransmitters, neuropeptides, chemokines, endocrine messengers, and microbial metabolites (e.g., short-chain fatty acids, branched chain amino acids, and peptidoglycans), some of which can enter the brain, influencing the function of brain cells. Animal studies investigating the potential of nutritional interventions on this axis have advanced our understanding of the role of diet in this bidirectional communication. This includes insights into microbial metabolites, immune, neuronal, and metabolic pathways amendable to dietary modulation. However, several aspects of the gastrointestinal tract and brain of animal models differ to humans, and it is important to consider these differences and similarities when evaluating the transability of the findings to the human context. Randomised clinical trials using dietary interventions in humans in this field are limited but have high potential application for clinical nutrition. In particular, several microbiota-targeted interventions have been explored as potential approaches for mental health. These approaches include probiotics, prebiotics, etc. as well as dietary approaches(1,2,3). However, there are limited clinical interventions with whole-dietary approaches. Most human studies used faecal samples to infer changes in microbiota parameters occurring in the gastrointestinal tract and do not consider the physiological changes in gastrointestinal physiology (e.g., transit time) that can directly or indirectly affect the diversity and composition of the gut microbiome. Future research considerations should include better characterisation of the participants at baseline (dietary patterns, gastrointestinal phenotype, and gut microbiota composition) to identify potential responders to dietary interventions. In addition to gut microbiota assessment, evaluations of physiological parameters, brain function and behavioural measurements should be considered as part of the study protocol. In this presentation, the current state of the literature triangulating the diet, the gut microbiota, and host behaviour/brain processes will be addressed. Future research considerations will also be discussed.

Breastfeeding is vital to infants’ health and development during their first year. The quality and quantity of breastmilk are closely linked to the mother’s nutrition [1]. However, for migrant women who become new mothers, various social, economic, and family factors can pose challenges that negatively affect their dietary and breastfeeding practices. Due to the limited research evidence, this study aimed to investigate the factors associated with breastfeeding duration in migrant women. The study sample was drawn from the Filipino Women’s Diet and Health Study (FiLWHEL). These women migrated to South Korea through marriage. At baseline (2014-2016), 504 women provided survey data, including demographic characteristics such as age, marital status, education, employment, income, and language proficiency. Anthropometric measures such as body mass index (BMI) and lifestyle factors were also recorded. Dietary intake of each food group was assessed using 24-hour recalls. We derived the Minimum Dietary Diversity for Women (MDD-W) from the ten food groups [2]. Breastfeeding (any) duration was defined as the average length in months per child. Multivariable logistic regression was used to evaluate the associations between participants’ characteristics and breastfeeding duration, with a cut-off of 12 months (<12 months; > = 12 months). Linear regression analysis was used to assess the relationship between each of these factors and breastfeeding duration in months. Out of the initial 504 women, 271 met the eligibility criteria, with the median age of 35 [interquartile range (IQR): 30,40] years, median breastfeeding duration of 4 [IQR: 1, 10] months, mean BMI of 23.8kg/m2, median (IQR) o fruits, vegetables, and legumes of 162.2 [76.9, 265.9] grams/day, and median of MDD-W score of 5 [IQR:4, 6]. Over 50% of the sample held a university degree or higher, but only 47.8% were employed. Most women were married (90%) and earned less than 20 million won (~AU$23,114.58) per year (65%). Over half had a good understanding of the Korean language. The cross-sectional regression analysis found no associations for breastfeeding length, except for the total fruit, vegetable, and legume intake. Women in the highest tertile of this consumption had a two-fold likelihood of breastfeeding for 12 months or longer [adj.OR (95% CI): 2.15 (0.99-4.68)]. While the MDD-W score had a positive association with breastfeeding for at least 12 months, it did not reach statistical significance [adj.OR: 1.11 (0.92-1.34)]. In the linear regression analysis, only vegetable consumption (per gram increase) was positively related to the length of breastfeeding (beta-coefficient: 0.016; SE: 0.006; p = 0.01). This study among Filipino migrant women in Korea suggests that higher consumption of fruit, vegetables, and legumes positively linked to breastfeeding for at least 12 months. Given the study’s small sample size, interpreting these results should be cautious and warrants further validation in other studies.

