Search

Background Overconsumption of energy-dense, nutrient-poor “discretionary” foods and beverages can indicate poor diet quality, which is a risk factor for obesity and chronic disease. With 60% of Australians exceeding the recommended intake of discretionary foods, there is a need for interventions to reduce their consumption. Objective The objective was to model the impact of 26 specific scenarios to limit discretionary food intake on energy and nutrient intake. Design The scenario modeling analysis was based on reduction strategies targeting portion size, frequency, or variety of discretionary food and beverage items consumed. Participants/Setting Data from 12,153 respondents aged 2 to 85 years from the 2011-12 Australian National Nutrition and Physical Activity Survey were used. Outcome measures The outcome measures were change in servings of discretionary foods and key nutrients (energy, total fat, saturated fat, sugar, alcohol, sodium, trans fat) for the population, and by sex, age group, weight status, and socioeconomic status. Statistical analyses performed Descriptive and inferential statistical analysis were conducted. Results Scenarios reduced total energy intake by up to 26% across the population as a whole. The removal of discretionary foods (not beverages) resulted in the greatest reduction in servings and energy (74.8% and 25.6%, respectively), followed by the removal of discretionary items in portions greater than 143 kcal (59.1% and 24.3%) and not consuming discretionary items at main meals (51.2% and 17.8%). Targeting single categories of discretionary foods reduced energy intake by an average of 5.6% for the removal of cakes and biscuits, 4.4% for alcohol, and 3.9% for sugar-sweetened beverages. Strategies reduced total fat, saturated fat, and sugar by up to 35%, 38%, and 40% respectively. Conclusions Strategies that are specific to discretionary food and beverage intake targeting reductions in portion size, frequency, or variety have the potential to reduce energy intake and improve diet quality. These findings have implications for designing interventions with potential to tailor messages to current dietary habits. Exploration of how these strategies could be effectively implemented will be the focus of further research.

Background Effects of dietary fat quality on liver fat remain to be elucidated. Inconsistent evidence may be influenced by fatty acid saturation, chain-length, and regio-specificity within triacylglycerol (TAG) molecules. Objectives We aimed to compare eucaloric diets enriched in palm olein (POo), cocoa butter (COB), and soybean oil (SBO) on liver fat concentration in healthy participants. Secondary outcomes included visceral (VAT) and abdominal subcutaneous (aSCAT) adipose tissue, plus other obesity and cardiometabolic health outcomes. Methods Eighty-three healthy participants (20-45 y, BMI 18.5-27.5 kg/m2) commenced and 64 completed a 16-wk randomized parallel intervention, preceded by a 2-wk run-in. Participants consumed identical eucaloric background diets differing in test fats [contributing 20% total energy intake (%E)], providing 33%E total fat with the following ratios for PUFAs/SFAs/MUFAs: POo, 4.2/13.5/15%E; SBO, 14.4/8.8/9.4%E; COB, 2.3/19.5/11%E. Liver fat and abdominal adiposity were measured at weeks 0 and 16 using 1H-magnetic resonance spectroscopy/imaging; all other outcomes were measured at 0, 4, 8, 12, and 16 wk. Results Fat quality did not affect liver fat concentration, VAT, aSCAT, obesity indexes, blood pressure, liver enzymes, leptin, or fasting glucose. Body fat mass decreased with SBO and COB compared with POo. SBO decreased serum total cholesterol (TC), LDL cholesterol, and TC:HDL cholesterol relative to POo [estimated marginal mean (95% CI) differences: -0.57 (-0.94, -0.20) mmol/L; -0.37 (-0.68, -0.07) mmol/L; and -0.42 (-0.73, -0.11) mmol/L, respectively]. No diet differences were observed on HDL cholesterol, TAG, apoA1, apoB, apoB:apoA1, or fecal free fatty acids (FFAs), except for lower FFA pentadecanoic acid (15:0) with COB than with SBO and POo. Conclusions In healthy adults, when consumed as part of eucaloric typical Australian diets, 3 different dietary fat sources did not differentially affect liver fat concentration and amounts of adipose tissue. Effects on serum lipids were inconsistent across lipid profiles. The findings must be confirmed in metabolically impaired individuals before recommendations can be made.

