One year after stroke incidence, stroke survivors present a 50-fold higher risk of dementia compared with people without a history of stroke(1). Considering the importance of modifiable factors in the prevention of cognitive impairment, we aimed to systematically review the current evidence on the effect of diet on post-stroke cognitive impairment and dementia. MEDLINE, Embase, Scopus, and CINHAL were searched for clinical trials, cohort, case-control, and cross-sectional studies published in all languages until 01 May 2024. Studies examining the association of any nutritional intervention/exposure and cognitive function or dementia in stroke survivor adults were included, except when the intervention was combined with non-nutritional treatment. ROB2 (RCT), ROBINS (non-randomised clinical trial, cohort and case-control) and NIH (cross-sectional) tools were used for quality assessment. Twelve RCTs, 2 non-randomised clinical trials, 5 cohort, 2 case-control and 5 cross-sectional studies met the inclusion criteria and were included in the review. Most of them had moderate (13) to high risk (13) of bias. RCTs revealed no benefits of supplementing a high-dose of vitamin D (300,000 UI), vitamin C or B-vitamins (folic acid, B6, B12) for post-stroke cognitive performance, while the supplementation of B-vitamins combined with omega-3 improved temporal orientation. Cognitive function was also not associated with vitamin C intake (1000 mg/d) as reported in a case-control study. A cross-sectional study reported that stroke survivors with and without cognitive impairment had similar daily intakes of B-vitamins, vitamins C and D, while omega 3 and 6 fatty acids intakes were higher in participants without cognitive impairment. A higher risk of incident dementia was reported in calcium supplement consumers compared to non-consumers with a history of stroke, according to a cohort study. Four RCTs showed that while increasing energy and protein intake did not change cognitive outcomes, daily supplementation of N-Pep-12 (peptides and amino acids mixture) increased global cognitive function. Four trials on different phytochemical supplements (Ginkgo biloba extract, pomegranate polyphenols, guipitang and pycnogenol) reported mixed effects on global cognitive function. Finally, six observational studies on dietary patterns and food components indicated that higher adherence to the MIND diet (a combination of Mediterranean and DASH diets), and higher consumption of fish and fruits were related to a lower risk of cognitive impairment. Further, the regular consumption of coffee (0.5–1 cup/d) and tea (2–3 cups/day) was reported to halve the risk of post-stroke dementia. Despite limited evidence, this review indicates that healthy dietary habits with the addition of some key foods such as fruits, fish, coffee and tea offer possible benefits to reduce the risk of post-stroke cognitive impairment, while the consumption of supplements seems to have mixed effects. Thus, more research is required to better elucidate the role diets may have in preventing post-stroke cognitive impairment.

Current nutritional rating systems, like the health star rating, help consumers understand the nutritional value of food and were designed in an effort to combat obesity. However, these systems have limitations, especially for edible oils, which vary widely in composition(1). Coupled with the lack of standardisation in ranking edible oils, there has been advocacy for the introduction of different nutritional scores for edible oils. This study aims to develop a simple and easy-to-use nutritional scoring index based on the composition of extra virgin olive oil (EVOO). The composition includes all fatty acid parameters and total polyphenol content, measurable by nuclear magnetic resonance (NMR) spectroscopy, thereby avoiding the need for multiple analytical platforms. The development of an EVOO nutritional score involved: i) establishing a unique consensus dietary reference index (DRIs) for each component and evaluating their impact on human health(2,3); and ii) computing Scoring Reference Values (SRVs) for each component, expressed as grams of component per 100 g of EVOO, based on the assumptions of a daily energy intake of 2000 kcal, with a fat intake of 35% of total caloric intake(2,3), and considering EVOO as the only source of fat. A nutritional score (0–100) was developed based on saturated fat (SFA), trans-unsaturated fat, oleic, linoleic, alpha-linolenic acids, and polyphenols. Components with more substantial effects/evidence on human health were given greater weight in the scoring. The developed index was subsequently applied to evaluate 314 EVOOs that passed the International Olive Oil Council (IOC) quality criteria. These oils were sourced from Australia (n = 94), Greece (n = 54), Italy (n = 54), Spain (n = 69), and Tunisia (n = 43) and analysed using 400 MHz NMR spectroscopy. Nutritional scores for all samples showed a mean of 62.3 (range 13 to 94), with Australian EVOOs exhibiting the highest mean score of 65, followed by Spain, Tunisia, Italy, and Greece. EVOOs were differentiated by their SFA content and the balance between polyunsaturated (PUFA) and monounsaturated fatty acids (MUFA). MUFA and PUFA were typically inversely related, except for two Australian oils that achieved high levels of both. This novel scoring index for EVOOs, grounded in health-related compositional parameters, facilitates the differentiation of EVOOs based on their nutritional value. This enables consumers to make informed choices regarding their oil selection. Given the rising prevalence of obesity and its associated morbidity, this tool is particularly significant. Additionally, the implementation of this nutritional index encourages producers to produce oils with superior nutritional profiles.

