The gastrointestinal (GI) tract plays a critical role in nutrition and the pathophysiology of disease, and there is an increasing variety of methodologies available for the assessment of various aspects of GI physiology. Advancements in assessment methods, including techniques to study gut motility, fermentation, permeability, and microbiota composition, have provided researchers with powerful tools to investigate the impact of diet on GI tract physiology and the microbiota-gut-brain axis. Mechanistic evidence from reverse translational studies, which apply findings from human studies to preclinical models in a ‘bedside-to-bench’ approach, have also enhanced our understanding of the bidirectional interactions and candidate signalling molecules among the diet-gut-brain relationship. Interpreting data from these advanced techniques and study designs requires a thorough understanding of their principles, applications, and limitations. This review aims to summarise the methodological advances in GI tract physiology measurements and their application in nutritional studies, focusing on gut motility, fermentation, and permeability. We will present examples of how these techniques have been utilised in recent research, discuss their advantages and limitations, and provide insights on their use and interpretation in research. Understanding the capabilities and limitations of these tools is crucial for designing robust studies and elucidating the complex interplay between diet and the GI tract. The scope of this review encompasses recent advancements in GI tract assessment methodologies and their implications for nutritional research, providing a comprehensive overview for researchers in the field.

Discretionary foods that are energy-dense and nutrient-poor contribute to over one third of total energy intake in Australian children and adults, and the typical portion sizes of many discretionary foods have increased significantly in the last two decades(1). The portion size norms (described as a typical perception of how much of a given food people choose to eat at a single eating occasion) are likely to have increased concurrently, with larger sizes now being considered the new normal(2). Public health interventions are urgently needed to reduce the portion size norms and consumption of discretionary foods(3), but the acceptability of such interventions remains unknown. Therefore, this qualitative study aimed to gain insights into consumers’ attitudes towards potential interventions targeted at promoting portion control of discretionary foods. Four online focus group sessions were conducted via Zoom with healthy Australian adults who regularly consume discretionary foods. A question guide was developed to gather participants’ perspectives around four potential public health interventions; reduction of the default serving sizes, increasing serving size options, changes to package sizes, and improving serving size labelling. A female facilitator moderated all focus groups, with a second moderator present to capture other relevant details. Collected data were analysed using a hybrid approach combining deductive and inductive thematic analyses. A total of 35 participants completed the study (19 females, mean age 38 ± 14 years). Participants identified the current food environment as promoting overconsumption; larger serving sizes were reported to be more ubiquitous and better value for money than smaller size options. An overall positive attitude towards the proposed interventions was noted. Out of the four proposed interventions, participants considered the most acceptable intervention to be providing a wider range of serving size options while maintaining a consistent unit price. Other acceptable interventions included reducing the default serving sizes with concurrent price reduction; education and clear guidance around portion size selection (for example, the involvement of health professionals to promote portion control, along with relevant recommendations of appropriate portion sizes from health authorities); more practical on-pack serving size suggestions; and innovative package designs that enable better portion control without contributing to food and plastic waste. In conclusion, participants identified a need for and were in support of interventions aimed at the portion control of discretionary foods. Further research should focus on examining the feasibility and effectiveness of the potential interventions to reduce the purchasing and consumption of large serving sizes. More efforts from public health authorities are required to develop practical and tailored recommendations for consumers around appropriate portion sizes for discretionary foods. Collaboration with the food industry and policy makers is also necessary for implementing public health interventions to reduce the excessive intake of discretionary foods.

Gut health is a 50-billion-dollar (US) industry that is forecast to continue growing. This growth is attributed to our increased understanding and interest in the gut microbiome and its association with many chronic diseases, mental health and gut and autoimmune disorders. In 2024, “dysbiosis”, “gut microbiome” and “gut probiotics” were some of the most commonly google searched words but, what constitutes “good gut health”? There is no exact definition but in clinical practice we may use symptoms as a proxy for gut health, for example normal gastrointestinal function and the absence of chronic gastrointestinal symptoms that negatively impact on our quality of life. Consumer research found that consumers regard gut health as well-being and are interested in latest science but that does not inform their purchasing behaviours(1). Interestingly, symptoms of suboptimal gut health, which may include abdominal bloating, diarrhoea, constipation, excessive flatulence, were most likely to influence consumer behaviours.1 In this presentation, I review the latest scientific evidence about foods and dietary patterns that are associated with markers of gut health. I also provide examples of how we can practically educate and advise New Zealanders on implementation of dietary changes that may support sustainable gut health.