Almost half of countries globally are implementing national strategies to lower population salt intake towards the World Health Organization’s target of a 30% reduction by 2025(1). However, most are yet to lower population salt intake(1). We conducted process evaluations of national salt reduction strategies in Malaysia and Mongolia to understand the extent to which they were implemented and achieving their intended outcomes, using the findings to generate insights on how to strengthen strategies and accelerate population salt reduction. Mixed methods process evaluations were conducted at the mid-point of implementation of the strategies in Malaysia (2018-19) and Mongolia (2020-21)(2). Guided by theoretical frameworks, information on the implementation, mechanism and contextual barriers and enablers of the strategies were collected through desk-based reviews of documents related to salt reduction, interviews with key stakeholders (n = 12 Malaysia, n = 10 Mongolia), and focus group discussions with health professionals in Malaysia (n = 43) and health provider surveys in Mongolia (n = 12). Both countries generated high-quality evidence about salt intake and salt levels in foods, and culturally-specific education resources in 3 and 5 years respectively. However, in Malaysia there was moderate dose delivered and low reach in terms of education and reformulation activities. Within 5 years, Mongolia implemented education among schools, health professionals and food producers on salt reduction with high reach but with moderate dose and reach among the general population. There were challenges in both countries with respect to implementing legislative interventions and both could improve the scaling up of their reformulation and education activities to have population-wide reach and impact. In the first half of Malaysia’s and Mongolia’s strategies, both countries generated necessary evidence and education materials, mobilised health professionals to deliver salt reduction education and achieved small-scale salt reformulation in foods. However, both faced challenges in implementing regulatory policies and the scaling up of their reformulation and education activities to have population-wide reach and impact could be strengthened. Similar process evaluations of existing salt reduction strategies are needed to strengthen intervention delivery and inform areas for adaptation, to aid achievement of the WHO’s global target of a 30% reduction in population salt intake by 2025.

Energy restricted diets improve liver function(1) and habitual nut consumption has been associated with a lower prevalence of fatty liver(2). This study examined the effect of incorporating almonds in an energy restricted diet on liver health biomarkers. One Hundred and forty adults (42M:98F, 47.5 ± 10.8 years, BMI 30.7 ± 2.3 kg/m2) enrolled in a 9-month (9M) dietary intervention comprising 3 months (3M) weight loss (30% energy restriction) followed by 6 months (6M) of weight maintenance. Participants were randomly assigned to consume almonds (n = 68, AED) or isocaloric carbohydrate-rich snacks (n = 72, CRD) which provided 15% of total daily energy. At baseline (BL), 3M and 9M, fatty liver index (FLI) scores (0-100)(3) were calculated using body mass index (BMI), waist circumference (WC), fasting serum gamma-glutamyl transferase (GGT) and triglyceride (TAG) levels, and other liver health biomarkers were assessed by ultrasound (volume, visual appearance and elastography (a marker of stiffness due to fibrosis)). Intention to treat analyses were conducted using mixed effects modelling (fixed effects group and time, with participants as the random effect). Significant reductions from BL occurred over time (all p<0.001 for 3M and 9M) with no difference between groups (AED vs CRD, P>0.05) in BMI (3M: −2.44 ± 0.20 vs −2.32 ± 0.20, 9M: −2.83 ± 0.19 vs −2.81 ± 0.19 kg/m2), WC (3M: −8.04 ± 0.79 vs −7.00 ± 0.81, 9M: −8.72 ± 0.83 vs −9.14 ± 0.81 cm), TAG (3M: −0.24± 0.08 vs −0.22 ± 0.09, 9M: −0.37 ± 0.09 vs −0.21 ± 0.09 mmol/L), FLI score (3M: −23.8 ± 2.0 vs −17.6 ± 2.1, 9M: −23.8 ± 2.0 vs −17.6 ± 2.1), and liver volume (3M: −134.56 ± 38.30 vs −100.96 ± 37.25, 9M: −113.68 ± 37.42 vs −110.64 ± 35.47cm3). Significantly greater reductions occurred for AED compared to CRD at 3M and 9M in GGT (p = 0.003) (3M: −9.68 ± 1.93 vs −0.01 ± 2.00, 9M: −7.75 ± 2.06 vs −2.78 ± 2.15 IU/L) and liver visual assessment scores (p = 0.03) (3M: −0.58 ± 0.24 vs −0.45 ± 0.23, 9M: −1.33 ± 0.23 vs −0.50 ± 0.22). There were no significant changes in liver elastography over time or between groups. Energy restriction improved body composition and reduced the extent of fatty liver and liver size but did not change liver stiffness. The inclusion of almonds in an energy restricted diet demonstrated additional benefits to some liver health biomarkers providing support for almonds being incorporated into lifestyle interventions to improve liver function.