Mood disorders such as depression and anxiety are increasing among individuals of all ages and can contribute significantly to decreased quality of life (QoL). The Mediterranean Diet (MedDiet) has been associated with improved mood state and QoL(1). However, few studies have determined the cost-effectiveness of delivering MedDiet interventions to address psychological wellbeing and QoL which is valuable as reducing the risk of non-communicable diseases through diet and lifestyle modification is a public health priority. We aimed first to determine the effect of a 6-month MedDiet intervention (MedLey) on QoL (SF-36V2), then to determine the cost of the intervention with the goal of completing a cost-effectiveness analysis. MedLey was a 6-month dietitian-led MedDiet randomised controlled trial in n = 152 Australian’s aged ≥ 65 years that led to significant improvements to markers of cardiovascular health. Intervention participants received intensive dietetic support while the equal-attention habitual diet group (HabDiet) were instructed to maintain their usual dietary pattern. Program costs were estimated including staff labour, food hampers and project development. Participants completed the SF-36V2 survey at three timepoints which generates 8 unweighted domain scores and a final ‘index score’ for use in economic evaluations and determination of quality-adjusted-life-years. Mean weighted index scores were generated using QualtiyMetrics software. Data were analysed using linear mixed effects models to determine a difference between groups in index score over time using a time*group interaction as a base model. A second model adjusting for age and gender was also analysed. MedLey program costs were estimated at $1,462 AUD per participant to deliver compared to control group participants $1,101—a differential of $361. Mean index scores at baseline and 6-months for the MedDiet and HabDiet group were 0.789, 0.824 and 0.818, 0.845, respectively. There were no statistically significant differences in index score from baseline to 6-months between or within groups for the base model. In a second model adjusting for age and gender, a within-group difference was identified in the control group between the 6 and 3-month timepoints (mean difference 0.040, p = 0.049). Though not statistically significant, the MedDiet group improved their index score from baseline to 6-months (mean difference 0.037, p = 0.141). The MedLey trial did not lead to statistically significantly improvements to QoL. Mean index scores of the MedDiet and HabDiet group at baseline were already considerably high leaving little room for improvement over a 6-month intervention period thus a robust cost-utility and economic evaluation could not be undertaken. A longer intervention period or follow up may have been needed to determine any protective effects of the MedDiet. RCTs should continue to investigate the relationship between a MedDiet and QoL and estimate program costs which could be used as community programs for mood disorder prevention.

Healthy eating patterns from sustainable food systems are crucial for population and planetary health(1). Primary schools are opportune settings for teaching children about food, nutrition and sustainability(2) (FNS), though little is known about the delivery of FNS education in this sector. This study aimed to analyse current approaches to FNS education in Australian primary schools. A cross-sectional online survey (open from August 2022–October 2023) with closed- and open-ended questions collected data about (i) teacher perceptions/attributes regarding FNS education (e.g., importance, understanding, knowledge/skills, training); (ii) FNS teaching practices (e.g., frequency, teaching approaches); and (iii) factors influencing FNS education (e.g., funding, policies). Statistical analyses were conducted using STATA. Descriptive statistics were generated for all categorical data. Chi-square tests and post hoc analyses using contingency tables and adjusted standardised residuals analysed associations between frequency of FNS education and teaching approaches (cross-curricular subject vs stand-alone subjects vs both) and presence of FNS-related policies, access to funding and teacher training. Statistical significance was set at p < 0.05. Qualitative content and thematic analyses of open-ended questions were conducted using NVivo 14. Participants were 413 Australian primary school teachers recruited via social media, organisational mailing lists and departmental school listings. Most teachers reported it is extremely/very important to teach students about nutrition (83.8%), food skills (69.7%) and food sustainability (74.1%), and these topics were considered equally important to most mandatory curriculum subjects. FNS was generally taught only 1–2 times per term (29.9%) or 1–2 times per year (31.6%), and 44.1% of teachers taught this as both a stand-alone and cross-curriculum subject. Teachers reported high levels of understanding (89.3%/92.5%/78.7%) and knowledge/skills (70.5%/75.5%/62.5%) to teach students about food, nutrition and sustainability respectively. Less than a third were trained in food (22.8%), nutrition (29.5%) or sustainability (24.5%) education. Less than a third of teachers had access to funding for FNS activities (29.8%) or training (19.9%) or were from schools with policies about including FNS education in the curriculum (28.5%). There was a significant association between frequency of FNS education and teacher training, access to funding and presence of FNS curriculum policies (all p < 0.001). Teachers who were trained to teach nutrition, food skills or food sustainability were more likely to teach this as both a stand-alone and cross-curricular subject (all p < 0.05). Within open-ended responses, teachers described personal factors (e.g., workload) that influenced their FNS teaching practices, as well as factors related to students’ families (e.g., family food practices), the curriculum (e.g., overcrowding) and the school environment (e.g., time, funding, training). Strengthening FNS education in the Australian primary school sector is an important next step for public health. Researchers and policy makers should explore opportunities for training, funding and policies to prioritise FNS within the curriculum.