Avocados are a rich source of unsaturated fats and bioactives, however, their role in altering cardiometabolic risk factors is unclear.To review the effects of consuming diets containing avocado compared to control diets containing no or low amounts of avocado on cardiometabolic risk factors in adults who were healthy, had clinical CVD or were at increased risk of CVD.Five electronic databases were searched (PubMed, Web of Science, Scopus, ProQuest and a Clinical Trials Registry) along with Google Scholar to identify studies published between January 1990 and November 10, 2021. Randomised controlled trials (RCT) ≥ 3 weeks and prospective cohort studies were included. Ten studies, nine RCTs (n=503 participants) and one prospective observational study (n=55,407), met the inclusion criteria. Outcomes assessed by meta-analysis were: LDL-C (primary), total cholesterol (TC), HDL-C and triglycerides. Outcomes assessed by narrative review were: TC to HDL-C ratio, non-HDL-C, apolipoprotein B, blood pressure, body weight, BMI, waist circumference, waist-to-hip ratio, body composition, blood glucose and insulin concentrations. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool and Newcastle-Ottawa Scale, and quality of evidence examined using the GRADE method. Random-effects models meta-analyses were performed where there was ≥ 3 studies of the same design (i.e. RCT) and reporting the same outcome. Statistical heterogeneity was assessed by calculating ChiOverall there was a small, significant reduction in TC (-5.08 mg/dL (-9.29, -0.87 mg/dL), p = 0.02) in avocado vs. control groups and no significant difference in LDL-C, HDL-C or triglycerides. Subgroup analysis demonstrated significant reductions in LDL-C (-9.4 mg/dl (-10.84, -7.95 mg/dL) p0.00001) and TC (-7.54 mg/dL (-9.40, -5.68 mg/dL), p0.00001) in avocado vs. control groups in hypercholesterolaemic populations while no differences were seen in normocholesterolaemic populations. However, the certainty in the findings was graded as low to very low. Body weight and composition were not negatively affected by avocado consumption.Avocado consumption may reduce TC and LDL-C in people with hypercholesterolaemia. Avocado consumption does not negatively impact body weight. Larger, well-conducted studies are needed to have greater confidence in the role of avocado consumption on CVD risk factors.

Objective:To understand how healthy menu labelling information is used by parents/caregivers and where it fits within predictors of healthy meal choices when eating out.Design:Parents were recruited to complete a 15-min observational, online survey regarding their experiences and hypothetical choices when eating out with their child/ren.Setting:Australia.Participants:Eligible participants had one or more child/ren aged between 2 and 12 years and attended cafes, restaurants, hotels and clubs (CRHC) for lunch or dinner at least four times a year. Of initial respondents (n 1802), 92·5 % provided complete and valid data. Participants were 84·7 % female, ranging from 18 to 68 years old.Results:98·3 % believed that healthier alternatives should be available for children in CRHC. For general food choices, health was a strong motivator (45·7 %); however, parents reported eating at CRHC mainly for pleasure or a treat (61·2 %) and being driven by children’s taste preferences (85·9 %) when selecting menu items. 59·0 % of orders included a combination of healthy and traditional items. 42·0 % of the sample were influenced by the healthy choice (HC) labelling. Multiple regression revealed that, in addition to some demographic variables, the percent of HC ordered was positively associated with self-reported parent vegetable consumption, making food choices for the children for health reasons, familiarity with HC items and making order choices due to dietary needs and good nutrition.Conclusions:Despite a preference for availability of healthier children’s menu choices in CRHC, menu labelling highlighting healthy options may have limited impact relative to child preferences.

