The early establishment of the gut microbiome during the first 1000 days of life is crucial for health and development during childhood and beyond(1,2). The composition of the microbiome is influenced by various factors including mode of delivery, gestational age, feeding method, medication use, and other early life experiences(1). Disruptions to optimal early microbial colonisation, as presented with preterm infants, and infants delivered via caesarean section, can compromise microbial diversity which in turn may manifest in health problems(2,3). This study aims to investigate parental awareness around infantile gut health to establish potential gaps in the education provided by healthcare professionals (HCPs).

This study involved the distribution of a 15-item questionnaire to parents of infants aged 0-12 months, via a parenting platform, ‘everymum.ie’. Descriptive statistics were conducted using IBM SPSS V29. Frequencies, Cross-tabulations and Pearson Chi-Squares were performed to analyse categorical variables (significance at p≤0.05).

A total of 933 valid responses were collected. The majority of respondents were female (98%), aged between 25 and 44 years (95%) and had received third level education (85%). Of the sample, 76% did not receive any information from a HCP on the importance of their infant having a healthy gut. Only 15% of parents received this information before their infant’s birth and 22% received this information after. Furthermore, 89% of respondents did not receive any information from a HCP about the role of pre- or probiotics for their infant’s gut health.

Of the 364 parents (39%) who gave birth via caesarean section, 70% were not aware that mode of delivery was linked to their infant’s gut health and 73% did not receive information on the importance of their infant having a healthy gut. Almost 7% of the sample (n=64) had a premature infant. Of this subgroup, only 22% received information after their infant was born on the importance of gut health in infants. Furthermore, 86% of parents with a preterm infant did not receive information about the role of prebiotics or probiotics in relation to their infant’s gut health. There was no significant difference in the information provided to those with or without a preterm infant, and those who gave birth vaginally or via caesarean section, where p=0.950 and p=0.824, respectively.

This study highlights gaps in parental knowledge around infantile gut health and in the education provided by HCPs. Preterm infants and those born via caesarean section are particularly at risk of disruptions to optimal early microbial colonisation and these parents may potentially benefit from information on the importance of supporting their infant’s gut microbiome for long term health and development. Further support and education for HCPs appears necessary to help deliver this message to parents to reduce the burden of health problems during infancy.

Inflammatory Bowel Diseases (IBD) are chronic intestinal disorders, characterised by periods of quiescent disease and episodes of heightened disease activity. The diseases mainly affect the gastrointestinal tract. Often, patients experience a limited quality of life as a result of dietary restrictions, fatigue and other factors leading to mood disturbances, malnutrition, and inactivity amongst others. This presentation will give an overview of work done to identify factors leading the above findings which in our view are to some degree modifiable. We will look at availability and expertise of dietitians supporting patients with IBD, dietary and lifestyle modifications aiming to reduce the Burden of Disease.

Telehealth, which involves the remote delivery of healthcare services through virtual technologies, has been shown to have benefits such as reducing hospitalisations and length of stay for patients (1,2). The global COVID-19 pandemic has greatly accelerated the adoption of telehealth among clinical nutritionists. For instance, in the USA, telehealth usage for nutritional care has increased from 37% to 78% among clinical nutritionists (3), while in Italy, the adoption of telenutrition services by Registered Dieticians (RDNs) has risen from 16% to 63% (4). These statistics highlight the rapid integration of telehealth into dietetics practices as a response to the global health crisis, reflecting a growing trend towards virtual care delivery as an effective method for providing nutritional care. While telehealth has made progress in Saudi Arabia (5), there is a research gap regarding its prevalence and effectiveness in dietetics practice. This study aims to evaluate the current implementation of telehealth in dietetics practice during the COVID-19 pandemic in Saudi Arabia.

In this cross-sectional, a web-based online survey was used from mid-December 2022 to mid-May 2023. The study was distributed in several Saudi Arabian regions including (central, western, eastern, south, and north) and was completed by 306 clinical Registered Dietitians (RDNs) in public and private healthcare facilities who met the study’s inclusion criteria. The survey consisted of 28 questions divided into four sections, covering sociodemographic information, past or current experiences, obstacles and challenges of telehealth usage, and the future prospects of telehealth. In this study, participants were requested to reflect on their current observations and previous experiences pertaining to the utilisation of telehealth in the field of dietetics. To ensure the validity and relevance of the survey, it was reviewed by a panel of experienced dietitians in Saudi Arabia to obtain their feedback before being used to collect data.

Our research findings reveal that 76% of RDNs in Saudi Arabia utilize telehealth in their practice. The most common obstacles reported by RDNs using telehealth include internet connectivity issues (21.9%), patient disengagement and lack of enthusiasm (21.3%), and difficulties in coordinating with patients (21%). Telehealth interventions used by RDNs primarily involve diet recall (33.7%), weight- related measurements (30.6%), lab findings (26%), and only 8% reported using telehealth for vital signs. A majority of participants (69.4%) believed that telehealth could improve patient accessibility and help reduce no-show rates (68.9%). Additionally, over 70% of participants agreed that telehealth offers them flexibility in inpatient consultations.

In conclusion, telehealth is widely utilised among RDNs in Saudi Arabia, with potential benefits such as decreased no-show rates. Further research is needed to gain a better understanding of telehealth usage among RDNs in Saudi Arabia.