Snacking, namely, consuming food and beverages in-between main meals, especially snacks with a high fat, salt and/or sugar content, is a major contributor to excessive energy intake and long-term weight gain(1). There are many potential drivers of snacking behaviours, including physiological (e.g., hunger) as well as social, psychological, and emotional reasons(2). Individual differences, such as personality traits, have been linked to unhealthy snacking. Nevertheless, it is important to examine the potential explanatory pathways, such as motivations for snacking and habit strength, that may explain this relationship between personality and snacking. This cross-sectional study investigated the associations between personality traits, habit strength, motivations for snacking, and snacking behaviour, including choice and consumption. Participants were n = 230 Australian adults (female: n = 164; 71.3%) aged 18-77 years old (M = 34 years, SD = 13.4) who completed an online survey. The survey included assessments of personality traits (The Big Five Inventory 2), habit strength (the Self-Report Habit Index), motivations for snacking (The Eating Motivation Survey), momentary snack food choice (Snack Preference Task), and habitual snack food consumption (Snack Frequency Questionnaire). Overall, the most frequently selected motivations for snacking were ‘liking’, ‘convenience’, and ‘habit’. Correlation analyses were conducted to examine the relationship between motivations for snacking and snacking behaviour. We found that health motivation for snacking was negatively correlated with momentary choice (r = -.042, p <.01) and habitual consumption (r = -.033, p <.01) of unhealthy snack foods and beverages. Hierarchical multiple regression analyses were used to examine whether habit strength and the Big Five personality traits predicted both motivations for snacking and snacking behaviours after controlling for demographic variables. For health motivations for snacking, habit strength (beta = −0.15, p = .025), openness (beta = 0.50, p = .003, and conscientiousness (beta = 0.58, p = .001) were significant predictors. For momentary choice of unhealthy snacks, health motivation (beta = −4.35, p = .004), pleasure (beta = 3.53, p = .029), and visual appeal (beta = 5.29, p <.001) were significant predictors. For habitual consumption of unhealthy snacks, health motivation (beta = −5.39, p = .001), habit strength (beta = 2.89, p = .045) and neuroticism (beta = 5.16, p = .045) were significant predictors. These findings indicate that health motivation for snacking predicts both momentary snack preference and habitual snack food consumption. Moreover, personality traits may be linked with habitual unhealthy snacking behaviour via their association with specific motivations for snacking. Overall, these findings suggest that health promotion messages focusing on health motivation may be important for increasing healthier momentary and habitual snack choices to improve dietary intake and support weight management.