There is growing interest in the role that dietary nitrate plays in cardiovascular health, with plant-sourced and animal-sourced nitrate showing potentially positive or negative effects. Inflammation is a key factor in the development and progression of atherosclerosis, a major contributor to cardiovascular disease (CVD). A recent review highlighted the potential of nitrate to modulate inflammatory processes.(1) However, research investigating the association between dietary nitrate intake from different sources (plant-sourced nitrate, nitrate-additive-permitted meat, and meat with naturally-occurring nitrate) and inflammation in humans is limited. This study aimed to investigate associations between source-dependent nitrate intake and inflammatory markers—namely lipoprotein-associated phospholipase A2 (Lp-PLA2) and high sensitivity C-reactive protein, (hs-CRP)—as well as traditional CVD risk factors. Among 100 non-smoking adults (mean age 49 ± 13 years, 31% male), cross-sectional associations between nitrate intakes from plant and animal sources (estimated from food frequency questionnaire data in combination with comprehensive food databases specifying food nitrate content)(2,3) and 1) Lp-PLA2 and hs-CRP measured in fasting plasma samples, and 2) blood lipid levels, blood pressure and waist circumference, were examined. Linear and logistic regression models were adjusted for sociodemographic, lifestyle and dietary confounders. Participants were classified as high-risk (either diagnosis of type 2 diabetes or two or more other CVD risk factors), or low-risk (normal health metrics and an absence of chronic disease). After adjusting for demographic and lifestyle confounders, a 1 standard deviation (SD) (95.73 mg/day) increment in plant-sourced nitrate intake was associated with a 0.191 SD lower LDL cholesterol (β = -0.191, 95% CI [-0.376, -0.004], p = 0.045; equivalent to -0.21 mmol/L), but not with any of the other outcomes. In contrast, intakes of naturally occurring animal-sourced nitrate were not associated with any of the outcomes. A 1 SD (0.32 mg/day) increment in nitrate intake from additive-permitted meat-sources was associated with a 0.192 SD higher waist circumference (β = 0.192, [0.005, 0.380], p = 0.042; equivalent to +1.29 cm) and a 0.208 SD lower HDL cholesterol (β = -0.208, [-0.362, -0.054], p = 0.009; equivalent to -0.10 mmol/L), but not with LDL cholesterol, triglycerides, blood pressure, Lp-PLA2, or CRP. No clear differences between CVD risk groups were observed. In conclusion, while no associations were found between naturally occurring animal-sourced nitrate and inflammatory markers or any CVD risk factors, nitrate from additive-permitted meat-sources were negatively associated with waist circumference and HDL cholesterol, whereas plant-sourced nitrate showed favourable associations with LDL cholesterol.

Systemic weight-bias may negatively influence nutrition recommendations and outcomes in the treatment of mental illness(1,2,3). However, weight loss is often considered a primary outcome in mental health care, despite the potential harm that may come from practising within a ‘weight-centric’ paradigm(4). Therefore, it is important to consider the impact of experiences of weight-based discrimination in mental health care, as well as investigate weight-neutral approaches in relation to mental and physical health and wellbeing. This study utilised a sequential explanatory study design. First, a systematic search was performed including observational studies of adult populations, with ≥ 1 mental or physical health outcome, and ≥ 1 validated measure of eating behaviour reflective of a weight-neutral approach. Outcomes were categorised into four domains (mental health, physical health, health promoting behaviours and other eating behaviours). Risk of bias was assessed using the Newcastle-Ottawa Scale. Next, a cross-sectional online survey was conducted among a community sample with self-reported diagnoses of depression or anxiety. Questions collected experiences of weight-stigma in mental health care, and validated measures such as the Depression and Anxiety Stress Scale (DASS-21), Stigmatizing Situations Inventory-Brief (SSI-B), and Weight Bias Internalization Scale (WBIS-M). Quantitative data were statistically analysed using Jamovi, while open-ended responses were thematically analysed using an inductive approach to reach consensus. In the systematic search, 8281 records were identified with 86 studies including 75 unique datasets, and 78 unique exposures including intuitive eating (n = 48), mindful eating (n = 19), and eating competence (n = 11). Eating behaviours were significantly related to lower levels of disordered eating, and depressive symptoms, and greater body image, self-compassion, diet quality, and higher fruit and vegetable intake. Among the 66 survey respondents (mean age 35.5 ± 11y), greater experienced weight bias (SSI-B) was significantly associated with greater depressive symptoms (r = 0.281, p < 0.05), and greater internalised weight-bias (WBIS-M) was significantly associated with greater depressive symptoms (r = 0.492, p < 0.001; β = 0.414, p = 0.001), anxiety symptoms (r = 0.437, p < 0.001; β = 0.390, p = 0.003), stress (r = 0.399, p < 0.01; β = 0.371, p = 0.006) and DASS-21 total score (r = 0.513, p < 0.001; β = 0.453, p < 0.001). Respondents reported experiences of weight-stigma that resulted in the mismanagement of mental health concerns, unsolicited diet and weight loss advice, and healthcare avoidance. Experiences of weight-stigma within mental health care have the potential to negatively impact mental health and nutrition-related recommendations. However, it must be considered that eating behaviours focused on health, not weight, are positively related to a range of mental and physical health outcomes. Therefore, it is vital healthcare professionals understand and assess their own biases related to weight, to reduce the impact of weight-bias on quality of care and consider weight-neutral approaches to better support mental health and wellbeing.