Obtaining data on pupils’ school food intakes often relies upon self-reported dietary assessment methods, which can be subject to reporting errors(1). Online tools offer an engaging, streamlined method, however reporting errors still exist. Furthermore, gaining access into schools to conduct research is challenging(2). School food purchase data may offer an alternative approach. Objective data on individual-level school food purchases can be obtained for the whole school day owing to cashless canteens. The use of school food purchase data as a method to assess dietary intakes in secondary school pupils warrants exploration. The aims of the study were to assess the information available in school food purchase data and explore its potential in assessing food group and nutrient intakes.

Individual pupil-level purchase data was obtained from five secondary schools over a four-week period. Following data cleaning and manipulation in excel and Stata v18, the proportion of food and drink items that were assigned an Intake24 food group and linked to a UK Nutrient databank code(s) was calculated.

Ethical approval was obtained from the Faculty of Medical Sciences Ethics Committee, Newcastle University (ref: 2482/26614). Data protection impact assessment was created to ensure efficient transfer of data.

The data captured school food purchases in 3466 pupils; this equated to approximately 80% of total pupils purchasing at least one item at school across the four-week period. A total of 119125 purchases were made by pupils. There were 367 different food and drink item descriptions. Ninetytwo percent (n = 338) of these were able to be assigned to a food group, for example ‘veg/salad’ and ‘hot meat baguette’. This accounted for 82% (n = 97821) of total purchases. Of these, 258 food and drink items (60% of total purchases) contained enough information for a nutrient code to be assigned, for example ‘flapjack’ and ‘Radnor Fizz drink’.

Eight percent (n = 29) did not have enough information to assign either a food group or nutrient code. These included items such as ‘Main Dish’ and ‘Packed Lunch Deal’. These accounted for 18% (n = 20954) of total purchases across the four-week menu cycle.

Pupil-level purchase data is a novel and feasible approach to obtaining objective food intake data on a large scale, maximising generalisability of findings. Obtaining intake data on >3000 pupils in a short time frame would be unachievable using traditional dietary assessment methods. There are some limitations in the use of pupil purchase data to assess pupils’ nutrient intakes, for example, missing portion size information. However, the use of average portions warrants investigation. Future work to compare purchases with self-reported data to assess agreement with validated dietary assessment methods is required.

Diet is a large influencer of the gut microbiota composition and function across the lifespan. However, information on whether and how diet can affect the brain via bidirectional communication between the gut and the central nervous system (the microbiota-gut-brain axis) is emerging. Immune, endocrine, humoral, and neural connections between the gastrointestinal tract and the central nervous system are important to this axis. The gut microbiota can produce cytokines, neurotransmitters, neuropeptides, chemokines, endocrine messengers, and microbial metabolites (e.g., short-chain fatty acids, branched chain amino acids, and peptidoglycans), some of which can enter the brain, influencing the function of brain cells. Animal studies investigating the potential of nutritional interventions on this axis have advanced our understanding of the role of diet in this bidirectional communication. This includes insights into microbial metabolites, immune, neuronal, and metabolic pathways amendable to dietary modulation. However, several aspects of the gastrointestinal tract and brain of animal models differ to humans, and it is important to consider these differences and similarities when evaluating the transability of the findings to the human context. Randomised clinical trials using dietary interventions in humans in this field are limited but have high potential application for clinical nutrition. In particular, several microbiota-targeted interventions have been explored as potential approaches for mental health. These approaches include probiotics, prebiotics, etc. as well as dietary approaches(1,2,3). However, there are limited clinical interventions with whole-dietary approaches. Most human studies used faecal samples to infer changes in microbiota parameters occurring in the gastrointestinal tract and do not consider the physiological changes in gastrointestinal physiology (e.g., transit time) that can directly or indirectly affect the diversity and composition of the gut microbiome. Future research considerations should include better characterisation of the participants at baseline (dietary patterns, gastrointestinal phenotype, and gut microbiota composition) to identify potential responders to dietary interventions. In addition to gut microbiota assessment, evaluations of physiological parameters, brain function and behavioural measurements should be considered as part of the study protocol. In this presentation, the current state of the literature triangulating the diet, the gut microbiota, and host behaviour/brain processes will be addressed. Future research considerations will also be discussed.

Social media platforms like YouTube have become tools to get information on self-care, including nutrition and health. Recently, there has been a growing public interest in protein sources and protein content of foods due to health and environmental concerns(1). High-protein diets, particularly, have gained popularity for their perceived benefits(2), highlighting the importance of individuals’ nutritional literacy. This study aimed to identify and describe the predominant topics about food protein discussed by YouTube commenters to explore their level of protein literacy.

Videos for analysis were selected employing the approach suggested by Gibson(3). Comments added from 2022 to 26 June 2023 (date of data collection), posted within 15 YouTube videos related to food proteins, were extracted through a big data text analysis software, Mozdeh(4), which allows the gathering of comments from YouTube videos by utilising YouTube APIs to collect data. Eight search terms (protein for vegetarians, protein shake, protein foods, low protein foods, Vegan diet, Keto or keto diet, plant based diet vs animal based diet, high protein diet), informed by YouTube’s search predictions and Google Trends, facilitated video identification. Inductive semantic thematic analysis(5) was conducted to organise comments into patterns (codes) and to summarise, interpret, and theorise meanings in broader concepts by connecting them(5).

