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Error in self-reported food and beverage intake affects the accuracy of dietary intake data. Systematically synthesizing available data on contributors to error within and between food groups has not been conducted but may help inform error mitigation strategies. In this review we aimed to systematically identify, quantify, and compare contributors to error in estimated intake of foods and beverages, based on short-term self-report dietary assessment instruments, such as 24-h dietary recalls and dietary records. Seven research databases were searched for studies including self-reported dietary assessment and a comparator measure of observed intake (e.g., direct observation or controlled feeding studies) in healthy adults up until December 2021. Two reviewers independently screened and extracted data from included studies, recording quantitative data on omissions, intrusions, misclassifications, and/or portion misestimations. Risk of bias was assessed using the QualSyst tool. A narrative synthesis focused on patterns of error within and between food groups. Of 2328 articles identified, 29 met inclusion criteria and were included, corresponding to 2964 participants across 15 countries. Most frequently reported contributors to error were omissions and portion size misestimations of food/beverage items. Although few consistent patterns were seen in omission of consumed items, beverages were omitted less frequently (0–32% of the time), whereas vegetables (2–85%) and condiments (1–80%) were omitted more frequently than other items. Both under- and overestimation of portion size was seen for most single food/beverage items within study samples and most food groups. Studies considered and reported error in different ways, impeding the interpretation of how error contributors interact to impact overall misestimation. We recommend that future studies report 1) all error contributors for each food/beverage item evaluated (i.e., omission, intrusion, misclassification, and portion misestimation), and 2) measures of variation of the error. The protocol of this review was registered in PROSPERO as CRD42020202752 (https://www.crd.york.ac.uk/prospero/).

Aims Dietary modification is essential for the secondary prevention of cardiovascular disease. However, there are limited published evidence syntheses to guide practice in the cardiac rehabilitation (CR) setting. This systematic review’s objective was to assess effectiveness and reporting of nutrition interventions to optimize dietary intake in adults attending CR. Methods and results Randomized controlled trials (RCTs) of nutrition interventions within CR were eligible for inclusion and had to have measured change in dietary intake. MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and The Cochrane Library were searched from 2000 to June 2020, limited to publications in English. Evidence from included RCTs was synthesized descriptively. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. This review is registered on PROSPERO; CRD42020188723. Of 13 048 unique articles identified, 11 were eligible. Randomized controlled trials were conducted in 10 different countries, included 1542 participants, and evaluated 29 distinct dietary intake outcomes. Five studies reported statistically significant changes in diet across 13 outcomes. Most nutrition interventions were not reported in a manner that allowed replication in clinical practice or future research. Conclusion There is a gap in research testing high-quality nutrition interventions in CR settings. Findings should be interpreted in the light of limitations, given the overall body of evidence was heterogenous across outcomes and study quality; 6 of 11 studies were conducted more than 10 years old. Future research should investigate strategies to optimize and maintain nutrition improvements for patients attending CR. Registration PROSPERO; CRD42020188723.

UNSTRUCTURED Background: Nutrition in pregnancy is pivotal to optimising infant growth and maternal wellbeing. The factors affecting Indigenous people’s food and nutrition intake are complex, with a history of colonisation impacting the disproportionate effect of social determinants to this day. Literature regarding the dietary intake or priorities of Indigenous women in Australia is scarce with supportive, culturally appropriate resources developing for and with this group rare. Research suggests mHealth tools are effective in supporting health knowledge of Indigenous people and positive health behaviour changes when designed and developed with the expertise of Indigenous communities. Objectives: This study seeks to build the body of knowledge related to nutrition needs and priorities for Indigenous women in Australia during pregnancy and co-design an mHealth digital tool to support these nutrition needs. Methods: The Mums and Bubs Deadly Diets study recruits Indigenous women and healthcare professionals who support Indigenous women during pregnancy into two phases. Phase One (pre-design) utilises a mixed methods convergent design utilising a biographical questionnaire and social/focus groups to inform Phase Two (generative). Phase Two will use a participatory action research process during co-design workshops to iteratively develop the digital tool, the exact actions within a workshop will evolve according to the participant group decisions. Conclusions: This study is an iterative and adaptive research program that endeavours to develop real world, impactful resources to support the nutrition needs and priorities of pregnant Indigenous women in Australia. This comprehensive project requires a combination of methods and methodologies to ensure Indigenous voices are heard at each stage and in all aspects of research output. The development of an mHealth resource for this cohort will provide a necessary bridge where there is often a gap in access to nutrition resources for women in pregnancy in Indigenous communities.

