School-based interventions to prevent obesity have shown heterogeneous results. Recent school-based trials with “negative” have cast doubt on their effectiveness. In the Juntos Santiago trial, we used an innovative, theory-based gamification strategy to increase motivation and participation in healthy behavioural changes. This is the first trial, to our knowledge, to use gamification to prevent childhood obesity.

To examine the effectiveness of a multicomponent gamification strategy to prevent obesity in 5th and 6th-grade schoolchildren in Santiago de Chile.

School-based, parallel cluster-randomized controlled trial. 81 schools in two municipalities in Santiago, Chile, with more than 40 students in 5th and 6th grade altogether were eligible. Schools were randomized and sequentially invited to participate. The multicomponent intervention was a gamification strategy with four components: (i) healthy challenges (snacks, steps and healthy activities); (ii) gamification incentives, such as points, levels, leaderboards and badges; (iii) rewards (infrastructure and fun activity) and (iv) an online platform for parents and students to monitor the progress. Participants were followed up at 5 and 8 months. Pre-registered primary outcomes were body mass index (BMI) z-score and waist circumference (WC) at 8 months. Secondary outcomes were BMI and systolic (SBP) and diastolic blood pressure (DBP) at 8 months. Multilevel analysis adjusted for individual and school-level covariates were used.

24 schools (9 controls) and 2333 students (709 controls) were assessed at baseline and 2264 students (689 controls) were assessed at 8 months. The mean BMI z-score was lower in the intervention group compared to the control group at 8 months (mean difference -0.132, 95% CI -0.249; -0.014), while no difference was observed for WC. Mean BMI and SBP were lower in the intervention arm compared to the control arm (mean difference for SBP -0.139; 95% CI -2.39; -0.40). No difference was observed for DBP.

The gamification strategy appears to prevent childhood obesity and reduce systolic blood pressure in school children in Santiago. These effects are larger than the pooled effects from existing meta-analyses. Further research should identify which components of the gamification strategy were more effective.

ClinicalTrials.gov NCT03459742

Mayors Challenge 2016, Bloomberg Philanthropies

Irritable Bowel Syndrome (IBS) is a functional and multifactorial gastrointestinal disorder characterized by pain, abdominal distention and motility changes, currently diagnosed based on the Rome IV criteria. The efficacy of classic pharmacological, psychological and dietary treatments for this condition are generally low. The Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP) are short chain carbohydrates poorly absorbed at the intestinal level, fermentable by the microbiota and presumably involved in IBS-associated symptomatology.

To evaluate the efficacy, feasibility and acceptability of a FODMAP-restricted feeding approach in the relief of symptomatology and in the improvement of the quality of life of patients with IBS, determining the reintroduction of the FODMAP food subgroup(s) involved in the symptom exacerbation.

After assessing the existence of initial emotional disorders through the Hospital Anxiety and Depression Scale (HADS) and eating habits, through dietary history, patients diagnosed with IBS were put on a FODMAP-restricted diet for 6 weeks. During this period, the weekly evolution of symptom frequency was assessed. At the end, tests were undertaken to discover the global evolution of the symptoms through the Irritable Bowel Syndrome - Global Assessment Scale (IBS-GAI), the severity of symptomatology through the Irritable Bowel Syndrome - Severity Scoring System (IBS-SSS) and quality of life through Irritable Bowel Syndrome - Quality of Life (IBS-QoL).Subsequently, participants tested their tolerance to various FODMAP subtypes with weekly and isolated reintroduction of these in their diet.

In the 36 participants, with a mean age of 38.8 years, there was a reduction in the total consumption of FODMAP from 22.1 g to 2.1 g (p < 0.001). A moderate or substantial improvement in the IBS-GAI was observed in 88.9%. An average reduction of 235 points in the IBS-SSS (p < 0.001) and a mean increase of 28.7 in the IBS-QoL (p < 0.001) was achieved. The initial anxiety and depression levels were not associated with IBS-SSS and presented an inverse association with the IBS-QoL. There was significant improvement in all symptomatology during the 1st week of total FODMAP restriction, except for constipation with an amelioration observed at the 6st week. There was a frequency of intolerance ranging from 30.8% for fructans to 80.8% for lactose with the reintroduction of the FODMAP subtypes.

A FODMAP-restricted diet, implemented over a period of 6 weeks, is effective in reducing the severity and frequency of GI symptoms and improving the quality of life of portuguese patients with IBS.

