Breastfeeding is the recommended way to feed infants. However, a safe and nutritious substitute for human milk is needed for infants when breastfeeding is not possible. As infants are a vulnerable population group, infant formula products are regulated by prescriptive provisions for composition and labelling. Any changes to the composition of these products must be established as safe prior to being permitted. As our knowledge of human milk expands, infant formula ingredients are developed to better replicate it. Food Standards Australia New Zealand (FSANZ) has assessed the addition of ingredients for the addition to infant formula products including human identical milk oligosaccharides (HiMOs) isolated using precision fermentation methodology. These ingredients are considered to be nutritive substances as their addition to food is intended to achieve specific nutritional purposes. In accordance with the Ministerial Policy Guidelines, FSANZ must assess both the safety and the health effect of nutritive substances for their use in infant formula. FSANZ risk assessments are undertaken by a multidisciplinary team covering toxicological and nutritional considerations using the best available scientific evidence. FSANZ assessments of the health effects concluded that the use of HiMOs in infant formula products would have a beneficial outcome for infants and align with the equivalent role of these substances in human milk(1,2). The weight of evidence supports health effects through an increase in the abundance of Bifidobacterium spp. in the infant gut microbiota, anti-pathogenic effects, inflammatory suppression and facilitation of appropriate immune responses and antigenic memory. FSANZ safety and technical assessments concluded that there are no public health and safety concerns associated with adding HiMOs to infant formula products(1, 2). The permitted levels are comparable to levels in human milk and are chemically and structurally identical to the naturally occurring forms. Food Standards Australia New Zealand, Canberra, 2606, Australia Based on the available evidence and intended purpose, a number of HiMOs have been permitted for use in infant formula products including 2′- fucosyllactose, lacto-N-neotetraose, difucosyllactose, lacto-N-tetraose, 3'-sialyllactose sodium salt, 6'-sialyllactose sodium salt. Evidence continues to emerge on the beneficial effects of HiMOs on infant health.

Handgrip strength (HGS) is a marker of protein-energy status in people on haemodialysis (HD). Best practice guidelines recommend measuring HGS before the commencement of the dialysis session, which is not always possible(1). No previous research has compared the reliability, reproducibility and agreement of HGS values pre- and mid-dialysis. Here we aimed to determine the reliability, reproducibility and agreement of HGS values pre- and mid-dialysis. Participants were recruited from four HD units (n = 47). Eligible participants were stable on HD for at least 3 months and not acutely unwell. HGS was measured in triplicate on the non-fistula arm before dialysis (pre-dialysis HGS) and two hours into dialysis (mid-dialysis HGS) for three consecutive weeks. Wilcoxon signed ranked tests were used to determine the difference between pre and mid-HGS. Friedman tests with Dunn’s post hoc test were used to determine the repeatability of the HGS measures over three weeks. Bland Altman plots were used to determine the agreement between pre- and mid-measures. We observed that HGS measures taken pre- and mid-dialysis differed statistically (19.0 kg [IQR, 14.5–28.1] vs 19.9 kg [IQR, 15.0–28.4], p = 0.005), but not to a clinically relevant level(2,3). There were no significant differences in pre-dialysis HGS measures (p = 0.34) nor mid-dialysis HGS measures (p = 0.16) over the 3 weeks. Bland Altman plots indicated agreement between pre- and mid-dialysis HGS measures, suggesting no systematic bias in HGS. This study found that HGS taken at either pre- or mid-dialysis were reliable and reproducible. These data indicate reasonable agreement between pre- and mid-dialysis HGS measures. Mid-dialysis HGS is a valuable tool for monitoring changes in the nutritional status of HD patients, providing HGS is consistently measured mid-dialysis.

This abstract was awarded the student prize for best oral presentation.

Research shows that beneficial diets in childhood support better physical, mental, and economic outcomes on a population scale (1). As 9 million UK children consume 30% of their daily food at school (2) the school lunch caterer plays an important role in the delivery of health supporting food. Unfortunately, school food provision is fragmented and complex with several conflicting priorities affecting food quality (3). Financial viability of provision is affected by school characteristics, with additional revenue from state free school meal (FSM) funding (4) and small, rural schools often making a loss (5). Despite £700m of annual public sector spend on school food (6), there is no central record of provision and a lack of research hindering effective policy and practice. This study aims to understand who provides school food in Yorkshire.

Details on providers and contracts for school food provision in 1,771 state funded primary schools across the 15 local authorities in Yorkshire was mapped, along with key characteristics (school size, geography and deprivation) and analysed. Data on the school food provider were collected through a school survey, lists from local authorities, and desk-based website review. School characteristics were obtained from public records. Descriptive statistical tests were performed to establish prevalence and central tendencies and independent sample anova established significance of differences in school characteristics between provider types.