Objective: Indigenous infants are disproportionately more likely to have negative outcomes compared to non-Indigenous infants with suboptimal nutrition in the first 1000 d playing a major role. This review aimed to systematically assess the effectiveness of interventions designed to optimise dietary intake and/or nutrition-related behaviours among Indigenous infants globally and to identify whether Indigenous populations were involved in the co-design of the intervention. Design: Articles published before June 2020 that reported nutrition-related interventions and outcomes for Indigenous infants were identified from a database search. Data extracted included study aims and design, target population, geographical location, the health condition of the participants, intervention characteristics and outcomes. A narrative synthesis consisting of effects and acceptability of the interventions and involvement of participants in the study design were highlighted. Settings: Population-based intervention studies that focused on improving dietary intakes and/or nutrition-related behaviours of Indigenous infants in the first 1000 d of life were included in this review. Results: Of the 2784 studies identified, three studies met the inclusion criteria. These were conducted among two Indigenous tribes in Guatemala and the USA. Two studies reported the food and nutrient intake of participants with one study showing an improvement in dietary intake of the infants. Only one study reported community participation in the study design, intervention design and implementation, and acceptability of the intervention by the participants. Conclusion: Engaging Indigenous communities throughout the entire process of nutrition interventions could have beneficial effects through improved outcomes in the first 1000 d of life.

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. This 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 health care 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 health care workers during routine antenatal care.

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.

Spot urinary polyphenols have potential as a biomarker of polyphenol-rich food intakes. The aim of this study is to explore the relationship between spot urinary polyphenols and polyphenol intakes from polyphenol-rich food sources. Young adults (18–24 years old) were recruited into a sub-study of an online intervention aimed at improving diet quality. Participants’ intake of polyphenols and polyphenol-rich foods was assessed at baseline and 3 months using repeated 24-h recalls. A spot urine sample was collected at each session, with samples analysed for polyphenol metabolites using LC-MS. To assess the strength of the relationship between urinary polyphenols and dietary polyphenols, Spearman correlations were used. Linear mixed models further evaluated the relationship between polyphenol intakes and urinary excretion. Total urinary polyphenols and hippuric acid (HA) demonstrated moderate correlation with total polyphenol intakes (rs = 0·29–0·47). HA and caffeic acid were moderately correlated with polyphenols from tea/coffee (rs = 0·26–0·46). Using linear mixed models, increases in intakes of total polyphenols or polyphenols from tea/coffee or oil resulted in a greater excretion of HA, whereas a negative relationship was observed between soya polyphenols and HA, suggesting that participants with higher intakes of soya polyphenols had a lower excretion of HA. Findings suggest that total urinary polyphenols may be a promising biomarker of total polyphenol intakes foods and drinks and that HA may be a biomarker of total polyphenol intakes and polyphenols from tea/coffee. Caffeic acid warrants further investigation as a potential biomarker of polyphenols from tea/coffee.

In order to manage blood glucose levels in pregnancy, women need to know what and how much to eat, particularly for foods containing carbohydrate. The aim was to assess pregnant women’s carbohydrate and standard serve size knowledge and examine whether health professionals provided nutrition education. Between July 2017 and April 2018 Australian pregnant women were recruited to complete an online survey, including a modified PedCarbQuiz carbohydrate knowledge questionnaire and an online buffet, where they selected images equivalent to one Australian Guide to Healthy Eating (AGHE) standard serve size. 186 pregnant women (mean age 30.9 years, SD = 4.7 years) 12–22 weeks gestation completed the survey. Participants achieved a median score of 27/36 for identification of carbohydrate-containing foods and a median score of 1/12 (range 0–11) for identification of grams of carbohydrate in specific portions. Participants achieved a median score of 14/22 (range 4–19) for identification of one AGHE standard serve of 11 carbohydrate-containing foods. Less than half (n = 92, 49.5%) received nutrition education from health professionals. Pregnant women had sub-optimal carbohydrate knowledge. This could contribute to impaired blood glucose concentrations and risk of adverse health outcomes in pregnancy. Opportunities for pregnant women to access nutrition advice from health professionals should be explored.