The 2023 Nordic Nutrition Recommendations (NNR23) emphasize both planetary health and disease prevention through food-based guidelines(1). While previous planetary health diets may not guarantee sufficient micronutrient intake(2), these dietary patterns focusing on human and planetary health have shown positive associations between higher adherence and lower mortality(3). However, the health effects of adhering to the NNR2023 have not been investigated. This study aims to construct a diet score to investigate adherence to NNR2023, micronutrient adherence, and the association with mortality.

We constructed a diet score based on NNR2023 with 15 food components [1]. Points were given proportionally between 0 and 1 points, reflecting the level of compliance with each food component, with a maximum possible score of 15 points. We then followed men aged 45-79 from the Cohort of Swedish Men (n=48,850) (COSM) and women aged 48–83 years from the Swedish Mammography Cohort (n=39,984) (SMC), with extensive information collected on diet and lifestyle in 1997, 2009 and 2019(4). Cases were retrieved through the Swedish Patient Register using the Swedish Personal Identification Number and The Death Register(4). Participants were followed until death or administrative end of follow-up on 31stof December 2019. Micronutrient intake was derived from reported food intake and dichotomized at the recommended intake for vitamins and adequate mineral intake. Multi-variable Cox proportional hazards regression models were used to estimate hazard ratios (HRs) with 95 % confidence intervals (CIs) using age as the underlying timescale.

Participants with the highest adherence to NNR2023 (>10 points, median (10 points), HR 0.77, 95% CI 0.74-0.80) exhibited a lower risk of all-cause mortality compared to those with the lowest adherence (<8 points, median (7.6 points)). Age- and sex-specific micronutrient recommendations for calcium, folate, and magnesium were more likely to be met for those with the highest adherence. However, vitamin D intake was lower in women, and calcium was lower in men under the age of 70. When analyzed as a restricted cubic spline, results indicate lower mortality risk with increasing adherence.

High adherence to NNR2023 is beneficial for achieving adequate micronutrient intake and reducing overall mortality.

Sufficient sleep is necessary for optimal health, daytime performance and wellbeing and the amount required is age-dependent and decreases across the lifespan. Sleep duration is usually affected by age and several different cultural, social, psychological, behavioural, pathophysiological and environmental factors. This review considers how much sleep children and adults need, why this is important, what the consequences are of insufficient sleep and how we can improve sleep. A lack of the recommended amount of sleep for a given age group has been shown to be associated with detrimental effects on health including effects on metabolism, endocrine function, immune function and haemostatic pathways. Obesity has increased worldwide in the last few decades and the WHO has now declared it a global epidemic. A lack of sleep is associated with an increased risk of obesity in children and adults, which may lead to future poor health outcomes. Data from studies in both children and adults suggest that the relationship between sleep and obesity may be mediated by several different mechanisms including alterations in appetite and satiety, sleep timing, circadian rhythm and energy balance. Moreover, there is evidence to suggest that improvements in sleep, in both children and adults, can be beneficial for weight management and diet and certain foods might be important to promote sleep. In conclusion this review demonstrates that there is a wide body of evidence to suggest that sleep and obesity are causally related and recommends that further research is required to inform policy, and societal change.

This review aims to highlight the relative importance of cardiovascular disease (CVD) lifestyle-associated risk factors among individuals with inflammatory bowel disease (IBD) and examine the effectiveness of lifestyle interventions to improve these CVD risk factors. Adults with IBD are at higher risk of CVD due to systemic and gut inflammation. Besides that, tobacco smoking, dyslipidaemia, hypertension, obesity, physical inactivity and poor diet can also increase CVD risk. Typical IBD behavioural modification including food avoidance and reduced physical activity, as well as frequent corticosteroid use, can further increase CVD risk. We reviewed seven studies and found that there is insufficient evidence to conclude the effects of diet and/or physical activity interventions on CVD risk outcomes among populations with IBD. However, the limited findings suggest that people with IBD can adhere to a healthy diet or Mediterranean diet (for which there is most evidence) and safely participate in moderately intense aerobic and resistance training to potentially improve anthropometric risk factors. This review highlights the need for more robust controlled trials with larger sample sizes to assess and confirm the effects of lifestyle interventions to mitigate modifiable CVD risk factors among the IBD population.