Chronic musculoskeletal pain (CMP) often disrupts daily activities, including dietary behaviours, which may lower overall diet quality(1). This study aimed to explore the extent to which participants with CMP perceived pain influences their eating behaviours and evaluate how diet quality is impacted during pain episodes. Twenty-five participants (72% women, 55 ± 16 years, 25.4 ± 4.6 kg/m2) were enrolled in a 2-week feasibility study, with scientific and exploratory outcomes reported(2). Clinic assessments captured pain sites, baseline pain intensity (0–100 mm Visual Analogue Scale, VAS), and thoughts and feelings evoked by pain (Pain Catastrophising Scale, PCS). Eating behaviours were assessed using the Dutch Emotional Eating Behaviours Questionnaire (DEBQ-E) and study-specific Food-Related Behaviours Questionnaire (FBQ). Participants completed 4-day weighed food records (WFR) and reported pain (via VAS) concurrently at each eating occasion. Daily pain intensity was obtained by averaging VAS at each eating occasion. Using a novel algorithm, diet quality was scored from WFR (FoodWorks, Xyris) data using the Dietary Guideline Index (DGI), generating total (0–120), core (0–70) and non-core scores (0–50) for each day’s intake, and averaged for the 4-days(3). Higher DGI scores reflect better diet quality. Spearman rho (rs) explored associations between baseline pain and diet outcomes. Linear mixed-effects (LME) models explored whether daily pain intensity (VAS) predicted fluctuations in diet quality (DGI scores). The FBQ responses were reported descriptively. Most participants (84%) reported multiple pain sites, with mild-moderate intensity (initial VAS, 40.8 ± 23.0) and poor diet quality (DGI total score 51.6 ± 18.0). Higher baseline pain intensity was associated with lower average DGI core food scores (rs −0.470, p = 0.018). Higher PCS scores correlated with lower average DGI total, and core food scores (rs −0.397, p = 0.049 and rs −0.442, p = 0.027), and higher DEBQ-E scores (rs 0.521, p = 0.008). However, when captured concurrently with dietary intake, LME models indicated that average daily pain intensity, which varied across the 4-days (VAS range: 0.8–85.0) did not significantly predict daily diet quality (DGI total, core, or non-core scores). Most participants disagreed that pain influenced their dietary behaviours (40–84% disagreement), with the highest agreements (31%) for choosing less healthy foods and snacking more frequently when in pain. This study suggests dietary behaviours are associated with CMP, with lower core food intake related to higher pain intensity, and emotional eating associated with pain catastrophising. The concurrent assessment of diet quality and pain intensity provided a novel approach to explore these relationships. However, although we observed fluctuations in pain intensity, these did not influence dietary intake and associated diet quality. This study highlights the importance of capturing diet quality and dietary behaviours in people with persistent pain.

People with intellectual disability experience significant health inequality, and consequently poor health outcomes. Although research can facilitate change, there is a risk of researchers propagating inequity by selecting methods that exclude people with some forms of intellectual disability. We argue for participatory research methods that enable inclusion.