PURPOSE This study sought to determine current practice regarding nutrition care within cardiac rehabilitation (CR) programs, including perceived barriers and facilitators to providing nutrition care in this setting. METHODS A cross-sectional survey was conducted in October and November 2019. Potential participants were program coordinators, identified through the Australian Cardiovascular Health and Rehabilitation Association program directory and invited to participate via e-mail. RESULTS Forty-nine respondents (response rate: 13%) are included in this analysis. Programs provided group (n = 42, 86%) and/or individual (n = 25, 51%) nutrition education, and most were supported by a dietitian (63%). However, the availability of dietitians and nutrition care provided at CR was variable. For example, individual education was consistently provided at 13 programs and usually by health professionals other than dietitians. Eight programs (16%) used a formal behavior change framework for nutrition care. Generally, respondents were positive about the role of nutrition; CR coordinators perceived nutrition as a valuable component of the program, and that they had good nutrition knowledge. An identified barrier was the financial resources available to support the provision of nutrition care. CONCLUSIONS To ensure that patients receive the benefits of evidence-based nutrition care, program staff may require additional support, particularly regarding the use of evidence-based behavior change techniques. Key facilitators that may be leveraged to achieve this include the high value and priority that CR program coordinators place on nutrition care.

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.

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.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.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'.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.

INTRODUCTION An optimal diet is imperative in preparing women for pregnancy and this may be influenced by socio-economic status (SES). This research aims to investigate the role of SES on the dietary energy density (ED) in Australian women of preconception age. METHODS A secondary analysis of the Australian National Nutrition and Physical Activity Survey 2011-12 for females aged 18-39 years (n = 1617) was conducted. Dietary intake was assessed by 24-hr recalls and dietary ED by dietary energy per weight (kJ.g-1 ). ED was further categorised as ED of foods and beverages separately. SES was assessed by three variables: Socio-Economic Indexes for Areas (SEIFA), developed by the Australian Bureau of Statistics; income decile; and level of education. Linear mixed model regressions were used to identify associations between ED and SES. RESULTS The median ED for food, beverages and combined food and beverages was 9.38 kJ g-1 , 1.02 kJ g-1 and 7.11 kJ g-1 , respectively. No significant variation was explained by SES variables when analysing combined ED in the adjusted model or ED from foods. Income decile reduced ED of beverages, although with little effect (coefficient: -0.04, P = 0.002). Significant confounders included inactivity, which increased ED in both combined ED and ED foods (coefficient: 0.51, P = 0.001 and coefficient: 0.78, P

Background Women of childbearing age are vulnerable to weight gain. This scoping review examines the extent and range of research undertaken to evaluate behavioral interventions to support women of childbearing age to prevent and treat overweight and obesity. Methods Eight electronic databases were searched for randomized controlled trials (RCT) or systematic reviews of RCTs until 31st January 2018. Eligible studies included women of childbearing age (aged 15–44 years), evaluated interventions promoting behavior change related to diet or physical activity to achieve weight gain prevention, weight loss or maintenance and reported weight-related outcomes. Results Ninety studies met the inclusion criteria (87 RCTs, 3 systematic reviews). Included studies were published from 1998 to 2018. The studies primarily focused on preventing excessive gestational weight gain (n = 46 RCTs, n = 2 systematic reviews), preventing postpartum weight retention (n = 18 RCTs) or a combination of the two (n = 14 RCTs, n = 1 systematic review). The RCTs predominantly evaluated interventions that aimed to change both diet and physical activity behaviors (n = 84) and were delivered in-person (n = 85). Conclusions This scoping review identified an increasing volume of research over time undertaken to support women of childbearing age to prevent and treat overweight and obesity. It highlights, however, that little research is being undertaken to support the young adult female population unrelated to pregnancy or preconception.