Plant-based milk import has been increasing in the Fijis supermarkets. While this milk may cater for vegans(1) and people with allergies from dairy milk, the question always remains that if the plant-based milk are equally nutritious and available at reasonable price in comparison to the dairy milk. Dairy milk is commonly consumed by the Fijian population while the plant-based milk is positioning itself into the market as alternatives. Therefore, this paper is aimed at comparing the nutrient content and price of milk from dairy cows and plant milk sources available in the supermarkets in Fiji. This study examines different brands of dairy and plant-based milk in 6 major supermarket chains in the central part of Fiji. There was 22 dairy milk, 6 soya milk, 5 almond milk and 4 oat milk sampled from these supermarkets. The median value of milk nutrient composition and price for dairy milks and different plant-based milks were calculated as the data was not normally distributed. The Kruskal- Wallis test was conducted to further analyse the difference between the nutrient composition and price of dairy milks and plant-based milk. The energy composition in the dairy milk was significantly higher (p < 0.01) when compared with plant-based milks soya almond milk and oat. There was a significant difference (p < 0.01) in dairy milk protein, fat and saturated fat when compared to plant-based milks. The result indicated that the protein, fat, and saturated fat are both significantly higher in cow’s milk. Milk carbohydrate analysis indicate higher composition in dairy milk therefore a significant difference (p < 0.01) was noted when compared to almond milk(except soya and oat milk). There is a significant difference (p < 0.01) in sugar indicating cow’s milk having higher sugar when compared to plant-based milk (except soya milk The sodium composition in the dairy milk and all the plant- based milk showed no significance difference (p > 0.05) in the composition. There was also significant difference (p < 0.05) in comparison of calcium composition of dairy milk and plant-based milk indicating almond milk with lower calcium. The phosphorus composition in dairy milk and plant-based milk indicates that there is a strong significant difference (p < 0.01) (except soya and oat milk). The riboflavin composition was significantly higher (p < 0.01) in dairy milk compared to soya and oat milk. Lastly, there was significant difference (p < 0.01) between price of dairy milk when compared to plant-based milk. The study concludes that there is more nutrient in dairy milk and the price is significantly lower than plant-based milk at which these nutrients are available in dairy milk.

Polycystic ovary syndrome (PCOS) is a common endocrine condition which affects up to 13% of reproductive-aged women and is associated with reproductive, metabolic and psychological features. Women with PCOS have a higher prevalence of longitudinal weight gain in population-based cohort studies compared to women without PCOS. On meta-analysis, women with PCOS also have an increased prevalence of overweight, obesity and central obesity, compared with controls. PCOS is therefore associated with an elevated prevalence of overweight and obesity which further worsen metabolic, reproductive and psychological dysfunction. Given the association between overweight and obesity and metabolic, reproductive and psychological dysfunction in women, weight management is a logical treatment strategy. This can be defined as prevention of excess weight gain, achieving a modest weight loss and sustaining a reduced weight long-term. This is best achieved through lifestyle management which traditionally refers to a complex multidisciplinary approach that combines dietary modification, physical activity and behavioural interventions. Lifestyle interventions and modest weight loss (5-10% of initial body weight) are associated with improvements in outcomes including central adiposity, hyperandrogenism, insulin resistance and cardiovascular risk factors. In PCOS specifically for dietary interventions, the majority of evidence indicates no differences between dietary approaches Lifestyle management advice should therefore follow general population guidance which states that lifestyle intervention can be achieved through a variety of dietary approaches providing these are tailored to dietary preferences and ensure the nutritional and health status of the individual patient with referral to a nutrition professional where possible. These recommendations are summarised in the 2023 International Evidence-based Guidelines on the Assessment and Management of PCOS. 1 These guidelines are now being translated and implemented internationally.

Carotenoids, a group of phytochemicals found in plant-based foods with yellow, red, or orange pigments, have been shown to be stored in the skin upon consumption of carotenoid-rich foods(1). Skin carotenoid levels can be measured using skin reflectance spectroscopy, which assesses skin lightness (L*), redness (a*), and yellowness (b*)(2). Previous research has demonstrated significant increases in skin yellowness (b*) after a 4-week high-carotenoid diet(2). The aim was to examine shorter-term changes (two weeks) in skin yellowness following the consumption of a Healthy Australian Diet rich in carotenoids compared to a Typical Australian Diet with low carotenoid content. The study analysed data from an eight-week randomised, cross-over feeding trial involving 34 adults (53% female, aged 38.44 ± 18.05 years). Participants were randomly assigned to each diet for two weeks, separated by a two-week washout period. The Healthy Australian Diet adhered to the Australian Dietary Guidelines(3), emphasising the consumption of carotenoid-rich fruits and vegetables such as carrots, pumpkin, tomatoes, red capsicum, and sweet potatoes. In contrast, the Typical Australian Diet was formulated based on apparent consumption patterns in Australia(4) and emphasised the intake of fruits and vegetables low in beta-carotene, such as white potatoes, onions, cauliflower, and pears. Skin carotenoids were measured using skin reflectance spectroscopy at three sites (palm, inner and outer arm), and each measurement was taken thrice. Overall skin yellowness (b*) was calculated as the average of all three measurements at all three sites. Measurements were conducted at four key visits: week 0 (end of run-in; baseline 1), week 2 (post-feeding phase 1), week 4 (end of washout; baseline 2), and week 8 (post-feeding phase 2). Differential changes in skin carotenoid levels between intervention groups were assessed using linear mixed-effect models, adjusting for diet sequence, feeding phase, body fat percentage, total fat intake, and subject ID as a random variable to account for potential autocorrelation. Post-hoc pairwise comparisons were conducted to evaluate the relative effects of each diet. Although there was a trend towards higher skin yellowness (0.215 ± 0.517; p = 0.41) following consumption of the Healthy Australian diet relative to baseline, and an inverse trend following the Typical Australian Diet (−0.118 ± 0.539, p = 0.56), the difference in change between the two diets was not statistically significant (p = 0.32). Notably, baseline values within this participant cohort were higher than previously reported at b* = 16.7(1) (baseline 1 b*: 17.57 ± 2.23, baseline 2 b*: 17.71 ± 2.26), which may influence the magnitude of observable change. The findings suggest that the two-week intervention duration may be insufficient to achieve statistically significant changes in skin carotenoid levels. Future investigations into whether plasma carotenoids increase first, with skin changes occurring later, could offer valuable insights into the potential utility of this as a biomarker validation of change in fruit and vegetable intake.