Of 3,993 comments, 307 referred to food and dietary protein-related content, with a subset of comments contributing to multiple codes. Five themes emerged: 1: Quality (with a reference percentage of comments (RP) = 20.0%, indicating the proportion of comments pertinent to a given theme, relative to the total number of comments), about comments on bioavailability and amino acids content of protein sources; 2: Intake (RP = 30.0 %), regarding protein requirements and metabolism; 3: Health (RP = 15.0%), about health consequences and benefits of protein intake; 4: Sources (RP = 10.5%), on aspects inherent to specific food protein sources; 5: Queries (RP = 25%), related on questions and concerns raised by users.

Comments primarily focused on the importance of identifying daily protein requirements, the perceived ineffectiveness of high-protein diets, and the need for personalised dietary guidance. Also, a polarised viewpoint regarding protein sources emerged, with a marked divergence between animal- and plant-based diet advocates. This study underscores the significant demand for nutritional advice on YouTube, emphasising the potential use of the platform as a means for sharing validated information by registered nutritionists and authoritative bodies. It also accentuates the pressing need for implementing methods into the platform to guarantee the reliability of shared information, such as community-driven approaches that can alert the public about potential misinformation. Future research should delve into the validity of nutritional claims made by non-expert contributors and shed light on their impact on shaping nutritional literacy among the public.

Dietary acculturation in immigrant groups can impact health and may increase the risk of conditions like diabetes and cardiovascular disease among East Asian immigrants as they adopt host-country eating patterns(1). Pakistani immigration to the UK has resulted in a dynamic cultural exchange, including modifications in culinary preferences and practices among Pakistani ethnic groups. Prior research indicates that second-generation adults exhibit more signs of acculturation in their choice of diets than their first-generation counterparts (2). There is limited understanding of the food habits or the effects of acculturation on this group. The primary purpose of this study was to investigate intergenerational disparities in food preferences among Pakistani immigrants and the impact of dietary acculturation.

This cross-sectional study examined the food habits and acculturation experiences of 51 first (1G) and 51 second-generation (2G) participants of the Pakistani community living in London. Data was collected using survey questionnaires modified from previous studies (3,4). We compared traditional foods like paratha and samosa with Western options like fish and chips through a set of questions, from which a dietary score was calculated (Global scale) (5). We measured food acculturation using a 5-point scale, with higher scores indicating greater Western influence and lower scores indicating less Western acculturation. Scores ranged from 6 to 30 and were categorised as low, moderate, high, or very high. Data was analysed using SPSS (version 28.0). Chi-square and t-tests were applied to identify differences between groups with significance levels set to p<0.05.

Most of the participants were male (67%) with 38.8% aged 36-45 years. Urdu ethnicity predominated in both generations (64.8%). Significant differences in dietary restrictions for health conditions (p =.008), language (p = .001), consumption frequency of traditional Pakistani cuisine (p = .001), desserts/sweets (p = .001), chai/lassi (p = .017), popular UK meals, fizzy drinks, and inclusion of rice/flatbread (p = .003) emerged between first and second generations. Health-related dietary behaviours differed in fruits/vegetables, dairy, and meat consumption (p =.001). ‘Traditional’ and ‘Western’ dietary scores were significantly different between generations (‘Traditional’: 1G: 17.15 ± 3.52 vs 2G: 13.68 ± 4.71, p = .001; ‘Western’: 1G: 16.29± 1.98 vs 2G: 18.21 ± 3.84, p = .001). The results demonstrated a preference for traditional eating patterns by 1G, whereas a nuanced move towards Western food preferences was observed among the 2G participants, falling into the high category of global scale. 1G Participants cited language acquisition, time constraints, and financial issues as factors affecting their dietary changes.

This study found significant differences in dietary habits and preferences between first- and second- generation Pakistani immigrants in the United Kingdom. The second generation displayed a more significant shift towards Western food patterns, possibly because of socio-cultural variables, language fluency, and adaptability to the local environment.

A healthy diet is a key determinant of healthy ageing(1). Research indicates that individuals from Black African communities (both born in the UK and migrants communities) often have bicultural dietary patterns including both Westernised and African dietary practices(2). While this is known for the general Black African adult population, there remains a dearth of research on older African adults who may experience a complex nutrition landscape owing to an interplay of perceptions of healthy/unhealthy diets, social and cultural factors which can have negative outcomes for nutrition and health in later life. The aim of this study was to explore perceptions of eating well and healthy diets as determinants of inequalities in nutrition and healthy ageing in older African adults.

A mixed methods cross-sectional study was conducted in older Africans, ≥ 55 years in the UK. Qualitative data was collected using Photovoice(3), an innovative visual, community-based participatory research (CBPR) method whereby participants take photographs to document, reflect upon health and social issues from their own perspective. As a research method, photovoice provides an alternative to the traditional barriers and enablers approach to understanding complex health challenges and is suited for use for populations who have been disenfranchised by traditional research methods(4). A purposive sample of 12 participants were provided with cameras and encouraged to take photos describing what they considered as healthy and unhealthy food and thoughts on eating well and older adult’s health. Semi-structured interviews were conducted to gain insights into the photos. Thematic analyses using both deductive and inductive approaches of photos and transcripts were conducted to develop and refine emerging themes using a framework.