Increased temporal variability in the gut microbiome is associated with intestinal conditions such as ulcerative colitis and Crohn’s disease, leading to the recently established concept of microbial volatility (1). Increased physiological stress has been shown to increase microbial volatility indicating that microbial volatility is susceptible to external interventions(1). Dietary fibre positively affects the gut microbiome, but it is unclear if it impacts microbial volatility. The gut microbiota influences hypertension, and high-fibre intake reduces blood pressure (BP)(2). However, not all individuals exhibit a response to these fibre-based dietary changes, and the reasons for this variability remain unclear. Similarly, it is unknown whether the degree of stability of the gut microbiota consortium could be a determining factor in individual responsiveness to dietary interventions. Here, we aimed to identify: i) whether gut microbiome volatility differs when dietary fibre vs placebo interventions, and ii) whether microbiome volatility discriminates between BP responders and non-responders to a high fibre intervention. Twenty treatment-naive participants with hypertension received either placebo or 40g per day of prebiotic acetylated and butyrylated high amylose maize starch (HAMSAB) supplementation for 3 weeks in a phase II randomised cross-over double-blind placebo-controlled trial(3). Blood pressure was monitored at baseline and each endpoint by 24-hour ambulatory BP monitoring, with those experiencing a reduction between timepoints of ≥ 2 mmHg classified as responders. Baseline stool samples were collected, and the V4 region of the 16S gene was sequenced. Taxonomy was assigned by reference to the SILVA database. Microbial volatility between timepoints (e.g., pre- and post-intervention) was calculated as the Euclidian distance of centred log-ratio transformed genera counts (Aitchison distance). No difference was observed in microbial volatility between individuals when they received the dietary fibre intervention or the placebo (21.5 ± 5.5 vs 20.5 ± 7.7, p = 0.51). There was no significant difference between microbial volatility on the dietary intervention between responders and non-responders (21.8 ± 4.9 vs 20.9 ± 7.2, p = 0.84). There was no association between the change in BP during intervention and microbial volatility during intervention (r2 = −0.09, p = 0.72). These data suggest that temporal volatility of the gut microbiota does not change with fibre intake or contribute to the BP response to dietary fibre intervention trials in people with hypertension.

Teacher food and nutrition (FN) practices influence their personal health and wellbeing outcomes, with implications for students. As educators, teachers role model FN practices to students and act as health promoters. Our team’s recent scoping review outlined the lack of standardised methods used to assess FN constructs in teachers, with limited validated and composite tools available that measure FN constructs, especially culinary factors, alongside measures of wellbeing(1). The importance of teacher FN education, to facilitate effective school health promotion, is highlighted by the World Health Organization and the United Nations Education Scientific and Cultural Organization. Therefore, understanding the scope of teacher FN practices in relation to teacher wellbeing is critical, yet limited evidence currently exists. This research aims to examine baseline data on teacher FN practices and potential FN predictors of teacher health and wellbeing from the Australian longitudinal teacher FN-related health and wellbeing study. The Teacher Food and Nutrition Questionnaire (TFNQ) consists of nine sub-scales and 21 single-item measures using pre-defined food, nutrition, and wellbeing constructs. This provides a composite evaluation tool to collate data on teacher FN practices for comparison with wellbeing outcomes, including stress and burnout. Descriptive statistics and Pearson correlation coefficient (r) were used to assess relationships between food, nutrition, and wellbeing constructs, and linear regression to determine slope of significant relationships using diet quality (i.e., the Fruit and Vegetable Variety index), wellbeing (i.e., burnout) and professional FN confidence as outcome variable(s) of interest. A total of n = 112 secondary teachers completed the baseline TFNQ (September 2023). Of these, the majority were female (87.5%), aged 31–45 years (52%), with 90% on full time contracts. Mean diet quality score was 92.0 (maximum score (MS) of 190), with sub-scale score for vegetable (63.2/122 MS) and fruit (28.9/68 MS) intake. Of the wellbeing measures, burnout (16.3/24 MS), stress (7.3/10 MS) and coping (6.2/10 MS) were measured alongside teacher food skills confidence (105.7/133 MS) and food agency (40.9/55 MS). Teacher FN confidence to role model healthy FN practices was moderately correlated to food agency r = −0.43 (p < 0.001), and personal subjective wellbeing ‘satisfied’ r = 0.41 (p < 0.001). A moderate correlation was observed between vegetable intake and food skills confidence r = 0.42 (p < 0.001), with a moderate negative correlation observed between food agency and teacher burnout r = −0.43 (p < 0.001). Overall, these baseline data confirm teacher diet quality is suboptimal, with teacher food agency and/or food skills confidence demonstrating moderate correlations with all three study outcomes of teacher wellbeing, diet quality and professional FN confidence. These data provide a snapshot of secondary teachers’ FN practices and wellbeing. Results inform development of professional development to support FN behaviours as a contributing factor for optimal teacher health and wellbeing.