Irritable bowel syndrome (IBS) is a chronic and painful gastrointestinal disorder associated with significantly worse physical functioning (abnormal physiology, visceral hypersensitivity, inflammation, immune dysregulation, microbiome, and malabsorption issues). IBS isinfluenced by genetic disposition, psychological factors and diet, significantly and adversely affects quality of life(1). Internationally IBS is a common disorder in primary and speciality care affecting 13 to 20% of people(2). IBS imposes a significant economic burden to health systems(2). The prevalence and economic results of IBS make it a major public health concern. Existing interventions revolve separately around diet (particularly the low FODMAP diet) and stress management. The goal of this project was to create a multimodal lifestyle intervention explicitly designed to enhance the health-related quality of life in women treated for IBS in Aotearoa with the imperative to minimise the risk of IBS recurrence and to reduce the burden of the long-term physical and psychological symptoms. This IBS programme builds on the well-established Women’s Wellness Programs (WWP) based at the Health Faculty, University of Technology, Sydney. These are robust and systematic programmes developed within the WWP team which comprises international experts in women’s health and chronic conditions, of cancer, diabetes, cardiovascular disease and stroke. All WWP employ individually tailored strategies to instil positive behavioural change. They are also designed for virtual delivery through participants’ mobile computing devices to ensure regional and rural access. This presentation explains the ‘The Aotearoa Women’s Wellness Program for IBS’ prototype that has been developed. This programme is designed based on the results of a study where IBS participants (n=15) and separately health professionals or researchers (n=15) working in the field of IBS in New Zealand were all asked the same questions about the IBS journey, including diagnosis and treatment. Their responses detailed how IBS adversely affected all aspects of quality of life, raised issues with diagnosis and treatment and articulated desired support approaches. When given information about the WWP and asked to provide feedback on it, all 30 interviewed participants agreed that a WWP health promotion approach for IBS was feasible, relevant, and warranted. Through this feedback the programme was developed. Participants work through the content to address issues such as nutrition, stress management, and physical activity, guided by a health professional with expertise in gut health. Various activities and opportunities to reflect are distributed throughout the programme to identify goals to help participants make and embed appropriate changes in their lifestyles. This new, evidence-based programme for IBS is now available to health professionals working in clinical situations related to gut health in Aotearoa. It gives them the opportunity to redesign care, irrespective of where care is delivered, in a way that is responsive to the needs of people with IBS.

Recipe boxes, or meal kits, offer pre-portioned ingredients for multiple meals, delivered to, and cooked at home. They are emerging on the food retail market and increasingly popular with an estimated grocery spend c.£1B GBP in 2023, tripled since 2018 [1]. They are marketed as healthy and may have the potential to improve dietary intake. but little or no research has been done on their nutritional profile. The aim is to assess the evolution of recipe box healthiness over time.

Data was collected in two cross-sectional online surveys in September 2018 and March 2023. At both time points, all recipe box companies operating were identified and, for those supplying sufficient nutritional information (for energy, total fat, saturated fat, carbohydrate, sugar, protein, salt, and fibre) per 100g or portion, details were extracted. Two internationally recognised standards were used to assess recipe box healthiness: the UK Food Standards Agency (FSA)Traffic Lights labelling guidance (2) and the World Health Organisation (WHO) guidelines for population nutrition (3) (4). The proportion of recipes that met FSA green colour coded nutrient levels indicating a healthier profile, (low in fat, saturates, sugars and salt, per 100g and per portion), or complied with WHO standards (for energy, fat, saturates, carbohydrate, sugar, protein, salt, and fibre content per portion), were calculated and compared between 2018 and 2023 using z-proportion tests in Python 3.10.

After excluding companies with insufficient nutritional information there was a decrease from 9 to 5 companies between 2018 and 2023. The number of recipes captured increased from 132 to 206. Approximately 50% of all recipes met the WHO standard for energy in both surveys (2023, 43-56%; 2018, 43-61%) (p=0.6207).