Participants were 62 ± 5.4 years and, 75% female. The majority were married (58.3%), living with family (41.7%), educated to postgraduate degree level (50.0%) and fulltime employed (66.7%). Emerging themes around healthy eating included variety and dietary diversity, organic foods, traditional foods, plant-based foods and healthy cooking methods. Themes around unhealthy food included ultra-processed foods, take-out foods, appearance, preservatives and consuming fats and oils. Hydration, social eating, accessing health and dietary advice, eating food that meets ageing needs, nostalgic eating and physical activity were the key themes that emerged around eating well and older adults’ health.

This research provides new insights on perceptions of healthy eating among older African adults using photovoice, a novel participatory research method. The findings contribute to a better understanding of perceptions of healthy diets as a determinant influencing nutrition and healthy ageing in older African adults. There is a need for further research to understand i) how these perceptions influence dietary intake and ii) the complex interactions in nutritional knowledge, tradition, cultural and social factors to inform the design of effective community-based nutrition intervention tailored to ethnic identity of older African adults.

The oral cavity is a vital part of the digestive system. Poor oral health can impact an individual’s ability to eat and has been associated with increased risk of non-communicable diseases and reduced longevity. Conversely, positive oral health has been associated with improved cardiometabolic, cognitive and systemic health and greater longevity. Consumption of dietary nitrate, which is processed in the mouth into nitrite, and is subsequently converted into nitric oxide (NO) in the body (1), has been demonstrated to reduce blood pressure, improve endothelial function, and enhance exercise performance. Interestingly, recent studies suggest that nitrate consumption could also positively modulate markers of oral health (2). To our knowledge, no systematic review has been published examining the effect of inorganic dietary nitrate on oral health. However, this could be valuable to summarise current state of the knowledge, identify effect modifiers and highlight gaps for future research. Therefore, this systematic review aims to investigate the effects of dietary nitrate supplements on markers of oral health in vivo in randomised controlled trials (RCTs).

This study was pre-registered with PROSPERO (CRD42023411159). Five databases (PubMed, The Cochrane Library, CINAHL, MEDLINE, and SPORTDiscus) were searched from inception until March 2023 to identify studies that met the following criteria: adult participants (≥ 18 years) and RCTs investigating the effects of oral dietary nitrate versus placebo on markers of oral health. A narrative synthesis of data was conducted. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool.

Nine articles reporting data on 284 participants were included. Nitrate was provided via beetroot juice (six studies), a beetroot-derived supplement dissolved in mineral water (one study), and lettuce juice (two studies). The duration of the interventions ranged from one day to a maximum of six weeks. Dietary nitrate supplementation increased the relative abundance of several individual bacterial genera including Neisseria (increased in three studies) and Rothia (increased in three studies). Dietary nitrate supplementation increased salivary pH (increased in two studies) and decreased salivary acidification resulting from the consumption of a sugar-sweetened beverage (decreased in two studies). Furthermore, dietary nitrate supplementation resulted in a decrease in the gingival inflammation index in one study. Overall, the risk of bias in studies was mixed. One study had a low risk of bias, while the rest were rated as having some concerns. No study was considered to have a high risk of bias.

The results show that dietary nitrate is a potential nutritional strategy that can potentially benefit oral health by modifying the oral microbiome, altering salivary pH, and minimising gingival inflammation.

The UK population is ageing and becoming more ethnically diverse(1). Nutrition is a key modifiable determinant of healthy ageing but there is little published data of dietary patterns in ethnic minority groups. The reasons for poor dietary habits of older adults from ethnic minority groups could be attributed to cost of living, language barriers, age, availability of traditional foods(2). As part of a larger research study to improve nutritional health in older adults (TANGERINE: nuTritional heAlth aNd aGeing in oldER ethnIc miNoritiEs), the aim of this study was to investigate vegetable intake in different older ethnic groups compared with a white (British) reference population.

We used food frequency questionnaire (FFQ) data drawn from Wave 2 (2010-2012) and Wave 13 (2021-2022) of Understanding Society, a UK household panel survey(3). We calculated the proportions of vegetable intake by ethnic group for each wave, weighted for population representativeness, and used (weighted) logistic regression for intake (everyday vs less than every day) to adjust for potential confounders. Data from the WHO food insecurity questionnaire in wave 13 was used to evaluate the ethnic group differences in food insecurity.

The percentage vegetable intake at least every day was reduced between Waves 2 and 13 in all ethnic groups. At both Waves all ethnic groups, except Indian ethnicity have lower vegetable intakes than white (British) reference group. The age and sex adjusted odds ratios (OR) (95% confidence intervals) at Wave 2 were 0.60 (0.51, 0.71) for Caribbean, 0.67 (0.56, 0.79) for African, 0.36 (0.28, 0.44) for Pakistani, 0.78 (0.62, 0.98) for Bangladeshi and 1.10 (0.94, 1.28) for Indian. The differences could be largely explained by lower income and greater area deprivation for Bangladeshi, less so for Caribbean, African and Pakistani groups. Results were similar for Wave 13. All ethnic groups, except Indian had higher odds of greater food insecurity than the white (British) reference group, largely attributed to income and area deprivation, for example, the OR for Pakistani group compared with white (British) reference group decreased from 1.74 (1.18, 2.56) to 1.05 (0.70, 1.58). However, for the African group, the OR remained greater than white reference population at 2.55 (1.73, 3.76) even after accounting for socioeconomic position.

The findings suggest differences in vegetable intake between different ethnic groups which have been maintained between 2010-2012 and 2021-2022 and may be explained to some extent by socioeconomic disadvantage. Whilst we used cross-sectional analyses of self-reported data, there remains a need for further large-scale studies using longitudinal and experimental designs in older ethnic groups considering socioeconomic position, recognising the importance of heterogeneity and the need to analyse ethnic groups individually, rather than as a group for measurements of dietary intake.

