Diet quality has been linked to socio-economic status. However, evidence within rural and regional populations is lacking. This cross-sectional study examined the relationship between diet quality and socio-economic position in adults living in rural and regional areas of Australia. The Australian Recommended Food Score (ARFS; range 0–73) measured diet quality (total and subscale scores). Area-level socio-economic position was determined by postcode-linked socio-economic index for areas (SEIFA), Index of Relative Social Advantage and Disadvantage scores, stratified into quintiles. The mean total ARFS (34·7; sd = 9·1; n 836) was classified as ‘getting there’. Findings showed significantly lower mean total ARFS between SEIFA quintile 1 (1 = lowest; mean total ARFS = 30·4; sd = 10·2; categorised as ‘needs work’) compared with all other SEIFA quintiles (F (44 831) = 8·44, P ≤ 0·001). Linear regression, adjusting for age, sex, income, education, employment status and household composition demonstrated significantly lower overall diet quality for SEIFA quintile 1 compared with SEIFA quintile 3 (B = –3·9; 95 % CI (–6·2, −1·5); P < 0·001) and lower subscale scores for vegetables (B = –1·6; 95 % CI (–2·7, −0·6); P = 0·003), fruit (B = –0·9; 95 % CI (–1·6, −0·1); P = 0·018) and grains (B = –0·6; 95 % CI (–1·3, −0·0); P = 0·050). After adjusting for individual confounders of diet quality, results indicate that lower area-level socio-economic position remained associated with poorer diet quality in this sample of rural and regional Australian adults. This suggests that broader social and environmental factors unique to these areas may impact diet quality and amplify individual barriers to achieving a healthy diet.

Foods in squeeze pouches are widely available and are marketed as practical, convenient, and healthy food options for infants and children. However, these products do not provide adequate nutrition for growth(1) or align with the front-of-pack health claims. To develop effective strategies and guidance for squeeze pouch consumption, we need to understand which squeeze pouches are used, by whom, and why. A cross-sectional online survey of Tasmanian residents was conducted and included questions about the frequency and types of squeeze pouches consumed by infants and children (aged 0–18 years), the demographics of families who use squeeze pouches frequently and an open-ended question to explore parental motivations for using these products. Data were analysed using descriptive statistics and logistic regression identified demographic predictors of frequent squeeze pouch use (weekly or more). Thematic analysis of qualitative survey responses explored parental experiences. Parents (n = 179; 78% female, 37% aged 35–45 years, 84% born in Australia; 73% university educated) reported on the squeeze pouch use of n = 248 children. Most infants (0–2 years; 71.4%) used squeeze pouches weekly (85.7% consumed in past year), favouring fruit-based (57%), dairy-based (57%), vegetable-based (50%), and meal-based (36%) pouches. Over half of children aged 2–5 years (62.5%) consumed pouches weekly (81.3% consumed in past year), preferring dairy-based (73%) and fruit-based (19%) pouches. Over a third of 6–12-year-olds (35.2%) consume pouches weekly (69.3% consumed in past year), including dairy-based (66%) and fruit-based pouches (20%). A smaller proportion (13.1%) of teenagers (13–17 years) consume pouches weekly (33.3% consumed in past year), primarily choosing dairy-based (26%) and fruit-based (6%) pouches. Younger parents were over 5 times more likely to be frequent users than parents aged over 46 years (18–34 years OR: 5.3, 95% CI 1.8–15.7; 35–45 years OR: 6.0, 95% CI 2.8–12.8). Speaking a language other than English (OR: 4.8; 95% CI 1.5–14.6) also significantly predicted frequent squeeze pouch use, while gender, education, employment status, income, and food security were not associated. Key themes from parents who identified as frequent squeeze pouch users centred around convenience, on-the-go feeding, and managing fussy eating or sensory needs. Parents discussed the societal paradox they experienced, with parents expressing a dislike for squeeze pouches yet using them for behaviour modification as a food reward or buying in bulk when discounted. An understanding of commercial food influences, and greater environmental consciousness were the most common themes described by parents who identified as non-users. This study highlights the widespread use of squeeze pouches among children, particularly in younger age groups but also into middle childhood and adolescence. Comprehensive national data is needed to inform public health strategies that minimise the use of squeeze pouches in children of all ages.

