Search

Background: A sleeve gastrectomy (SG) is a lifelong treatment that improves health and better outcomes are associated with follow‐up. However, there is lack of access or high attrition to aftercare. This potentially contributes to sub‐optimal dietary intake and a lack of evidence for nutrition interventions. The present study assessed the feasibility and preliminary efficacy of a nutrition intervention to improve diet quality in Australian adults living with a SG. Methods: Adults (n = 96) post‐SG were recruited into a cross‐sectional diet quality study, with 68 eligible for randomisation to an intervention or wait‐list control group. Over 10 weeks, a Facebook group was used to post daily nutrition education. Feasibility outcomes included participant recruitment, engagement, retention and acceptability. Preliminary efficacy was assessed using change in Australian Recommended Food Score (ARFS). Linear mixed models were used to measure differences in mean outcome between the experimental groups over time. Results: Sixty‐eight participants (97% female) aged 48.2 ± 9.8 years, body mass index 33.1 ± 5.8 kg/m2, and mean ± SD ARFS 39 ± 9 points were randomised to the intervention, with 66% retention at 10 weeks. At follow‐up, diet quality increased for the intervention group (mean ARFS, 95% confidence interval = 0.2 [−1.5 to 1.9]) and decreased for the control group (mean ARFS, 95% confidence interval= −2.0 [−5.2 to 1.2]) with no between group difference (p = 0.2). Participants (n = 30) rated the intervention positively. Conclusions: Recruiting and retaining adults post‐SG into a nutrition intervention is feasible. Low‐cost recruitment attracted strong interest from women to identify greater support to know what to eat following SG. A future fully powered trial to assess intervention efficacy is warranted. Highlights: An online nutrition education intervention for Australian adults' post‐sleeve gastrectomy has been found to be effective and feasibleThe interventions attracted strong interest, especially from women, who were looking for greater support in understanding what to eat after a sleeve gastrectomy.Researchers recommend conducting a fully powered trial to assess the efficacy of this intervention further. [ABSTRACT FROM AUTHOR]

Background: Weight stigma is prevalent within healthcare settings and is an aspect of the lived experience of people living with obesity. There is international evidence of weight stigma in the dental setting, where currently there is also evidence indicating limited training amongst dental professionals regarding obesity or obesity‐related stigma. There has been Australian research and none have included dental support staff. Aims: This cross‐sectional survey aimed to assess stigmatizing attitudes and beliefs of dental professionals (registered general dentists, oral health therapists) and support staff (dental assistants, dental receptionists) working in private and public regional practices in New South Wales and specialists in Special Needs Dentistry across Australia toward people living with obesity. Methods: An anonymous electronic validated survey was administered through REDCap™ to assess stigmatizing attitudes and beliefs held amongst respondents in relation to people living with obesity. Results: Fifty‐three participants completed the survey (n = 33 clinicians, n = 20 support staff). The majority 47/53 (88.7%) held positive attitudes toward people living with obesity. Of the clinicians, 15/33 (45.5%) reported 1 hour or less and 14/33 (42.4%) reported two to 5 hours of obesity‐related education. 14/20 (70%) of the support staff reported no prior education or training about obesity. Of responses reflecting weight stigma, only three clinicians reported negative reactions toward the appearance, or discomfort during examination, of a patient with obesity, or a perception of laziness, compared with normal weight individuals. A higher proportion 4/20 (20%) of support staff reported responses indicating negative attitudes for people with obesity compared with normal weight individuals. Conclusion: Survey responses reflected evidence of weight stigma in both dental professionals and support staff. Professional development targeting weight stigma reduction in the dental setting is needed for both clinicians and support staff. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability have diverse needs and experience higher rates of diet‐related chronic disease such as type 2 diabetes compared to people without disability. However, they are infrequently included in development and implementation of interventions to address diet‐related chronic disease. The present study describes the process to plan, develop and refine the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild‐to‐moderate intellectual disability. Methods: The project was initiated by a disability service provider and was guided by the Cook‐Ed™ model and inclusive research principles. Initially the disability service provider and academic research team members co‐designed pre‐program consultation and pilot studies, and draft program resources. Pre‐program consultation explored paid disability support worker (n = 10) perceptions of cooking and food skills, nutrition priorities and optimal program format, which guided further program drafting. Program resources and pilot study design were further developed and refined with co‐researchers with lived experience of intellectual disability who attended a pre‐pilot and then pilot study sessions as remunerated co‐facilitators. Results: Key characteristics of the FLIP intervention arising from pre‐program consultation included providing cooking task instruction in small steps, enabling participant choice in program activities, promoting an inclusive and social atmosphere, and providing paper‐based resources. Conclusions: FLIP intervention co‐design was enabled through ongoing input from the disability service provider and people with lived experience of intellectual disability. Evaluation of FLIP feasibility, acceptability and preliminary effectiveness to improve diet‐related health is underway. Highlights: An academic research team, disability service provider and people with lived experience of intellectual disability co‐designed a culinary nutrition intervention for adults with mild‐to‐moderate intellectual disabilityKey considerations for culinary nutrition programs for people with intellectual disability include providing small group practical instruction, paper‐based Easy Read recipes, providing choice and creating a social and inclusive atmosphere [ABSTRACT FROM AUTHOR]

Background: Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three‐arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian‐led telehealth intervention at 3 months. Methods: Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non‐core foods were reported. Results: The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) −0.0 to 12.9], p = 0.049), non‐core foods (−6.4%/day [95% CI −12.9 to 0.0], p = 0.049), sweetened drinks (−1.7%/day [95% CI −2.9 to −0.4], p = 0.013), takeaway foods (−2.3%/day [95% CI −4.5 to −0.1], p = 0.045) and sodium (−478 mg/day [95% CI −765 to −191 mg], p = 0.001). Conclusions: A dietitian‐led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change. Highlights: A full range of dietary intake variables, eating behaviours, sleep quality and physical activity was evaluated.There was a significant negative relationship between change in diet quality and change food addiction (FA) symptoms at 3 months compared to baseline, indicating that, as FA symptoms decreased, diet quality increased.Participants allocated to the active intervention group reported statistically significant improvements in a range of dietary intake variables compared to the participants allocated to the passive intervention or control groups. [ABSTRACT FROM AUTHOR]

Background: Many young adults report poor diet quality. However, research evaluating whether young adult males and females differ in diet quality is limited. Additionally, although diet quality has a known inverse association with body mass index (BMI), it is unclear whether this association is observed in young adults and whether it varies by gender. The present study aimed to evaluate gender differences in diet quality in young adults, as well as the associations between diet quality and BMI. Methods: Data collected via the Healthy Eating Quiz (HEQ) in respondents aged 18–35 years between July 2019 and December 2021 were analysed, including demographics, and diet quality calculated using the Australian Recommended Food Score (ARFS). Differences in characteristics were analysed using a two‐sample t‐test, chi‐squared and one‐way analysis of covariance. Linear regressions were performed to estimate associations between diet quality and BMI. An interaction term was included in the model to test differences between genders. Results: The respondents (n = 28,969) were predominantly female (70.8%) with a mean ± SD age of 25.9 ± 5.0 years and BMI of 24.6 ± 5.2 kg/m2. The mean ± SD ARFS was significantly different between females and males (33.1 ± 8.6 vs. 31.4 ± 9.3 points out of 70; p < 0.001). Diet quality had a small, significant inverse association with BMI in both genders. The interaction effect between diet quality score and gender in predicting BMI was significant (p < 0.001), suggesting the impact of diet quality on BMI varies by gender, with lower diet quality more strongly associated with higher BMI in females compared to males. Conclusion: Interventions that target young adults are needed to improve diet quality and its potential contribution to BMI status. As a result of the small observed effect sizes, caution should be applied in interpreting these findings. Key points: Young male and female adults (18–35 years) demonstrate significantly different diet quality, with females scoring higher.Diet quality and body mass index (BMI) were inversely associated in both males and females, but the impact of diet quality on BMI varies by gender.Dietary interventions in young adults are needed to improve diet quality and the contribution to BMI status. [ABSTRACT FROM AUTHOR]