Uncontrolled hypertension is a primary cause of non-communicable diseases and death globally(1). The gut microbiota plays a role in hypertension and dietary interventions high in fibre have been shown to lower blood pressure (BP)(2). Not all participants respond to dietary fibre interventions, for reasons which are unclear. Here we aimed to identify responders of a high fibre intervention based on their baseline gut microbiome. Twenty treatment-naive participants with hypertension received either placebo or 40g per day of prebiotic acetylated and butyrylated high amylose maize starch (HAMSAB) supplementation for 3 weeks in a phase II randomised cross-over double-blind placebo-controlled trial. Blood pressure was monitored at baseline and each endpoint by 24-hour ambulatory BP monitoring, with those experiencing a reduction between timepoints of ≥ 2 mmHg classified as responders. Baseline stool samples were collected and the V4-V5 region of the 16S gene sequenced. Taxonomy was assigned by reference to the SILVA database. The MaAsLin2 package was used for assessing the relationship between baseline gut microbiota and response to dietary intervention. Overall participants had significant reduction in 24-hour systolic BP (–6.1 mmHg, p = 0.03), with 14 individuals classified as responders and six individuals as non-responders. 13 genera were found to be differentially abundant between responders and non-responders. Genera significantly enriched in responders included Dialister (β = 1.29, q = 1.921x10-134), Coprococcus (β = 1.26, q = 3.282x10-121), Bifidobacterium (β = 1.67, q = 1.11x10-81), Ruminococcus (β = 0.161, q = 1.11x10-8) and Roseburia (β = 0.82, q = 4.275x10-2). Participants who experienced a decrease in systolic BP following a dietary fibre intervention had increased level of bacterial genera known to contain species that produce short-chain fatty acids (e.g. Bifidobacterium, Roseburia and Ruminococcus) at baseline. These data suggest that baseline microbiota composition contributes to the response to dietary fibre intervention trials in people with hypertension.

Approximately two out of three adults and three in ten children living in Scotland are overweight or obese, which increases their susceptibility to non-communicable diseases such as type II diabetes, specific cancers, heart disease, and stroke(1). The burden of poor diet and its associated health consequences disproportionately affect those living in the most deprived communities(1). Cost of living pressures have exacerbated this issue, making a healthy diet unaffordable for many lowincome households(2,3). Thus, promoting affordable and practical ways to help low-income families improve dietary behaviours and achieve a healthy weight represents a priority for Scottish public health policy(3). For such interventions to be appropriately tailored and targeted, it is important to better understand the intended recipients. The present study aimed to assess the dietary practices and psychosocial characteristics of users of Aberdeen City community-based interventions (e.g., food banks, social cafés, community kitchens) designed to support low-income communities in accessing food and engaging in healthier food practices.

From January to June 2023, a cross-sectional survey was conducted employing convenience sampling among users of community-based interventions (N = 105; 73 females) situated in an urban location. The questionnaire assessed diet quality (measured through a short-form FFQ and a 10point self-rated diet quality item), household food insecurity (HFIAS), mental health (PHQ-4), wellbeing (Cantril Ladder), intention and self-efficacy toward healthy eating, and sociodemographic variables. Data were analysed using descriptive statistics, group comparisons, Pearson correlations, and regression analyses.

Results indicated that community-based food provision users are highly vulnerable to food insecurity and related negative health experiences. Among participants, 53.3% reported severe food insecurity, 18.1% reported moderate levels, and higher food insecurity was significantly associated with higher levels of mental distress (r = .41, p<.001) and lower well-being (r = -.460, p<.001). Results also indicated that service users have a diet high in discretionary foods and drinks (26% consume daily >1 portion of fizzy juice, 18.2% sweets, 16.7% crisps vs. 11.5% fruits and 10.6% vegetables). The mean dietary quality score (DQS) based on fruit, vegetable, oily fish, non-milk extrinsic sugar, and fat intake was 9.48 (SD =1.90) from a possible 15. In addition, 73.8% of participants rated their diet as unsatisfactory. Both low objective and subjective diet quality scores were also significantly associated with greater mental distress (r = -.287, p = .005; r = -.332, p = .001) and poorer well-being (r = .19, p = .049; r = .462, p<.001). Notably, service users who perceived their current diet as healthier reported stronger intentions to eat healthily in the future (r = .249, p = .013).

This study is part of a larger project aiming to optimise community-based dietary interventions for low-income populations. The results provide a clearer picture of the intended beneficiaries of such interventions and highlight user needs that can be prioritised in optimisation efforts.

Research studies suggest that date-palm (Phoenix dactylifera L.) fruits provide a superior nutritional and health benefits, compared to other fruits (1). They are rich source of many essential nutrients including carbohydrates, dietary fibre, vitamins, minerals, phytochemicals, and antioxidants. The date palm fruits are produced in many countries around the world and about 10-15% of the total production is lost or sold extremely at low prices (2, 3). Despite these, date fruits have been rarely used as an ingredient in commercially available energy bars. The aim of this study is to investigate the impact of newly formulated date-based energy bar (DBEB) (4) intake on subjective appetite, postprandial metabolism, energy substrate oxidation and diet-induced thermogenesis (DIT).