Statistically significant changes in realising nutrient guidelines occurred between surveys. By either metric only 20% (CI 15-26%) of recipes achieved salt targets in 2023: a 30-point reduction from 2018 (p<0.0001). There was a 20% increase in recipes fulfilling WHO carbohydrate guidelines with 63% (CI 56-69%) compared to 43% (CI 35-52%) (p=0.000457) in 2023 and 2018 respectively and relatedly for sugar, 50% (CI 42-59%), from 62% (CI 56-69%), (p-0.028).

Across the surveyed recipes, 43% (95% CI 39-46%) of all nutrients achieved FSA green light status in 2023, a smaller proportion than in 2018, 52%, (95% CI 47-56%) (p=0·0001). Similar proportions of nutrients complied with all WHO standards in 2023 and 2018, 40% (CI 37-42%) vs 41% (CI 37-43%) (p=0.744).

Most recipe boxes surveyed in 2023 had a poor nutritional profile, that had worsened since 2018. Recipe boxes need an improved nutritional profile, worthy of their 'health-halo', if they are to improve population nutrition. This is the first study to comprehensively analyse the nutritional profile of recipe boxes. A limitation is the lack of nutritional information for some companies.

Childhood obesity persists at historically high rates globally, including an increasing number of children with severe obesity(1–3). Despite the growing demand of families with children needing treatment, effective interventions are largely unavailable or inaccessible(4,5). Using technology to transform such services that are conventionally delivered in person and offering electronic health (e-Health) interventions, may address limitations of current childhood obesity treatment. A randomised control trial (RCT) with a waitlisted control group evaluated the effectiveness of a 10-week family-focused web-based healthy lifestyle program with health coaching sessions, for treating childhood overweight and obesity, over 10 weeks. Outcome measures included change in children’s body mass index (BMI) z-score, waist circumference, dietary intake, physical activity, and quality of life, collected online at baseline and end of the web-based program (10 weeks). A total of 148 children (125 families) aged 7–13 years, with BMI ≥ 85th percentile, living in Victoria, Australia, were recruited and randomised to intervention (Cohort 1) or waitlist control (Cohort 2), of which 102 children (85 families) completed the RCT. Cohort 2 received no intervention during the control period. A clinically meaningful decrease in BMI z-score, in the context of weight maintenance and height growth, was observed in Cohort 1 compared to a negligible change found in Cohort 2 (mean difference in change in BMI z-score Cohort 1 vs Cohort 2 = −0.1; 95% confidence interval, −0.2, –0.0). Compared with Cohort 2, Cohort 1 adopted health-supporting lifestyle behaviours, such as improved diet quality and increased physical activity; and reported a clinically significant improvement in children’s quality of life at 10 weeks. Cohort 2 demonstrated similar changes in outcome measures after receiving the web-based program. Findings from this study furthers the growing body of evidence on the potential of e-Health interventions to upscale childhood obesity treatment. E-Health interventions, including a low-intensity program that requires minimal contact time with health professionals online, can enhance the effectiveness of conventional treatment services.

This review aims to emphasise the impact of poor nutrition on children’s health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.

Despite debilitating consequences, cancer-associated malnutrition often goes under-detected due to the lack of a standardised diagnostic tool (1). The Global Leadership Initiative on Malnutrition (GLIM) criteria was established in 2018 in order to standardise the diagnosis of malnutrition globally (2). The aim of this study was to determine the association between GLIM-diagnosed malnutrition and overall survival in a large cohort of patients with mixed-cancer types. This is the first study to stratify patients according to treatment intent and is one of the largest studies to identify reduced muscle mass using gold-standard CT analysis of body composition.

Patients receiving anti-cancer treatment for solid tumours were enrolled in a cross-sectional study to examine nutritional status between 2011-2016. The GLIM criteria was retrospectively applied. CT images at the third lumbar vertebrae (L3) were used to quantify skeletal muscle index and categorised according to previously published cut-points. Survival analysis was carried out using Kaplan-Meier curves and Cox-Regression.

