Athletes’ dietary intake impacts performance and recovery. Dietary intake is influenced by a variety of factors—including nutrition knowledge and perspectives on nutrition. In previous research, athletes have been found to have low nutrition knowledge scores(1). A great deal of research has been done exploring how nutrition knowledge impacts dietary intake, but little has explored the relationships between nutrition knowledge and perspectives on nutrition in student-athletes. The aim of this study is to explore the relationship between nutrition knowledge and athlete perspectives on nutrition among Australian university student athletes. In this cross-sectional study, we recruited athletes within Australia, 18+ years of age, who are also enrolled in some form of post-secondary education (student-athletes). Data was collected on demographics (including age, weight, sport experience, type of sport, and education), nutrition knowledge (NK) (Abridged Nutrition for Sport Knowledge Questionnaire (ANSKQ)) and attitude towards dietary behaviour (Athlete’s Perspective on Nutrition (APN)). APN includes three domains: attitude towards the behaviour, subjective norms, and perceived behavioural control. Data analysis methods included Shapiro-Wilk testing for normality, and Pearsons or Spearman correlations between APN and ANSKQ, data. Results look at 49 participants from the student-athlete group. Student-athletes participated in a variety of sports (n = 25), with some student-athletes participated in two sports (n = 7). Mean APN scores (n = 51) were total 52.4 (SD = 5.0), and behavioural control 20.4 (SD = 2.40), with median APN scores for attitude (17.0 [IQR = 2.0]) and subjective norms (15.0 [IQR = 2.0]). Median NSKQ score (n = 49) for the full survey was average (21.0 [IQR = 2.5] out of 35 total), with mean general nutrition knowledge scores of 6.8 (SD = 1.7) and sport nutrition knowledge scores of 13.4 (SD = 3.7). Correlation tests were carried out between NK scores and APN scores (n = 48). Statistically significant, moderate correlations were found between APN scores for behavioural control and both total NK (rs = 0.357, p = 0.013) and sport NK (n = 44, rs = 0.329, p = 0.029), with borderline significant, moderate correlations for APN scores for behavioural control on general NK (rs = 0.284, p = 0.051) and total APN score and sport NK (rs = 0.287, p = 0.058). In this first study of university student-athletes in Australia, NK scores are consistent with other studies. The relationship between nutrition knowledge scores and behavioural control, which indicates ‘the ease or difficulty of performing the behavior’(2), could indicate these factors have an impact on dietary intake within athletes. This exploration may assist in the development of holistic tools to improve dietary intake within athletes in the long-term. Future analysis should explore the impact of NK and APN scores on dietary intake.

Nutrition represents a promising strategy for increasing antioxidants in the brain, with potential implications for mitigating illnesses with oxidative stress-related neuropathology(1). Emerging evidence indicates that bioactive compounds, including phenolics and betalains—responsible for the red, yellow, and purple hues in fruits—may decrease oxidative damage(2). Therefore, research into novel plant-based sources of phenolics and betalains with potential antioxidant properties is needed. This study aimed to examine the neuroprotective effects of key fruit extracts and to correlate effects with their phytochemical and antioxidant profile. Dragon fruit (DF), queen garnet plum (QGP) jaboticaba (JB), green apple (GA), blueberry (BlueB), blackberry (BlackB), watermelon (WM), and apricot (AP) extracts were analysed for their phenolic, flavonoid, anthocyanin and betalain concentrations, and antioxidant capacity (Oxygen Radical Absorbance Capacity (ORAC)). The neuroprotective efficacy of the fruits (10, 25, 50, 100 μg/mL) was then examined in-vitro using H2O2-induced oxidative stress in SH-SY5Y neuroblastoma-like cells. Cells were treated with the fruit extracts either prior to H2O2 administration (to examine protective effects), or after the H2O2 stressor (to determine treatment effects), with cell viability examined using MTT assays. Statistical analyses determined differences between fruits and the controls (healthy (untreated) and H2O2 controls) using one-way ANOVAs and post-hoc Tukey comparisons. Correlations were examined using Spearman’s correlation tests. QGP and BlueB were significantly higher in phenolics and anthocyanins (p < 0.01), QGP highest in flavonoids (p < 0.01), and DF was highest in betalains (p < 0.001) and ORAC (p < 0.01), compared to the remaining fruits. Pre-treatment with DF and JB prevented H2O2-induced loss in cell viability, retaining control-like levels (p > 0.05 vs healthy controls). GA pre-treatment also exhibited significant neuroprotective effects (p < 0.01 vs H2O2 alone) but could not restore control levels (p < 0.01 vs healthy controls). The ability of DF, JB and GA to treat existing damage to cell viability induced by H2O2 was then examined; however, the extracts were ineffective as a treatment (p > 0.001 vs H2O2 alone and healthy controls). Interestingly, there were moderate correlations between cell viability and both ORAC (r2 = 0.680, p < 0.001) and betalain concentration (r2 = 0.446, p < 0.05). This study revealed novel sources of bioactive compounds, including characterisation of betalain concentrations, in these fruits. The results demonstrate an ability of DF and JB to prevent oxidative stress in neuronal-like cells, but not treat damage after it has occurred. This finding agrees with the evidence that implementing a healthy diet rich in bioactive compounds, such as betalains and phenolics, may support brain health(1). The data also support a link between increased betalains, antioxidant capacity and neuroprotection; however, further research into the mechanisms underpinning the beneficial protective effects of DF and JB are required.