Twenty-seven healthy male adults (mean ± SD, aged 20.8 ± 3.5 years with body weight of 66 ± 8 kg) participated in a randomised crossover design study. Each participant conducted two experimental arms and was investigated prior to (baseline) and for three-hours after consumption of either a date- based energy bar (DBEB) or an isocaloric and macronutrient matched mixed fruit-based energy bar (FBEB) as control arm. The DBEB contained significantly less fructose and glucose, but more sucrose and fibre than FBEB. Both experimental arms involved blood sampling, subjective appetite, and indirect calorimetry measurements. At the end of each experiment, an ad libitum buffet meal was provided. Data analysis used descriptive statistics, paired t-test, and two-way ANOVA.

Time-averaged composite appetite and satiety scores were not significantly different between control (FBEB) and DBEB arms. Energy intake during ad libitum buffet was also not different between arms. Metabolic rate measured at baseline and during post-ingestion of the bars were not significantly different between FBEB and DBEB arms (arm effect, P>0.05). Thermic effect of bars calculated as percentage increase in metabolic rate above RMR during whole postprandial duration was (mean ± SE) 9.5 ± 1.6 % in DBEB arm and 8.7 ± 1.3 % in the FBEB arm (arm effect, P>0.05). Rates of carbohydrate and fat oxidation were also not different between the two arms (arm effect, P>0.05) Time-averaged concentrations of blood glucose, insulin and triglycerides were similar between the study arms.

The obtained results suggest that energy bars based on dates or mixed fruits produce similar effects on postprandial appetite, fat and carbohydrate oxidation, thermic effect and cardiometabolic risk factors. Date fruits can be used as rich source for carbohydrate and energy. However, future research should investigate the impact of date-based energy bars on antioxidant capacity and other health related markers.

A majority of Australians consume a limited range of different dietary fibres and insufficient total dietary fibre(1). This contributes to low intestinal microbial diversity and impaired microbial function, such as capability in producing beneficial metabolites like short-chain fatty acids (SCFA). This diet-induced dysbiosis is associated with poor gastrointestinal health and a broad range of non-communicable diseases(2). Our study aimed to determine whether one dietary change, substitution of white bread with a high fibre bread improves faecal microbial diversity and butyrate-producing capability. Twenty-six healthy adults completed a randomised, cross-over, single-blinded intervention. Over the two intervention phases separated with a 4-wk washout, participants consumed either 3 slices of a high fibre bread (Prebiotic Cape Seed Loaf with BARLEYmax®) or control white bread as part of the usual diet, each for 2 weeks. At the beginning and end of each intervention period, participants completed a 24-h diet recall, a gut symptoms rating questionnaire and provided a faecal sample for microbiome analysis. The composition of faecal microbiome was characterised using 16S rRNA amplicon sequencing (V3-V4) and a marker of butyrate synthesis capability, the faecal content of butyryl-CoA:acetate CoA-transferase (BCoAT) gene was assessed using Real-time PCR. The high fibre bread intervention increased the servings of whole grain from 1.5 to 4 per day and increased total dietary fibre intake to 40 g/d which was double the amount of fibre consumed by participants at baseline or during the white bread intervention. Compared to white bread, the high fibre bread increased richness and evenness (Shannon, p = 0.014) of the gut microbiota and increased the relative abundance of SCFA producing taxa Lachnospiracae ND3007 group (p <0.001, FDR = 0.019). In addition, the high-fibre bread tended to increase relative abundance of butyrate-producing genus Roseburia, and microbial BCoAT gene content compared to white bread. In conclusion, the substitution of white bread with high-fibre bread improved the diversity of gut microbiota, specific microbes involved in SCFA production and may enhance the butyrate production capability of gut microbiota in healthy adults.

Polycystic ovary syndrome (PCOS) is a common endocrine condition which affects up to 13% of reproductive-aged women and is associated with reproductive, metabolic and psychological features. Women with PCOS have a higher prevalence of longitudinal weight gain in population-based cohort studies compared to women without PCOS. On meta-analysis, women with PCOS also have an increased prevalence of overweight, obesity and central obesity, compared with controls. PCOS is therefore associated with an elevated prevalence of overweight and obesity which further worsen metabolic, reproductive and psychological dysfunction. Given the association between overweight and obesity and metabolic, reproductive and psychological dysfunction in women, weight management is a logical treatment strategy. This can be defined as prevention of excess weight gain, achieving a modest weight loss and sustaining a reduced weight long-term. This is best achieved through lifestyle management which traditionally refers to a complex multidisciplinary approach that combines dietary modification, physical activity and behavioural interventions. Lifestyle interventions and modest weight loss (5-10% of initial body weight) are associated with improvements in outcomes including central adiposity, hyperandrogenism, insulin resistance and cardiovascular risk factors. In PCOS specifically for dietary interventions, the majority of evidence indicates no differences between dietary approaches Lifestyle management advice should therefore follow general population guidance which states that lifestyle intervention can be achieved through a variety of dietary approaches providing these are tailored to dietary preferences and ensure the nutritional and health status of the individual patient with referral to a nutrition professional where possible. These recommendations are summarised in the 2023 International Evidence-based Guidelines on the Assessment and Management of PCOS. 1 These guidelines are now being translated and implemented internationally.

This abstract was awarded the prize for best poster presentation.