Replacing missing teeth alone is not enough to engender dietary behaviour change amongst older adults. Whilst there is a body of evidence to support oral rehabilitation in conjunction with dietary advice, this is currently limited to edentate patients even though the majority of older adults are now partially dentate. One approach proven to change long-term food behaviours but is novel in this population is habit-formation. Consequently, this study developed and tested a habit-based tailored dietary intervention, in conjunction with oral rehabilitation amongst partially dentate older adults.

A pilot randomised control trial was conducted on 57 partially dentate older patients. Participants were randomised to an intervention group (habits-based dietary intervention) or a control group and followed up for 8 months. The intervention group attended four meetings with a trained researcher to target habit-formation around 3 dietary domains (fruit/vegetables, wholegrains, healthy proteins). The primary outcome measure was self-reported automaticity for developing healthy habits and habit formation was assessed using the Self-Report Behavioural Automaticity Index (SRBAI). Preliminary analysis was conducted on n = 36 participants between baseline and 8 month follow up.

Preliminary results showed that SRBAI scores and self-reported frequency of days doing habits in the intervention group for all tailored dietary habits was significant between baseline and follow up visits (p < 0.001). There were moderate positive correlations between automaticity and habit adherence (Fruit/vegetables rho = 0.43, p = 0.09: Wholegrains rho = 0.44, p = 0.08: Healthy Proteins rho = 0.52, p = 0.03) for the intervention group. Automaticity trends were increased in the intervention group for all 3 dietary habits compared to the control group but, other than wholegrain (p = 0.005), between group differences were non-significant (p > 0.05). BMI decreased in the intervention group (29.6 to 28.7 kg/m2) compared to a non-significant increase in the control group (27.7 to 27.8 kg/m2) (p = 0.08). There were slight increases in Mini Nutritional Assessment mean change scores (0.19 intervention: 0.32 control) for both groups, however between-group differences were not statistically significant (p = 0.9). Greater improvements in food intake around dietary habits were observed in the intervention group (Fruit/vegetables:108 g Fibre 4g: Protein 11g) compared to the control group (Fruit/vegetables -17g: Fibre 2g: Protein -4g).

Preliminary results demonstrate the success of a habit-based dietary intervention coupled with oral rehabilitation in positively influencing dietary behaviours and other nutritional outcomes in partially dentate older adults.

South Africa (SA) is a developing country with an ageing population. Adequate nutrition and physical activity (PA) protect against the loss of muscle mass and physical function, both of which are important components of sarcopenia. This study aimed to measure the prevalence of sarcopenia in older black SA women and investigate its associations with PA and protein intake.

Older black SA women (age, 68 (range; 60–85 years) n = 122) completed sociodemographic questionnaires, 24 h urine collection (estimate protein intake), venous blood (hs-C-reactive protein (hs-CRP) and ferritin), functional tests (grip strength, 3 m timed-up-and-go (TUG), 10 m walk test) and PA monitoring (activPAL). Dual-energy x-ray absorptiometry whole-body scans assessed fat and fat-free soft tissue mass (FFSTM).

According to the European Working group on Sarcopenia in Older People (EWGSOP)2, 2.5% (n = 3) had confirmed sarcopenia of a low severity based on normal physical function. Of the total cohort, 9% (n = 11) had low grip strength, 22.1% (n = 27) had a low appendicular skeletal muscle index (ASMI), and no women had low TUG (s) or gait speed (m/s). Higher ASMI was associated with lower hs-CRP (p = 0.05; Rho = -0.209) and higher ferritin (Rho = 0.252; p = 0.019), grip strength (kg, Rho = 0.223; p = 0.015), and gait speed (m/s, Rho = 0.180; p = 0.050). Protein intake suggested intake of 41.8g/day/ or 0.51 g/kg of body mass/day. Higher total protein intake (g/24h), was associated with higher FFSTM (kg) and ASMI (p < 0.001). PA outcomes were not correlated with FFSTM or ASMI (p > 0.05), however, there was a strong positive correlation of TUG (s) and gait speed (m/s) with time spent: 1) stepping per day (min) and; 2) at a high cadence (> 100 steps/min) (all p < 0.01). Daily step count was 7137 ± 3233 (mean ± Standard deviation), with 97.9 ± 38.7 min of total time spent stepping and 12.6 ± 16.8 min spent stepping at a high cadence (> 100 steps/min). Of note, 13.9% (n = 17) of women were completing > 10,000 steps/day.