Background: Optimal maternal nutrition is associated with better pregnancy and infant outcomes. Culinary nutrition programmes have potential to improve diet quality during pregnancy. Therefore, this research aimed to understand the experiences of cooking and the wants and needs of pregnant women regarding a cooking and food skills programme in the United Kingdom (UK) and Republic of Ireland (ROI). Methods: Online focus group discussions with pregnant women and those who had experienced a pregnancy in the UK or ROI were conducted between February and April 2022. Two researchers conducted a thematic analysis. Seven focus groups with ROI participants (n = 24) and six with UK participants (n = 28) were completed. Results: Five themes were generated. These were (1) cooking during pregnancy: barriers, motivators and solutions; (2) food safety, stress and guilt; (3) need for cooking and food skills programmes and desired content; (4) programme structure; (5) barriers and facilitators to programme participation. Overall, there was support for a programme focusing on broad food skills, including planning, food storage, using leftovers and to manage pregnancy‐specific physiological symptoms such as food aversions. Participants emphasised the importance of inclusivity for a diverse range of people and lifestyles for programme design and content. Conclusions: Current findings support the use of digital technologies for culinary nutrition interventions, potentially combined with in‐person sessions using a hybrid structure to enable the development of a support network. Highlights: Thirteen online focus group discussions were conducted across the UK and Ireland.Five themes were generated around cooking during pregnancy and the content and structure of a cooking and food skills programme.There was support for an inclusive cooking programme that included a wide range of food‐related skills.Participants believed the programme should be supported by the health services.There was support for the use of digital technologies, potentially combined with in‐person sessions using a hybrid structure. [ABSTRACT FROM AUTHOR]

Aims: To identify barriers and enablers that influence engagement in and acceptability of diabetes prevention programmes for people with pre‐diabetes. The results will provide insights for developing strategies and recommendations to improve design and delivery of diabetes prevention programmes with enhanced engagement and acceptability for people with pre‐diabetes. Methods: This review used a critical realist approach to examine context and mechanisms of diabetes prevention programmes. Medline, Embase, PsycInfo, Cinahl, Web of Science, Scopus and Pre‐Medline were searched for English language studies published between 2000 and 2023. A quality assessment was conducted using Joanna Briggs Institute critical appraisal tools. Results: A total of 90 papers met inclusion criteria. The included studies used a variety of quantitative and qualitative methodologies. Data extracted focused on barriers and enablers to engagement in and acceptability of diabetes prevention programmes, with seven key mechanisms identified. These included financial, environmental, personal, healthcare, social and cultural, demographic and programme mechanisms. Findings highlighted diverse factors that influenced engagement in preventive programmes and the importance of considering these factors when planning, developing and implementing future diabetes prevention programmes. Conclusions: Mechanisms identified in this review can inform design and development of diabetes prevention programmes for people with pre‐diabetes and provide guidance for healthcare professionals and policymakers. This will facilitate increased participation and engagement in preventive programmes, potentially reducing progression and/or incidence of pre‐diabetes to type 2 diabetes and improving health outcomes. [ABSTRACT FROM AUTHOR]

Aims: To (1) synthesise evidence from Health at Every Size® interventions on physical and psychological health in people with overweight and obesity and (2) report between‐group differences within interventions evaluating the impact of Health at Every Size® interventions on health and health‐related outcomes. Methods: Six databases (Medline, Embase, Cochrane, PsychInfo, CINAHL, and Scopus) were searched from inception until November 2022. Included studies were conducted in adults with overweight or obesity, used Health at Every Size®‐based interventions compared with control interventions and reported dietary, physical and/or psychological outcomes, including diet quality, anthropometry, or quality of life. Data on between‐group differences were extracted. Risk of bias was assessed using ROB2. Random‐effects meta‐analyses were undertaken for outcomes with at least three studies reporting the same or comparable data. Results: From 128 studies identified, 19 full‐text articles (10 unique studies, 6 published since 2017), were included. Meta‐analysis found a significant reduction for susceptibility to hunger in Health at Every Size® intervention groups relative to controls (p = 0.005), with no significant difference (p > 0.05) between Health at Every Size® interventions and control groups for anthropometric, psychological or cardiometabolic outcomes (total cholesterol, HDL cholesterol, triglycerides, systolic or diastolic blood pressure). Conclusion: Health at Every Size® interventions had similar results compared with weight‐based interventions on anthropometric outcomes and cardiometabolic outcomes. Health at Every Size® interventions had a significant benefit for reducing susceptibility to hunger. The decision to use a Health at Every Size®‐based intervention should be personalised to individual needs. Further research in more diverse populations is required using standardised outcome measures to facilitate future meta‐analyses. [ABSTRACT FROM AUTHOR]

Determine how healthcare professionals perceive their role in nutrition assessment and management, and explore barriers and enablers to assessment and management of nutrition in individuals with DFU. Mixed methods including a cross‐sectional online survey derived from current international guidelines and theoretical domains framework, and semi‐structured interviews with conventional content analysis was performed. One hundred and ninety‐one participants completed the survey, with 19 participating in interviews. Many health professionals are not confident in their ability in this area of practice, are uncertain their nutrition advice or management will be effective in assisting wound healing outcomes and are uncertain their intervention would result in adequate behaviour change by the individual with DFU. Major barriers to implementation of nutrition assessment and management were: inadequate time, lack of knowledge and lack of clinical guidance and enablers were as follows: professional development, a standardised clinical pathway and screening tool and a resource addressing wound healing and diabetes management. Nutrition assessment and management in individuals with DFU is not consistently applied. Whilst health professionals believed nutrition was important for wound healing, they lacked confidence in implementing into their practice. Further dissemination of existing guidance and implementation of education programs and resources would help overcome cited barriers. [ABSTRACT FROM AUTHOR]

The article focuses on motivating early career nutrition researchers to achieve impactful and successful outcomes in their research endeavors. It provides guidance and strategies to ignite passion, enhance research impact, and navigate challenges commonly faced by emerging researchers in the field of nutrition.

Aims: University students may experience food insecurity due to financial constraints, reducing the quality of their diet. This study aimed to identify students at higher risk of food insecurity, their engagement with on‐campus food initiatives and evaluate the relationship between food insecurity and a validated index of diet quality. Methods: A cross‐sectional online survey used the six‐item Household Food Security Survey Module to assess food insecurity. Total diet quality and subscale scores for eight food groups were measured using the Australian Recommended Food Score (range 0–73). Univariate and multivariate regression identified groups at risk of food insecurity, their engagement with campus food initiatives and relationship with diet quality scores. Results: Of student respondents (n = 197), over half (54%) experienced food insecurity (14% mild, 23% moderate and 18% severe food insecurity). Male students and students not living with parents were at significantly higher risk. Food‐insecure students were significantly more likely to use the campus food pantry (odds ratio = 2.3 [95% confidence interval = 1.286–4.142]; p = 0.005) but not a campus community garden. The mean diet quality score was 32.9 (standard deviation = 8.9). Food‐insecure students reported a mean diet quality score over three points lower than food‐secure respondents (B = −3.5 [95% confidence interval = −6.0 to −1.0]; p = 0.006), with significantly lower fruit and vegetable subscale scores. Conclusions: Results suggest a high occurrence of food insecurity and poor dietary quality in university students. Despite high levels of engagement with the campus food pantry, the poor diet quality of food‐insecure students suggests an urgent need for greater university‐led interventions to improve students' dietary intake. [ABSTRACT FROM AUTHOR]

The inaugural expert consensus and guidance for Nutrition Interventions in Adults with Diabetic Foot Ulcers (DFU) have been welcomed by clinicians internationally. This short report aimed to determine how the macronutrient and micronutrient status of individuals living with DFU compared to the American Limb Preservation Society Nutrition Interventions in Adults with DFU expert consensus and guidance. Descriptive analysis was conducted as a secondary analysis of an existing dataset. Mean (SD) dietary intake, the proportion meeting the nutrition recommendations and the proportion exceeding the upper limit (UL) for specific vitamins and minerals were reported. Most individuals with DFU do not meet current consensus guidelines for optimal dietary intake for wound healing, with inadequacies evident for fibre, zinc, protein, vitamin E and vitamin A. Future iterations of the consensus guideline should consider using evidence‐informed recommendations for clinical practice, with the inclusion of all nutrients that are essential for wound healing in DFU. [ABSTRACT FROM AUTHOR]