Older adults are at an increased risk for both malnutrition and cognitive decline(1,2). However, the relationship between nutritional status and cognitive decline remains unclear, and was investigated in this study. This is a cross-sectional analysis of baseline data from the Capacity of Older Individuals after Nut Supplementation (COINS) study, a randomised controlled trial investigating the effect of peanut butter on functional capacity in older adults. Older adults aged 65 years and over, who were community-dwelling, generally healthy and at risk for falls (simplified fall risk screening score ≥ 2) were recruited as part of COINS study. Nutritional status was measured using the Mini Nutritional Assessment (MNA) tool (score range 0 to 30). An MNA score of ≥ 24 indicated normal nutrition status, while a MNA score of < 24 was indicative of at-risk for malnutrition. Cognitive performance was measured by the validated Montreal Cognitive Assessment MoCA (range 0 to 30), and Trail Making Tests-A and B (TMT-A, TMT-B) (as time taken to complete tasks) tools. The MoCA test further provided scores on visuospatial/executive function, naming, language, attention, abstraction, delayed recall, and orientation domains. Multivariable linear regression analysis was used to investigate the association between nutritional status and cognitive function, adjusted for age, sex and BMI. A total of 118 older adults with complete data were analysed (83% females, age (mean ± SD) = 74 ± 4 years; BMI = 27.5 ± 4.2 kg/m2), of which 93.2% (n = 110) were considered to have normal nutritional status, and the remaining 6.8% (n = 8) were deemed at risk of malnutrition. In terms of cognitive function status, 40.7% (n = 48) had normal cognitive function (MoCA score ≥ 26), 56.7% (n = 68) had mild cognitive impairment (MoCA score 18–25), and 1.7% (n = 2) had severe cognitive impairment (MoCA score 10–17). After adjusting for age, sex, and BMI, MNA score was positively associated with both overall MoCA scores (β (95% CI): 0.29 (0.04, 0.54), p = 0.024) and the visuospatial/executive function (β (95% CI): 0.16 (0.05, 0.28), p = 0.006), but not with other cognitive domains or TMT performance. In summary, our findings suggest that nutritional status assessed via MNA may be predictive of global cognitive function. Future studies are needed to determine if MNA could be a surrogate marker or risk factor for cognitive declines.

What does empire look like from spaces where multiple imperial projects converge? Through analysis of Molla Nasraddin, a pioneering satirical magazine from the early twentieth-century Caucasus, I reveal local engagements with empire that defy traditional binaries of center versus periphery, indigenous versus foreign, and resistance versus accommodation. While critical scholarship has powerfully demonstrated how imperial power shapes local life—from technologies of rule to cultural categories and patterns of inequality—such analysis is typically conducted through the lens of a single empire. In the Caucasus, where Russian, Ottoman, and Iranian empires overlapped, Molla Nasraddin developed a distinctive blend of visual satire, character types, and multilingual wordplay that functioned as a form of satirical pedagogy, cultivating what I term “inter-imperial literacy”: the capacity to recognize deep connections between neighboring imperial worlds while maintaining critical distance from each. Through sustained correspondence with readers across three empires during their near-simultaneous revolutionary upheavals (1905–1908), the magazine gave voice to a public defined not by fixed identities but by their capacity for protean transformations across imperial boundaries. While nation-states would eventually redraw the Caucasus, Molla Nasraddin provides a window into a moment when historical borderlands—not imperial centers—offered the most penetrating insights into the workings of empire. In these spaces, elements adopted from competing empires become creative resources for local expression, while apparent cultural alignments conceal critical distance, enabling views of empire at once intimate and askance.

Published discussions of academic plagiarism in theology are uncommon but nevertheless necessary. This article defends the importance of post-publication peer review of prior scholarship in theology as an essential practice for maintaining the reliability of the body of published research literature. Open conversations about violations of research and publication ethics support a culture of scholarly integrity. Two articles published by one prolific 20th-century researcher provide distinctive and instructive case studies. Those two continue to be cited as original contributions to scholarship, even though they consist of sentences and paragraphs copied without clear attribution from a variety of earlier authors. Without post-publication peer review, yesterday’s plagiarism will affect the scholarship of tomorrow.