Objective:To examine core and discretionary food and beverage intake at eating occasions, and to explore the variation in consumption by age and gender in Australian adults and children.Design:The study utilised one 24-h dietary recall with self-reported eating occasions from a nationally representative sample of Australians. Average servings of each food group for age and gender subpopulations were compared with the Australian Dietary Guidelines. The percentage contribution of each eating occasion to total daily food group intake and typical composition of eating occasions were described. Frequently consumed discretionary foods were reported for eating occasions by age and gender.Setting:2011–2012 Australian National Nutrition and Physical Activity Survey.Participants:12 153 Australian people aged 2 years and above.Results:Grains were consumed in equal proportions throughout the day across all age and gender subgroups, while remaining core food groups were unequally distributed, featuring more prominently at specific eating occasions. Children consumed two-thirds of their fruit intake as snacks, and up to three quarters of adults’ vegetable and meat intake was consumed at dinner. Children consumed more of their discretionary intake at mid-meals, while adults consumed a greater proportion as part of a main meal.Conclusions:The present study provides a detailed understanding about when food groups are consumed, the ‘typical’ meal composition across the day, and how consumption patterns and compliance with dietary guidelines differ by age group and gender. These findings can assist in developing more specific nutrition messages which may help to achieve greater improvements in population dietary intake.

Soybean is the most economically important legume globally, providing a major source of plant protein for millions of people; it offers a high-quality, cost-competitive and versatile base-protein ingredient for plant-based meat alternatives. The health benefits of soybean and its constituents have largely been attributed to the actions of phytoestrogens, which are present at high levels. Additionally, consumption of soy-based foods may also modulate gastrointestinal (GI) health, in particular colorectal cancer risk, via effects on the composition and metabolic activity of the GI microbiome. The aim of this narrative review was to critically evaluate the emerging evidence from clinical trials, observational studies and animal trials relating to the effects of consuming soybeans, soy-based products and the key constituents of soybeans (isoflavones, soy proteins and oligosaccharides) on measures of GI health. Our review suggests that there are consistent favourable changes in measures of GI health for some soy foods, such as fermented rather than unfermented soy milk, and for those individuals with a microbiome that can metabolise equol. However, as consumption of foods containing soy protein isolates and textured soy proteins increases, further clinical evidence is needed to understand whether these foods elicit similar or additional functional effects on GI health.

Food-based dietary guidelines (FBDGs) provide country-specific guidance on what constitutes a healthy diet. With increasing evidence for the synergy between human and planetary health, FBDGs have started to consider the environmental sustainability of food choices. However, the number of countries that discuss environmental sustainability in their guidelines is unknown. The purpose of this Review was to identify countries with government-endorsed FBDGs that made explicit mention of environmental sustainability and to examine the breadth and depth of the inclusion of sustainability in FBDGs. The Food and Agriculture Organization of the UN identified 95 countries with FBDGs. We assessed 83 countries against our inclusion criteria, of which 37 mentioned environmental sustainability. Relevant content was assessed against a set of criteria based on the Food and Agriculture Organization's guiding principles for sustainable healthy diets. The depth to which environmental sustainability was discussed varied and it was often restricted to general explanations of what a sustainable diet is. Few FBDGs addressed why sustainability is important, how dietary changes can be made, or provided quantified advice for implementing sustainable diets.