Undernutrition is common among older adults and, if untreated, can lead to weight loss, adverse cognitive and functional health outcomes and poorer quality of life. The Mediterranean diet (MedDiet) has been associated with reduced nutrient deficiency1 and better cognitive health in older adults2, while adequate protein intake combined with exercise is crucial for maintaining muscle health during ageing3. Early intervention with MedDiet to meet energy and increased protein (1.2g/kg/day)4 and micronutrient needs of older adults in combination with exercise could help to prevent undernutrition during ageing but has not yet been tested.

The PROMED-EX trial is a 6-month randomised controlled trial evaluating a PROtein-enriched MED Diet, with and without Exercise on nutritional status and cognitive performance, in older adults at increased risk of undernutrition and cognitive decline.5 The current objective is to evaluate the 3month change in nutritional status and diet quality measured using repeated Mini Nutritional Assessment (MNA), 4-day food diaries and PROMED diet score (0-14). Food diaries were analysed for energy and nutrients using Nutritics at each time-point. Data was analysed on the intention-totreat principle using multiple linear regression to compare outcomes at 3 months after adjusting for baseline values. Dunnett’s procedure was used to control for multiple comparisons when comparing the two intervention groups with the control group.

One hundred and five eligible participants (69% female; mean age 67.7years [60-87 years]; BMI: 23.8 ± 3.4 kg/m2) were recruited and randomised into one of three groups: PROMED-EX (diet + exercise; n = 34), PROMED (diet only; n = 35) and Standard Care (control; n = 36).

After 3-months, the MNA score improved in both PROMED-EX and PROMED intervention groups compared with the control group by on average 2.6 points (95% CI 1.1, 4.1; P<0.01) and 2.2 points (95% CI 0.8, 3.7; P<0.01) respectively; after adjusting for baseline MNA. Similarly, the mean 3-month increase in diet quality score was +4.0 (95% CI 3.1, 5.0); +4.6 (95% CI 3.7, 5.4) points in PROMEDEX and PROMED respectively; P<0.001, versus Control.

No between group changes in energy intake were detected, however protein and selected micronutrient intakes improved in the intervention groups. Compared to the control group, the between-group difference in mean protein intake was +21.4g/day (95% CI 9.8, 32.9) in PROMED (P<0.001) and +9.0g/day (95% CI -3.1, 21.0) in PROMED-EX (P>0.05). There was significantly greater improvement in dietary fibre, selenium, iron and vitamin D intakes in both interventions relative to Control (all P<0.001).

This 3-month analysis demonstrates the positive effects of the PROMED-EX and PROMED interventions on nutritional status and diet quality, as well as improvement in selected nutrients in older adults vulnerable to both undernutrition and cognitive decline.

The adoption of plant-based meat analogues is increasing as an alternative to real meat products among consumers because they offer a more ecologically friendly and sustainable source of protein while also alleviating the ethical concerns related to livestock rearing and slaughter (1). However, there are concerns regarding plant-based meat analogues in terms of its nutritional quality, particularly their protein digestibility. This study aims to compared between chicken and plant-based chicken analogues in terms of nutritional composition and degree of protein hydrolysis.

Proximate analyses were performed for raw and cooked samples to assess protein, fat, and energy concentrations in two chicken samples (breast and thigh) and four commercial plant-based chicken (P-C1[Wheat Protein 37%, Pea Protein 10%], P-C2 [ Soya Protein 63%], P-C3 [ Soya and Wheat Protein 83%], and P-C4 [Soya Protein 30%, Pea Protein 2%]). As a first step, the proximate analyses were assessed for the averaged samples, then the product-cooking interactions was assessed using a one-way ANOVA followed by Tukey test (p <0.05). In vitro digestion was performed following the INFOGEST harmonised static in vitro digestion model (2) for cooked samples. After digestion, o- Phthaldialdehyde (OPA) assay was carried out to measure the degree of protein hydrolysis for each sample, and two-way ANOVA test was performed.

Protein content of chicken was higher compared with the plant-based chicken, whereas fat content and energy concentrations were higher in plant-based chicken. The protein content of chicken was higher for raw and cooked samples (raw: 19.8 ± 0.38 g/100 g; cooked: 30.55 ± 4 g/100g), compared with plant-based chicken (raw: 13.8 ± 5.3 g/100 g; cooked: 23.4 ± 4.5 g/100g). Plant-based chicken have a higher fat content and energy concentrations for raw and cooked samples (raw:6.52 ± 1.5 g/100 g; cooked: 9.6 ± 3.17 g/100g) and (raw:189.4 ± 28.1 g/100 g; cooked: 291.3 ± 48.1 g/100g) respectively; compared to chicken fat content (raw:4.6 ± 2.7 g/100 g; cooked: 6.1 ± 4 g/100g) and energy concentration (raw:150.9 ± 25.4 g/100 g; cooked: 228.3 ± 20.7 g/100g). The product-cooking interactions showed a significant increase (P ≤0.0001) in the protein content (raw: 15.6 ± 2.3g/100g to 19.8 ± 0.74 g/100g; cooked: 21.4 ± 0.55 g/100g to 33.06 ± 0.71 g/100g), and fat content P<0.001 (raw: 2.7 ± 0.06 g/100g to 8.3 ± 0.27 g/100g; cooked: 3.29 ± 0.19 g/100g to 13.22 ± 0.33 g/100g) in both chicken and plant-based chicken samples. No significant product-cooking interactions on energy content was found. The results from a two-way ANOVA test of the OPA and the degree of hydrolysis analyses demonstrated a significant increase in the degree of hydrolysis of chicken samples compared with plant-based chicken (P<0.0001).