A relationship between characteristics of gut microbiota and obesity are now well-established(1). However, less well-understood is the extent to which these microbiological features change during periods of weight loss. This study aimed to investigate the relationship between gut microbiota and weight loss in adults (aged 25 to 65 years, BMI of 27.5 to 34.9 kg/m2) enrolled in a 9-month randomised controlled trial(2). Participants were randomised to consume an energy-restricted diet that was either almond-enriched (30–50 g/daily) or nut-free (carbohydrate-rich snack foods). Data were collected at baseline (BL, n = 108), 3 months (3M, weight loss, n = 87) and 9 months (9M, weight maintenance, n = 82) for body weight, diet composition (weighed food diaries) and faecal microbiota composition (16S rRNA V4 amplicon sequencing). Paired data were analysed using mixed-effects models adjusted for baseline BMI, age, sex, dietary fibre. As reported previously, significant weight loss occurred for both diet groups to an equal extent(3). Significant inverse relationships were observed at BL between BMI and both microbiota richness (number of unique bacterial taxa detected) (estimate = −6.56, 95% CI = −9.9 to −3.19, p = 0.0002) and diversity (Shannon’s index) (−0.06, −0.1 to −0.02, p < 0.001). The strongest relationship at BL involved members of the Christensenellaceae bacterial family, which negatively correlated with BMI (r = −0.26, p = 0.007), consistent with prior studies(3,4). Microbiota richness (8.79, −0.73 to 18.34, p = 0.024) and diversity (0.08, −0.01 to 0.18, p = 0.019) were significantly higher at 9M compared to BL but not at 3M (p > 0.05). Compared to BL, microbiota composition (the taxa detected and their relative abundance) was significantly at 3M (p < 0.001) and 9M (p = 0.007). Following weight loss at 3M, significant increases in the relative abundance of members of the Christensenellaceae and Ruminococcaceae families were observed (log2 fold change > 1, FDR p < 0.05). Positive associations between weight loss and an increase in the relative abundance of Christensenellaceae family was evident at 3M (0.001, 0.0002 to 0.002, p = 0.010), but did not remain significant at 9M. Additionally, weight loss at 3M (0.0002, 1.3 × 10-5 to 0.0005, p = 0.038) and at 9M (0.0002, 4.6 × 10-6 to 0.0005, p = 0.045) was positively associated with an increase in the relative abundance of Lachnospiraceae ND3007, a bacterial genus associated with improved diet quality(5). Our findings demonstrate that the abundance of specific bacterial populations within the gut microbiota change in a manner that is proportionate to weight loss resulting from an energy-restricted diet. The extent to which these microbes are simply markers of altered diet, or whether they contribute in a causal manner to weight loss, as suggested by emerging preclinical data(3), is yet unknown.

Asthma is a chronic inflammatory disease of the lungs, characterised by variable airflow limitation and symptoms including shortness of breath, wheezing, coughing and chest tightness(1). One in 9 Australians has asthma and 42% also have obesity(1). The risk of developing asthma doubles in people who have obesity(2). While obesity is associated with increased severity of asthma(3), people with obesity have more severe asthma symptoms, poorer lung function, reduced quality of life and an increased risk of an asthma exacerbation(3). Response to medication also tends to be impaired, therefore limiting the efficacy of pharmaceutical management(4). Obesity is associated with increased systemic inflammation and there is some evidence that this inflammation may extend to the airways of adults with asthma; with research suggesting obesity is associated with increased airway inflammation(5). The impact of weight management on airway and systemic inflammation in asthma is unclear. Weight loss has been shown to improve asthma and, as such, has been recommended in asthma management guidelines(1). However, the ideal approach to sustainable weight loss in people with asthma is unknown. The aim of this systematic review is to determine both the short- and long-term efficacy of different obesity management approaches in adults with obesity and asthma, by systematically reviewing the literature. Medline, Embase, CINAHL, Scopus, Web of Science, Current Contents and Cochrane Central Register of Controlled Trials were searched up to January 2024, for obesity management interventions that assessed changes in clinical asthma outcomes, body composition, inflammation, and/or metabolic parameters. Studies were grouped by intervention type (lifestyle modification, pharmacotherapy, and bariatric surgery) and follow-up duration (< 12 months and ≥ 12 months). Eighteen lifestyle interventions, two pharmacotherapy and 17 surgical studies were included in the systematic review and 15 in the meta-analysis. All (n = 18) lifestyle interventions reported short-term results (< 12 months) and two reported long-term results (≥ 12 months). For surgical interventions, five reported short-term outcomes and 94% (16/17) reported long-term outcomes. 69% (9/13) of the lifestyle interventions observed statistically significant improvement in asthma symptoms in the short-term. Only 2 studies report long-term results (≥ 12 months) with improvements maintained in 50% (1/2) of studies. All surgical interventions (8/8) observed statistically significant long-term (≥ 12 months) improvements in asthma symptoms at twelve months. Research suggests that lifestyle interventions to manage obesity improve asthma symptoms in the short-term; however, the long-term efficacy is less certain due to the small number of studies. Surgical interventions show improved asthma symptoms at 12 months. Additional research is required to better understand the optimal obesity management approach and duration for adults with comorbid obesity and asthma.