Background/Objectives Hypercholesterolaemic effects of saturated fatty acids (SFA) may be influenced not only by the chain length, but also by their specific location within the triacylglycerol (TAG) molecule. We examined the hypothesis that dietary fats rich in SFA, but containing mostly unsaturated fatty acids in the sn-2 position with most SFA in sn-1 and -3 (palm olein [PO] and cocoa butter [CB]) will have similar serum lipid outcomes to unsaturated olive oil (OO). Subjects/Methods Thirty-eight participants (20–40 yr, 18.5– ≤ 27.5 kg/m2) completed a 4-week randomised 3 × 3 crossover feeding intervention, preceded by 2-week run-in and separated by 2-week washout periods. Background diet contained 35 percentage of total energy (%E) fat, 18%E protein, 48%E carbohydrates, differing in test fats only (palm olein (PO), CB, OO; 20%E). Total cholesterol (TC)/high density lipoprotein cholesterol (HDL-C) ratio and related variables; TC, HDL-C, low density lipoprotein cholesterol (LDL-C), TAG, apoA1, ApoB, ApoA1 (apolipoprotein A1)/ApoB (apolipoprotein B), lipoprotein (a) (Lp(a)), NEFA, LDL sub-fractions, were assessed pre- and post-intervention. Data were analysed using mixed effects longitudinal models with a P-value

Background Large-scale initiatives to improve diet quality through increased vegetable consumption have had small to moderate success. Digital technologies have features that are appealing for health-related behavior change interventions. Objective This study aimed to describe the implementation and evaluation of a mobile phone app called VegEze, which aims to increase vegetable intake among Australian adults. Methods To capture the impact of this app in a real-world setting, the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was utilized. An uncontrolled, quantitative cohort study was conducted, with evaluations after 21 and 90 days. The app was available in the Apple App Store and was accompanied by television, radio, and social media promotion. Evaluation surveys were embedded into the app using ResearchKit. The primary outcomes were vegetable intake (servings per day) and vegetable variety (types per day). Psychological variables (attitudes, intentions, self-efficacy, and action planning) and app usage were also assessed. Descriptive statistics and multiple linear regression were used to describe the impact of the app on vegetable intake and to determine the characteristics associated with the increased intake. Results Data were available from 5062 participants who completed the baseline survey; 1224 participants completed the 21-day survey, and 273 completed the 90-day survey. The participants resided across Australia and were mostly women (4265/5062, 84.3%) with a mean age of 48.2 years (SD 14.1). The mean increase in intake was 0.48 servings, from 3.06 servings at baseline to 3.54 servings at the end of the 21-day challenge (t1223=8.71; P Conclusions The VegEze app was able to increase intake by half a serving in a large sample of Australian adults. Testing the app in a real-world setting and embedding the consent process allowed for greater reach and an efficient, robust evaluation. Further work to improve engagement is warranted.

Overconsumption of energy-dense, nutrient-poor "discretionary" foods and beverages can indicate poor diet quality, which is a risk factor for obesity and chronic disease. With 60% of Australians exceeding the recommended intake of discretionary foods, there is a need for interventions to reduce their consumption.The objective was to model the impact of 26 specific scenarios to limit discretionary food intake on energy and nutrient intake.The scenario modeling analysis was based on reduction strategies targeting portion size, frequency, or variety of discretionary food and beverage items consumed.Data from 12,153 respondents aged 2 to 85 years from the 2011-12 Australian National Nutrition and Physical Activity Survey were used.The outcome measures were change in servings of discretionary foods and key nutrients (energy, total fat, saturated fat, sugar, alcohol, sodium, trans fat) for the population, and by sex, age group, weight status, and socioeconomic status.Descriptive and inferential statistical analysis were conducted.Scenarios reduced total energy intake by up to 26% across the population as a whole. The removal of discretionary foods (not beverages) resulted in the greatest reduction in servings and energy (74.8% and 25.6%, respectively), followed by the removal of discretionary items in portions greater than 143 kcal (59.1% and 24.3%) and not consuming discretionary items at main meals (51.2% and 17.8%). Targeting single categories of discretionary foods reduced energy intake by an average of 5.6% for the removal of cakes and biscuits, 4.4% for alcohol, and 3.9% for sugar-sweetened beverages. Strategies reduced total fat, saturated fat, and sugar by up to 35%, 38%, and 40% respectively.Strategies that are specific to discretionary food and beverage intake targeting reductions in portion size, frequency, or variety have the potential to reduce energy intake and improve diet quality. These findings have implications for designing interventions with potential to tailor messages to current dietary habits. Exploration of how these strategies could be effectively implemented will be the focus of further research.