Background: Yeast extract spreads and tomato‐based sauces (i.e., ketchup) are consumed regularly by the Australian population. Therefore, there is a need to explore the contribution of these condiments to nutrient intakes among Australians. Methods: The present study comprises a secondary analysis of data from the 2011–2012 Australian National Nutrition and Physical Activity Survey. Dietary intake data were undertaken for 12,153 Australians aged ≥ 2 years, using 24‐h recalls. Yeast extract spreads and tomato‐based sauces were categorised based on how they were defined in the Australian Food and Nutrient (AUSNUT) 2011–2013 database. Kruskal–Wallis H tests and the post‐hoc Dunn's test with Bonferroni correction were applied to test whether a significant difference existed in the percentage contribution of yeast extract spreads and tomato‐based sauces to intakes of select nutrients. Results: In total, 19.6% (n = 2384) of the population sample consumed yeast extract spreads and/or tomato‐based sauces during the 24‐h recall. The percentage contribution of yeast extract spreads to daily intakes of sodium, potassium, thiamine, riboflavin, niacin, folate, magnesium, iron, zinc and iodine were significantly higher in line with a greater quantity of yeast extract spread consumed (p < 0.05). The percentage contribution of tomato‐based sauces to daily intakes of sodium, potassium, riboflavin, niacin, folate, beta‐carotene, magnesium, iron, zinc and iodine was increased significantly with a greater quantity of tomato‐based sauces consumed (p < 0.05). Conclusions: Consumption of yeast extracts and tomato‐based sauces contribute to greater intake of key nutrients, such as B‐vitamins and beta‐carotene, and may assist in meeting key nutrient reference values. However, consumption of these sauces and condiments also resulted in greater intakes of sodium, contributing to population intakes exceeding recommendations. Reducing sodium content of frequently consumed condiments may potentially assist in lowering population intakes, at the same time as preserving intakes of other important nutrients. Key points: The majority of Australians consume sauces and condiments. Hence, the contribution of yeast extract spreads and tomato sauces to total sodium intakes was investigated using data from the national nutrition survey.About one in eight Australians had consumed yeast extract spreads and one in 12 tomato‐based sauces in the previous 24 h, which contribution up to approximately 14% and 12% of total sodium intakes for the highest consumers.Reformulation of condiments, particularly yeast extract and tomato‐based sauce, to a lower sodium content has the potential to lower population level intakes, especially for Australian who are frequent consumers. [ABSTRACT FROM AUTHOR]

Aims: To evaluate relationships between diet quality and cardiovascular outcomes. Methods: Six databases were searched for studies published between January 2007 and October 2021. Eligible studies included cohort studies that assessed the relationship between a priori diet quality and cardiovascular disease mortality and morbidity in adults. The Academy of Nutrition and Dietetics Checklist was used to assess the risk of bias. Study characteristics and outcomes were extracted from eligible studies using standardised processes. Data were summarised using risk ratios for cardiovascular disease incidence and mortality with difference compared for highest versus lowest diet quality synthesised in meta‐analyses using a random effects model. Results: Of the 4780 studies identified, 159 studies (n = 6 272 676 adults) were included. Meta‐analyses identified a significantly lower cardiovascular disease incidence (n = 42 studies, relative risk 0.83, 95% CI 0.82–0.84, p < 0.001) and mortality risk (n = 49 studies, relative risk 0.83, 95% CI 0.82–0.84, p < 0.001) among those with highest versus lowest diet quality. In sensitivity analyses of a high number of pooled studies (≥13 studies) the Mediterranean style diet patterns and adherence to the heart healthy diet guidelines were significantly associated with a risk reduction of 15% and 14% for cardiovascular disease incidence and 17% and 20% for cardiovascular disease mortality respectively (p < 0.05). Conclusions: Higher diet quality is associated with lower incidence and risk of mortality for cardiovascular disease however, significant study heterogeneity was identified for these relationships. [ABSTRACT FROM AUTHOR]

In high‐income nations, multiple micronutrient (MMN) supplementation during pregnancy is a common practice. We aimed to describe maternal characteristics associated with supplement use and daily dose of supplemental nutrients consumed in pregnancy, and whether guideline alignment and nutrient status are related to supplement use. The Queensland Family Cohort is a prospective, Australian observational longitudinal study. Maternal characteristics, nutrient intake from food and supplements, and biochemical nutrient status were assessed in the second trimester (n = 127). Supplement use was reported by 89% of participants, of whom 91% reported taking an MMN supplement. Participants who received private obstetric care, had private health insurance and had greater alignment to meat/vegetarian alternatives recommendations were more likely to report MMN supplement use. Private obstetric care and general practitioner shared care were associated with higher daily dose of supplemental nutrients consumed compared with midwifery group practice. There was high reliance on supplements to meet nutrient reference values for folate, iodine and iron, but only plasma folate concentrations were higher in MMN supplement versus nonsupplement users. Exceeding the upper level of intake for folic acid and iron was more likely among combined MMN and individual supplement/s users, and associated with higher plasma concentrations of the respective nutrients. Given the low alignment with food group recommendations and potential risks associated with high MMN supplement use, whole food diets should be emphasized. This study confirms the need to define effective strategies for optimizing nutrient intake in pregnancy, especially among those most vulnerable where MMN supplement use may be appropriate. Key messages: Multiple micronutrient (MMN) supplementation during pregnancy is a common practice in high‐income countries.Participants who received private obstetric care, had private health insurance and had greater alignment to meat/vegetarian alternatives recommendations were more likely to report MMN supplement use.There was high reliance on supplements to meet intake guidelines for folate, iodine and iron, which also raised concern for excess nutrient intake.This study confirms the need to define effective strategies for optimizing nutrient intake in pregnancy, including the promotion of whole food diets and appropriate use of MMN supplements. [ABSTRACT FROM AUTHOR]

Issues Addressed: To (i) determine the prevalence of health risk factors (physical activity, diet, alcohol, smoking, blood pressure medication use and mental health) in community‐dwelling stroke survivors; and (ii) examine how these health risk factors cluster, and identify associations with physical functioning, independent living, or sociodemographic factors. Methods: A secondary analysis of data obtained during a national randomised controlled trial. Participants had experienced stroke and completed a baseline telephone survey on demographic and stroke characteristics, health risk factors, physical functioning and independence in activities of daily living. A latent class analysis was performed to determine health risk profiles. Univariate logistic regressions were performed to identify if participant characteristics were associated with resulting classes. Results: Data analysed from 399 participants. Two classes of health risk factors were identified: Low Mood, Food & Moves Risk (16% of participants) and Alcohol Use Risk (84% of participants). The Low Mood, Food & Moves Risk group had poorer diet quality, lower physical activity levels and higher levels of depression and anxiety. Lower levels of independence and physical functioning were predictor variables for this group. In contrast, the Alcohol Use Risk group had better physical activity and diet scores, significantly lower probability of depression and anxiety, but a higher probability of risky drinking. Conclusions: We identified two distinct health risk factor groups in our population. So What?: Future interventions may benefit from targeting the specific needs and requirements of people who have experienced stroke based on their distinct risk group. Alcohol consumption in poststroke populations requires further attention. [ABSTRACT FROM AUTHOR]

The article discusses the role of dental professionals in addressing obesity, highlighting the importance of patient consent and non-stigmatizing communication. It emphasizes the need for education and training for dental teams to effectively engage with patients on weight-related issues. The study suggests integrating weight assessment, prevention, and referral pathways into dental practice, particularly benefiting population groups less likely to seek support for weight management. Overall, the article underscores the potential contribution of dental professionals to comprehensive obesity care and the importance of creating inclusive dental environments. [Extracted from the article]

Background: Receiving medical nutrition therapy (MNT) from an accredited practising dietitian (APD) can reduce diet‐related cardiovascular disease (CVD) risk factors. However, people living in rural areas of Australia experience barriers to accessing dietitians because of their remote location. Telehealth has the potential to improve dietetic access in rural areas; however, there is limited research into the development and delivery of telehealth MNT interventions specific to these areas. The present study describes the development of the Healthy Rural Hearts (HealthyRHearts) telehealth MNT intervention, which was developed as a part of the HealthyRHearts randomised control trial, set in primary care practices in rural areas of the Hunter New England and Central Coast Primary Health Network. The aim of HealthyRHearts is to improve diet‐related risk factors for CVD in rural adults at moderate to high CVD risk using a telehealth MNT intervention delivered by an APD. Methods: The study describes the development of the HealthyRHearts telehealth MNT intervention, using the 14‐item GUIDance for rEporting of intervention Development (GUIDED) checklist and the Template for Intervention Description and Replication (TIDieR) framework to guide description. Results: HealthyRHearts is a complex intervention that aims to translate a telehealth MNT intervention for CVD prevention into rural and remote primary care settings. The intervention is designed to be implemented across multiple sites of varying characteristics and needs, with the ability to accommodate individual complexities within the rural context and target population. Participants are adults aged 45–75 years who are assessed as moderate to high risk of CVD by their general practitioner (GP). Consenting participants are referred to the intervention by their GPs and receive five telehealth MNT consultations with an APD over 6‐months. APDs are trained in the intervention protocol including intervention materials, resources and behaviour change counselling strategies. Conclusion: Using the GUIDED and TIDieR frameworks to guide description of the HealthyRHearts intervention development process facilitates detailed description of decision‐making pathways for each element of the intervention design. The comprehensive description of the intervention development process for HealthyRHearts is intended to facilitate replication, iteration and optimisation of the intervention for rural contexts. Key points: Medical nutrition therapy (MNT) delivered by dietitians to address cardiovascular risk factors is effective and recommended in clinical guidelines.Limited studies have described the development and delivery of MNT interventions within primary care to address needs of rural communities.Comprehensively describing the development of the HealthyRHearts Medical Nutrition Therapy intervention will facilitate replication, iteration and optimisation of the intervention for rural primary care contexts. [ABSTRACT FROM AUTHOR]