Three provider types were identified; local authority caterer, commercial caterer, and in-house caterer (including academy trust). School size varied widely from 5 to 789 children (M= 271, SD = 146) with 12% of schools (n=206) having fewer than 100 pupils necessary to financially breakeven (4). Local authority caterers serve most schools (48%) and had the highest proportion of small, rural schools (headcount: M = 256, SD = 150, p<0.001, rural =33%) and the lowest deprivation (FSM: M = 21.9%, SD = 14.4%, p<0.001). Commercial caterers serve 30% of schools, with the largest schools (M = 289, SD = 134, p<0.001) and the highest proportion of urban schools (79%), indicating higher profitability potential. Just 5 companies accounted for 78% of the commercial catering. In-house catering was less prevalent at 8% and data were unavailable for 14% of schools. Provision models were not always clearly defined, and some local authorities had no, or partial, catering service or outsourcing provision to a commercial contractor.

The data further demonstrates the fragmentation and complexity of school food provision and the differences in school characteristics which may affect the quality of school food through financial viability. Given the potential to leverage public funding of school food provision and the urgency of the UK health crisis, further research is needed to understand how the provision contract type may influence dietary health through the quality of food provided.

In childhood, diets high in sodium and low in potassium contribute to raised blood pressure and cardiovascular disease later in life(1). For New Zealand (NZ) children, bread is a major source of dietary sodium, and fruit, vegetables, and milk are major dietary sources of potassium(2,3). However, it is mandatory to use iodised salt in NZ bread meaning reducing the salt and thus sodium content could put children at risk of iodine deficiency(4). Our objective was to measure the sodium, potassium, and iodine intake, and blood pressure of NZ school children 8-13 years old. A cross-sectional survey was conducted in five primary schools in Auckland and Dunedin. Primary schools were recruited between July 2022 and February 2023 using purposive sampling. Seventy-five children (n= 37 boys, 29 girls, and nine children who did not state their gender) took part. The most common ethnicity was NZ European and Other (n=54 or 72%) followed by Māori (indigenous inhabitants; n=9 or 12%) and Pasifika (n=5 or 7%). The main outcomes were 24-hour sodium and potassium intake, sodium to potassium molar ratio, 24-hour iodine intake, and BP. Sodium, potassium, and iodine intake were assessed using 24-hour urine samples and BP was assessed using standard methods. Differences by gender were tested using two-sample t-tests and nonparametric Wilcoxon two-sample tests. The mean (SD) 24-hour sodium excretion, potassium excretion, and sodium to potassium molar ratio for children with complete samples (n=59) were 2,420 (1,025) mg, 1,567 (733) mg, and 3.0 (1.6), respectively. The median (25th, 75th percentile) urinary iodine excretion was 88 (61, 122) µg per 24 hours and the mean (SD) systolic and diastolic blood pressure (n=74) were 105 (10) mmHg and 67 (9) mmHg, respectively. There was a significant difference between boys and girls for iodine (77 (43, 96) vs. 98 (72, 127) µg per 24 hours; p=0.02) but no other outcomes. In conclusion, children consumed more sodium and less potassium and iodine than World Health Organization recommendations(5). However, future research should confirm these findings in a nationally representative sample. Evidence-based, equitable interventions and policies with adequate monitoring should be considered to reduce potentially suboptimal sodium, potassium, and iodine intakes in New Zealand.

This abstract was awarded the student prize for best poster presentation.

Online nutrition information is an important point of reference for the general population, with the potential to influence food choices and dietary behaviours (1). Current lack of regulation of nutrition and health content on social media (SM) allows the rapid spread of inaccurate, contradictory and often poor-quality information (2). Autism is a complex spectrum of neurodevelopmental differences that has been increasingly diagnosed in recent years (3). Dietary approaches are popular for symptom management, but neurodivergent brains may find it challenging to navigate and filter the huge volume of nutrition information available on SM. This study aimed to explore the quality and tone of online written nutrition information around diet and autism on the SM platform X to better support those with autism to find good quality nutrition information on SM.

Keyword searches were conducted systematically using synonyms for 'diet’ and 'autism’ and related X posts were captured for a ten-day period in April 2024. A validated online quality assessment tool (OQAT)(4) was used to classify the source and content type and to assess the quality of shared written nutrition information articles. Ten questions

covering currency, credibility and reliability criteria were each scored manually to give a total score per article between 0-10, with higher scores equating to better quality (poor 0-2: satisfactory 3-6: high 7-10). A web-based sentiment detection tool, 'Sentigem (5)', was used to analyse the text of data, indicating its polarity as positive, negative or neutral.

The search strategy returned a total of 596 X posts, with most being classified as irrelevant short-form SM discourse. Application of inclusion/exclusion criteria identified 10 relevant news articles and 18 blogs for OQAT analysis. News articles had a higher mean total OQAT score than blogs at 6.6 (SD 1.65) and 5.3 (SD 2.05) respectively (p=0.09), although both were of satisfactory quality (3-6/10). Individual post OQAT data suggested that nutrition writers might improve article quality by including an author biography, quoting a specialist and linking to peer reviewed science articles. A predominantly negative sentiment (52%) was conveyed by the data.

The quality of written nutrition information relating to diet and autism available on the SM platform X is variable. News articles tend to be of better quality than blogs, although results were statistically insignificant. Future challenges involve ensuring that SM users have access to clear, credible and consistent nutrition information. Regulation is needed, preferably via a multi-agency collaborative approach to limit the spread of false information. Nutrition professionals should be encouraged to develop their SM skills to create and share engaging, evidence-based content. Individuals with autism would be advised to seek out original nutrition articles written or shared by trusted nutrition professionals with appropriate qualifications.