BACKGROUND Large-scale initiatives to improve diet quality through increased vegetable consumption have had small to moderate success. Digital technologies have features that are appealing for health-related behavior change interventions. OBJECTIVE This study aimed to describe the implementation and evaluation of a mobile phone app called VegEze, which aims to increase vegetable intake among Australian adults. METHODS To capture the impact of this app in a real-world setting, the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was utilized. An uncontrolled, quantitative cohort study was conducted, with evaluations after 21 and 90 days. The app was available in the Apple App Store and was accompanied by television, radio, and social media promotion. Evaluation surveys were embedded into the app using ResearchKit. The primary outcomes were vegetable intake (servings per day) and vegetable variety (types per day). Psychological variables (attitudes, intentions, self-efficacy, and action planning) and app usage were also assessed. Descriptive statistics and multiple linear regression were used to describe the impact of the app on vegetable intake and to determine the characteristics associated with the increased intake. RESULTS Data were available from 5062 participants who completed the baseline survey; 1224 participants completed the 21-day survey, and 273 completed the 90-day survey. The participants resided across Australia and were mostly women (4265/5062, 84.3%) with a mean age of 48.2 years (SD 14.1). The mean increase in intake was 0.48 servings, from 3.06 servings at baseline to 3.54 servings at the end of the 21-day challenge (t1223=8.71; Pt1123=9.59; PF9,1208=42.09; PPPP=.02), BMI (beta=.070; P=.01), and app usage (beta=.081; P=.002) were all significant predictors of the change in intake. CONCLUSIONS The VegEze app was able to increase intake by half a serving in a large sample of Australian adults. Testing the app in a real-world setting and embedding the consent process allowed for greater reach and an efficient, robust evaluation. Further work to improve engagement is warranted.

Recent dietary trends have prompted growing support for a variety of fasting paradigms involving extreme restriction or nil-caloric intake on fasting days. Some studies indicate that fasting may negatively influence factors including cognitive function through inducing fatigue, which may prove problematic in the context of completing a range of cognitively demanding activities required by daily obligations such as work. This randomised within-subjects cross-over trial explored the effects of true fasting (i.e., nil-caloric intake) versus modified fasting, the latter of which involved two sub-conditions: (1) extended distribution (three small meals distributed across the day, 522 kcal total), and (2) bulking (two meals eaten early in the day, 512 kcal total) over a period of 7.5 h on a single day with a 7-day washout period between conditions. Participants were n = 17 females (Body Mass Index (BMI) Mean (M) = 25.80, Standard Deviation (SD) = 2.30) aged 21&ndash, 49 years. Outcomes included cognitive function, subjective mental fatigue, satiety, food cravings and blood glucose. Results showed that there were no differences in cognitive test performance between conditions, however, both modified fasting sub-conditions had improved blood glucose levels, cravings, hunger and fullness compared to true fasting. Moreover, subjective mental fatigue was significantly reduced in the modified fasting conditions relative to true fasting. Overall, results indicated that the subjective experience of true fasting and modified fasting is different, but that cognition does not appear to be impaired.