Aim: Social media platforms are being increasingly used to support participant recruitment into paediatric health‐related research. This study aimed to develop a multi‐phase approach for using social media as a recruitment strategy for paediatric research studies. Methods: The process was informed by the authors' prior experiences recruiting for paediatric obesity‐related research studies, expertise in social media marketing and digital participant/ patient recruitment. Reflection on these experiences resulted in the iterative creation of a draft process which was further refined. A narrative literature review using a structured search was conducted to refine and augment the content and finalise the process. Results: A six‐phase recruitment approach was developed that includes: (i) plan for social media use as a recruitment strategy, (ii) explore relevant ethical considerations to protect the wellbeing of potentially vulnerable groups and create an ethical management plan, (iii) identify and understand the different target audiences and develop the advertising strategy, (iv) develop and design campaign content, (v) implement, monitor and iteratively refine the recruitment campaign, (vi) evaluate the campaign success. Potential activities and key considerations relevant for paediatric research are presented within each phase. Conclusion: Due to the widespread use and diverse characteristics of social media users, social media has the potential to disseminate details of research opportunities to community members who may otherwise not hear about, engage with, and potentially benefit from research participation. Researchers should collaborate with communication experts and target audiences to generate relevant and effective recruitment campaigns. Researchers should implement processes to protect vulnerable audiences' wellbeing at each stage of the process. Recruitment via social media may support wider community participation in research studies designed to improve young people's health. [ABSTRACT FROM AUTHOR]

Background and objective: Maternal nutrition has profound and lasting effects on growth and health from infancy into adulthood. The aim of this manuscript was to assess diet quality and nutrient adequacy in preconception and pregnancy in BABY1000 pilot study participants (n = 171). Study design and methods: The Australian Eating Survey (AES) Food Frequency Questionnaire was administered to women based in Sydney, Australia, at preconception or 12 weeks' gestation (n = 158), and again at 36 weeks' gestation (n = 99). Primary outcomes were diet quality and nutrient intake. Diet quality was evaluated using the AES diet quality subscale, the Australian Recommended Food Score (ARFS). Nutrient intakes were compared to Australian Nutrient Reference Values. Diet quality and nutrient intakes were not consistent with Australian recommendations. Over 83% of women exceeded the suggested target limits for percentage energy from saturated fat. Median ARFS was 37 at baseline, and 38 in late pregnancy (maximum score 73). Inadequate micronutrient intakes from food were common; no participants met the Estimated Average Requirement for iron, 76%–84% for iodine, 70%–78% for calcium and 44%–50% for folate. Maternal diet quality and nutrient intakes in the current sample are inconsistent with pregnancy recommendations and therefore may not be supporting optimal perinatal or long‐term offspring health. Stronger messaging around the importance of prenatal nutrition, prevalence of dietary inadequacy, and availability of reliable support and information specific to nutrition in pregnancy is crucial in supporting women to improve their nutrition both before and during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Poor diet, including inadequate vegetable intake, is a leading risk factor for noncommunicable disease. Culinary and nutrition education provided to trainee and practising health and education professionals is an emerging strategy to promote improved dietary intake, including vegetable consumption. We evaluated the impact and feasibility of an online culinary medicine and nutrition (CM/CN) short course for health, education and vegetable industry professionals. The course aimed to improve participants' skills and confidence to prepare vegetables, knowledge of evidence‐based nutrition information and recommendations for improving vegetable consumption and diet quality. Methods: A pre–post study consisting of two separate groups participating in two course rounds recruited practising professionals (n = 30) working in health; community, adult and/or culinary education; and the vegetable industry. Evaluation assessed diet quality, vegetable consumption barriers, cooking and food skill confidence, nutrition knowledge and process measures. Results: Seventeen participants (68%) completed the programme. Pre‐ to postintervention statistically significant increases in vegetables (M 1.3, SD 2.2), fruit (M 1.6, SD 3.1), and breads and cereal (M 1.1, SD 1.7) intakes were observed. Statistically significant increases and large effect sizes for mean food skill confidence scores (M 8.9, SD 15.4, Cohen's d 0.56) and nutrition knowledge scores (M 6.2, SD 15.4, Cohen's d 0.83) were also observed pre‐ to postintervention. Conclusions: The short online course was feasible and improved diet quality, food skill confidence and nutrition knowledge. Online CM/CN education for practising professionals represents a promising area of research. Future research involving a larger study sample and a more rigorous study design such as a randomised control trial is warranted. Key points: The online asynchronous course was feasible to run and well received by health, education and vegetable industry professionals.After completing the 5‐week online culinary nutrition course, participants had increased vegetable intake, bread and cereal intake, food skill confidence and nutrition knowledge.Findings indicate larger studies, with randomised control trial design, and that examine the impact on professionals' patients, clients and students are warranted. [ABSTRACT FROM AUTHOR]

Background: Dietary assessment commonly focuses on particular foods/food groups as indicators of overall dietary intake. Accompaniments such as sauces are not often a focus. The present study describes daily intakes of sauces, condiments and seasonings (SCS) using the most recent Australian National Nutrition and Physical Activity Survey (NNPAS), as well as the contribution to total energy and selected nutrient intakes. Methods: NNPAS dietary data were collected by one 24‐h recall for 12,153 individuals aged ≥ 2 years (53% female, 29% aged 31–50 years). SCS (i.e., any food items not normally consumed as a food itself, consumed as an addition to a dish after cooking/preparation to enhance flavour) were identified/coded within the dietary data and reported in terms of how they were consumed, primary composition, and contribution to total daily energy and selected macro‐ and micronutrient intakes. Results: Most participants (85.1%) reported consuming at least one SCS on the day of the recall (median [interquartile range], 2 [1–4]). SCS were predominantly consumed within main meals (breakfast, lunch, dinner) (73.9%), and were predominantly sugar/sugar products (e.g., white sugar) (35.0%), or fats and oils (e.g., butter) (25.9%). SCS contributed a median (interquartile range) of 3.8% (1.1–7.9) of total energy, 5.3% (0.0–15.5) of fat, 2.3% (0.1–6.6) of carbohydrate and 0.2% (0.01–1.2) of protein intake. SCS made the largest contribution towards vitamin E (females median 3.6%; males median 3.4%) and sodium intakes (females median 3.0%; males median 2.9%). Conclusions: Although SCS contribute a small proportion of total energy and nutrient intakes in the Australian population, the contribution is more substantial for some nutrients and population groups. Key points: Sauces, condiments and seasonings are small contributors to Australians' energy and nutrient intakes.Sauces, condiments and seasonings may have positive and negative contribution.Contributions vary by age and gender, and are more substantial for older adults. [ABSTRACT FROM AUTHOR]