Cardiovascular diseases (CVD) are the leading cause of mortality worldwide, with impaired lipids levels being a significant risk factor (1). This meta-analysis provides comprehensive insights on the impact of bovine dairy-derived milk fat globule membrane (MFGM) supplementation on blood lipid profiles in adults. A systematic search was conducted across various databases (including PubMed, Scopus, Web of Science, the Cochrane Library, Google Scholar, ACS Publications, Academic Search Index, BMJ Journals, BNP Media, and others) up until March 2024, resulting in the inclusion of six trials with a total of 464 participants. The findings indicate that MFGM phospholipid supplementation may significantly reduce total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol levels. A combined analysis of the effects on TC, LDL and triglycerides (TG) revealed a significant overall reduction in these markers (SMDs = −0.174; 95% CI: −0.328~−0.021; p = 0.026; I2 = 0%). However, no significant increase or reduction was observed for high-density lipoprotein (HDL) (SMDs = 0.019; 95% CI: −0.289~0.326; p = 0.906; I2 = 95.5%) and TG levels (SMDs = −0.083; 95% CI: −0.198~0.033; p = 0.160; I2 = 0%). Overall, these results suggest that MFGM supplementation could be a promising dietary intervention for improving lipid profiles in adults. Nonetheless, further research is warranted to confirm these results and to better understand the potential variability in the impact of MFGM on blood lipid levels.

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.

Pregnancy prompts a cascade of anatomical, metabolic, hormonal, and immunological adaptations important for foetal development, labour and birth(1). These multi–system adaptations interact with the maternal gut microbiome and may affect pregnancy and infancy outcomes(2). However, the nature and extent of changes to gut microbiome composition and diversity during pregnancy and the influence of dietary intake remains contentious. The ‘BABY1000’ pilot prospective birth cohort study based in Sydney, Australia(3) sought to explore associations between maternal diet, the maternal gut microbiome before and across pregnancy, and the infant gut microbiome. Primary aims were to (1) explore the composition and diversity of the gut microbiome of women at preconception, at 12-, 28- and 36-weeks’ gestation, and in infants at six weeks of age; and (2) determine how maternal and infant gut microbiomes are influenced by diet quality and fibre intake during pregnancy. Mothers (n = 146) and infants (n = 105), encompassing 86 mother–infant dyads were involved. RStudio (v 4.2.3) was used to perform microbiome composition and diversity analyses using 350 maternal and 102 infant stool samples. Maternal dietary quality was assessed at recruitment (preconception or 12 weeks’ gestation) and at 36 weeks’ gestation using the Australian Eating Survey (AES)(4). At the group level, maternal dietary quality was suboptimal and did not change significantly across pregnancy (mean scores of 37.5 ± 7.3 and 38.3 ± 6.7 out of 73 points at recruitment and late pregnancy, respectively; p > 0.05). Although differences in gut microbiome alpha (within–person) diversity between mothers and infants was highly significant (p < 0.0001), no differences in gut microbiome composition or diversity related to pregnancy status or gestational stage were observed. Maternal diet quality in pregnancy was also not significantly correlated with microbial beta (between–people) diversity in samples taken in late pregnancy (PERMANOVA: R2 = 0.039, p > 0.05). When fibre intake was separated into quartiles, there was a significant (p < 0.01) difference in alpha diversity between the lowest and highest quartiles of intake, though differences in beta diversity were not significant (PERMANOVA: R2 = 0.06, p > 0.05). Microbiota composition and diversity in infant samples was also not significantly affected by maternal dietary quality or fibre intake, but rather by birth mode and feeding type. Significantly different clustering of infant samples was clear between vaginal and caesarean births (PERMANOVA: R2 = 0.029, p = 0.005). Gut bacterial alpha diversity was significantly lower (p < 0.01) between infants receiving breastmilk compared to formula. As this area of research is still in its ‘infancy’, appropriately powered longitudinal studies are required to understand the processes that shape diet and microbiome interactions during the critical first 1,000 days of life and beyond.

Healthy life expectancy is not increasing at the same rate as life expectancy in UK (1). The health of older adults can impact on their dietary needs. Furthermore, dietary needs change with age, with diet offering the potential to prevent and/or lessen the impact of poor health. There is a need for research that identifies the barriers to accessing healthy foods for older adults, and how these barriers might be addressed. This qualitative study of preliminary data aimed to explore the perceptions of age-related influences on food behaviours (purchasing, preparation, food choice and intake) of older community-dwelling adults.

Semi-structured interviews were conducted with older UK adults living independently. Views were sought on potential barriers and enablers for healthy eating and explored food purchasing, preparation and consumption and nutrition knowledge in the context of getting older. Interviews were recorded and transcribed verbatim and a reflexive thematic approach was used to analyse the data (2). The study was approved by the Faculty of Medicine, Health, and Life Sciences Research Ethics Committee, Queens University Belfast (REC MHLS 24_26).

To date 20 interview results have been analysed of participants in England (Berkshire n=15) and Northern Ireland (n=5), comprising the following people (n=8 men; n=12 women; white n=15 (75%), black n=2 (13%), other n=3 (12%), and mean age; female 72 years (range 65 - 82, SD 5.24); men 71 years (range 65 -80, SD 5.14).