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.

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.

To investigate associations between eating behavior constructs (social eating, perceived competence, habit automaticity, self-determined motivation) and diet quality among young adults.Cross-sectional analysis.Young adults (n = 1,005; mean age, 21.7 ± 2.0 years; 85% female) enrolled in the Advice, Ideas, and Motivation for My Eating (Aim4Me) study.Four eating behavior measures collected via online surveys: Social Eating Scale, Perceived Competence in Healthy Eating Scale, Self-Report Behavioral Automaticity Index, and Regulation of Eating Behaviors scales. Diet quality was assessed using the Australian Recommended Food Score (ARFS) and percentage energy from energy-dense, nutrient-poor (EDNP) foods.Multivariate linear regression investigating associations between eating behavior measures (independent variables) and ARFS and EDNP foods (dependent variables), adjusting for sociodemographic and lifestyle confounders.Greater perceived competence in healthy eating and behavioral automaticity for consuming healthy foods, limiting EDNP food intake, and higher intrinsic motivation, integrated regulation, and identified regulation of eating behaviors were associated with higher ARFS and lower percentage energy EDNP foods (P0.001). Greater self-reported social influence on eating behaviors was associated with higher ARFS (P = 0.01). Higher amotivation was associated with greater % energy from EDNP foods (P0.001).Perceived competence, habit automaticity, and self-determined motivation are determinants of diet quality in young adults. These findings support the development of interventions that promote healthy eating habits by focusing on eating behavior constructs and evaluating their use in improving diet quality.

Aim Water is critical for human survival, yet water intake equations may not reflect contemporary populations. This research aims to determine the total water intake of a representative Australian population, per kilogram of body weight (mL/kg) and stratified by age and sex. Methods A secondary analysis of the 2011 to 2013 National Nutrition and Physical Activity Survey (n = 10 146) was conducted. Dietary intake from food and beverages was assessed by a 24-hour recall, with respondent's weight objectively measured. Data were descriptively analysed, with multiple linear regressions used to identify the impact of demographic and physiologic factors on total water intake (mL/kg). Results The median (interquartile range) daily total water intake per kilogram of body weight for children (2-8 years), adolescents (9-18 years) and adults (19+ years) were 77.1 (57.4-100) mL/kg, 40.4 (29.3-53.4) mL/kg and 35.5 mL/kg (26.1-47.8), respectively. Increasing height and waist circumference were associated with reduced total water intake, with a change of -1.03 mL/kg (-1.43, -0.618) [coefficient (95% confidence interval)] in children for height and -0.448 mL/kg (-0.484, -0.412) in adults for waist circumference. Similarly, seasonality decreased intake, with greatest reductions in winter [adolescents: -4.11 mL/kg (-6.83, -1.40)]. In comparison, being male, living in rural areas and having a physical occupation were associated with greater intake, by 1.73 mL/kg (0.347, 3.10), 4.74 mL/kg (3.47, 6.00) and 2.82 (trade workers: 1.08, 4.59) in adults, respectively. Conclusions Total water intake (mL/kg) decreased with age in both sexes. The results highlight possibilities to incorporate other factors into water intake equations to improve their accuracy.

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.

Background: Reaching and engaging individuals, especially young adults, in web-based prevention programs is challenging. ‘No Money No Time’ (NMNT) is a purpose built, healthy eating website with content and a social marketing strategy designed to reach and engage a young adult (18–34 year olds) target group. The aim of the current study was to conduct a process evaluation of the 12-month social marketing strategy to acquire and engage NMNT users, particularly young adults. Methods: a process evaluation framework for complex interventions was applied to investigate the implementation of the social marketing strategy component, mechanisms of impact and contextual factors. Google Analytics data for the first 12 months of operation (17 July 2019 to 17 July 2020) was evaluated. Results: in year one, 42,413 users from 150+ countries accessed NMNT, with 47.6% aged 18–34 years. The most successful channel for acquiring total users, young adults and return users was via organic search, demonstrating success of our marketing strategies that included a Search Engine Optimisation audit, a content strategy, a backlink strategy and regular promotional activities. For engagement, there was a mean of 4.46 pages viewed per session and mean session duration of 3 min, 35 s. Users clicked a ‘call-to-action’ button to commence the embedded diet quality tool in 25.1% of sessions. The most common device used to access NMNT (63.9%) was smartphone/mobile. Engagement with ‘quick, cheap and healthy recipes’ had the highest page views. Conclusions: findings can inform online nutrition programs, particularly for young adults, and can apply to other digital health programs.