Based on the EWGSOP2 criteria, there is a low prevalence of sarcopenia in older black SA women, explained by the maintenance of strength and physical function that directly related to PA, especially that performed at higher intensities. In contrast, low muscle mass was relatively prevalent (22.1%) and was associated with low dietary protein and not PA. Notably, it may be important to review the cut-points of EWGSOP2 criteria to be specific to the older SA women from disadvantaged communities.

Precision medicine is changing the way people are diagnosed and treated into a more personalized approach. In medical research, several statistical methods have been proposed for estimating personalized treatment effects. However, in nutritional science these methods have hardly been used. By re-evaluation of pre-treatment biomarker data, we demonstrate how two diets cause differential weight loss depending on pre-treatment fasting plasma glucose (FPG) and fasting insulin (FI) levels.

Overweight people with increased waist circumference were randomly assigned to receive an ad libitum New Nordic Diet (NND) high in dietary fiber and whole grain or an Average Danish (Western) Diet (ADD) for 26 weeks. All foods were provided free of charge. Body weight was measured throughout the study and blood was drawn before randomization from where FPG and FI were analyzed. Weight was described by linear mixed models including biomarker-diet group interactions, covariate adjustment, and participant-specific random effects. Personalized predictions of additional weight loss from NND compared to ADD given specific values of FPG or FI were estimated as contrasts of intercepts and slopes obtained from the biomarker-diet group interaction term.

Baseline FPG predicted a 3.00 (1.18;4.83, n = 181, P = 0.001) kg larger weight loss per mmol/L from choosing NND over ADD. For instance, a baseline FPG level of 4.7 mmol/L would lead to an average of 1.42 kg larger weight loss on NND vs. ADD (above 0.41 kg with 95% certainty), whereas the average effect size would be 8.33 kg (above 5.50 kg with 95% certainty) among subjects with FPG level of 7.0 mmol/L. Among individuals with FPG < 5.6 mmol/L, each pmol/L lower baseline FI predicted a 0.039 (95% CI 0.017;0.061, n = 143, P < 0.001) kg larger weight loss from choosing NND over ADD. For instance, a baseline FI level of 25 pmol/L would lead to an average larger weight loss of 4.10 kg on NND vs. ADD (> 2.51 kg with 99% certainty). Likewise, a baseline FI level of 75 pmol/L would result in an average effect size of 2.15 kg (> 1.11 kg with 99% certainty).

Use of pre-treatment FPG and FI led to truly individualized predictions of treatment effect of introducing more fiber and whole grain in the diet on weight loss, ranging from almost no effect to losing more than 8 kg. These findings tentatively suggest that re-evaluation of data from existing randomized controlled trials through suitable statistical methods may have a great potential.

The transition from adolescence toward adulthood is a critical period regarding changes in dietary behaviours. Moreover at these ages, socio-economic and regional disparities in food group consumption are observed. The aim of our study was to determine how the nutritional quality of diet, measured by the modified Nutrient Profiling System of the British Food Standards Agency (FSAm-NPS), evolved between 2004 and 2014, according to socio-economic and regional characteristics of adolescents and young adults living in Belgium.

Two non-consecutive 24-hour dietary recalls were carried out in two nationally-representative samples of 15-to-39-year-old respondents included in the Belgian Food Consumption Surveys in 2004 (n = 1,186) and 2014 (n = 952). Weighting factor (according to age, gender, day of recall, season and province) and sample design were considered. The weighted mean individual FSAm-NPS was computed from all foods and beverages consumed and converted into a scale from 0 (less favourable diet) to 100 (more favourable diet). Slope (SII) and Relative (RII) Index of Inequality were compared between 2004 and 2014 in three age groups (15–18 y, 19–25 y and 26–39 y), adjusting for gender, energy intake, and other socio-economic and regional characteristics.