The degree of hydrolysis and digestibility of chicken and chicken analogues was influenced by protein type, nutrient composition, and processing. These findings would provide substantial information for the improvement of plant-based chicken products with enhanced nutritional profiles. This work will be extended to investigate the availability and digestibility of individual amino acids.

Sales of plant-based meat alternatives (PBMAs) are increasing(1). While these products are becoming more popular, little is known about their impact on health(2). Therefore, the aim of this work was to systematically review the evidence on PBMA consumption and associated health outcomes.

A wider systematic review looking at the environmental impact, ingredient composition, nutritional impact and health outcomes associated with PBMAs was conducted. A search strategy combined terms “meat alternatives” AND “environment” OR “ingredients” OR “nutrition” OR “health.” Five databases were searched, MEDLINE, EMBASE, Web of Science, Scopus and Greenfile, as well as reference lists of relevant articles. All study designs reporting primary data were included, except for animal studies and in vitro studies. Non-English studies and studies published before 2011 were excluded (PROSPERO Registration Number: CRD42021250541).

2184 papers were identified, 1802 papers remained after duplicates were removed, 1536 were excluded at title and abstract screen stage, 266 full texts were assessed for eligibility and 54 papers were included in the analysis for all outcomes investigated. Ten studies examined the impact of PBMA vs. meat consumption on health outcomes. Three studies measured postprandial response to single test meals(3–5), four studies were longer-term RCTs(6–8) with two further separate publications reporting on different outcomes for the same RCT(9,10). One study was a prospective cohort(11) and one a cross-sectional study(12).

Of the single test meal studies, no significant differences were observed for glucose levels in 2/2 studies (100%)(3,5), PYY and GLP-1 levels in 2/2 studies (100%)(3,4) and self-reported hunger/fullness in 3/3 studies (100%)(3–5). Significantly lower insulin concentrations and subsequent energy intakes were both reported in 1/2 studies (50%) following consumption of mycoprotein vs. chicken meals(3).

Longer-term full and partial replacement of meat with PBMAs resulted in significantly lower body weight (kg) in 2/2 studies (100%)(6,10), significantly lower saturated fat intakes in 2/2 studies (100%) (6,10), significantly higher fibre intakes in 2/3 studies (67%)(6,7), improvements in plasma lipid profile in 2/3 studies (67%)(7,10) and positive changes in gut microbiota in 1/2 studies (50%)(8) compared to meat diet phases/control groups with no restrictions on meat intakes. There were no significant differences in protein intakes in 3/3 studies (100%)(6,7,10), energy, total fat and carbohydrate intakes in 2/2 studies (100%) (6,7), blood pressure in 2/2 studies (100%)(6,10), glucose levels in 2/2 studies (100%) (7,10) and insulin levels in 2/2 studies (100%)(7,10).

No definitive conclusions can be made on the impact of PBMAs on health outcomes due to the small number of studies and variation in study designs, outcomes measured and the type of PBMA used. From the limited evidence available, no negative health effects from PBMA consumption were observed, however, further longer-term RCTs are needed to confirm this.

The traditional Mediterranean Diet (MedDiet) is consistent with a dietary pattern and time-honoured eating behaviours by populations living in the olive-tree growing areas of the Mediterranean basin before the mid-1960’s. The MedDiet is described in the literature as a plant-based dietary pattern, consistent with a high intake of vegetables, fruits, nuts, legumes, wholegrains cereals, and daily use of extra-virgin olive oil incorporated into all meals; moderate consumption of fish, shellfish, fermented dairy products (cheese and yogurt), and wine (typically during meals); and a low or infrequent consumption of meat and processed meat products, processed cereals, sweets, vegetable oils, and butter(1). Being predominately plant-based, the MedDiet is naturally low in saturated fat, and rich in several functional components, including vitamins and minerals, carotenoids, unsaturated fatty acids, and phenolic compounds, depicted by antioxidant and anti-inflammatory properties. As a result of its putative beneficial health effects, the MedDiet is one of the most widely evaluated dietary patterns in the scientific literature(2). In both observational and intervention studies, there is a large and consistent body of evidence to support that a MedDiet is protective against chronic and inflammatory conditions, including cardiovascular disease, metabolic syndrome, management and prevention of type 2 diabetes, central adiposity, cancer, neurodegenerative conditions, and frailty(3). The effect of the MedDiet on women’s reproductive health is an emerging area in the literature. There have been a range of studies (observational and interventional) examining outcomes related to menarche, menstrual cycle, pregnancy, infertility, lactation, and menopause. The MedDiet has also been studied for the management of conditions such as polycystic ovary syndrome and endometriosis. These conditions are often associated with hormonal imbalances, inflammation, and oxidative stress, all of which can be influenced by the diet’s key components. The MedDiet may be a promising nutritional strategy for promoting women’s reproductive health. However, more extensive, and rigorous studies, including randomized controlled trials and longitudinal investigations, are necessary to establish a causal relationship between the MedDiet and women’s reproductive health outcomes. While the adoption of a MedDiet in non-Mediterranean populations is appealing, consideration needs to be given about potential barriers and enablers towards adherence(4). Furthermore, while the primary focus has been on nutritional strategies within the framework of the Mediterranean Diet, equal attention must be given to the eating behaviours and lifestyle factors associated with it.