Urinary polyphenol metabolites are potential biomarkers of dietary polyphenol intake. The current study aims to evaluate associations between total diet, vegetable and fruit polyphenol intakes with urinary polyphenol metabolite concentrations in a sample of adults prescribed a diet rich in vegetables and fruit. Thirty-four participants completed a 10-week pre-post study. Participants were asked to consume Australian recommended daily vegetable and fruit serves and attend measurement sessions at baseline and at weeks 2 and 10. Two 24-h diet recalls were collected at each time-point and polyphenol intakes were calculated using the Phenol-Explorer database. Spot urine samples, collected at each time-point, were analyzed for 15 polyphenol metabolites using liquid chromatography-mass spectroscopy. Spearman&rsquo, s correlation analyzes assessed the strength of relationships between urinary and dietary polyphenols. Linear mixed models were used to investigate relationships between polyphenol excretion and intake. Total urinary polyphenols were significantly correlated with total polyphenol intakes at week 10 (rs = 0.47) and fruit polyphenols at week 2 (rs = 0.38). Hippuric acid was significantly correlated with vegetable polyphenols at baseline (rs = 0.39). Relationships were identified between individual polyphenol metabolites and vegetable and fruit polyphenols. Linear mixed model analyzes identified that for every 1 mg increase in polyphenol intakes, urinary polyphenol excretion increased by 16.3 nmol/g creatinine. Although the majority of relationships were not sufficiently strong or consistent at different time-points, promising relationships were observed between total urinary polyphenols and total polyphenol intakes, and hippuric acid and vegetable polyphenols.

The impact of pre-pregnancy obesity and maternal diet quality on the use of healthcare resources during the perinatal period is underexplored. We assessed the effects of body mass index (BMI) and diet quality on the use of healthcare resources, to identify whether maternal diet quality may be effectively targeted to reduce antenatal heath care resource use, independent of women&rsquo, s BMI. Cross-sectional data and inpatient medical records were gathered from pregnant women attending publicly funded antenatal outpatient clinics in Newcastle, Australia. Dietary intake was self-reported, using the Australian Eating Survey (AES) food frequency questionnaire, and diet quality was quantified from the AES subscale, the Australian Recommended Food Score (ARFS). Mean pre-pregnancy BMI was 28.8 kg/m2 (range: 14.7 kg/m2&ndash, 64 kg/m2). Mean ARFS was 28.8 (SD = 13.1). Higher BMI was associated with increased odds of caesarean delivery, women in obese class II (35.0&ndash, 39.9 kg/m2) had significantly higher odds of caesarean delivery compared to women of normal weight, (OR = 2.13, 95% CI 1.03 to 4.39, p = 0.04). Using Australian Refined Diagnosis Related Group categories for birth admission, the average cost of the birth admission was $1348 more for women in the obese class II, and $1952 more for women in the obese class III, compared to women in a normal BMI weight class. Higher ARFS was associated with a small statistically significant reduction in maternal length of stay (RR = 1.24, 95% CI 1.00, 1.54, p = 0.05). There was no evidence of an association between ARFS and mode of delivery or &ldquo, midwifery-in-the-home-visits&rdquo