In the three age groups, the weighted mean FSAm-NPS significantly increased between 2004 and 2014 (2004: 55.2 (SEM: 0.2) vs. 2014: 57.3 (0.5), p < 0.001 in 15–18-year-olds; 54.9 (0.6) vs. 58.0 (0.4), p < 0.001 in 19–25-year-olds; 56.9 (0.3) vs 58.3 (0.3), p < 0.01 in 26–39-year-olds). While a significant FSAm-NPS gradient was observed according to household education among 15–18- and 26–39-year-olds in 2004 (adjusted SII: 2.56 (95% CI: 1.08–4.04) and 2.73 (0.34–5.12), respectively; RII: 1.05 (1.02–1.08) and 1.05 (1.01–1.09)), no significant difference was found in 2014. Conversely, no significant score disparity was observed according to household type in 2004, but disparities appeared in 2014: index of inequality were significant among subjects aged 19–25 y (SII: 3.89 (0.62–7.17); RII: 1.07 (1.01–1.13)) and 26–39 y (SII: 2.74 (0.31–5.17); RII: 1.05 (1.01–1.09)), the FSAm-NPS being more favourable for those living in two-parent families. The FSAm-NPS was generally higher for subjects living in Flanders than those in Wallonia (significant SII and RII only among 26–39-year-olds), the magnitude of regional disparities remaining stable over time.

Overall FSAm-NPS improved during this 10-year period, but differentially according to family structure and household education. However, statistical power was weakened by the limited sample size. Additional investigations of changes in food group consumption disparities will complement our interpretations.

Studying the link between children's stress and diet is crucial, as early childhood is an important period for the development of eating habits as well as other health behaviours. Among adults, studies have shown that elevated cortisol levels (indicator of long-term stress) might be associated with overweight and a preference for energy-dense foods. However, the association between hair cortisol concentration (HCC) and diet among pre-school-aged children is poorly understood. The aim of this study was to investigate whether HCC, a measure of long-term stress, is associated with diet among 3–6-year-old Finnish children.

The current cross-sectional study is a part of the DAGIS study conducted in 66 Finnish pre-schools in 2015–2016. Of the 864 participating pre-schoolers, 578 (67%) provided the information needed to examine the association between HCC and diet. HCC was measured from 4-cm hair samples using a chemiluminescence immunoassay, and the HCCs were categorized into fifths. The parents of the participating children filled in a food frequency questionnaire (FFQ) assessing the child's food consumption outside preschool hours. The FFQ items (n = 47) were used as inputs in principal component analysis to derive dietary patterns. The associations between HCC and food group consumption frequencies as well as dietary pattern scores for ‘sweets-and-treats’, ‘health-conscious’ and ‘vegetables-and-processed meats’ patterns were examined with multilevel linear mixed models and adjusted for age, gender and parental education.

The median HCC was 11.7 pg/mg (min 0.24, max 879.6). Compared to the children who had the lowest HCCs, the children with the highest HCCs consumed vegetables as well as fruits and berries less frequently (β = -1.62, 95% CI -3.14, -0.09; β = -1.49, 95% CI -2.95, -0.04) and scored lower on the ‘health-conscious’ dietary pattern (β = -0.31, 95% CI -0.51, -0.11). After adjustments, the associations between HCC and fruit and berry and sugary beverage consumption as well as ‘health-conscious’ pattern were significant (β = -1.62, 95% CI -3.09, -0.16; β = 1.30, 95% CI 0.06, 2.54; β = -0.33, 95% CI -0.53, -0.14).

This study supports the link between long-term stress and lower-quality diet, as it showed that elevated HCCs and less healthful diets were connected already in the early childhood. However, because of the cross-sectional design of the study, we are not able to conclude whether stress affects diet or vice versa. Nevertheless, these results give reason to further investigate the relationship between stress and children's eating habits as well as health in general.

The foetal programming hypothesis posits that optimising early life factors e.g. maternal diets can help avert the burden of adverse childhood outcomes e.g. childhood obesity. To improve applicability to public health messaging, we investigated whether maternal whole diet quality and inflammatory potential influence childhood adiposity in a large consortium.

We harmonized and pooled individual participant data from up to 8,769 mother-child pairs in 7 European mother-offspring cohorts. Maternal early-, late-, and whole-pregnancy dietary quality and inflammatory potential were assessed with Dietary Approaches to Stop Hypertension (DASH) and energy-adjusted Dietary Inflammatory Index (E-DII), respectively. Primary outcome was childhood overweight and obesity (OWOB), defined as age- and sex-specific body-mass-index-z score (BMIz) > 85th percentile based on WHO growth standard. Secondary outcomes were sum-of-skinfold-thickness (SST), fat-mass-index (FMI) and fat-free-mass-index (FFMI) in available cohorts. Outcomes were assessed in early- [mean (SD) age: 2.8 (0.3) y], mid- [6.2 (0.6) y], and late-childhood [10.6 (1.2) y]. We used multivariable regression analyses to assess the associations of maternal E-DII and DASH with offspring adiposity outcomes in cohort-specific analyses, with subsequent random-effects meta-analyses. Analyses were adjusted for maternal age, pre-pregnancy BMI, parity, lifestyle factors, energy intake, educational attainment, offspring age and sex.