Understanding individual variability to dietary interventions is emerging as an important consideration in dietary interventions. Prior research has demonstrated ranging success of interventions. For example, Gardner and colleagues (2007) compared 4 weight loss diets in participants over a 12-month period(1), noting the range of weight loss was between 3.1kg to 6.3kg depended on individual and diet. Song and colleagues (2023) examined post prandial glucose response (PPGR) to four different carbohydrate meals. Dependent on the meal, the PPGR varied significantly between individuals(2). As such, it is inappropriate to assume that there is one dietary pattern appropriate for all individuals. Understanding the driving factors behind individual variation to specific foods and dietary patterns will allow us to tailor interventions to create optimal health outcomes for each individual. The aim of our study is to examine individual responses to different diets promoted for health. In our study, we investigated the biological diversity in response to the same dietary inputs among 23 participants at risk of type 2 diabetes and chronic disease over a two-week period. All participants completed four days on three dietary interventions (Mediterranean, Australian and low carbohydrate diets). Urine, serum, plasma, and faecal samples were collected, alongside the use of continuous glucose monitoring data, to explore the metabolic and glycaemic responses. Our findings reveal significant individual differences in blood glucose levels and metabolic outcomes. When examining fasting blood glucose levels, the low carbohydrate and Australian diets were optimal for 8 participants each, while the Mediterranean diet was optimal for 7 participants. However, this did not always correlate with post prandial blood glucose level optimisation. While blood, urine and faecal samples are yet to be analysed, these are expected to provide further understanding of individual biological responses. These results underscore the limitations of a universal dietary approach for optimising glycaemic control and highlight the necessity of personalised dietary recommendations that consider individual metabolic profiles. Our study provides crucial insights for future advances in precision nutrition, suggesting that personalised nutrition plans could lead to more effective management and prevention of T2D.

Identifying reliable blood pressure biomarkers is essential for understanding how dietary interventions might supported a reduction in hypertension. Metabolomics, which involves the analysis of small molecules in biological samples(1), offers a valuable tool for uncovering metabolic biomarkers linked to both dietary patterns and blood pressure, providing insights for more effective dietary strategies to manage or prevent hypertension. The aim was to evaluate associations between plasma and urinary metabolite concentrations with blood pressure measures (systolic blood pressure [SBP] and diastolic blood pressure [DBP]) in healthy Australian adults. This cross-sectional secondary analysis used baseline data from a randomised, cross-over feeding trial(2). Plasma and urinary metabolomic data were generated using Ultra-high Performance Liquid Chromatography-Tandem Mass Spectrometry (UHPLC-MS/MS) through Metabolon Inc.’s (Morrisville, USA) Global Discovery Panel. Blood pressure was assessed in clinic using the Uscom BP+ supra-systolic oscillometric central blood pressure device, with the cuff positioned on the upper arm at the strongest pulse signal location. Participants sat relaxed and comfortably for 5 minutes before their measurements were taken. They remained seated with legs uncrossed, feet flat on the floor, and were instructed to maintain even breathing throughout the tests. Blood pressure was measured with three consecutive readings taken from the supported left arm, with a 1-minute rest between each reading. The first reading was discarded, and the average of the remaining two was used as the final measurement. Metabolite concentrations were log-transformed. Associations among blood pressure measures and urinary or plasma metabolites were evaluated using linear regression models, adjusting for age and sex. A total of 34 healthy Australian adults (mean age 38.4 ± 18.1 years, 53% females) baseline data was included. After adjusting for multiple comparisons using the Benjamini-Hochberg procedure with a significance threshold of q < 0.2, a negative association between two urinary metabolites (gamma-glutamyl histidine and gamma-glutamyl phenylalanine) and DBP was identified. In addition, 32 plasma metabolites were associated with SBP with 18 showing a negative association, including 1,2-dilinoleoyl-GPC (18:2/18:2) and 1-linoleoyl-GPC (18:2), and 14 showing a positive association (beta-hydroxyisovalerate, 3-Hydroxyisobutyrate). Potential mechanisms based on existing research that might explain these associations include the role of gamma-glutamyl peptides in lowering DBP by reducing oxidative stress and improving endothelial function(3). In contrast, 3-hydroxybutyrate may elevate blood pressure due to metabolic disturbances linked to impaired branched-chain amino acid catabolism(4). Furthermore, 1,2-Dilinoleoyl-GPC and 1-linoleoyl-GPC, both contain linoleic acid, which could contribute to lowering systolic blood pressure (SBP) by mitigating vascular inflammation(5). Although some of these metabolites have been implicated in blood pressure regulation in prior research, others revealed new associations. These findings suggest potential candidate nutritional biomarkers for blood pressure, but further research is needed to confirm their reproducibility, and causal role in blood pressure regulation.