Of 1405 patients enrolled, 52.5% were male. Mean age was 62 years (SD:12 years). The most common cancer diagnosis was gastrointestinal (44.5%) and 60.3% had metastatic disease. In total, 40.4% of participants were diagnosed with GLIM-malnutrition (14.8% had stage 1 moderate and 25.6% had stage 2 severe malnutrition). Median follow-up time was 102.4 months (95% CI 99.6–105.2 months). Median survival for those without malnutrition was 30.4 months (95% CI 23.5–37.2 months), versus 11.0 months (95% CI 6.6 – 15.4 months p<0.001) for those with stage 1 moderate and 10.0 months (95% CI 8.1–11.9 months p<0.001) for stage 2 severe malnutrition. Multivariate-analysis (controlling for gender, age, cancer site, GLIM-malnutrition and treatment intent) demonstrated a hazard ratio (HR) of death of 1.499 (95% CI 1.233–1.822, p<0.001) for stage 1 moderate and HR 1.548 (1.322–1.800, p<0.001) for stage 2 severe-malnutrition. The prevalence of stage 2 severe malnutrition was significantly higher in the palliative cohort (receiving supportive measures) (32.7%) when compared to patients being treated with curative intent (18.2%, p=0.004).

This study is one of the largest studies to date which uses CT analysis to accurately identify reduced muscle mass and confirms that the GLIM criteria can be used to predict overall survival in a large mixed-cancer cohort. These findings suggest that malnutrition, regardless of GLIM severity ranking has a significant impact on overall survival. Future research should focus on determining oncology specific cut-points for the GLIM criteria.

The transition from breastmilk to solid foods (weaning) is a critical stage in infant development and plays a decisive role in the maturation of the complex microbial community inhabiting the human colon. Diet is a major factor shaping the colonic microbiota, which ferments nutrients reaching the colon unabsorbed by the host to produce a variety of microbial metabolites influencing host physiology(1). Therefore, making adequate dietary choices during weaning can positively modulate the colonic microbiota, ultimately contributing to health in infancy and later life(2). However, our understanding of how complementary foods impact the colonic microbiota of weaning infants is limited. To address this knowledge gap, we employed a metagenome-scale modelling approach to simulate the impact of complementary foods, either combined with breastmilk or with breastmilk and other foods, on the production of organic acids by colonic microbes of weaning infants(3). Complementary foods and combinations of foods with the greatest impact on the in silico microbial production of organic acids were identified. These foods and food combinations were further tested in vitro, individually or in combination with infant formula. Fifty-three food samples were digested using a protocol adapted from INFOGEST to mimic infant digestion and then fermented with faecal inoculum from 6 New Zealand infants (5-11 months old). After 24h of fermentation, the production of organic acids was measured by gas chromatography. Differences in organic acid production between samples were determined using the Tukey Honestly Significant Difference test to account for multiple comparisons. The microbial composition was characterised by amplicon sequencing of the V3-V4 regions of the 16S bacterial gene. Taxonomy was assigned using the DADA2 pipeline and the SILVA database (version 138.1). Bioinformatic and statistical analyses were conducted using the R packages phyloseq and ANCOM-BC2, with the Holm-Bonferroni adjustment to account for false discovery rates in differential abundance testing. Blackcurrant and raspberries increased the production of acetate and propionate (Tukey’s test, p<0.05) and the relative abundance of the genus Parabacteroides (Dunnett’s test, adjusted p<0.05) compared to other foods. Raspberries also increased the abundance of the genus Eubacterium (Dunnett’s test, adjusted p<0.05). When combined with infant formula, black beans stood out for increasing the production of butyrate (Tukey’s test, p<0.05) and the relative abundance of the genus Clostridium (Dunnett’s test, adjusted p<0.05). In conclusion, this study provides new evidence on how complementary foods, both individually or in combination with other dietary compounds, influence the colonic microbiota of weaning infants in vitro. Insights generated by this research can help design future clinical trials, ultimately enhancing our understanding of the relationship between human nutrition and colonic microbiota composition and function in post-weaning life.