The local food environment plays an important role in food purchasing behaviours, and it is important to understand the how this context shapes the highly complex drivers of food choice for children and families. In Australia, children consume more than one-third of their total energy intake whilst at school(1), thus making the content of school lunchboxes an important target for nutrition promotion efforts. Supermarkets invest heavily in promoting food for inclusion in school lunchboxes, particularly in the ‘Back to School’ period, but little is known about the nutrition content or the packaging of the foods included in these promotions. This study aimed to examine the types and packaging of foods that are promoted by supermarkets as school lunchbox foods. Catalogues for six supermarket chains in Adelaide, South Australia were collected during the four weeks of January 2023, the window often described as the ‘Back to School’ period. An audit of the contents was conducted and items promoted specifically as ‘Back to School’ items were coded according to the type of food (fruits, vegetables, dairy, grains/cereals, protein or drinks), whether the items was packaged or unpackaged and the processing classification according to the NOVA criteria(2). Descriptive statistics were calculated. In the ‘Back to School’ period, each of the six supermarket chains produced 4 catalogues and items relating specifically to foods promoted for inclusion in school lunchboxes appeared in 18 of the 24 catalogues. A total of 151 food or drink items appeared in the ‘Back to School’ promotions in these catalogues, and 100% of these items were packaged; 29% were packaged in single-use plastic packaging, 25% were packaged in recyclable packaging and 46% were packaged in a combination of single-use plastic and recyclable packaging. In terms of foods, snack foods, including sweet (n = 32, 21%) and savoury (n = 21, 14%) snacks were highly represented (35% overall). Dairy products (n = 23, 15%), grains/cereal products (n = 23, 15%) and drinks (n = 20, 13%) were also featured, and spreads (e.g. vegemite, Nutella) appeared in 13% of catalogues (n = 12). Fruits (n = 8, 5%), vegetables (n = 3, 2%) and proteins (n = 5, 3%) did not appear in many catalogues. Seventeen (11%) foods were unprocessed, with 111 (74%) classified as ultra-processed foods. Supermarket catalogues promote ‘Back to School’ lunchbox foods that are overwhelmingly packaged and ultra-processed. Working with supermarkets to adapt the promotion of foods that are less packaged and less processed is an important step to improving the local food environment.