Climate change is a pressing global issue, with food systems contributing significantly to greenhouse gas (GHG) emissions, biodiversity loss, and freshwater depletion(1). A major challenge is to feed a projected 10 billion people by 2050 whilst minimising environmental impact(2). Numerous factors influence food choices, including convenience, affordability, taste, nutrition, accessibility, cooking skills, and cultural norms. The growing demand for convenience has transformed the food landscape, with availability of ready-to-eat meals and prepackaged products rapidly increasing, potentially impacting health if not integrated into balanced diets. The aim was to quantify and compare the environmental and financial impact of two diets: a heart-healthy Australian diet (HAD) aligned with national dietary guidelines and a typical Australian diet (TAD) reflecting current population intakes. Both plans were designed for convenience, using ready-to-eat meals and minimal preparation options for a randomised, cross-over, feeding trial. The environmental footprint of each dietary pattern was calculated using the Global Warming Potential (GWP*) metric(3), considering individual foods, multi-ingredient foods, and mixed dishes. Prices were obtained from a large Australian supermarket. The study focused on two-week meal plans designed to meet the nutritional needs of a reference 71-year-old male (9000 kJ). Results showed that the HAD produced 23.8% less CO2 equivalents (CO2-e) per day than the TAD (2.16 kg vs 2.83 kg CO2-e). Meat and discretionary foods were the main contributors to the TAD’s environmental footprint, while dairy and vegetables were the most significant contributors to the HAD’s footprint. The potential impact of widespread adoption of the HAD is substantial. For example, if half of the adult population switched to the HAD, it could lead to a reduction of approximately 2.6 billion kg of CO2 emissions annually, equivalent to the emissions of 1.2 million passenger cars per year(4), which would require over 256 million trees to offset the amount of CO2e produced(5). However, the HAD was 51% more expensive than the TAD, presenting a significant barrier to adoption. Strategies to reduce costs of convenient healthy food are needed. Future studies should expand the GWP* database and consider additional environmental dimensions to comprehensively assess the impact of dietary patterns. Current findings have implications for menu planning within feeding trials and for individuals seeking to reduce their carbon footprint while adhering to heart-healthy eating guidelines.

The world population is predicted to increase to ~10 billion by 2050 and the world hunger is nearly 10% of the world’s population.(1) The growing population underline the need for reliable alternative solutions to support future food security while decreasing the impact on global sustainability. Food industry has recently shown increasing interest in edible insects due to their high nutritional values and low environmental footprints.(2) Edible insects are currently consumed by some two billion people in over 130 countries and rearing them is more sustainable and economical compared to livestock farming. Edible insects such as black soldier fly larvae (BSFL) are highly efficient at converting low value food waste into valuable nutrient sources, making them a great solution to global food wastage problem.(2) BSFL show an immense potential as a viable alternative for protein and oil in food and feed. This study focused on exploring the nutritional composition of Australian grown BSFL and antioxidant and antimicrobial activities of BSFL chitin compared to commercial chitin. Australian grown dried BSFL was tested for the proximate composition and the sample was fractionated into oil, protein, and chitin fractions.(3) The chitin fraction was then evaluated for their DPPH radical scavenging activities and antimicrobial activities using well diffusion method.(4) All analyses were conducted in triplicates. The Tukey’s significant difference test was performed and p < 0.05 was regarded as significant. The results indicated protein (53.7 ± 0.15%), oil (34.7 ± 0.96%), and chitin (7.0 ± 0.15%) as three main usable fractions in BSFL. Protein was rich in essential amino acids including valine (6.0 ± 0.07%), leucine (5.4 ± 0.05%) and lysine (5.0 ± 0.16%). BSFL oil was observed with a healthy fatty acid profile and the most abundant fatty acid was lauric acid (42.0 ± 0.32%), a medium-chain fatty acid known for its biochemical, nutritional and health benefits. Chitin fraction, the remaining residue after fat and protein extraction showed strong antioxidant activities (82.0 ± 0.71%) compared to commercial shrimp chitin (75 ± 0.68%) at the concentration of 50 mg/mL (p < 0.05). Additionally, BSFL chitin was observed with higher microbial inhibition zones against Escherichia coli (7.0 ± 0.19 mm) and Staphylococcus aureus (9.0 ± 0.12 mm) compared to antimicrobial activities of commercial shrimp chitin against E. coli (5.0 ± 0.03 mm) and S. aureus (6.0 ± 0.32 mm) (p < 0.05). These outcomes underscore the potential of BSFL as a source of healthy fatty acids, essential amino acids, and bioactive compounds such as lauric acid and chitin.