The obesity prevalence among the Chinese population has increased more than three-fold over the last twenty years.(1) A cross-sectional study involving 15.8 million Chinese adults revealed that in 2023 one in every two Chinese adults was categorised as overweight or obese.(2) Chinese individuals face a higher health risk of developing chronic disease at comparable Body Mass Index levels to Caucasians.(3) Thus, it is urgent to address the increasing obesity prevalence in this population. People’ s perception towards obesity is likely to play an important role in influencing their weight management behaviour.(4) For Chinese people, the unique Confucianism ideology, collectivist society, and modern mass media information exposure may have a profound influence on how Chinese people develop their perceptions about weight issues. It is therefore valuable to understand Chinese people’s obesity-related perceptions as this may inform more culturally appropriate interventions for weight management. To the authors’ knowledge, this is the first bilingual systematic review which aimed to synthesise published literature exploring the perceptions of Chinese adults towards overweight and obesity. Four English databases and two Chinese databases (Medline, APA PsycINFO, Social Science Premium Collection, Scopus, Wanfang Chinese Journal Database, and Chinese Electronic Periodical Services) were searched from inception to 17 Jun 2023. Studies were included if they were published in English or Chinese, investigated perceptions towards overweight and obesity, and focused on Chinese adults living in or outside of Mainland China. All retrieved citations were screened by two reviewers independently. A narrative synthesis method was employed. Forty-eight studies (n = 20 in English, n = 21 in simplified Chinese, n = 7 in Traditional Chinese) were included, involving n= 73910 participants. Females were more often researched. Also, the overall sample consisted more younger and more highly educated people, with 22 studies including solely university students. The collective quality or risk of bias of the studies was suboptimal. Three overarching themes emerged from this review: (i) Chinese adults tend to misperceive their weight status, largely stemming from limited awareness of BMI and societal norms idealizing thinness, leading to high dissatisfaction with body weight and high motivation to pursue weight loss. Females perceived a stricter weight ideal than males; (ii) Despite a pronounced motivation for weight management, study participants lacked practical knowledge regarding sustainable strategies. Non-scientific weight-loss methods and unproductive perceptions were prevalent among this population; (iii) Chinese adults perceived dealing with obesity as a lonely journey, influenced by the pervasive negative societal attitude towards obesity and the prevailing mindset emphasizing personal responsibility for weight-related issues. This review provides a comprehensive profile of perceptions towards obesity among Chinese adults over the last two decades and discusses methodology implications and future research directions.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder amongst reproductive-aged women associated with cardiometabolic, reproductive and psychological abnormalities. Lifestyle modification, including a healthy diet, is considered first-line treatment for management of clinical symptoms. However, there is limited high-quality evidence to support one superior therapeutic dietary intervention for PCOS management that is beyond general population-based dietary guidelines. Adherence to a Mediterranean diet (MedDiet) has been shown to decrease cardiometabolic disease risk and attenuate depressive symptoms, particularly in patients with metabolic perturbations. This narrative review summarises the proposed biological mechanisms underpinning the potential therapeutic benefits of a MedDiet for the management of cardiometabolic, reproductive and psychological features related to PCOS. Observational evidence suggests an inverse relationship between MedDiet adherence and PCOS features, particularly insulin resistance and hyperandrogenemia. Although the exact mechanisms are complex and multifaceted, they are likely related to the anti-inflammatory potential of the dietary pattern. These mechanisms are underpinned by anti-inflammatory bioactive constituents present in the MedDiet, including carotenoids, polyphenols and n-3 polyunsaturated fatty acids (PUFAs). Synthesis of the available literature suggests the MedDiet could be a promising therapeutic dietary intervention to attenuate short and long-term symptoms associated with PCOS and may aid in reducing the longer-term risks associated with cardiometabolic diseases and reproductive and psychological dysfunction. Nevertheless, current evidence remains insufficient to inform clinical practice and well-designed clinical trials are needed. As such, we provide recommendations for the design and delivery of future MedDiet interventions in women with PCOS, including exploring the acceptability, and feasibility to enhance adherence.