Advances in web and mobile technologies have created efficiencies relating to collection, analysis and interpretation of dietary intake data. This study compared the impact of two levels of nutrition support: (1) low personalization, comprising a web-based personalized nutrition feedback report generated using the Australian Eating Survey&reg, (AES) food frequency questionnaire data, and (2) high personalization, involving structured video calls with a dietitian using the AES report plus dietary self-monitoring with text message feedback. Intake was measured at baseline and 12&thinsp, weeks using the AES and diet quality using the Australian Recommended Food Score (ARFS). Fifty participants (aged 39.2&thinsp, &plusmn, &thinsp, 12.5 years, Body Mass Index 26.4&thinsp, 6.0 kg/m2, 86.0% female) completed baseline measures. Significant (p &lt, 0.05) between-group differences in dietary changes favored the high personalization group for total ARFS (5.6 points (95% CI 1.3 to 10.0)) and ARFS sub-scales of meat (0.9 points (0.4 to 1.6)), vegetarian alternatives (0.8 points (0.1 to 1.4)), and dairy (1.3 points (0.3 to 2.3)). Additional significant changes in favor of the high personalization group occurred for proportion of energy intake derived from energy-dense, nutrient-poor foods (&minus, 7.2% (&minus, 13.8% to &minus, 0.5%)) and takeaway foods sub-group (&minus, 3.4% (&minus, 6.5% to 0.3%). Significant within-group changes were observed for 12 dietary variables in the high personalization group vs one variable for low personalization. A higher level of personalized support combining the AES report with one-on-one dietitian video calls and dietary self-monitoring resulted in greater dietary change compared to the AES report alone. These findings suggest nutrition-related web and mobile technologies in combination with personalized dietitian delivered advice have a greater impact compared to when used alone.

Research in the area of food addiction is continuing to increase with recent reviews suggesting that food addiction is a distinctive condition that has many symptoms similar to substance use disorders. The current study explored the perspectives and experiences of Australian adults seeking treatment for addictive eating. Quantitative data for this study was collected via self-report questionnaires completed online, including demographics, the Yale Food Addiction Scale 2.0, and the Depression, Anxiety, and Stress Scale-21. Qualitative data was collected via semi-structured interviews using open-ended questions about the individual experience of food addiction and perspectives regarding intervention and recovery. Interview data was available for 34 participants, with the majority (n = 33) being females who were overweight, (mean ± SD age = 42.9 ± 13.2 years, BMI=36.5 ± 6.8 kg/m2). Stress (19.9 ± 11.4 out of 21) and depression (16.8 ± 10.2 out of 21) were the most prominent negative emotional states. Thematic analysis identified two themes of compulsion and control. Compulsion distinguished the participants' experiences related to addictive eating behaviours, in particular the notion of craving. Control encompassed their perception of both the processes and outcomes of overcoming their addictive eating. The two themes identified were not mutually exclusive, and relationships between them and their influence on each other were observable. This study provides a unique contribution to understanding adults’ experience of food addiction by highlighting the strong desire to be in control of eating behaviours, and the inability of participants to overcome their compulsions to eat specific food despite minimal anticipation of positive effect.

The maternal diet influences the long-term health status of both mother and offspring. The current study aimed to compare dietary intakes of pregnant women compared to food and nutrient recommendations in the Australian Guide to Healthy Eating (AGHE) and Nutrient Reference Values (NRVs). Usual dietary intake was assessed in a sample of women in their 3rd trimester of pregnancy attending antenatal outpatient clinics at John Hunter Hospital, Newcastle, New South Wales (NSW). Dietary intake was measured using the Australian Eating Survey, a validated, semi-quantitative 120-item food frequency questionnaire. Daily food group servings and nutrient intakes were compared to AGHE and NRV targets. Of 534 women participating, none met the AGHE recommendations for all food groups. Highest adherence was for fruit serves (38%), and lowest for breads and cereals (0.6%). Only four women met the pregnancy NRVs for folate, iron, calcium, zinc and fibre from food alone. Current dietary intakes of Australian women during pregnancy do not align with national nutrition guidelines. This highlights the importance of routine vitamin and mineral supplementation during pregnancy, as intakes from diet alone may commonly be inadequate. Future revisions of dietary guidelines and pregnancy nutrition recommendations should consider current dietary patterns. Pregnant women currently need more support to optimise food and nutrient intakes.