Emerging research has highlighted a relationship between diet and genetics, suggesting that individuals may benefit more from personalised dietary recommendations based on their genetic risk for cardiovascular disease (CVD)(1,2). This current study aims to: (1) Measure knowledge of genetics among healthcare professionals (HCPs) working in CVD, (2) Identify HCPs’ attitudes to using genetic risk to tailor dietary interventions, and (3) Identify perceived barriers and enablers to implementing genetics to tailor dietary interventions. In a mixed-methods study, Australian HCPs (dietitians and AHPRA registered healthcare professionals) working with people with CVD were invited to complete an anonymous online survey (REDCap) and an optional interview. Recruitment occurred through social media and relevant professional organisations. Survey questions were underpinned by the theoretical domains framework(3) and data was synthesised descriptively. Semi-structured interviews were undertaken via Zoom. Interview responses were analysed using a thematic analysis approach using Braun & Clarke methodology(4). Survey responders (n = 63, 89% female, mean age 42 ± 14 years) were primarily dietitians (83%), with ≥ 10 years of experience (56%) and spent at least 20% of their time working with people with CVD (n = 55, 87%). Approximately half of respondents were aware that genetic testing for CVD exists (n = 36) and always assess family history of CVD (n = 31). Few respondents reported using genetic testing (n = 5, 8%) or felt confident interpreting and using genetic testing (n = 7, 11%) in practice. Respondents were interested in incorporating genetics into their practice to tailor dietary advice (n = 44, 70%). Primary barriers to using genetic testing included financial costs to patients and negative implications for some patients. Almost all respondents agreed genetic testing will allow for more targeted and personalised approaches for prevention and management of CVD (94%). From the interviews (n = 15, 87% female, 43 ± 17 years, 87% dietitian), three themes were identified: (1) ‘On the periphery of care’—HCPs are aware of the role of genetics in health and are interested in knowing more, but it is not yet part of usual practice; (2) ‘A piece of the puzzle’—using genetic testing could be a tool to help personalise, prioritise and motivate participants; and (3) ‘Whose role is it?’—There is uncertainty regarding HCP roles and knowing exactly whose role it is to educate patients. Healthcare professionals are interested in using genetics to tailor dietary advice for CVD, but potential implications for patients need to be considered. Upskilling is required to increase their knowledge and confidence in this area. Further clarity regarding HCP roles in patient education is needed before this can be implemented in practice.

Heathy eating recommendations are shifting to incorporate environmentally sustainable eating principles. It is crucial to understand whether children’s dietary intakes align with global sustainable diet recommendations such as the EAT-Lancet Planetary Health Diet (PHD)(1), in addition to national health-promoting guidelines, such as the Australian Dietary Guidelines (ADG)(2). This study aimed to assess the alignment of young Australian children’s food intakes with these recommendations. 24-hour dietary recall data from the 2011–2012 National Nutrition and Physical Activity Survey (NNPAS)(3) for children aged 2–8 years were used. Usual energy intakes were calculated separately for two age groups (2–3 and 4–8 years) using PC-Side software version 1.0. The target amounts for the PHD food groups were calculated for both age groups by proportionally adjusting the PHD target amounts for adults based on children’s estimated usual energy intake. The mean intake of each food group (g/day) was then compared with energy-adjusted target amounts of the PHD and ADG Foundation Diets. The mean intake of each food group (g/day) was determined through one 24-hour dietary recall. Survey weights were incorporated into the statistical analysis to calculate nationally representative estimates of dietary intake. For both age groups (2–3 years: n = 463; 4–8 years: n = 776), the daily mean consumption of wholegrains, starchy vegetables, other vegetables, eggs, fish, legumes, nuts, and unsaturated oils was below the PHD targets, while the consumption of red meat, dairy products, poultry, and added sugars was above the targets. The ADG Foundation Diets trends were similar to the PHD for whole grains, vegetables, nuts, and legumes in both age groups. However, there were discrepancies in intakes meeting the ADG targets and PDH targets, with the daily mean consumption of dairy products, red meat, and other meat and alternatives below the ADG targets and the mean consumption of dairy, red meat, and poultry above the PHD targets. By focusing health promotion efforts on food groups such as wholegrains, legumes, and nuts and seeds, there are aligned benefits for both environmental sustainability and child health. Additionally, this comparison highlights the need to address the overconsumption of discretionary foods and beverages to improve both child health and environmental health. Investigating parents’ perceptions of sustainable diets, including their motivators and barriers, will be an important next step to understanding how child intakes of legumes, nuts, wholegrains, vegetables, and fish can be improved.