Higher-protein diets, meal replacements, and greater early weight loss have separately been associated with greater weight loss. We compared a high-protein, meal replacement program with daily energy restriction (DER) to one which provided greater energy restriction adding alternate day fasting (ADF + DER, alternating days of modified-fasting and DER plus 1 ad libitum day/week) on retention, weight loss, physiological, nutritional, and behavioral markers. Participants were randomized to ADF + DER or DER for 16 weeks (n = 162, age 40 &plusmn, 8 years BMI 36 &plusmn, 6 kg/m2 (Mean &plusmn, SD)) plus 8 weeks weight maintenance. At week 16 weight change was &minus, 10.7 &plusmn, 0.5 kg and &minus, 11.2 &plusmn, 0.6 kg in ADF + DER and DER groups (treatment NS). Fat mass, visceral adipose tissue, and lean mass (p &lt, 0.05) were similarly reduced between treatments. Weight loss was sustained to 24 weeks (treatment NS). Fasting LDL-cholesterol, triglycerides, insulin, hsCRP, glucose, and blood pressure all improved (p &lt, 0.05, treatment NS). Transferrin saturation, ferritin, serum zinc, folate, and B12 improved (p &lt, treatment NS). Plasma thiamine and vitamin D levels decreased, reflecting lower carbohydrate intakes and seasonal changes, respectively. Food cravings, quality of life, and mood improved (treatment NS). Energy, fatigue, and pain improved slightly more in DER (p &lt, 0.05). This study supports the use of higher protein, meal replacement programs with or without ADF in weight management.

BACKGROUND Poor-quality dietary patterns are often characterized by inadequate consumption of fruits and vegetables. Changing dietary behavior is difficult, and although it is often clear what needs to change, how to enact change is more difficult. Smartphones have characteristics that may support the complexity of changing dietary behavior. OBJECTIVE This paper describes the iterative process of developing a theory-based smartphone app called VegEze that aimed to increase vegetable consumption. METHODS To upscale, reach target users, and create a user-friendly end product, a collaborative research-industry partnership was formed to build the app over a 20-week period. The Integrate, Design, Assess, and Share framework was used as a scientific basis to guide the development. The behavior change wheel was also used as a theoretical grounding in combination with other theory-based strategies, such as self-monitoring, social comparison, and gamification—which have all been shown to be successful in dietary change or digital health interventions. We conducted 1 consumer survey (N=1068), 1 usability testing session (N=11), and a pilot effectiveness and usability trial (N=283) to inform the design of the app. RESULTS The target behavior for the app was defined as having 3 different types of vegetables at dinner. The perceived achievability of this target behavior was high; 93% of respondents (993/1068 users) felt they were likely or very likely to be able to regularly achieve the behavior. App features that users wanted included the following: recipes and meal ideas (876/1068, 82% of users), functionality to track their intake (662/1068, 62%), and information on how to prepare vegetables (545/1068, 51%). On the basis of importance of self-monitoring as a behavior change technique (BCT) and its rating by users, the vegetable tracker was a core feature of the app and was designed to be quick and simple to use. Daily feedback messages for logging intake and communicating progress were designed to be engaging and fun, using friendly, positive language and emoji icons. Daily and weekly feedback on vegetable consumption was designed to be simple, informative, and reinforce monitoring. A creative team was engaged to assist in the branding of the app to ensure it had an identity that reflected the fun and simple nature of the underlying behavior. The app included 16 BCTs, most of which were from the goals and planning subsection of the BCT taxonomy. CONCLUSIONS Combining a theoretical framework with an industry perspective and input resulted in an app that was developed in a timely manner while retaining its evidence-base. VegEze is an iOS app currently available in the App Store, and the overall impact of the VegEze app will be evaluated in an uncontrolled, quantitative study. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12618000481279; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12618000481279 (Archived by WebCite: at http://www.webcitation.org/769oG9EaA)