Background: An Australia wide cross‐sectional online survey examined facilitators and barriers of health and education professionals to providing culinary nutrition (CN) and culinary medicine (CM) education and behaviour change support in usual practice, in addition to identifying continuing professional development (CPD) needs in this domain. Methods: Survey items included socio‐demographic characteristics, cooking and food skills confidence, nutrition knowledge (PKB‐7), fruit and vegetable intake (FAVVA) and CPD needs. Data were summarised descriptively. Results: Of 277 participants, 65% were likely/somewhat likely to participate in CN CPD. Mean (SD) cooking and food skill confidence scores were 73 (17.5) and 107.2 (24), out of 98 and 147, respectively. Mean PKB‐7 score was 3.7 (1.4), out of 7. Mean FAVVA score was 98 (29), out of 190. Conclusions: Gaps in knowledge and limited time were the greatest modifiable barriers to providing CM/CN education and behaviour change support in practice. Health and education professionals are interested in CPD conducted by dietitians and culinary professionals to enhance their knowledge of CM/CN and behaviour change support. Key points: Poor knowledge is a barrier to providing education about nutrition, cooking and food skills and to providing support to others to improve food behaviour.Participants want to understand differences between special diets and 'fad' diets.Health and education professionals are interested in continuing professional development to enhance their knowledge of culinary nutrition education and behaviour change support. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to report Australian dietetic practice regarding management of gestational diabetes mellitus (GDM) and to make comparisons with the findings from a 2009 survey of dietitians and with the Academy of Nutrition and Dietetics Evidence‐Based Nutrition Practice Guidelines (NPG). Methods: Cross‐sectional surveys were conducted in 2019 and 2009 of dietitians providing medical nutrition therapy (MNT) to women with GDM in Australia. The present study compares responses on demographics, dietetic assessment and interventions, and guideline use in 2019 vs. 2009. Results: In total, 149 dietitians (2019) and 220 (2009) met survey inclusion criteria. In both surveys >60% of respondents reported dietary interventions aiming for >45% energy from carbohydrate, 15%–25% energy from protein and 15%–30% energy from fat. Many variations in MNT found in 2009 continued to be evident in 2019, including the percentage of energy from carbohydrate aimed for (30%–65% in 2019 vs. 20%–75% in 2009) and the wide range in the recommended minimum daily carbohydrate intake (40–220 and 60–300 g). Few dietitians reported aiming for the NPG minimum of 175 g of carbohydrate daily in both surveys (32% in 2019 vs. 26% in 2009). There were, however, some significant increases in MNT consistent with NPG recommendations in 2019 vs. 2009, including the minimum frequency of visits provided (49%, n = 61 vs. 33%, n = 69; p < 0.001) and provision of gestational weight gain advice (59%, n = 95 vs. 40%, n = 195; p < 0.05). Conclusions: Although many dietitians continue to provide MNT consistent with existing NPG, there is a need to support greater uptake, especially for recommendations regarding carbohydrate intake. Key points: Consistencies continue a decade later in broad education topics covered for gestational diabetes mellitus.Variations in dietetic practice remain, especially regarding carbohydrate recommendations and frequency of review visits.Adherence to some Nutrition Practice Guidelines (NPG) (2016) recommendations remain low, especially regarding minimum carbohydrate intake.Adherence to NPG recommendations increased for the minimum frequency of visits provided and provision of gestational weight gain advice.There is a need to further increase medical nutrition therapy consistent with existing NPG, especially for recommendations regarding carbohydrate intake. [ABSTRACT FROM AUTHOR]

Aim: Modifiable behaviours during the first 1000 days of life influence developmental trajectories of adult chronic diseases. Despite this, sub‐optimal dietary intakes during pregnancy and excessive gestational weight gain are common. Very little is known about partners' dietary patterns and the influence on women's pregnancy dietary patterns. We aimed to examine dietary intake during pregnancy among women and their partners, and gestational weight gain patterns in the Queensland Family Cohort pilot study. Methods: The Queensland Family Cohort is a prospective, observational study piloted at a Brisbane (Australia) tertiary maternity hospital from 2018 to 2021. Participant characteristics, weight gain, dietary and nutrient intake were assessed. Results: Data were available for 194 pregnant women and their partners. Poor alignment with Australian Guide to Healthy Eating recommendations was observed. Highest alignment was for fruit (40% women) and meat/alternatives (38% partners) and lowest for breads/cereals (<1% women) and milk/alternatives (13% partners). Fewer women (4.4%–60.3%) than their partners (5.4%–92.3%) met guidelines for all micronutrient intakes from food alone, particularly folic acid, iodine, and iron. Women were more likely to meet daily recommendations for fruit, vegetables, dairy, bread/cereals, and meat/alternatives when their partners also met recommendations. Women with a higher pre‐pregnancy body mass index were more likely to gain above recommended weight gain ranges. Conclusions: In this contemporary cohort of pregnant women and their partners, sub‐optimal dietary patterns and deficits in some nutrients were common. There is an urgent need for evidence‐informed public health policy and programs to improve diet quality during pregnancy due to intergenerational effects. [ABSTRACT FROM AUTHOR]

Background: Despite economic growth, Cambodia continues to have high rates of malnutrition, anaemia and nutrition‐related deficiencies. Government policies promote nutrition strategies, although dietary intake data is limited. A detailed synthesis of existing intake data is needed to inform nutrition policy and practice change. This review aims to characterise and assess quality of dietary assessment methods and outcomes from individual‐level 'whole diet' studies of Khmer people living in Cambodia. Methods: Searches were conducted using PRISMA‐ScR guidelines. Included papers reported dietary intake at an individual level for 'whole diet'. Studies using secondary data or lacking dietary assessment details were excluded. Extracted data included dietary assessment features, nutrient/food group intakes and database. Results: Nineteen publications (15 studies) were included, with nine carried out among children under 5 years and six among women. Eleven studies reported intake by food groups and four by nutrients, prominently energy, protein, vitamin A, iron, calcium and zinc. Inconsistent intakes, food groupings and reporting of study characteristics limited data synthesis. All but one study used 24‐h recalls. Trained local fieldworkers used traditional interview‐administered data collection and varied portion estimation tools. Food composition databases for analysis were not tailored to the Cambodian diet. Overall quality was rated as 'good'. Conclusions: We recommend the development of a best‐practice protocol for conducting dietary assessment, a Cambodia‐specific food composition database and a competent trained workforce of nutrition professionals, with global support of expertise and funding for future dietary assessment studies conducted in Cambodia. Key points: Fifteen studies with highly variable intake data included in the review.The food composition databases used were not specific to Cambodian diet.Minimum reporting standards and best practice protocols recommended, including in‐country nutrition training.Lack of whole population dietary intake data indicates the need for a national survey. [ABSTRACT FROM AUTHOR]

Summary: Objective: To systematically review and meta‐analyze randomized controlled trials on the effects of technology‐based interventions for maintenance of lost weight. Methods: A systematic literature search was performed to identify randomized controlled trials with at least one intervention arm delivered through the internet or mobile application, published in English until September 2021. Weight change at the end of the weight loss maintenance phase was considered the primary outcome. Results: Twelve manuscripts with 2941 adults were included in the review; 10 studies were meta‐analyzed. Included interventions had a duration of 3–30 months and were tested compared with minimum interventions (no contact with the study staff or intervention with only a limited number of features) or in‐person groups. Technology‐based interventions resulted in similar weight regain when compared with minimum interventions (ES = −0.07 kg; 95% CI = [−0.57, 0.42]; p = 0.770). However, when compared with in‐person interventions, technology‐based interventions were found to lead in significantly higher weight regain (ES = 1.36 kg; 95% CI = [0.29, 2.43]; p = 0.010). Conclusion: Web‐ and app‐based interventions for weight loss maintenance produced similar results with minimum interventions and resulted in greater weight regain compared with in‐person interventions. Appropriate interventions for weight loss maintenance provide benefits against weight regain, only when provided in‐person. [ABSTRACT FROM AUTHOR]

Background: The interplay between cardiovascular disease (CVD) genetic risk indexed by a polygenic risk score (PRS) and diet quality still requires further investigation amongst older adults or those with established or treated CVD. The present study aimed to evaluate the relative contribution of diet quality, measured using the Australian Recommended Food Score (ARFS) and PRS, with respect to explaining variation in plasma lipids CVD outcomes in the Hunter Cohort. Methods: The study comprised a secondary analysis of cross‐sectional data from the Hunter Cohort study. Single‐nucleotide polymorphisms from previously derived polygenic scores (PGSs) for three lipid classes were obtained: low‐density lipoprotein, high‐density lipoprotein and triglycerides, as well as PRS for coronary artery disease (CAD) from the PGS catalogue. Regression modelling and odds ratios were used to determine associations between PRS, ARFS and CVD risk. Results: In total, 1703 participants were included: mean ± SD age 66 ± 7.4 years, 51% female, mean ± SD total ARFS 28.1 ± 8 (out of 74). Total diet quality and vegetable subscale were not significantly associated with measured lipids. By contrast, PGS for each lipid demonstrated a markedly strong, statistically significant correlation with its respective measured lipid. There was a significant association between CAD PRS and 5/6 CVD phenotypes (all except atrial fibrillation), with the largest effect size shown with coronary bypass. Adding dietary intake as a covariate did not change this relationship. Conclusions: Lipid PGS explained more variance in measured lipids than diet quality. However, the poor diet quality observed in the current cohort may have limited the ability to observe any beneficial effects. Future research should investigate whether the diet quality of older adults can be improved and also the effect of these improvements on changes in polygenic risk. Key points: The Australian Recommended Food Score (ARFS) had little association with lipid and cardiovascular disease (CVD) endpoints.Lipid polygenic score (PGS) explained more variance in measured lipids than diet quality.The lipid PGS was associated with all three lipid parameters and some CVD endpoints, especially high cholesterol.Coronary artery disease polygenic risk score was associated with CVD endpoints angina, coronary bypass, heart attack, high cholesterol and hypertension and some lipid parameters (high‐density lipoprotein cholesterol). [ABSTRACT FROM AUTHOR]