Human milk oligosaccharides (HMOs), which account for the third largest component of human milk, transit to the large intestine where they are fermented by gastrointestinal microbiota, or excreted unchanged(1). Recent advances in gene technology utilising microbial fermentation have allowed for the manufacture of human-identical milk oligosaccharides (HiMOs), which are chemically and structurally identical to the naturally occurring form. The HiMOs that have been manufactured are 2′-fucosyllactose (2′-FL), lacto-N-neotetraose, difucosyllactose, lacto-N-tetraose, 6′-sialyllactose and 3′-siallyllactose. The naturally occurring versions of these represent the most abundant in human milk, with 2′-FL identified in the greatest amounts(2). A pre-market assessment by Food Standards Australia New Zealand (FSANZ) of these substances is required prior to inclusion in infant formula products. The assessment aimed to examine the safety and health effects of the addition of HiMOs to infant formula in Australia and New Zealand in place of currently permitted non-human identical oligosaccharides. Multidisciplinary teams assessed applications (n = 7) to permit six HiMOs in infant formula. Specifically, the safety assessment included the genetically modified microbiological matter for production, the adverse effects of consumption, and any impacts on infant growth. The health effects assessment identified the benefit of HiMO consumption for infants. Risk analysis was used to assess in vitro, ex vivo, animal and human studies, and to consider relevant Ministerial Policy Guidelines. No public health and safety risks were identified for the addition of HiMOs to infant formula, including when the substances are added cumulatively at the requested amounts. No safety concerns were identified for the gene donors or microbial sources for any of the manufactured HiMOs. No adverse effects to recipients that consumed HiMOs were identified in both clinical and laboratory settings, with a no observed adverse effect level of 2′-FL observed at 7500 mg/kg. No difference in growth outcomes was observed between infants who consumed formula with or without HiMO supplementation (p < 0.05), with no clinical significance observed (±3 g/day). Two substantiated health benefits for HMOs were identified; the promotion of a bifidogenic effect (reported in n = 39 studies), and limiting infection by pathogens including Campylobacter jejuni (reported in n = 25 studies). The development of a microbiota profile closer to that of breastfed infants is supported by the inclusion of a wider range of HiMOs in infant formula products. Based on these results, FSANZ permits the voluntary addition of six HiMOs to infant formula to create products that better reflect the oligosaccharide profile of human milk to support the normal growth and development of infants. Assessments of applications to expand these permissions are ongoing. This suggests that based on innovation and economies of scale, HiMOs could one day replace the previously used non-digestible oligosaccharides in infant formula products.

Growing population sizes, increasing demand for nutritious foods, biodiversity impacts of farming, and climatic pressures have put the global food system under increasing pressure.(1) Significant issues are evidenced by social equity and food access inequality, with over 800 million people food insecure at one extreme, more than one billion people suffering from overnutrition and obesity,(2) and many more consuming low-quality diets that cause micronutrient deficiencies and contribute to a substantial rise in the incidence of diet-related obesity and non-communicable diseases. Sustainable, resilient food systems for healthy diets, the defining issue for public health nutrition,(1) have been identified as the first of the six pillars for action by the UN Decade of Action on Nutrition.(3) Novel solutions for future food security and sustainability, including possible approaches of consuming more plant-based foods, without compromising food safety are needed to achieve the UN Sustainable Development Goals. The Food Plants International (FPI) project focused on Zimbabwean women in nutrition education/knowledge, health promotion and helping stay-at-home mothers and women to be engaged in community gardening, soil build-up (compost, mulching, keeping stems of maize and not burning them), food plants gardening skills, and growing local and traditional foods plants, mainly Okra (derere), Rapoko grass, Sorghum, Maize and Finger Millet. 112 participants from 25 diverse communities in different locations were trained in the FPI agroecology and traditional food workshops. Communities in these locations received FPI training materials (posters/books), planted traditional food plants, learned how to cook them, and encouraged to consume these nutritious traditional foods, fresh vegetables, and more plant-based foods. These foods have great beneficial nutrient effects including carbohydrates, calories, plant-based proteins, dietary fiber, vitamins C, K1, A and D, minerals, antioxidants, zinc, calcium, magnesium, iron, and phosphorus among others, which may help support healthy pregnancy, heart health, blood sugar, and even anticancer properties. We have been able to promote nutrition/health education and knowledge among local women to identify different species of food plants, how to plant them, soil build-up methods, compost generation and usage, how to cook traditional foods for effective and beneficial absorption of nutrients, and encouraging their consumption, which in the long term helps food safety, fights food insecurity, unemployment, maternal, infant, and young child anaemia, and maximizes resources to achieve sustainability. Feeding 10 billion people in 2050 sustainably requires changes in whole food chains; changing our food demand to more plant-based diets could help.(1) Intensifying the harvest of vegetable crops to double the output with the same footprint will support sustainable intensification and source reduction.(4) Economic, social, and environmental bases to generate and not compromise food security for our future generations need to be ensured.(5)