The review aims to explore the potential benefit and risk of high-protein diets (HPD) regarding the comorbidity of sarcopoenia and CVD in the setting of cardiac rehabilitation (CR). CR is standard care for individuals who have experienced a cardiac event, but the current practice of predominantly aerobic exercise, a lower-fat diet and weight loss poorly addresses the issue of sarcopoenia. HPD, especially when combined with resistance exercise (RE), may be valuable adjuncts to current CR practice and benefit both muscle and cardiovascular health. Meta-analyses and randomised controlled trials of HPD and CVD risk show beneficial but variable effects regarding weight loss, the lipid profile, insulin resistance and lean body mass in those living with or high risk of CVD. Meta-analyses of prospective cohort studies on hard CVD endpoints favour lower- and plant-protein diets over higher animal protein, but the evidence is inconsistent. HPD augment the strength and muscle gaining benefits of RE in older populations, but there are no published data in those living with CVD providing promising opportunities for CR research. HPD raise concern regarding renal and bone health, the microbiome, branched chain amino acids and environmental sustainability and findings suggest that plant-based HPD may confer ecological and overall health advantages compared to animal-based HPD. However, incorporating RE with HPD might alleviate certain health risks. In conclusion, a largely plant-based HPD is deemed favourable for CR when combined with RE, but further research regarding efficacy and safety in CR populations is needed.

The practice of antenatal colostrum expression (ACE), or the extraction of colostrum from the breasts during pregnancy, has an interesting history and continues to evolve. This narrative review aims to describe how perception and practices of ACE have changed over time, summarise the evidence on ACE in maternal and infant care, and highlight areas for future research. The literature demonstrates that ACE is safe for low-risk women when done from around 36 weeks’ gestation. Women should be reassured that the skill of hand expressing is a valuable tool post-birth, regardless of whether they are able to collect colostrum antenatally or not. The collection and storage of colostrum in pregnancy can help avoid formula use in hospital, which may have follow on effects immune function and other areas. Ideally, colostrum collected during pregnancy would be kept safely frozen during the hospital stay and only defrosted and used during the stay if medically indicated, with parents supported through that process. Although ACE does not appear to improve long-term breastfeeding rates at present, it can increase confidence around breastfeeding. Further research in more diverse population groups, long-term breastfeeding and long-term health outcomes of using frozen antenatally expressed colostrum for babies (as compared to formula or fresh colostrum) would be valuable to gain a better understanding of the importance of ACE in maternity care.

The out-of-home (OOH) food sector has a growing importance on the UK population diet, but the nutritional quality of the most influential OOH menu items has not yet been comprehensively characterised(1). It is also unclear how OOH food healthiness should be assessed. The primary study objectives were to assess the compliance of best-selling menu items in the UK with the ongoing calorie, salt, and sugar reduction programmes(2) and to compare the use of UK official healthiness assessment models and metrics,(3,4) using data collected in 2023/24. A secondary objective was to examine item-level changes in nutritional composition over time using 2021 data for a subset of menu items.

A cross-sectional survey of the 10 best-selling menu items of the 20 largest OOH companies in the UK was conducted online between September 2023 and March 2024, with manual imputation of missing nutrition data. Candidate healthiness assessment approaches included the UK Nutrient Profile Model (NPM)(3), Multiple Traffic Light Labelling (MTL),(4) and the targets, guidelines, and levy threshold included in the UK calorie, salt, and sugar reduction programmes.(2) Longitudinal item-level changes in nutrition composition were assessed retrospectively using archived August 2021 web-extracted data.

After excluding items where data imputation was not possible, 189 menu items were included in 2023/24, consisting mostly of main meals (25%), starter/side dish/small plates (18%), and sandwiches (18%). 59% of 184 products met their respective maximum calorie, salt, and/or sugar target/guideline; and 8 of the 20 applicable average target/guidelines were achieved. Depending on the healthiness assessment approach used, 46-78% of the menu items would not be deemed healthy. The NPM yielded the most lenient assessment due to not accounting for portion size; combining it with either category-specific or across-the-board maximum thresholds resulted in more stringent assessments. 117 food and 23 drink menu items could be tracked from 2021 to 2023/24; an increase in the median [interquartile range] salt content per serve was found in food (from 2.0g [1.3–3.7g] to 2.2g [1.4–3.8g], p=0.004). No other change in nutrition composition was observed over time at the menu item level.