Hypertension, characterised by elevated blood pressure (BP), continues to be a major global public health problem. It is defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmH(1) and is the leading risk factor for cardiovascular diseases(2). Nutritional metabolomics (Nutrimetabolomics) presents an objective approach to explore the interplay between diet and health outcomes(3). Through analysis of intermediate molecules and metabolic byproducts, metabolomic profiles can objectively reflect an individual’s dietary intake and assess variations in metabolism(3). To date, no review has been conducted that investigates the relationship between diet, metabolites and BP regulation. This systematic review aimed to identify and synthesise findings of human dietary feeding intervention studies that have examined the role of metabolites in BP regulation. A comprehensive search was conducted in November 2022 across EMBASE, Medline, CINAHL, PsychINFO, Scopus and Cochrane databases. Search terms were defined using a combination of keywords, including “metabolome”, “diet”, and “blood pressure”. All included intervention studies explored the dietary metabolome from food provision, meals or supplements to a comparator or control intervention and, examined the relationship between dietary-related metabolites and BP in humans and published in English. The initial search identified 1,109 studies, with a final six studies meeting all eligibility criteria and included in the final review. Metabolites were identified in urine (n = 4), plasma (n = 2), or faeces (n = 1). Various analytical techniques were employed, including H-NMR, LC-MS, and GC-MS, while majority of studies used untargeted metabolomics (n = 4). Among included studies, five reported a significant association between individual metabolites and BP or change in BP. These investigations emphasised dietary patterns as the primary focus of analysis. In contrast, one study revealed no relationship between the investigated metabolites and BP. However, this particular study evaluated the impact of a single food product rather than dietary patterns. In total, 39 metabolites were linked to BP, with 36 associated with SBP and 25 with DBP. Several super-pathways involved in blood pressure regulation were identified, across metabolism of amino acids, carbohydrates, cofactors, vitamins, lipids, nucleotides, peptides, and xenobiotics. Within these, 17 distinct sub-pathways were delineated. The only metabolite found to have a significant relationship with BP measures across multiple studies was N-Acetylneuraminate. In one study, it showed a relationship with DBP, while another study linked it to a decrease in both 24-hour DBP and SBP. No other metabolites were consistently replicated between studies. Nutrimetabolomics appears to be a promising field in evaluation of diet and BP reduction. However, further research is required to understand which metabolites influence BP regulation.

Cow’s milk is the primary source of calcium in the NZ diet(1). The absence of dietary planning in a vegan diet can result in the individual unknowingly obtaining low intakes of calcium. Prolonged low calcium intakes can result in negative implications on bone mineral density by increasing the risk of osteoporosis later in life. The measurement of bone health parameters in NZ vegan adults have not been investigated. Therefore, we measured bone mineral density, markers of calcium homeostasis and assessed intake of essential nutrients for optimal bone health in vegans. This cross-sectional study included adults (>18yrs), who followed a vegan diet for 2 years minimum. Demographic and lifestyle information was obtained from questionnaires including previous history of bone fractures and background of familial osteoporosis. A 4-day food record was completed for analysis of calcium, zinc, protein, magnesium, phosphorus and vitamin C intake and compared to the Estimated Average Requirement (EAR)(2). Weight, height and BMI were obtained, bone mineral density was measured at the hip and spine via dual x-ray absorptiometry (DXA) and reported as Z and T scores. Plasma calcium concentrations were corrected for albumin. All values are presented as mean and standard deviation. The study included 212 participants, aged 39 ± 12.38 years, 71% female. T scores at the lumbar spine and femoral neck were −0.63 ± 1.22 (Z score: −0.29 ± 1.12) and −0.66 ± 1.00 (Z score: −0.24 ± 0.89), respectively. Nine participants had a Z-score of <-2.0 at the lumbar spine, and three at the femoral neck. Corrected calcium concentrations were 2.21 ± 0.33 mmol/L. Calcium intake was 917 ± 347.23 (range 195 to 2,429 mg/day) in all participants, which exceeded the EAR of 840 mg/day for adults aged 19-50 years. Men had higher intakes of calcium than women, 1,051 ± 363.7 mg/day (range 382 to 2,267 mg/day) vs. 867 ± 328.04 mg/day (range 194 to 2,428 mg/day), P-value <0.001. The main source of calcium in the vegan diet was tofu. The intake of protein (77 ± 27.80) g/day, magnesium (569 ± 181.05) mg/day, and vitamin C (145 ± 96.94) mg/day met the EAR, excluding vitamin and mineral supplements. However, the intake of phosphorus (1,472 ± 459.98) mg/day and zinc (10.6 ± 4.01) mg/day were below the EAR. The findings of this study suggest that bone health of vegans are not negatively affected by the exclusion of dairy in the diet, provided that appropriate dietary planning is included to avoid nutrient deficiencies associated with poor bone health. Despite mean intake of calcium exceeding the EAR, very low intakes demonstrated significant variations between participants.