Interest in the consumption of food containing live microbes (LM) as a component of dietary patterns has accelerated, due to potential positive contributions to health and chronic disease risk, including cardiovascular disease (CVD)(1,2). There are different patterns of LM consumption, including through the intake of probiotics or fermented foods or via a broader spectrum of foods that may harbour microbes, such as raw, unpeeled fruits and vegetables(3). To date, no study has quantitatively assessed potential intake of LM in a sample of Australians. The aim was to quantify presence of LM for common foods and beverages consumed in Australia, using the Australian Eating Survey® (AES) and AES-Heart®(4,5 food frequency questionnaires as the dietary assessment tool. Quantification of potential live microbial content (per gram) was conducted in accordance with the methodology outlined by Marco et al.(3). Briefly, foods were assigned to categories with LM ranges defined as low (Low; < 104 CFU/g), medium (Medium; 104–107 CFU/g), or high (High; > 107 CFU/g) for level of live microbes(3). These categories were based on the expected prevalence of viable microorganisms within different food matrices. Specifically, pasteurised food products are characterised as having microbial concentrations Low < 104 CFU/g. In contrast, fresh fruits and vegetables, consumed unpeeled exhibit a microbial range considered medium (Medium; 104–107 CFU/g), while unpasteurised fermented foods and probiotic supplemented foods exhibit significantly higher microbial content (High > 107 CFU/g). Based on this methodology, the estimated quantities of live microbes in 400 foods and beverages (including individual products and mixed dishes) within the AES and AES-Heart®(4,5 FFQs were determined and summarised across 22 food groups using the 2-digit codes from the 2011–2013 AUSNUT database(6). Preliminary results indicate the Low group was the most represented, out of the 400 foods 369 belong to this category. The food groups that represent the highest percentages in the Low group were vegetable products and dishes (13.8%) followed by meat, poultry, and game products and dishes (13.6%). The Medium group was composed by 25 items, with the most representative food groups being fruit products and dishes (48%). In the High group, the representative food groups were dairy and meat substitutes (e.g., soy yoghurt; 66.7%) and milk products and dishes (33.3%). The creation of this database will facilitates new research opportunities to investigate relationships between intake of live microbes and health outcomes, including CVD. Future research into how dietary pattern rich in live microbes related to chronic disease risk factors, such as reduced BMI, blood pressure, plasma lipids and glucose, in the Australian population could offer new insights into risk factor management through LM dietary interventions.

The aim was to assess food security on Stuart’s sixth expedition to the north (20 December 1861 to 10 December 1862), when he succeeded in crossing the continent from Adelaide to Van Diemen Gulf and returned without loss of life. Contemporary methods were applied to the evidence available for the expedition food supply in published reports(1). These included qualitative assessment of dietary food group diversity and food variety. These measures have been used as a proxy for the level of food security provided by the rations over the duration of the expedition. The food rations were also subjected to nutrient analysis and the results compared to recommended dietary intakes for explorers who had a high physical activity level. Observations of the edible wild flora and fauna observed along the route were collated and assessed. Weekly food ration packs were taken (7 lb flour, 2 lb meat-dried, 1 lb sugar, ¼ lb tea) and found to be very poor in both dietary diversity of food groups (excluding dairy, fruit, vegetable) and the variety of food items. The packs were low in energy, high in protein, low in riboflavin and probably other micronutrients. Vitamins A (retinol) and C were completely absent. The Naturalist on the expedition (FG Waterhouse) was the only man authorised to shoot (for the Adelaide Museum collection) and, after processing, the remaining tissues were added to the cooking pot, which increased food variety more than food group diversity. The men (10) were travelling rapidly with a large group of horses. The gathering of edible wild foods was intermittent, determined by their availability according to latitude and seasonal conditions. The men could not supplement their inadequate food rations by hunting and gathering enough edible foods. On one of his earlier and less successful expeditions (to achieve the same aim), Stuart wrote that he was aware that five pounds of flour per man per week was not enough, but he soon reduced (day 35) the weekly rations per man to 4 lb flour, 1 lb meat-dried, 1 lb sugar and ¼ lb tea. The men suffered from food insecurity and its health consequences for the entire duration of the expedition (day 356). They were perpetually hungry and became gaunt shadows of their former selves. Stuart himself suffered from night blindness (Vitamin A deficiency) and grievous scurvy (Vitamin C deficiency). Stuart achieved his aim to cross the continent against the great odds of food insecurity. He knew better but chose to ignore it, creating great danger for himself and his companions.