Themes that emerged included the food environment (availability, accessibility and quality), eating habits and influences, nutrition awareness and source of nutrition knowledge, life changes (e.g. divorce, retirement, relocation) and management strategies (e.g. improvements to cooking equipment and seeking assistance in shops). Chronological age was not seen as an influencer of food behaviours.

Within the food environment theme, food quality and eating experience were highly valued regardless of budget. A subtheme of nutrition awareness was how dietary misinformation and past behaviours affected food choices, such as choosing low-fat and low-calorie foods to facilitate weight loss rather than focusing on increasing the nutrient density of their diet.

Overall, participants demonstrated that changes in their food behaviours are predicated in a large part by life events, and the need to adapt to these and the evolving food environment in which they find themselves. This concurs with previous research on environmental supports for healthy ageing diets (3).

Strategies to improve nutritional intake could consider current consumption patterns, and the themes of food environment, eating habits and influences, nutrition awareness and source of nutrition knowledge, life changes and management strategies.

The analysis will be completed with the results from all 40 participants. The output will inform stakeholder co-creation workshops to design food solutions that can support people to eat familiar foods with increased nutrient density.

New Zealand ranks among the highest globally for childhood obesity(1). One of the main platforms to maximize the prevention of child excess adiposity is the establishment of healthy diets in early life(2,3). Despite this recommendation, Aotearoa has limited information on children’s whole diet quality and its associations with child healthy weight. This study explored the associations between dietary patterns and indicators of excess adiposity among 4.5-year-olds within the Growing Up in New Zealand birth cohort study (n= 6,048, 98.2% of the children who took part of the 4.5-year data collection wave). At 4.5 years, two dietary patterns were previously derived and described: “Refined, high in sugar, sodium and fat” and “Fruit and vegetables”(4). The indicators of excess adiposity examined at 4.5 years were body-mass-index-for-age (BMI/A) (>+2 z-score) and waist-to-height ratio (WtHR) > 90th percentile. Information on child and maternal sociodemographic and maternal health behaviour characteristics was sourced from the antenatal and the 4.5-year-interviews. Children’s scores in both dietary patterns were ranked in tertiles. Multiple Poisson regressions with robust variance were performed to examine the associations between the dependent variables (BMI/A z-score >+2 and WtHR >90th percentile) and the independent variables (dietary patterns), adjusted by child and mother characteristics (IBM SPSS software). Sensitivity analyses excluding children with outliers for BMI/A (<-5 z-score or >+5 z-score) was also performed. Findings were reported as adjusted risk ratio (RR) and 95% confidence intervals (CIs). Children in the highest tertile of the “Refined high in sugar, salt and fat” dietary pattern were more likely to be overweight/obese (BMI/A) compared to children in the lowest tertile (RR:1.51; 95% CI: 1.20-1.90; p<0.001). This significant association was confirmed in the sensitivity analyses (RR:1.49; 95% CI: 1.18-1.89; p <0.001). There were no significant associations between this dietary pattern and WtHR > 90th percentile nor between the “Fruit and vegetables” dietary pattern and the indicators of child excess adiposity. This study provided nationally generalizable information that poor diet quality in early life is associated with child excess adiposity. National strategies to prevent childhood obesity need to encompass approaches to reduce the availability and intake of refined foods and those high in sodium, sugar and unhealthy fats in children.

Universal free school meals represent a powerful public health tool to promote healthy eating among all children. Yet, in Catalonia, school lunches are not guaranteed for all, leaving the most vulnerable children at risk of nutrient inadequacy. Although grants that subsidize school lunches are available, this assistance only reaches 12.44% of at-risk-of-poverty students (1). Moreover, for those who do receive the support, the economic relief is tied to the number of monthly school days.

Therefore, the aim of this study is to estimate the economic relief that subsidized school meals offered in Catalonia constitute for the recipient families, assessing its fluctuation throughout the twelve months of the year.

The economic relief provided by subsidized school lunches has been assessed by estimating the monetary savings that families achieve by not having to cover these food costs. To do so, an economic value is assigned to hypothetic school meals designed based on the recommendations of the regional School Menu Review Program (PReME, for its acronym in Spanish) (2). The resulting cost is then deducted from the overall month expense for each age profile, as estimated by the reference budgets approach.

The daily cost of meals in the canteen ranges from €1.09 for children aged 1-3, and €1.91 for teenagers, with the cost of the menu for children aged 4-6 and 7-11 years of €1.38 and €1.72, respectively. As for the monthly cost, it fluctuates depending on the school days of each month. Therefore, July and August offer the least financial relief for families, as no school lunches are provided during the summer holidays, leaving parents to cover the full cost of meals. December follows as the third month with the lowest relief, offering only 11 school days. The estimated savings for these days are: €11.97 for ages 1-3, €15.17 for ages 4-6, €18.94 for ages 7-11, and €21.04 for ages 12-18. November and April, with 21 school days, are the months that represent the highest economic relief (1-3 years: €22.85; 4-6 years: 28 €96; 7-11 years: €36.15; 12-18 years: €40.16).