Objective: Electronic scooter (eScooter) popularity has soared, despite public concerns around injury risk. We aimed to explore the burden of injury from eScooters presenting to Tasmania's major trauma centre during the first 6 months of the Hobart eScooter trial. Methods: We screened all ED presentations and interhospital transfers from 11 December 2021 to 26 June 2022 to identify eScooter-associated injury. All injuries were coded using the Abbreviated Injury Scale and an Injury Severity Score (ISS) was computed for each presentation. Data were entered into the Tasmanian Trauma Registry and then exported into standard statistical software for descriptive analysis. Results: There were 135 eScooter presentations to the ED and 31 were admitted. Patients were mostly young (median age 27 years) with an even sex distribution. Injuries were mostly minor (median ISS of 2) with injuries to soft tissues and the head and neck predominating. Approximately, onethird required operative interventions, but none required intensive care. Injured patients were less likely to have been wearing protective gear (36% helmet wearing) and alcohol intoxication was common (41% overall, 71% admitted patients). Conclusion: Overall, our 6-month prospective dataset shows that the Hobart eScooter trial has been associated with few major injuries. [ABSTRACT FROM AUTHOR]

Background: Focused antenatal care currently implemented in Tanzania recommends that women receive nutrition care during routine clinic visits. However, little detail is documented in regard to the nutrition information provided to pregnant women during these visits. The present study aimed to investigate whether pregnant women recalled nutrition information or support provided and, if so, who provided this during routine antenatal clinic visits. The secondary aim was to determine how pregnant women intended to implement the information and what mode of delivery was preferred for receiving nutrition information. Methods: An exploratory cross‐sectional study comprising exit interviews was conducted with 50 pregnant women attending antenatal clinics in three regional referral hospitals in Dar es Salaam, Tanzania. Results: All participants (n = 50) reported receiving nutrition care from healthcare workers in regard to; haemoglobin checks (79% of participants), iron and folic acid supplementation (70%), weight measurement (70%), eating advice (60%), and dietary intake assessment (38%). However, the information recalled on each category was inconsistent. For 60% of participants, nurses were reported as the source of nutrition care during pregnancy, followed by medical doctors (22%). The most preferable mode for receiving nutrition information was reported as individual face‐to‐face sessions with health practitioners, followed by mobile phone. All of the participants who received nutrition information indicated that they intended to implement. Conclusions: Nurses were the main source of nutrition information for pregnant women attending antenatal clinics, followed by medical doctors. However, the content of nutrition information recalled by participants was inconsistent. Healthcare facilities need to implement strategies to ensure pregnant women understand and can implement nutrition information provided by healthcare workers during routine antenatal care. [ABSTRACT FROM AUTHOR]

Background: Culinary medicine (CM) or culinary nutrition (CN) education provided to professionals with the capacity to influence behaviour change is an emerging strategy to promote diet quality and reduce the burden of diet related chronic disease in adults. The purpose of this scoping review was to synthesise current research describing CM/CN education provided to or by health, education and culinary professionals, or students of these disciplines. Methods: Preferred Reporting Items for Systematic reviews and Meta‐Analysis extension for Scoping Reviews (PRISMA‐ScR) was used. Eleven electronic databases were searched in March 2019. Included studies were: (i) nutrition, health or lifestyle programs with a CM/CN component; (ii) study participants or programs facilitated by people working or training in health, community and/or adult education, or culinary roles where facilitator training was described; (iii) reported in the English language; and (iv) published from 2003. Results: In total, 33 studies were included. Nineteen studies delivered programs to general population groups and were facilitated by health professionals and/or health university students. Fourteen studies delivered CM/CN training to health professionals or students. Studies reported changes in participants' culinary skill and nutrition knowledge (n = 18), changes in dietary intake (n = 13), attitudes and behaviour change in healthy eating and cooking (n = 4), and competency in nutrition counselling and knowledge (n = 7). Conclusions: Further research examining the effectiveness of CM/CN programs, and that describes optimal content, format and timing of the programs, is needed. Research evaluating the impact of training in CM/CN to education and culinary professionals on healthy cooking behaviours of their patients/clients is warranted. Highlights: Culinary medicine (CM) or culinary nutrition (CN) education provided to professionals with the capacity to influence behaviour change is an emerging strategy to promote diet quality and reduce the burden of diet related chronic disease in adults.A reasonable number of interventions were identified; however, interventions in the CM/CN field are very heterogeneous.Further research examining effectiveness of CM/CN programs, and that describe optimal content, format and timing of programs, is needed.Research evaluating the impact of training in CM/CN to education and culinary professionals on healthy cooking behaviours of their patients/clients is warranted. [ABSTRACT FROM AUTHOR]

Aim: The aim of this systematic review was to examine the literature regarding rural healthcare delivery for women with any type of diabetes in pregnancy, and subsequent maternal and infant outcomes. Methods: Eight databases were searched in September 2020, including Medline, EMCare, CINAHL, EMBASE, Maternity and Infant Care, Cochrane, Rural and Remote Health and Aboriginal and Torres Strait Islander Health bibliography. Studies from high‐income countries in rural, regional or remote areas with interventions conducted during the antenatal period were included. Intervention details were reported using the template for intervention description and replication template. Two reviewers independently assessed for risk of bias using the RoB2 and ROBINS I tools. Results: Three articles met the inclusion criteria: two conducted in Australia and one in the United States. A multidisciplinary approach was reported in two of the included studies, which were modified specifically for their respective rural settings. All three studies reported rates of caesarean section, birthweight (grams) and gestational age at birth as maternal and infant outcomes. One study was considered at moderate risk of bias, and two studies were at serious risk of bias. Conclusion: There is a significant gap in research relating to healthcare delivery for women with diabetes in pregnancy in rural areas. This lack of research is concerning given that 19% of individuals in high‐income countries reside rurally. Further research is required to understand the implications of healthcare delivery models for diabetes in pregnancy in rural areas. [ABSTRACT FROM AUTHOR]

Summary: The aim of this systematic review and meta‐analysis was to examine the effectiveness of e‐health interventions for the treatment of children and adolescents with overweight or obesity. Databases were searched up to November 2020. Studies were randomized controlled trials where interventions were delivered via e‐health (e.g., computers, tablets, and smartphones, but not phone calls). Studies should target the treatment of overweight or obesity in children or their agent of changes and report body mass index (BMI) or BMI z‐score. A meta‐analysis using a random‐effects model was conducted. Nineteen studies met the inclusion criteria, and 60% were of high quality. The narrative review revealed variation in behavior change strategies and modes of delivery. The pooled mean reduction in BMI or BMI z‐score showed evidence for a nonzero effect (standardized mean difference = −0.31, 95% confidence interval −0.49 to −0.13), with moderately high heterogeneity between studies (I2 = 74%, p < 0.001). Subgroup analysis revealed high heterogeneity in studies with a high or unclear risk of bias. E‐health interventions can be effective in treating children and adolescents with overweight and obesity and should be considered by practitioners and policymakers. However, an understanding of the most effective and acceptable intervention components, long‐term benefits, and sustainability should be further studied. [ABSTRACT FROM AUTHOR]

Aims: To assess the impact of achieving an Institute of Medicine based personalised weight target in addition to conventional glycaemic management after gestational diabetes mellitus diagnosis on maternal and neonatal outcomes. Methods: A retrospective audit of clinical data (2016–2019) for singleton gestational diabetes pregnancies was conducted in a multi‐ethnic cohort. Logistic regression analyses assessed relationships between achieving, exceeding and gaining less than a personalised weight target provided after gestational diabetes diagnosis and rates of large for gestational age, small for gestational age infants, insulin therapy initiation and neonatal outcomes. Adjusted odds ratios (aOR) were adjusted for glucose 2‐h post‐glucose load value, family history of type 2 diabetes, previous gestational diabetes, macrosomia in a previous pregnancy, and East and South‐East Asian ethnicity. Results: Of 1034 women, 44% (n = 449) achieved their personalised weight target. Women who exceeded their personalised weight target had significantly and higher mean insulin doses (28.8 ± 21.5 units vs. 22.7 ± 18.7, p = 0.006) and higher rates of large for gestational age infants (19% vs. 9.8%, p < 0.001), with aOR of 1.99 [95% CI 1.25–3.15] p = 0.004, but no difference in rates of small for gestational age infants (5.3% vs. 8.0%) (aOR 0.77 [0.41–1.44] p = 0.41). Lower rates of large for gestational age infants occurred in those who gained below their personalised weight target (aOR 0.48 [0.25–0.95] p = 0.034), but rates of small for gestational age infants concurrently increased (aOR 1.9 [1.19–3.12] p = 0.008). Conclusions: Weight management after gestational diabetes diagnosis does not appear to be too late to confer additional benefits to glucose‐lowering treatment, resulting in lower mean insulin doses, and lower rates of large for gestational age infants without increasing the risk of small for gestational age infants. [ABSTRACT FROM AUTHOR]