Background: Poor-quality dietary patterns are often characterized by inadequate consumption of fruits and vegetables. Changing dietary behavior is difficult, and although it is often clear what needs to change, how to enact change is more difficult. Smartphones have characteristics that may support the complexity of changing dietary behavior. Objective: This paper describes the iterative process of developing a theory-based smartphone app called VegEze that aimed to increase vegetable consumption. Methods: To upscale, reach target users, and create a user-friendly end product, a collaborative research-industry partnership was formed to build the app over a 20-week period. The Integrate, Design, Assess, and Share framework was used as a scientific basis to guide the development. The behavior change wheel was also used as a theoretical grounding in combination with other theory-based strategies, such as self-monitoring, social comparison, and gamification—which have all been shown to be successful in dietary change or digital health interventions. We conducted 1 consumer survey (N=1068), 1 usability testing session (N=11), and a pilot effectiveness and usability trial (N=283) to inform the design of the app. Results: The target behavior for the app was defined as having 3 different types of vegetables at dinner. The perceived achievability of this target behavior was high; 93% of respondents (993/1068 users) felt they were likely or very likely to be able to regularly achieve the behavior. App features that users wanted included the following: recipes and meal ideas (876/1068, 82% of users), functionality to track their intake (662/1068, 62%), and information on how to prepare vegetables (545/1068, 51%). On the basis of importance of self-monitoring as a behavior change technique (BCT) and its rating by users, the vegetable tracker was a core feature of the app and was designed to be quick and simple to use. Daily feedback messages for logging intake and communicating progress were designed to be engaging and fun, using friendly, positive language and emoji icons. Daily and weekly feedback on vegetable consumption was designed to be simple, informative, and reinforce monitoring. A creative team was engaged to assist in the branding of the app to ensure it had an identity that reflected the fun and simple nature of the underlying behavior. The app included 16 BCTs, most of which were from the goals and planning subsection of the BCT taxonomy. Conclusions: Combining a theoretical framework with an industry perspective and input resulted in an app that was developed in a timely manner while retaining its evidence-base. VegEze is an iOS app currently available in the App Store, and the overall impact of the VegEze app will be evaluated in an uncontrolled, quantitative study. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618000481279; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12618000481279 (Archived by WebCite: at http://www.webcitation.org/769oG9EaA)

While advanced cancer is often associated with weight loss, curative cancer treatment is often associated with weight gain. Weight gain during treatment may be associated with greater risk of cancer recurrence and development of lifestyle diseases. Currently, limited resources are available to cancer patients focussed on weight control. This study assessed the information needs of patients undergoing curative chemotherapy regarding diet, exercise and weight management for the purpose of developing weight management resources. Focus groups were held with oncology practitioners, patients and survivors to determine current information provision and needs. Focus groups highlighted a perception that information provision regarding diet, exercise and weight management is insufficient and no routine assessment of weight occurs during chemotherapy. Barriers to information provision described included lack of resources and time, and practitioners' uncertainty regarding appropriate messages to provide. Patients wanted more information regarding diet, exercise and weight during treatment time. The findings of this study suggest an increase in provision of diet, exercise and weight management information is needed. This information should be evidence-based and delivered at an appropriate time by the preferred health care professional. It would also be beneficial to implement protocols regarding assessment of weight during treatment.

Whey protein isolate (WPI) contains vitamin BIn this randomized controlled cross-over intervention trial, 56 subclinically vitamin BResults indicate that WPI consumption improves active B

cope Whey protein isolate (WPI) contains vitamin B12 and folate. However, the efficacy of WPI as a bioavailable source of these vitamins in the elderly with low vitamin B12 was not previously tested. We investigated the effects of WPI supplementation on vitamin B12 and folate status in blood and measured changes in homocysteine (HCY), methylmalonic acid (MMA), and genome integrity biomarkers in elderly individuals with low vitamin B12 status. The effect of WPI was compared to soy protein isolate (SPI). Methods and results In this randomized controlled cross-over intervention trial, 56 subclinically vitamin B12-deficient participants received 50 g WPI or 50 g SPI as a control for 8 wk followed by 16-wk washout phase and then cross-over to alternative supplement for next 8 wk. Consumption of WPI resulted in significant increase in serum active B12 (p < 0.0001) and serum folate (p = 0.0094). MMA, HCY, and nucleoplasmic bridges increased significantly after SPI intake but not after WPI (p = 0.052; p = 0.028; p = 0.0009, respectively). Conclusion Results indicate that WPI consumption improves active B12 and folate status. Unlike SPI, WPI consumption may prevent increase in MMA, HCY, and genome instability in older Australians with low vitamin B12 status.