Dietary fat type has been suggested as a risk factor for development of multiple sclerosis (MS)(1); however, the evidence is inconclusive. We aimed to test associations between dietary patterns correlated with intake of saturated fat (SFA), polyunsaturated fat (PUFA), monounsaturated fat (MUFA), along with the Dietary Approaches to Stop Hypertension (DASH) score, and risk of a first clinical diagnosis of central nervous system demyelination (FCD), a common precursor to the diagnosis of MS. We used data from the Ausimmune Study, a multicentre Australian case-control study of people with an FCD, aged 18–59 years. Using dietary intake data from a 101-item food frequency questionnaire(2), dietary patterns characterised by fat type (DP1; DP2) were generated through reduced rank regression with SFA, PUFA and MUFA as response variables. DASH scores were calculated. Logistic regression with full propensity score matching (matched on age, sex, study region, education, smoking history, history of infectious mononucleosis, deseasonalised serum 25-hydroxyvitamin D concentration, total energy intake, dietary misreporting) was used to test associations between dietary patterns (DP1, DP2, DASH) and FCD (cases = 259, controls = 497). Interactions between dietary exposures and sex were explored. DP1 was positively correlated with all fats and was characterised by high positive factor loadings for whole milk, processed red meat, and high-fat cheese, and high negative factor loadings for skimmed milk and fruits. DP2 was negatively correlated with SFA, but positively correlated with PUFA and MUFA, and was characterised by high positive factor loadings for margarine, nuts, and wholemeal bread, and high negative factor loadings for butter, whole milk, and sugar, preserves and confectionary. There were no associations between DP1, DP2 or DASH with FCD. These dietary patterns, characterised by fat type, showed no association with risk of FCD. To generate robust evidence on the role of dietary fat in MS onset, dietary patterns characterised by fat type could be explored in other population groups.

Dietary nitrate is a precursor to nitric oxide, for which plausible mechanisms exist for both beneficial and detrimental influences in multiple sclerosis (MS)(1,2). Whether dietary nitrate has any role in MS onset is unclear. We aimed to test associations between nitrate intake from food sources (plant, vegetable, animal, processed meat, and unprocessed meat) and likelihood of a first clinical diagnosis of central nervous system demyelination (FCD). We used data from the Ausimmune Study (264 cases, 474 controls). Case participants (aged 19–59 years) presenting to medical professionals in four latitudinally different regions of Australia were referred to the study with an FCD. The Australian Electoral Roll was used to recruit one to four controls per case, matched by age (± 2 years), sex and study region. Habitual dietary intake representing the 12-month period preceding the study interview was assessed to determine dietary nitrate intake. In addition to matching variables, data on education, smoking history, and history of infectious mononucleosis, weight and height were collected. A blood sample was taken for measurement of serum 25-hydroxyvitamin D concentration, which was de-seasonalised. To test associations, we used logistic regression with full propensity score matching. We used two levels of covariate matching: in model 1, cases and controls were matched on the original matching variables (age, sex, and study region); in model 2, cases and controls were additionally matched on well-established/potential risk factors for MS (education, smoking history, and history of infectious mononucleosis) and dietary factors (total energy intake and dietary misreporting). In females only (n = 573; 368 controls and 205 cases), higher nitrate intake (per 60 mg/day) from plant-based foods (fully adjusted odds ratio [aOR] = 0.50, 95% CI, 0.31, 0.81, p < 0.01) or vegetables (aOR = 0.44, 95% CI, 0.27, 0.73, p < 0.01) was statistically significantly associated with lower likelihood of FCD. No association was found between nitrate intake (any sources) and likelihood of FCD in males. To our knowledge, this is the first study to investigate dietary nitrate intake in relation to FCD. Our result that higher intake of nitrate from plant-based foods (mainly vegetables) was associated with lower likelihood of FCD in females supports our previous findings showing that following a Mediterranean diet (rich in vegetables) associates with lower likelihood of FCD(3). The lack of association in males may be due to low statistical power and/or differing food preferences and pathological processes among males and females. Our results support further research to delineate the independent effect of nitrates form other dietary factors and explore a possible beneficial role for plant-derived nitrate in people at high risk of MS.