Our findings underscore the crucial role of subsidized school meals in alleviating the economic burden on families. However, the potential instability of such assistance poses challenges to maintaining food security and adequate nutrition. Additionally, the study emphasizes age-specific variations in the capacity of subsidized meal programs to allow economic relief. In view of the alarming rate of child poverty in Spain, which rose to 28.9% in 2023, and even higher in Catalonia, affecting 32.5% of children (3). These findings underscore the urgent need for effective targeted interventions to ensure equitable access to nutritious meals for children and adolescents.

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.

Gymnema lactiferum (G. lactiferum) is a medicinal plant that has played a significant role in traditional medical systems(1). This plant has been used in Ayurveda, Siddha, and Unani medicinal practices to address various health conditions, including diabetes, rheumatoid arthritis, as a diuretic agent, and for digestive disorders. However, there are few scientific studies on its nutritional value and bioactive compounds. Additionally, no prior study has endeavoured to introduce this plant’s extracts into food and beverages. Accordingly, the objectives of this study were to extract bioactive compounds from G. lactiferum using different extraction methods and to analyse its nutritional value and bioactivity. G. lactiferum leaf powder was extracted using different techniques and quantified for mineral and proximate composition, as well as phenolic, flavonoid, and antioxidant properties. Accelerated solvent extraction (ASE), water bath extraction (WB), and ultrasonication (US) techniques were used with 100% water extract (WE) and 50% aqueous ethanol extract (EE) as extracting solvents. Total phenolic content (TPC), total flavonoid content (TFC), and total antioxidant capacity (TAC) using 2,2-diphenyl-1-picrylhydrazyl (DPPH) scavenging activity(2) were measured. Statistical analysis was carried out using one-way analysis of variance (ANOVA), followed by Tukey’s test for post hoc comparison analyses. The composition included carbohydrates (19.3%), crude protein (17.5%), dietary fibre (35.1%), and fat content (4.8%). The mineral profile included potassium (4200 mg/100g), calcium (950 mg/100g), phosphorus (240 mg/100g), magnesium (240 mg/100g), iron, zinc, copper, and chromium. The extracts yielding the highest TPC (11.12 ± 0.32 mg gallic acid equivalents/g), TFC (4.73 ± 0.22 mg quercetin equivalents/g), and TAC (791.00 ± 18.9 mg ascorbic acid equivalents/mg) values were for WB-WE, ASE-EE, and WB-EE, respectively. The results indicate that water extracts in all three methods exhibited pronounced efficacy in the extraction of phenolic compounds. All 50% ethanol extracts demonstrated heightened efficiency in the extraction of flavonoids from G. lactiferum leaf powder. Furthermore, ethanol extracts exhibited higher antioxidant activity compared to the water extracts across all extraction methods. The results of this study show that G. lactiferum is a significant source of various nutritional compounds, such as crude protein, dietary fibre, and potassium-like minerals, as well as bioactive compounds. The phenolic, flavonoid, and antioxidant characteristics varied greatly depending on the extraction method and solvent used. These results provide a better understanding of the possible uses of G. lactiferum in the development of functional food.

Ceylon cinnamon (Cinnamomum zeylanicum), a native spice of Sri Lanka, is rich in bioactive compounds known for their potent antioxidant properties, which contribute to various health benefits such as anti-diabetic, anti-cancer, lipid-lowering and anti-inflammatory effects(1). However, the concentration of these bioactives can fluctuate throughout the plant’s life due to internal and external factors such as light, temperature, and stress responses. This study aimed to investigate the changes in total phenolic content (TPC), total flavonoid content (TFC), and the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging activity at different stages of maturity (1st to 4th year), using two extraction methods: ultrasonic extraction and accelerated solvent extraction. The identification and quantification of key bioactive compounds, including cinnamaldehyde, eugenol, and cinnamic acid, were performed using high-performance liquid chromatography (HPLC). The accelerated solvent extraction proved to be more effective in extracting TPC, TFC, cinnamaldehyde, eugenol and inhibiting DPPH. The extracts obtained from the accelerated solvent extractor showed a notable decrease in TPC (from 55.89±4.28 to 14.12±0.75 mg/g gallic acid equivalent) and TFC (from 170.08±13.75 to 39.35±9.39 mg/100g quercetin equivalent) up to the 3rd year, followed by an increase in TPC (from 14.12±0.75 to 19.71±0.49 mg/g gallic acid equivalent) and TFC (from 39.35±9.39 to 68.82±9.44 mg/100g quercetin equivalent) thereafter. The highest and lowest DPPH inhibition of 85.30 ± 0.39% and 40.68 ± 1.08% was observed with the 1st year and 3rd year plants. There was no significant difference between the DPPH inhibition of the 2nd and 4th year plants (p>0.05). The highest yields of eugenol (18.2485±0.02 mg/g of dry weight) and cinnamaldehyde (22.1475±0.024 mg/g of dry weight) were observed in the 3rd-year plant extracts obtained via accelerated solvent extraction. Conversely, the highest yield of cinnamic acid (0.4161±0.00 mg/g of dry weight) was found in 4th-year plants extracted using ultrasonic extraction. A statistically significant correlation was observed between cinnamaldehyde and eugenol content (p<0.05, R²=0.992), TPC and cinnamic acid (p<0.05, R²=0.906), and TFC and cinnamic acid (p<0.05, R²=0.956) across all ages. This study offers valuable insights into the variation of essential bioactive compounds in cinnamon as the plant matures, facilitating the optimization of its applications.