Background: This scoping review aims to describe the body of nutrition intervention and dietary assessment research undertaken with Khmer populations in Cambodia, as well as summarise the nutrition knowledge base and highlight priority areas for future research. Methods: Five databases and the grey literature were searched, following PRISMA‐ScR guidelines. Studies involving dietary assessment or nutrition interventions published after 1992 were identified using specific search terms and extracted to a customised data extraction table for categorisation and analysis. Study participants were Khmer people of any age and gender, living in rural or urban Cambodia. Results: Of the 100 included studies, 58 were dietary assessment only studies, 24 were nutrition interventions only, and 18 studies involved both assessment of intake and an intervention. Sixty‐eight percent of study populations were mothers and young children, of which 52 studies focused on children aged under 5 years. Nineteen interventions involved supplementation and six trialled fortification of rice or fish sauce. Anaemia was the most common nutrition condition studied (n = 17), followed by malnutrition (n = 15) and malnutrition risk factors (n = 11). General nutrition status was explored in 25 studies, and individual micronutrients that were studied included iron (n = 27), zinc (n = 6), vitamin A (n = 4) and thiamine (n = 3). Conclusions: Diet‐related research in Khmer populations in Cambodia has predominantly focused on dietary assessment or evaluation of interventions aimed at reducing malnutrition and resolving micronutrient deficiencies. Areas identified as emerging needs included non‐communicable diseases, the ageing population and non‐iron deficiency anaemia. Highlights: Previous research involving nutrition interventions and/or dietary assessment research among Khmer populations living in Cambodia has largely focused on malnutrition and anaemia.Populations studied have been predominantly maternal and young children, addressing Sustainable Development Goals.Supplementation and fortification interventions are prominent.Wide variety of study outcomes involving dietary assessment, e.g., health behaviours, food security, intervention effectiveness and oral health, across different population groups. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compare food and nutrient intakes of young Australian adults (18‐24 years) to national recommendations as per the Australian Guide to Healthy Eating and Nutrient Reference Values. Methods: Dietary intake of 18 to 24 year olds (n = 1005) participating in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study was self‐reported using the 120‐item Australian Eating Survey Food Frequency Questionnaire. Median daily servings of Australian Guide to Healthy Eating food groups, macronutrients and micronutrients were compared to recommendations in the Australian Guide to Healthy Eating and Nutrient Reference Values using t‐tests or Kruskal‐Wallis tests (P <.05). Results: None of the young adults met all Australian Guide to Healthy Eating recommendations. The highest adherence [% meeting recommendations, median (IQR)] was for meat/alternatives [38%, 2.1(1.8)] and fruit [32%, 1.5(1.6)], with <25% meeting remaining food‐group recommendations. The majority (76%) exceeded recommendations for the consumption of discretionary foods [4.0(3.3) vs 0‐3 serves] and 81% had excessive saturated fat intakes. Young adults who met all key Nutrient Reference Values (dietary fibre, folate, iodine, iron, calcium and zinc) (18%) consumed a higher number of serves of all food groups, including discretionary foods. Conclusions: Dietary intakes of contemporary young adults do not align with Australian Guide to Healthy Eating targets, while meeting Nutrient Reference Values is achieved by a higher consumption of all food groups, including discretionary foods. Strategies to increase consumption of nutrient‐dense foods in young adults to achieve the Nutrient Reference Values are warranted. [ABSTRACT FROM AUTHOR]

Aim: The nutritional quality of foods consumed by infants and young children to complement breastfeeding or formula feeding influences growth and development. The aim of this study was to identify the dietary intake of Indigenous infants and young children in the Gomeroi gaaynggal cohort, and evaluate the nutritional adequacy of their intake compared with Australian recommendations. Methods: Dietary intake was assessed using diet recalls at approximately 9‐, 12‐ and 24‐month visits. Nutrient values of foods were obtained from AUSNUT 2011‐13 and nutrient intake compared to the Australian Nutrient Reference Values. Foods were categorised into food groups and intakes compared to the Australian Guide to Healthy Eating. Results: A total of 206 infants and young children were included in the study. Of these, 95 individual children had dietary data collected between 7.6 and 24.7 months. Infant formula and breastfeeding rates were highest among infants (70% and 20%, respectively). Cow's milk intake was highest among young children (75%). Infants and young children in the cohort met most macro‐ and micronutrient intake recommendations. Few young children met recommendation for iron (42%), no infant met recommendation for omega‐3 fatty acids and almost all exceeded recommendation for sodium. Most young children met daily dairy and fruit recommendations although intake of discretionary foods was high. Conclusions: This study found that diets of Indigenous infants and young children met most key nutrient reference targets. Potential target areas that require dietary optimisation have been identified and will be the focus of community‐led strategies in adequate infant nutrition promotion. [ABSTRACT FROM AUTHOR]

Aim: To assess cerebral oxygenation in premature infants who are transitioning from nasal continuous positive airway pressure (nCPAP) to heated humidified high‐flow nasal cannula therapy (HFNC). Methods: A prospective observational study done in a single‐centre neonatal intensive care unit (NICU). Regional cerebral oxygen saturations (RcSO2) were measured using frequency‐domain near‐infrared spectroscopy (FD‐NIRS) in very low birthweight (VLBW) premature infants born at <32 weeks transitioning from nCPAP to HFNC. Results: Median gestational age was 27 weeks and median birthweight was 924 g. Recordings were performed at a median gestational age of 30 weeks and a median postnatal age of 10 days. Median weight at study entry was 1111 g. Cerebral oxygenation was not significantly different in infants transitioning from nCPAP to HFNC (66% vs 66%). Conclusion: No difference in cerebral oxygenation in premature infants transitioning from nCPAP to HFNC was observed. This finding is reassuring and further supports the use of HFNC in preterm infants. [ABSTRACT FROM AUTHOR]

Aim: To inform future training and professional development for individuals who measure, analyse and interpret dietary intake data. Methods: A cross‐sectional online survey was distributed via e‐newsletter to members of Dietitians Australia, Dietitian Connection and Nutrition Society Australia. The survey included 37 questions on three key areas of practice: (a) methods used to assess dietary intake, (b) barriers faced when conducting dietary intake assessment and (c) resources needed to optimise collection, analysis and interpretation of dietary intake data. Results: Of 173 responses, 103 respondents provided complete data over 2 weeks. Of these, 76% were APDs. The majority (90%) indicated that dietary assessment was important in their role. Respondents (63%) undertook dietary assessments to inform individual/patient care. When assessing intakes, the majority (79%) were interested in examining food/food group intakes. Paper based methods were most commonly used and diet histories, food frequency questionnaires and 24‐hour recalls were the most frequently used methods. The biggest barrier identified to implementing dietary assessment methods into practice was participant burden. Over a third of respondents reported they had received specific training on selecting an appropriate dietary assessment method. The majority of respondents (83%) believed having access to a dietary assessment methods toolkit would be useful. Conclusion: Survey findings provide insight into the need for further capacity building strategies, including professional development to improve collection, analysis and interpretation of dietary intake for Australian nutritionists and dietitians. The creation of online resources could help overcome identified barriers and provide a link to best practice methodologies and contemporary tools. [ABSTRACT FROM AUTHOR]

The Tasmanian Trauma Registry began collecting data in April 2020 and in April 2021 the first 12 months' data were submitted to the Australia New Zealand Trauma Registry. In this perspective, we share the lessons we have learned in establishing a trauma registry and acknowledge how important support from the broader trauma community has been in allowing Tasmania to participate in national benchmarking and quality assurance processes. [ABSTRACT FROM AUTHOR]