As concerns grow about the impact of animal farming on the environment, the appeal of plant-based diets has increased(1). The most extreme of these diets is the vegan diet which excludes all animal and insect sourced products. The vegan diet is often lauded as being beneficial for cardiovascular health, with the exclusion of saturated fats from animal meats, and the high intake of fibre from fruit and vegetables. More lately, however, there has been an exponential increase in the availability of vegan ultra-processed (UPFs), ready to eat foods which may not be so heart healthy. This study aimed to audit the vegan-labelled, plant-based meat and dairy analogues (PBMAs and PBDAs) available in New Zealand supermarkets. The objective was to compare the nutrient content against foods of animal origin that these products emulate. The audit was completed between March and June 2022 using a combination of on-site data collection and online sources. Data were collected from New Zealand’s five major supermarkets, Countdown, Fresh Choice, New World, Pak’nSave and Four Square. The audit recorded vegan and plant-based labelled products imitating animal meats (chicken, mince, beef, sausage, burgers, bacon, nuggets), and dairy (milk, cheese, yoghurt). Nutrient composition was taken from the Nutrition Information Panel (NIP) for each product and then a mean (SD) derived from a sample of each category. Nutrient composition for the comparison meat and dairy products was taken from NZ FOODFiles(2). All nutrients were reported per 100g or100ml. The PBMAs generally had higher energy, sodium and fibre, and lower protein than their meat counterparts. For example, plant-based burgers compared with beef burgers had 863kJ vs 761kJ energy, 436g vs 130g sodium, 2.3g vs 1.2g fibre, 15g vs 19g protein per 100g. Total fat and saturated fat were mostly lower in the meat products than in PBMAs, except for sausages. The plant-based milk analogues were lower in protein and fat than dairy milk, except soy (protein) and coconut (fat) milks. PBDAs were either completely lacking in calcium or were fortified to a similar level as dairy milk. Most plant-based cheeses and yoghurts were not fortified with calcium and were higher in energy, total fat and saturated fat than dairy. Vitamin B12 fortification of all plant-based products varied widely but contained less than meats and dairy. The wide range of plant-based UPFs included in this audit demonstrated little or no health advantage over animal derived meats and dairy products. The high salt and saturated fat content of these products suggest increased cardiometabolic risk if consumed as a regular part of the vegan diet despite higher fibre content.

Brown Buttabean Motivation (BBM) is a Māori and Pacific-driven community-based organisation operating in Tāmaki Makaurau (Auckland) and Tokoroa. It provides free community exercise bootcamps and other social and health support programs. BBM’s foundational mission was to reduce, among Māori and Pacific people, the prevalence of obesity in Auckland through exercise and nutrition programs.1 This study aimed to understand participants’ engagement with BBM, and the meaning it has had in their lives, with a focus on nutrition. Combining Pacific Fonofale and Te Whare Tapa Wha frameworks, this was a process evaluation to understand the impact of BBM’s services on the community using qualitative methods and a systems analysis to identify program sustainability and improvement. Semi-structured interviews explored the benefits and values of engagement with BBM. Followed by cognitive mapping interviews (CMI) and group model building (GMB) to identify the motivations and challenges of sustained engagement. Participants described holistic health benefits and impacts on community wellbeing. BBM responds to inequitable nutrition contexts, through its FoodShare (food bank), community kitchen, and BBM Kai (nutrition literacy). Engagement changed family nutrition patterns, and benefits included healthier spending habits, and addressing food insecurity. Social inclusiveness represented the Fonofale foundation (family) and the roof (culture) was described as ethnic cultural practices and BBM culture. Nutrition was not highlighted by BBM participants in CMI or GMB activities. However, participants suggested BBM increase nutrition initiatives to enable all members to improve their health journeys. BBM was seen as not just an exercise program but their own and their family’s new way of life, that health was a journey, not a destination. Moreover, although participants mentioned nutrition and health benefits, there was an overwhelming understanding that the values of BBM, Pacific culture, and social collectivism were the drivers of engagement, motivating healthier practices. BBM could leverage existing strengths by incorporating nutrition-enabling initiatives that are achieved collectively. Opportunities for systematic intervention will be presented.