Evidence supports plant-based dietary patterns for preventing cardiovascular diseases (CVD)(1). Fat mass is a strong predictor of CVD(2), however it’s unclear whether this mediates the relationship between plant-based dietary patterns and CVD. Hence, the aim of this study was to determine if longitudinal associations between plant-based dietary patterns and incidence of CVD events, CVD mortality and all-cause mortality are mediated by fat mass in mid-life. Dietary data (Oxford WebQ) from 14,247 adults (median 56 years [IQR 49–61]) in the UK Biobank cohort study were used to derive diet quality index scores for an overall plant-based diet (PDI), a healthy plant-based diet (hPDI), and a less healthy plant-based diet (uPDI). Health registries and national records provided CVD event and mortality data. Percentage fat mass was measured by dual X-ray absorptiometry. Cox proportional hazard ratios (95% CI) identified associations between each diet quality index and CVD events, CVD mortality or all-cause mortality. Regression-based mediation analysis was used to identify the direct effect (plant-based diet quality indices on CVD mortality, CVD events, or all-cause mortality), and the indirect effect, which was mediated by fat mass. New CVD events (n = 364), CVD mortality (n = 52) and all-cause mortality (n = 220) were identified with mean follow up of 11.6 (SD ± 0.4) years for CVD events, and 11.5 (SD ± 0.7) years for mortality. The mean score for PDI was 50.5 (SD ± 5.9), hPDI 52.8 (SD ± 7.2), and uPDI 54.0 (SD ± 6.8). The PDI and hPDI were inversely associated with fat mass, and the uPDI was positively associated with fat mass (p < 0.001). There was no association between the diet quality indices and health outcomes, with (direct effect) or without (total effect) the fat mass mediator for males and females (p ≥ 0.1). Fat mass was associated with risk of mortality in some models, after controlling for the indices, such as a lower risk of all-cause mortality after controlling for the hPDI (p < 0.1). There was a significant negative indirect effect of hPDI on CVD mortality via fat mass for females only (observed coefficient 0.81; 95% CI 0.60–0.99). Overall, there was limited evidence of a mediating effect from fat mass in the association between plant-based dietary patterns and incidence of CVD events, CVD mortality and all-cause mortality. Studies with larger samples and longer follow up are needed to determine whether the mediating effect of fat mass on hPDI and CVD mortality in females is reproducible.

While weight loss is the primary focus of weight management programmes, it is important that service users establish healthier eating habits to support overall long-term health and weight loss maintenance. Many dietary plans and weight loss programmes are now available, particularly in the digital landscape, but few offer insights into their users’ dietary intakes while following these programmes, and whether they support individuals with meeting dietary recommendations. Slimming World Online, delivered through a website and app, supports members with weight loss through a healthy eating plan, an activity programme, and an online community. This research aims to evaluate the nutrient intakes of members following Slimming World’s digital programme, and compare intakes to UK dietary recommendations and current intakes of the general UK population.

Adults who had been members of Slimming World Online for at least 4 weeks were invited to complete a short survey and use a validated online dietary assessment tool, myfood24®, via an advert on the online member website. Food and drink intake over a 3-day period (2 weekdays and 1 weekend day) was collected and compared against UK dietary recommendations and mean general population intakes, as reported in the National Diet and Nutrition Survey (NDNS)(1).

61 adults (95.1% female; mean age 51.7±10.5 years) who completed the survey and all food diaries were included in the analysis. Mean daily energy intake was 1424.0±457.8kcal. Compared to the UK general population, members were consuming a lower proportion of energy from fat (25.5% vs 34.1%) and saturated fat (8.6% vs 12.3%). Intakes were in line with UK recommendations of <35.0% and <11.0% of total daily energy respectively. Members were consuming a greater proportion of total daily energy from protein than the general population (25.4% vs 17.0%). Mean protein intake was 90.6±32.0g/day, higher than general population intakes of 76.0g/day. Members, on average, were consuming 8.4±4.9 portions of vegetables and fruit/day, with 68.9% meeting the ‘5 a day’ recommendation, compared to 33.0% of the general population. Mean fibre intake was higher than the general population (27.2±12.9g vs 19.7±8.4g/day), while mean salt intake was in line with UK recommendations of <6g/day and lower than the general population (5.3±2.6g vs 8.4±4.1g/day).

In addition to having a reduced energy intake necessary for weight loss, members of Slimming World’s digital programme are consuming a diet which meets current UK dietary guidelines and is of better nutritional quality than that of the general UK population. Limitations include potential underreporting of intakes, the small sample size for males and slight differences to the data collection methodology of the NDNS, who use a 4-day food diary. Further research will aim to address these limitations.