Establishing early healthy eating behaviours in the complementary feeding period through to adolescence is fundamental as it can affect the health trajectory of an infant’s life into adulthood and impact lifelong eating patterns(1). Consumer demand for commercial squeeze pouches is increasing and now expanding from infants to older children. Yet, emerging research suggests that these products are nutritionally poor(2), and are frequently marketed with misleading claims that oppose infant and child feeding guidelines(3). There is a paucity of information to inform public health strategies regarding the use of squeeze pouches throughout infancy and beyond. The aim of this scoping review was to determine the frequency and types of squeeze pouches consumed by children aged 0–18 years, the sociodemographic characteristics of users, and insights from parental experiences when using these products. The scoping review was conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. Three online databases were searched (MEDLINE, Scopus, CINAHL) in addition to grey literature. Screening of papers was completed by two independent reviewers. The database and grey literature search identified 125 articles, of which 16 underwent full-text review and 11 studies across five countries were included. In eight studies, the prevalence of squeeze pouch consumption ranged from 23.5% to 82.8% of infants and children, with studies reporting daily (n = 4; 8.7–29.2%), weekly (n = 7; 20.9–75.2%), and monthly consumption (n = 7; 16.7–70.4%). The predominant types of squeeze pouches consumed were fruit-based and dairy-based squeeze pouches. Frequent squeeze pouch use was 2.5 times more likely among families residing in areas of high deprivation, or if childcare was used. Household composition also impacted squeeze pouch use as families with two or more children were more likely to use these products. Additionally, frequent pouch use was associated with early cessation of breastfeeding and early introduction of solids. Five studies on parental perceptions of squeeze pouches reported benefits including convenience, perceived health, and perceived low cost while four studies expressed concerns relating to waste and environmental impacts, health and nutrition, and perceived high cost. This review highlights that the widespread use of squeeze pouches, particularly fruit and dairy-based pouches among infants and children is driven by convenience, changing family needs and effective marketing strategies. Public health policy is needed to address concerns regarding the nutritional quality of squeeze pouches and regulate marketing strategies to ensure parents are adequately informed about the health implications of these products. Further research should focus on identifying barriers to safe and nutritious complementary feeding practices and developing targeted education programs to promote optimal feeding practices that minimise the use of squeeze pouches in infants and children of all ages.

Food insecurity, the inadequate or insecure access to food due to financial constraints, is a growing concern in high-income countries like Australia(1). Food insecure adults may have reduced diet quality due to constraints on food purchasing and consumption(2) but further research is needed to understand how the severity of food insecurity impacts diet quality in an Australian setting. This study aimed to examine the relationship between diet quality and increasing severity of household food insecurity using validated measurement tools. A cross-sectional, online survey of Australian adults (aged 18 years+) used the USDA Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately, or severely food insecure. The Australian Recommended Food Score (ARFS; score between 0–73) determined diet quality (ARFS total) and sub-scale scores for eight food groups(3), with higher scores indicating higher diet quality. Diet quality score results are further categorised as “needs work” (<33), “getting there” (33-38), “excellent” (39-46) or “outstanding” (47+). Survey-weighted linear regression (adjusted for age, sex, income, education, location, household composition) analyses indicate that 45% of participants were living in households that experienced food insecurity, comprising 7% marginally, 18% moderately and 20% severely food insecure households. The ARFS total survey-weighted mean score for the whole sample (n = 804) was 32.4 (SD = 9.8). As the severity of household food insecurity increased, ARFS scores decreased. Marginally food insecure respondents reported a mean ARFS score three points lower than food-secure adults (B=-2.7; 95%CI [−5.11, −0.34]; p = 0.03), and scores reduced by six points for moderately (B=-5.6; 95%CI [−7.26, −3.90]; p<0.001) and twelve points for severely food insecure respondents (B=-11.5; 95%CI [−13.21, −9.78]; p<0.001). Marginally food insecure respondents had significantly lower vegetable sub-scale scores, moderately food insecure respondents had significantly lower sub-scale scores for all food groups except dairy, severely food insecure respondents had significantly lower scores for all sub-scale scores. Poorer diet quality is evident in adults living with any food insecurity but gets progressively worse as the severity of food insecurity increases. Interventions to reduce food insecurity and increase diet quality are required to prevent adverse nutrition-related health outcomes in food-insecure populations in Australia and beyond.

The reliability of different egg counting methods for estimating the intensity of Trichostrongylus tenuis infections in red grouse, Lagopus lagopus scoticus, was investigated in the autumn, when grouse may harbour high parasite intensities. Possible limitations to the use of these methods were also examined. Faecal egg counts were found to accurately estimate T. tenuis worm intensities, at least up to an observed maximum of c. 8000 worms. Two egg counting methods (smear and McMaster) gave consistent results, although the exact relationship with worm intensity differed according to the method used. Faecal egg counts significantly decreased with increasing length of sample storage time, but egg counts were reliable for estimating worm intensity for three weeks. The concentration of eggs in the caecum was also found to reliably estimate worm intensity. However, egg counts from frozen gut samples cannot be used to estimate worm intensities. These results conclude that, despite some limitations, faecal and caecum egg counts provide useful and reliable ways of measuring T. tenuis intensities in red grouse.