A more pro-inflammatory maternal diet, indicated by higher E-DII, was associated with a higher risk of offspring late-childhood OWOB [pooled-OR (95% CI) comparing highest vs. lowest E-DII quartiles: 1.22 (1.01,1.47) for whole-pregnancy and 1.38 (1.05,1.83) for early-pregnancy; both P < 0.05]. Moreover, higher late-pregnancy E-DII was associated with higher mid-childhood FMI [pooled-β (95% CI): 0.11 (0.003,0.22) kg/m2; P < 0.05]; trending association was observed for whole-pregnancy E-DII [0.12 (-0.01,0.25) kg/m2; P = 0.07]. A higher maternal dietary quality, indicated by higher DASH score, showed a trending inverse association with late-childhood OWOB (pooled-OR (95% CI) comparing highest vs. lowest DASH quartiles: 0.58 (0.32,1.02; P = 0.06). Higher early-pregnancy DASH was associated with lower late-childhood SST [pooled-β (95% CI): -1.9 (-3.6,-0.1) cm; P < 0.05] and tended to be associated with lower late-childhood FMI [-0.34 (-0.71,0.04) kg/m2; P = 0.08]. Higher whole-pregnancy DASH tended to associate with lower early-childhood SST [-0.33 (-0.72,0.06) cm; P = 0.10]. Results were similar when modelling DASH and E-DII continuously.

Analysis of pooled data suggests that pro-inflammatory, low-quality maternal antenatal diets may influence offspring body composition and obesity risk, especially during mid- or late-childhood. Due to variation of data availability at each timepoint, our results should be interpreted with caution. Because most associations were observed at mid-childhood or later, future studies will benefit from a longer follow-up.

Dietary changes in pregnancy may be a marker for later pregnancy complications. This study aims to investigate if there is a difference in the proportion of women who experience specific pregnancy related complications vs those who do not, in relation to specific dietary changes made during pregnancy.

Within the Danish National Birth Cohort, established during 1996 and 2003, dietary changes from 70,053 pregnancies were assessed in gestational week (GW) 25 using two open-ended questions (q1 and q2) on aversions or preferences appended to a 350-item food frequency questionnaire; “did you stop(q1) or start(q2) consuming a specific food during pregnancy?” After restricting to the firstborn child enrolled, born at term (GW 37 + 1–42 + 0) with a birth weight between 1,0 and 6,0 kilograms, excluding multiple pregnancies and abortions, dietary change answers from 55,087 women were coded into 65 food groups. Using chi-X2 test, we compared proportions of women with and without three pregnancy complications: preeclampsia (obtained via linkage to the Danish National Patient Registry), children born small-for-gestational-age (SGA, < 10th percentile) or children born large-for-gestational-age (LGA, > 90th percentile) with respect to their answers about aversions/preferences.

Among the 55,087 women, 49% and 31% reported any aversions or preferences, respectively. Most frequent were women reporting aversion of alcohol (22.7%) or coffee (15.4%), and preference of milk products (7.9%) or fruits and berries (6.9%), which were selected a priori for analyses. 8.3% of women experienced preeclampsia, and 9.7% and 9.3% of children were characterizes as being born SGA or LGA, respectively. Compared with no dietary change: avoiding alcohol or coffee was associated with smaller proportion of SGA (10% vs 8%, p = 0.01 and 10% vs 7%, p < 0.0001) and avoiding coffee was also associated with greater proportion of LGA (9% vs 11%, p = 0.01). Increasing milk products or fruit/berries was associated with smaller proportions of SGA (14% vs 10% in both conditions, p < 0.009). No significant association in reported aversions/preferences was detected for preeclampsia.

The results lead to additional questions, such as “Why do women who increase consumption of milk products or fruits/berries tend to deliver SGA infants and why do women who stop drinking coffee tend to deliver LGA infants?” The presented results and further analyses are important to public health initiatives for optimizing maternal nutrition with long-term influence to offspring Health.