FODMAPs (Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols) are indigestible, short-chain carbohydrates fermented in the large intestine, causing discomfort in patients with irritable bowel syndrome (IBS). FODMAPs, specifically fructans, galacto-oligosaccharides (GOS), lactose, fructose in excess of glucose, and polyols, are found in fruits, vegetables, grains, milk and their processed products. The aim of this project was to identify the major sources of FODMAPs in the New Zealand diet to guide research into reducing FODMAPs in those major sources. FODMAP data were collected from the New Zealand Food Composition Database(1), in-house data and published sources(2-5). NZ food consumption data were sourced from multiple published sources. Estimated potential dietary intake of FODMAPs in NZ was calculated in grams per capita per annum. Foods and beverages were ranked to ascertain major FODMAP sources within each food group. Without replicated data for individual foods, inferential statistical analysis was not possible. NZ food consumption data on a per capita per annum basis is limited, therefore consumption data were calculated based on serving size and serves per day per capita for some foods. Comprehensive FODMAP data are not available for NZ foods and beverages. In terms of FODMAP data, the New Zealand Food Composition Database(1) contains only fructose and glucose data (to calculate excess fructose) and lactose data. The main cereal and grain source of FODMAPs is wheat flour (763–831 g fructan) and the main cereal-based product sources are breads (55–1194 g fructan, up to 121 g excess fructose and 55–159 g GOS) and breakfast cereals (60–525 g fructan, up to 99 g excess fructose, up to 159 g GOS, and 2409 g lactose if consumed with cow’s milk). The main fruit source of FODMAPs is apples, providing up to 456 g excess fructose and 68–81 g sorbitol. The main vegetable sources are onion bulb (134–662 g fructan), cauliflower (131 g mannitol) and mushroom (53 g mannitol). Consumption data for garlic were unavailable. Cow’s milk is the main source of lactose (4516–5259 g), followed by ice cream (415–937 g), cheeses and butter. The main beverage sources are milk and milk-based café-style coffee (1407–4220 g lactose) and apple-based fruit juices (486–836 g excess fructose). Little data exist for sweeteners and confectionery. Honey and pear juice (containing excess fructose) are sources, as are artificial sweeteners such as erythritol, maltitol and xylitol (i.e. polyols), commonly found in chewing gum, diabetic and low-carb food products. Milk chocolate contributes to lactose consumption. More comprehensive New Zealand food consumption data (on a per capita per annum basis) are required to obtain a more accurate picture of dietary FODMAP intake. Adding oligosaccharide and polyol data to the New Zealand Food Composition Database would be beneficial to provide complete FODMAP data of New Zealand foods.

Eggs are a unique food that are high in cholesterol, but low in saturated fat. Egg consumption recommendations have fluctuated over time due to the belief that increased intake of dietary cholesterol raises plasma low density lipoprotein cholesterol (LDL-C) and therefore cardiovascular disease risk(1). Research suggests it is saturated fat, rather than dietary cholesterol, that is implicated in this association, yet controversy over egg consumption remains(1,2). This study aimed to evaluate the independent effects of dietary cholesterol (from eggs) and saturated fat intakes on LDL-C. Sixty-one adults with LDL-C less than 3.5 mmol/L (39 ± 2 years, BMI 25.8 ± 0.8 kg/m2) were enrolled in a randomised controlled counter-balanced, three-arm cross-over study(3). Participants consumed three isocaloric diets for five weeks each in randomised order: a high-cholesterol (600 mg)/low-saturated fat (6%) diet including two eggs per day (EGG) diet, a low-cholesterol (300 mg)/high-saturated fat (12%) without eggs (EGG-FREE) diet, and a control diet (CON) high in both cholesterol (600 mg) and saturated fat (12%) including one egg per week. Each diet phase included eight detailed daily meal plans with recipes, which were used on rotation for the five-week period. Throughout each dietary phase participants attended three diet review consults (via video conference or phone) and received individualised dietary advice from a dietitian. Dietary intake (5-day diaries analysed using Foodworks, Xyris Software, Australia), and lipid and lipoprotein levels were measured at study entry, and at the end of each diet phase. Treatment effects were analysed using linear mixed effects models. Results are reported as mean ± standard error. Forty-eight participants completed all three diets, with dietary analyses demonstrating target cholesterol and saturated fat intakes were generally met for each diet. Notably, saturated fat intake was 2% higher than target for all diets (CON and EGG 14%; EGG-FREE 8%). Compared to CON, plasma LDL-C concentration was significantly lower following the EGG diet (2.83 ± 0.08 mmol/L vs 2.68 ± 0.08 mmol/L, p = 0.02), but not the EGG-FREE diet (2.75 ± 0.08 mmol/L, p = 0.52). Across all three diets there was a significant within-individual relationship between dietary saturated fat intake and LDL-C concentration (β = 0.35, p = 0.002), but there was no significant relationship with dietary cholesterol intake (β = −0.006, p = 0.42). Our findings indicate that dietary saturated fat, not cholesterol, is responsible for elevating plasma LDL-C concentrations. Consuming two eggs per day within a low-saturated fat diet does not adversely affect plasma LDL-C.

Breakfast clubs create an opportunity for children to have a nutritious breakfast before school starts(1). Due to the perceived benefits, about 80% of schools across the United Kingdom run breakfast clubs, though this is likely to increase following the new government manifesto commitment on free breakfast provision in schools(2). Breakfast clubs are presently offered through the National School Breakfast Programme(3), charities or funded by schools’ budget(2). There is no standard model for delivery of breakfast clubs and research are limited. This study aimed to investigate how breakfast clubs are delivered, types of food provided and the benefits and constraints of delivery.