This study comprehensively highlights the generally poor nutritional quality of best-selling OOH menu items in the UK, the lack of success of current voluntary programmes in driving impactful OOH product reformulation, and the limitations of the NPM for OOH application. Limitations include uncertainty around nutrition data accuracy (as either extracted from company websites or estimated using single purchases) and assessment of compliance with the calorie, salt, and sugar reduction programmes based solely on reformulation or portion size adjustments, not capturing mechanisms such as shifting sales. Our findings suggest that healthiness assessment in the OOH sector requires using either category-specific or across-the-board maximum thresholds for energy and ‘negative’ nutrients (e.g., salt, sugars) per serve.

Social media platforms such as Instagram and TikTok have transformed how individuals seek and engage with dietary advice, leading to the rapid propagation of unverified nutrition information that can result in poor dietary choices, contribute to disordered eating and broader health issues(1). This study aims to measure the accuracy and frequency of nutrition misinformation, identify the types of thematic misinformation, and understand user engagement metrics on Instagram and TikTok. A mixed-methods approach was employed, analysing 500 posts (250 from each platform) collected over a six-month period from September 15, 2023, to March 15, 2024, using keywords like healthy eating, healthy food, diet, and weight loss. Posts were evaluated using a modified, previously developed, Social Media Evaluation Checklist(2) and evidence coding framework to measure accuracy. Results indicated a higher prevalence of misinformation on TikTok compared to Instagram, with a significant portion (p < 0.05) of users lacking relevant credentials. The most common characteristic was cooking/recipes and meal plans. TikTok posts with mostly accurate and completely inaccurate information had higher engagement than Instagram posts. TikTok had a larger proportion of completely inaccurate posts (10.8%), mainly related to weight loss. Descriptive statistics for engagement metrics showed TikTok posts had significantly (p < 0.05) higher likes and comments compared to Instagram posts across various accuracy levels. For Instagram, completely accurate posts had a mean of 4,318 likes and 40 comments, while mostly accurate posts had a mean of 25,153 likes and 186 comments. For TikTok, completely accurate posts had a mean of 146,327 likes and 423 comments, mostly accurate posts had a mean of 75,804 likes and 483 comments. An independent t-test revealed significant (p < 0.05) differences in likes and comments between platforms for posts with varying accuracy levels. The study highlights the need for social media platforms to verify the qualifications of individuals providing nutrition advice and implement measures to promote accurate information. Further research is necessary to develop effective strategies to mitigate the spread of misinformation via social media platforms and its impact on public health.

The objective of the food safety system is to provide safe and suitable food in New Zealand(1). This is of particular importance for our youngest members– infants and young children. During the first 2000 days of life, food and nutrition have crucial roles. Nutrient requirements are high, and children often have an increased vulnerability to hazards associated with chemical and microbiological contamination. Foods targeted to this age group typically have strict regulations, as the quality and safety of foods for infants and young children is of great concern to caregivers, public health authorities and regulatory bodies worldwide. The recent First Foods New Zealand Study (FFNZ) and Young Foods New Zealand (YFNZ) Study have provided important data into what, and how, we feed our infants and young children under four years of age(2). Insights from the dietary intakes and health of 925 infants and young children from these studies are being used by NZFS to inform its work on food monitoring surveillance and food policy. Currently New Zealand Food Safety (NZFS) is conducting the 2024 New Zealand Total Diet Study (NZTDS) (Infants and Toddlers)(3). The NZTDS is a food monitoring and surveillance programme which aims to evaluate the risk to New Zealanders from exposure to certain chemicals such as agricultural chemicals, contaminants (including from food packaging), and nutrients. The 2024 NZTDS will, for the first time, focus exclusively on infants and young children. The FFNZ and YFNZ studies informed the selection of 117 foods to be tested from four New Zealand regions throughout 2024/2025. The dietary intake data will then be used to estimate the dietary exposure to each of the 362 chemicals analysed. This monitoring programme informs policy decision-making and food standard setting and provides assurance on the safety of our food supply. Concerns around the nutrient quality and labelling of some commercial products for infants and young children have been identified in Australia and New Zealand. Within the joint food regulatory system, consultation is underway to consider regulatory and non-regulatory options for improving commercial foods for infants and young children(4). This presentation will discuss NZFS’s role in monitoring foods and diets of infants and young children in Aotearoa New Zealand, the importance of, and application of evidence to inform policy, food safety, and potential regulatory and non-regulatory options to ensure that the food safety system continues to deliver safe and suitable food in New Zealand.