In Australia, Sports foods are increasingly being consumed by non-athletes, despite their intended purpose to supplement additional nutrient intake for high energy output by athletes(1,2). Recent evidence suggests that sports food are perceived as regular foods and are being used by non-athletes for purposes contrary to which they were designed(1,3). However, in contrast to lay-perceptions, this growing trend poses health risks, including nutrient overconsumption and unwanted health-related side effects such as caffeine overdose(4,5). Many consumers are also relying on the recommendation of sports food products through digital media sources and the use of misleading packaging information to choose products(1,6), although the factors influencing the use of these is unclear. Consumer sports food choice is complex, influenced by multiple social and ecological factors, therefore this study used an adapted Social-Ecological Model of sports food choice to examine the relevant factors that influence the perception of risks, regulations and on-pack attributes. The aim of this study was to explore non-athlete Australian sports food consumers’ perceptions of the risks associated with consumption, views about on-pack warnings and regulations in Australia and perceptions of packaging attributes displayed on these foods through a social ecological lens. This study also examined the suggestions to improve on-pack warnings and regulations of sports food products in Australia. Qualitative semi-structured online interviews were conducted with n = 15 non-athlete Australian adult sports food consumers. Reflexive thematic analysis was used to code responses using NVivo software. Participants had conflicting views on the risks associated with sports food consumption perceiving them to be high risk to others but of limited risk to themselves. Consumers trusted some packaging information more than others. That is, the Nutrition Information Panel and claims were seen as more credible than packaging colours and images. Digital media was the key source of recommendation for the selection of sports food products, particularly YouTube and podcasts. All participants in the study mentioned that warnings and regulations were too generic, not applicable to them and that government regulations lacked credibility and validity. Participants also suggested improvements for warning labels and regulatory measures such as providing more information, greater restriction on sale locations and on the ability for certain consumers to purchase these products. Consumption of sports foods by non-athletes is influenced by attitudes towards personal risks, the persuasive influence of digital media, and perceptions of the warnings and regulations as being inadequate. Findings highlight the need for stricter packaging and regulations that ensure marketing controls and provide safer sports food products for non-athletes to consume. Future research should track these perceptions over time to ensure that improvements to packaging clarity and regulatory measures impact consumer consumption of sports foods.

In this paper, we show that the diffraction of the primes is absolutely continuous, showing no bright spots (Bragg peaks). We introduce the notion of counting diffraction, extending the classical notion of (density) diffraction to sets of density zero. We develop the counting diffraction theory and give many examples of sets of zero density of all possible spectral types.

The number of people affected by at least one chronic disease is increasing worldwide, with poorer health-related quality of life (HRQOL) being a major consequence(1). HRQOL is an important measure for quantifying and evaluating the impacts of a disease or intervention on self-perceived wellbeing. Anti-inflammatory diets are consistently associated with improvements in disease-specific outcomes(2,3), but their effect on HRQOL is unclear. This systematic review and meta-analysis aimed to estimate the effectiveness of anti-inflammatory dietary interventions on HRQOL in adults with one or more chronic diseases. Five databases were searched from inception to May 2024 for randomised controlled trials evaluating the impact of an anti-inflammatory diet (e.g., Mediterranean, low-carbohydrate) on HRQOL. Screening, data extraction, and risk of bias assessment using the Cochrane Risk of Bias v2.0 tool were performed independently by two authors. Certainty of evidence was determined using the GRADE approach. Pooled effect sizes for HRQOL, separated into mental (MCS) physical (PCS) and general component scores (GCS) were calculated using random-effects meta-analyses and reported as standardised mean difference (SMD). Subgroup analyses and meta-regressions were performed to assess the influence of study-level characteristics on HRQOL outcomes. Twenty-three studies reporting HRQOL data for 2753 participants were included. The most common chronic diseases evaluated were type 2 diabetes (8 studies, 35%), musculoskeletal conditions (5 studies, 22%), and cardiovascular conditions (3 studies, 13%). Anti-inflammatory dietary interventions evaluated included the Mediterranean diet (14 studies, 61%), low-carbohydrate diets (8 studies, 35%), Dietary Approaches to Stop Hypertension (1 study, 4%) and low-sugar, low-yeast diet (1 study, 4%). Anti-inflammatory diets were associated with small improvements in PCS compared to usual care/non-anti-inflammatory dietary interventions such as national dietary guidelines and low-fat diets (SMD 0.22, 95% CI 0.06 to 0.38) but not MCS (SMD 0.10, 95% CI −0.02 to 0.23) or GCS (SMD 0.40, 95% CI −0.32 to 1.13). Assessment by study-level characteristics revealed that studies with a higher risk of bias reported a larger effect on PCS, and diet-only interventions (compared to multi-component interventions) had a greater effect on MCS. No study met the Cochrane criteria for low risk of bias, and certainty of evidence was low (PCS and MCS) to very low (GCS). This systematic review suggests that anti-inflammatory diets may lead to a small improvement in physical HRQOL, but not mental or general HRQOL. The low certainty of evidence calls for further high-quality RCTs with detailed descriptions of dietary interventions in individuals with one or more chronic diseases.