Primary schools offering breakfast clubs (n=17) across Yorkshire were visited and researchers observed and engaged with students and staff (including those involved in delivery) through participatory research. Researchers conducted interviews with 17 school leads and focus group discussions with 103 children (between 3-7 children from each school). Topic guides were developed by the research team to understand the food system within schools, including barriers to food provision, nutrition education and whole school approaches to food. The data was audio recorded and transcribed verbatim. Thematic analysis was conducted using the CONNECTS-Food principles Framework(4).

Our findings revealed that breakfast clubs provided children with an enjoyable start to the school day. The main themes developed were Type/quality of provision, Eating environment and Pastoral care. The delivery schemes varied and most schools offered places free or subsidised for children on Free School Meals (FSM) or other government schemes. Several schools considered children from disadvantaged families and offered a free breakfast regardless of FSM eligibility. Our findings revealed that there was diversity of foods on offer. However, the quality was perceived to relate to availability and price and was often dictated by providers rather than through school or child preferences. Offers commonly included bagels, cheese sandwiches, toast, cereals, milk, spreads and juice. The potential of schools to offer breakfast was key, particularly for families who do not have the resources or time to provide breakfast for their children. The eating environment was largely dependent on space and facilities; although, pleasant and supportive atmospheres were commonplace. Activities included drawing, reading books and games. We learnt about the value of breakfast clubs to create an environment with social and educational benefits. Our research specifically highlights the importance of breakfast clubs to support working parents through the childcare provision.

The findings suggest that further research is needed to investigate the adherence of the food provided to school food standards. This study is important as it provides insights into how breakfast clubs can be better delivered considering the new government’s manifesto commitment on school breakfast.

FixOurFood Project is funded by UKRI Transforming Food Systems with grant number BB/V004581/1

In Aotearoa New Zealand, approximately 1 in 3 adults and 1 in 8 children are classified as obese, with Māori and Pacific communities disproportionately affected(1). While maternal nutrition has been extensively studied, paternal impacts and the combined effect of both parents’ obesogenic environments on offspring health remain underexplored(2). The primary objective of this study is to characterise the metabolic phenotype of parent rats fed a High Fat High Sugar (HFHS) diet and investigate the birth characteristics of their offspring, from a factorial mating design.Eighty female and 40 male Sprague-Dawley rats were randomised to a standard chow diet (SD) (24% protein, 18% fat, 58% carbohydrates) or HFHS diet (Specialty Feeds SF23-120: 16% protein, 41% fat, 43% carbohydrates) for five weeks prior to mating. Females were then continued on their respective diets throughout pregnancy and lactation. Four mating combinations were established: SDmum-SDdad, SDmum-HFHSdad, HFHSmum-SDdad, and HFHSmum-HFHSdad. A subset of parents (n=38) underwent body composition assessments using dual-energy X-ray absorptiometry (DEXA). Additionally, a subgroup (n=23) was evaluated for metabolic profiles using Prometheon metabolic cages. Offspring birth weights and body lengths were recorded. The HFHS diet’s efficacy was confirmed in both male and female rats, with HFHS groups showing higher body weight (females: 327.1 g ± 19.7 vs. 288.2 g ± 20.1; males: 575.8 g ± 39.8 vs. 532.6 g ± 50.3; p < 0.05), greater fat percentage (females: 46.8% ± 5.6 vs. 29.2% ± 5.6; males: 40.5% ± 7.2 vs. 28.7% ± 6.8; p < 0.001), and a lower respiratory exchange ratio (RER) (females: 0.8108 ± 0.0275 vs. 0.8679 ± 0.0288; males: 0.8257 ± 0.0304 vs. 0.8759 ± 0.0266; p < 0.05) compared to the SD group. In male offspring, birth weights in HFHSmum-SDdad (6.3 g ± 0.9) and HFHSmum-HFHSdad (6.0 g ± 0.9) groups were significantly lower (p < 0.0001) than in SDmum-SDdad (6.980 g ± 0.7753) and SDmum-HFHSdad (7.0 g ± 0.7) groups. Birth weights were further reduced in HFHSmum-HFHSdad versus HFHSmum-SDdad (Mean Diff. = 0.3g; p < 0.05).Body lengths in HFHSmum-HFHSdad males were shorter (43.1 mm ± 3.2; p < 0.0001) compared to other groups (≥ 45.3 mm). Female offspring birth weights were lower in the HFHSmum-SDdad (5.8g ± 0.8) and HFHSmum-HFHSdad groups (5.8 g ± 0.9; p<0.0001) compared to the other groups (means ≥ 6.4g) but paternal HFHS diet had no additional effect on birth weight. As with males, body lengths in the HFHSmum-HFHSdad female offspring were significantly shorter (4 mm ± 3; p<0.0001) compared to all other groups (≥44mm). Parental HFHS diets synergistically reduce offspring birth length and weight, with stronger effects in males. These findings underscore the importance of inclusive dietary guidelines for both parents to reduce intergenerational obesity risk and support long-term health.