Automatic detection of intake gestures is a key element of automatic dietary monitoring. Several types of sensors, including inertial measurement units (IMU) and video cameras, have been used for this purpose. The common machine learning approaches make use of the labeled sensor data to automatically learn how to make detections. One characteristic, especially for deep learning models, is the need for large datasets. To meet this need, we collected the Objectively Recognizing Eating Behavior and Associated Intake (OREBA) dataset. The OREBA dataset aims to provide comprehensive multi-sensor data recorded during the course of communal meals for researchers interested in intake gesture detection. Two scenarios are included, with 100 participants for a discrete dish and 102 participants for a shared dish, totalling 9069 intake gestures. Available sensor data consists of synchronized frontal video and IMU with accelerometer and gyroscope for both hands. We report the details of data collection and annotation, as well as details of sensor processing. The results of studies on IMU and video data involving deep learning models are reported to provide a baseline for future research. Specifically, the best baseline models achieve performances of $F_1$ = 0.853 for the discrete dish using video and $F_1$ = 0.852 for the shared dish using inertial data., To be published in IEEE Access

A lack of core food accessibility negatively affects diet quality, potentially increasing the prevalence of health risk factors such as obesity. The purpose of this study was to investigate core food access in an Australian regional center through the use of data visualization techniques.Supermarkets were used as a proxy for core food accessibility and were identified and mapped by town region with a combination of Google Maps and Stata/IC 15.1 software. A statistical analysis comparing the demographics of each town region was also completed using Stata.The maps generated suggest that there may be a disparity in core food accessibility between town regions. The analysis of demographics demonstrated that one town region had a greater proportion of disadvantaged residents, with statistically significant variation between regions.Data visualization and analysis may be a useful tool for clinicians to communicate accessibility information experienced by local residents. This need not be limited to food accessibility and extended to health services.

The prevalence of Gestational Diabetes Mellitus (GDM) increased from 7% to 13.1% between 2013 and 2017 in NSW, Australia. Limited detail has been reported on dietary patterns prior to GDM diagnosis. Aim To evaluate adequacy of micronutrient intakes and contribution of nutrient-dense versus energy-dense, nutrient-poor food groups to total energy. Method Dietary intake of women with GDM was assessed over the six months prior to attending the first outpatient nutrition education group using the Australian Eating Survey: food frequency questionnaire with food group serves compared to the Australian Guide to Healthy Eating recommendations. Nutrient intakes compared to Estimated Average Requirements (EARs). Diet quality was evaluated using the Australian Recommended Food Score diet quality index. Results Fifty women with a mean age of 30.8±4.6 years completed the Australian Eating Survey. Mean percentage (SD) energy intake derived from nutrient-dense versus energy-dense, nutrient-poor foods was 66.6% (12.4) and 33.4% (12.4); respectively. Median intakes of iron, calcium, fibre, iodine and folate were below EARs. Median (IQR) total Australian Recommended Food Score was 31(15) from a maximum 73 points. Adherence to the Australian Guide to Healthy Eating recommendations was low, with no participants meeting recommendations for serves of bread and cereals, 92% below dairy and dairy alternatives and 82% below vegetable intake recommendations. Conclusions Before being diagnosed with GDM, women derive a high percentage of total energy from energy-dense, nutrient-poor foods, have low dietary variety amongst nutrient-dense foods, and sub-optimal intakes of key pregnancy micronutrients. Poor dietary patterns require attention within medical nutrition therapy for GDM in order to optimise nutrition-related health outcomes.

This review summarises the issues related to the measurement and interpretation of dietary intake in individuals with overweight and obesity, as well as identifies future research priorities. Some aspects of the assessment of dietary intake have improved through the application of technology-based methods and the use of dietary biomarkers. In populations with overweight and obesity, misreporting bias related to social desirability is a prominent issue. Future efforts should focus on combining technology-based dietary methods with the use of dietary biomarkers to help reduce and account for the impact of these biases. Future research will be important in terms of strengthening methods used in the assessment and interpretation of dietary intake data in the context of overweight and obesity.

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