Aim: To investigate associations between changes in vegetable and fruit (V&F) intakes and anthropometric indices (weight, BMI, % body fat, waist circumference), including differences by sex, during a dietary weight‐loss intervention. Methods: Adults (18‐45 years) with overweight/obesity (BMI 25‐35 kg/m2) entered a 10‐week pre‐post study, receiving individualised consults with an Accredited Practising Dietitian targeting increased V&F intakes. Dietary intake was assessed using 24‐hour recalls and food frequency questionnaires. Linear mixed models were used to examine how much of the changes in anthropometric indices were explained by changes in V&F intakes. Sex differences were assessed by Wilcoxon rank sum tests. Results: Of the 43 participants enrolled, 34 completed the study (53% female). Significant differences in energy intake and anthropometric indices were observed between males and females at baseline. After 10 weeks, females significantly reduced their weight (−2.9%, P <.01), BMI (−0.82 kg/m2, P <.01), waist circumference (−1.70 cm, P <.01), energy intake (−824 kJ/day, P =.01) and improved diet quality (−14.0% energy‐dense, nutrient‐poor foods, P <.01). Males significantly reduced weight (−2.5%, P =.04), BMI (−0.76 kg/m2, P =.03), waist circumference (−2.40 cm, P =.02), energy intake (−2875 kJ/day, P <.01), increased fruit intake (+0.89 serves/day, P =.02) and improved diet quality (−6% energy‐dense, nutrient‐poor foods, P <.01). Compared to the other sex, greater reductions were observed in energy intake in males and energy‐dense, nutrient‐poor foods in females. Linear mixed models identified that changes in V&F intakes did not explain the variation in anthropometric measures. Conclusion: Future interventions may benefit from trialling sex tailored messages to enhance effects on anthropometric changes. [ABSTRACT FROM AUTHOR]

Summary: Socio‐economic status and ethnic background are recognized as predictors of risk for the development of obesity in childhood. The present review assesses the effectiveness of treatment for children according to their socio‐economic and ethnic background. Sixty‐four systematic reviews were included, from which there was difficulty reaching general conclusions on the approaches to treatment suitable for different social subgroups. Eighty‐one primary studies cited in the systematic reviews met the inclusion criteria, of which five directly addressed differential effectiveness of treatment in relation to social disparities, with inconsistent conclusions. From a weak evidence base, it appears that treatment effectiveness may be affected by family‐level factors including attitudes to overweight, understanding of the causes of weight gain and motivation to make and maintain family‐level changes in health behaviours. Interventions should be culturally and socially sensitive, avoid stigma, encourage motivation, recognize barriers and reinforce opportunities and be achievable within the family's time and financial resources. However, the evidence base is remarkably limited, given the significance of social and economic disparities as risk factors. Research funding agencies need to ensure that a focus on social disparities in paediatric obesity treatment is a high priority for future research. [ABSTRACT FROM AUTHOR]

It is the position of Dietitians Australia that clients can receive high‐quality and effective dietetic services such as Medical Nutrition Therapy (MNT) delivered via telehealth. Outcomes of telehealth‐delivered dietetic consultations are comparable to those delivered in‐person, without requiring higher levels of additional training nor compromising quality of service provision. Dietitians Australia recommends that policy makers and healthcare funders broaden the recognition for telehealth‐delivered dietetic consultations as a responsive and cost‐effective alternative or complement to traditional in‐person delivery of dietetic services. The successful implementation of telehealth can help to address health and service inequalities, improve access to effective nutrition services, and support people with chronic disease to optimise their diet‐related health and well‐being, regardless of their location, income or literacy level, thereby addressing current inequities. [ABSTRACT FROM AUTHOR]

Summary: Young adulthood is associated with the highest rate of weight gain compared with any other adult age group. This review evaluates the effectiveness of interventions with adiposity outcomes among young adults and identifies which behaviour change techniques (BCTs) are most effective. BCT utilization was assessed using Michie's 93‐item BCT Taxonomy v1. Six electronic databases were searched for randomized controlled trials assessing change in adiposity in young adults (17‐35 years) until December 2019; identifying 21,582 articles. Fifty‐one studies were included. Meta‐analyses for weight (n=19 studies), body mass index (BMI) (n=20 studies), and waist circumference (n=10 studies) demonstrated no significant between‐group differences at ≤3 or >3 months. There were no differences between interventions focusing on weight loss or weight‐gain prevention. Narrative synthesis showed significant between‐group differences in weight change, favouring the intervention in 14/43 (33%) studies. In studies assessing BMI and waist circumference, this was 31% (11/36) and 25% (4/16). Two BCTs had a percentage effectiveness ratio >50% in weight loss interventions; social support (unspecified) and self‐monitoring behaviour, and one in weight‐gain prevention interventions; and goal‐setting (outcome). Findings demonstrate initial potential for these types of BCTs and can help build cumulative evidence towards delivering effective, cost‐efficient, and replicable interventions. [ABSTRACT FROM AUTHOR]

Aim: While diet quality has declined globally, the promotion of cooking skills as a potential target to counter the decline has been proposed. The aim of the current study was to investigate the relationship between food and cooking skills and diet quality in Australian adults. Methods: A sample of 910 Australian adults completed an online cross‐sectional survey to evaluate their level of cooking and food skills confidence, food related psychological variables, diet quality using the Australian Recommended Food Score (ARFS) and sociodemographic characteristics. Analysis of variance with post hoc analysis, Pearson's correlations and hierarchical multiple regressions were conducted using IBM SPSS V25, with statistical significance set at P <.05. Results: Older respondents and females reported higher levels of both cooking and food skills confidence compared to younger and male participants, all P <.001. Cooking and food skills confidence scores were highly correlated (r =.70, P <.001), but weakly correlated with ARFS (r =.22, P <.001; r =.31, P <.001, respectively). Participants with higher diet quality scores had greater cooking and food skills confidence and they consumed less takeaway food (P <.001 and P =.006, respectively). Sixteen percent of the variance in ARFS was accounted for, with age, sex, food creativity and food skills confidence contributing the most variability. Conclusions: Strategies to improve food skills confidence could potentially enhance diet quality and variety to a greater degree than focusing on cooking skills alone. However, development of both skills sets should be encouraged within education programs and targeted to differing aspects of diet quality. Tailoring interventions to specific population groups with low confidence in their skills, including younger adults and males, may facilitate individuals in making healthy food choices. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including Nutrition & Dietetics brings together a collection of papers that examine the validity of self-reported dietary intake.

Aim: There has been an increase in the use of text messaging to deliver and support health interventions. The aim was to develop a bank of text messages targeting healthy eating for children in the context of parenting partnerships that could be used in a family intervention. Methods: Text messages were developed using the Theoretical Domains Framework and Behaviour Change Wheel COM‐B model by study investigators using a three‐phase approach: (i) initial development of a message bank; (ii) messages were reviewed and evaluated by experts and parents on their clarity, usefulness, and relevance using a 5‐point Likert scale and open text spaces for additional feedback and (iii) refinement of messages content and finalised the message bank. Results: Messages were reviewed for 'clarity', 'usefulness' and 'relevance' by 20 parents and 28 health experts, who were predominantly female (92%), parents of primary school age children (33%), of low to middle socioeconomic status (78%), with a mean age of 39 years (SD ± 9.87). From an initial set of 97 messages developed, 48 messages were retained through consultation. Messages were designed to complement the intervention, while engaging both parents. Conclusions: The three‐phase development created a set of text messages acceptable to experts and parents that aim to support improvement in child eating behaviours. The process provides a template and practical guide for researchers and health providers looking to apply a systematic approach to text messages development. Future research should investigate acceptability and impact of these messages as a component of family‐based nutrition intervention. [ABSTRACT FROM AUTHOR]

Summary: The objective of this review was to evaluate the efficacy and safety of very low‐energy diet (VLED) programs for weight loss in children and adolescents with obesity. Six electronic databases were searched identifying 24 eligible studies (16 pre‐post studies, four nonrandomized trials, two randomized controlled trials [RCTs], and two chart reviews) published up to October 2018. Studies were in English, implemented a VLED (≤3360 kJF/day [≤800 kcal/day] or <50% estimated energy requirements) in 5‐ to 18‐year‐olds with obesity, and reported at least one weight‐related outcome. Weight‐related outcomes significantly improved postintervention in all studies. Meta‐analysis of 20 studies indicated a mean 10.1 kg (95% confidence interval [CI], 8.7‐11.4 kg, P < 0.001; I2 = 92.3%) weight loss following interventions lasting 3 to 20 weeks. Moderator analysis indicated greater weight loss in adolescent‐only studies (10‐18 years) and formulated meal replacement interventions and inpatient settings. Meta‐analysis of seven studies reporting weight at follow‐up (5‐14.5 months from baseline) indicated 5.3 kg mean weight loss (CI, 2.5‐8.0 kg, P < 0.001; I2 = 50.6%). Details of adverse events were limited. VLED programs are effective for treating children and adolescents with obesity. However, conclusions on their safety cannot be drawn from the existing literature at this time. Future studies should include long‐term follow‐up with ongoing support and comprehensive monitoring of all adverse events. [ABSTRACT FROM AUTHOR]