Breastfeeding can improve health outcomes for mothers and babies and is an important factor in the reduction of obesity. However, breastfeeding rates in Ireland are amongst the lowest internationally, with rates of 59.9% in 2016.

The objective of this study was to assess intention to breastfeed at booking, feeding status at hospital discharge, one and three months postnatal and influencing factors.

Secondary data from 124 healthy pregnant women participating in an RCT in the National Maternity Hospital who recorded their intention to breastfeed at booking were included. Observational data including demographic and lifestyle data was collected from participants.

Of the 124 women, 80.7% were Irish, 86.2% had achieved third level education, and 43.5% (n = 54) were multiparous. Mean age was 32.7years and mean BMI 24.9kg/m2. 91.1% (n = 113) reported intending to breastfeed at booking. Upon hospital discharge, 91% of those intending to breastfeed had initiated breastfeeding (n = 101/111). 78.6% (n = 77/98) and 66.7% (n = 58/87) of those who had intended to breastfeed remained breastfeeding at one and three months postnatal respectively. Intention to breastfeed in early pregnancy was significantly higher amongst women with third level education (p < 0.001). Intention to breastfeed did not differ significantly with maternal age, ethnicity, BMI, or parity, however, women who had breastfed previously were more likely to intend to breastfeed for future infants (p < 0.001). Women with higher education were more likely to breastfeed at discharge, one and three months postnatal (p < 0.05). Although maternal BMI was not associated with intention to breastfeed, women who did not initiate breastfeeding at hospital discharge had a significantly higher BMI (M = 27.22kg/m2, SD = 4.53, p = 0.018) compared to women who initiated breastfeeding (M = 24.68kg/m2, SD = 3.05). Similarly, of those intending to breastfeed, women who were not breastfeeding at three months postnatal had a significantly higher BMI (M = 26.33kg/m2, SD = 3.99, p = 0.01) than those continuing breastfeeding (M = 24.08kg/m2, SD = 2.61). There were no significant differences regarding feeding status with maternal ethnicity, age, or parity at discharge and one month postnatal (p > 0.05). However, primiparous women intending to breastfeed were significantly more likely to continue breastfeeding at three months compared to multiparous women (p < 0.05).

Many factors are shown to influence breastfeeding intention and duration including parity, education and BMI. It is important to identify these potentially inhibiting factors during pregnancy to develop support measures to encourage initiation and continuation of breastfeeding.

Healthy eating recommendations advise eating two portions of fish per week. Although seafood consumption has doubled globally over the last 50 years there is currently very little data on seafood consumption in Ireland. It is important to know what is being consumed by a population for nutritional and food safety purposes. The aim of this study is to collect reported dietary intake data from Irish seafood consumers, using an online dietary intake assessment tool, to determine habitual intakes of seafood for use in risk assessment.

Foodbook24 is a self-administered, online 24hr recall tool developed for the purpose of nutritional surveillance in Ireland. For the purpose of this study it was further developed to include a detailed list of seafood regularly consumed in Ireland. Foods were selected using established food databases (Langual, FoodEx2 and BIM Seafood Handbook). Food composition was determined using McCance and Widdowson (7th Ed.) and portion sizes were based on NANS, published portion size books and recipes. Participants will be recruited using commonly used approaches; radio adverts & face-to-face recruitment. Seafood consumers (n = 1000), balanced for gender, age and urban/rural location, will be targeted. Participants will complete 2×24hr recalls, over 2 weeks, and complete an accompanying food frequency questionnaire. Demographic and lifestyle data will also be collected.

In the development of the tool, a total of 246 foods were added to Foodbook24, including 38 species of fish, with approximately 2–25 fish dishes for each fish. The composition of 156 foods were a direct match to McCance and Widdowson, 36 were similar and 24 used a combination of foods. For fish meals and recipes, 17 meals had a direct match in McCance and Widdowson and 10 were obtained using the average of 3 recipes. Foodbook24 contained a large proportion (92%) of the relevant portion sizes, others came from relevant books and recipes.

Data collection is currently ongoing, but it is expected that the study will represent a significant step forward in public health policy contribution by characterising the likelihood of illness within a population on an annual basis. Furthermore, it will demonstrate the use of novel intake assessment technologies for fast and cost-effective collection of data for risk assessment purposes, reducing the time and cost required for data collection.