Excess sodium consumption, mostly from dietary salt, causes high blood pressure and an increased risk of cardiovascular disease(1). In parallel, insufficient potassium intake also contributes to raised blood pressure(2). Switching regular salt for potassium-enriched salt, where a proportion of the sodium chloride is replaced with potassium chloride, is a promising public health intervention to address both these issues(3). However, the supply chain to support increased use of potassium-enriched salt in Australia is not well understood. The objectives of this study were to investigate how the salt supply chain operates in Australia and to obtain food industry stakeholder perspectives on the technical barriers and enablers to increased potassium-enriched salt use. Twelve interviews with industry stakeholders (from food companies, salt manufacturers and trade associations) were conducted and thematically analysed using a template analysis method. Two top-level themes were developed: ‘supply chain practices’ and ‘technical barriers and enablers’. The potassium-enriched salt supply chain was described as less well-established than the low-cost production and distribution of regular salt in Australia. However, food companies reported not having difficulty sourcing potassium chloride. For Australian food industry stakeholders, cost, flavour and functionality were perceived as key barriers to increased uptake of potassium-enriched salt as a food ingredient. Stakeholders from food companies were hesitant to use potassium-enriched salt due to concerns about bitter or metallic flavours and uncertainty whether it would provide the same microbial/shelf-life functions or textural quality as regular salt. However, potassium-enriched salt manufacturers had divergent opinions stating potassium-enriched salt was a suitable functional replacement for regular salt and that flavour differences observed may be due to the incorrect use of potassium chloride as opposed to use of a purpose-made potassium-enriched salt. Stakeholders identified that establishing a stable and affordable supply of potassium-enriched salt in Australia and increased support for food technology research and development would enable increased use. To improve uptake of potassium-enriched salt by the Australian food industry, future efforts should focus on strengthening potassium-enriched salt supply chains and improving appeal for food industry to use in manufacturing and for consumers to purchase. Public health advocacy efforts should ensure that industry is equipped with the latest evidence on the feasibility and benefits of using potassium-enriched salt as an ingredient. Ongoing engagement is critical to ensure that industry is aware of their responsibility and opportunity to offer healthier foods to consumers by switching regular salt to potassium-enriched salt within foods.

Fatigue is a prevalent symptom in people with multiple sclerosis (MS), significantly impacting quality of life and daily functioning(1). The Mediterranean diet, with its anti-inflammatory and neuroprotective properties, may help to alleviate fatigue(2). However, existing evidence linking the Mediterranean diet to fatigue in people with MS is primarily cross-sectional, providing limited insights into long-term effects(3). This study aimed to prospectively test associations between the alternate Mediterranean diet score (aMED) and fatigue using data from the United Kingdom (UK) Multiple Sclerosis Register. Dietary intake was measured in 2016 (n = 2,455) and 2022 (n = 3,740) using the EPIC-Norfolk 130-item Food Frequency Questionnaire. A total of 879 participants provided dietary intake data at both timepoints. aMED is a score ranging from 0 to 9, with higher scores indicating greater adherence to a Mediterranean diet (higher consumption of vegetables, fruit, nuts, legumes, whole-grains, fish; greater monounsaturated-to-saturated fat ratio; lower consumption of red meat; moderate consumption of alcohol). Fatigue was measured using the Fatigue Severity Scale (FSS), a 9-item questionnaire that evaluates the extent to which fatigue interferes with daily activities, with scores ranging from 1 to 7. Additionally, fatigue levels were categorised as either ‘high’ (FSS score: ≥ 5) or ‘low’ (FSS score: < 5). The association between aMED and fatigue over six years (from 2016 to 2022) was assessed using generalized mixed-effects models for the continuous FSS score, while mixed-effects logistic regression models were employed to examine the association between aMED and binary FSS categories (high/low). The models were adjusted for age, sex, MS type (benign, relapse-remitting, secondary progressive, primary progressive, unknown), and total energy intake (kcal/day). Analysis was restricted to those participating at both timepoints and who had complete data on diet, covariates, and FSS (n = 379). The study population consisted of 71.5% females, with a mean age of 55.0 years (standard deviation, 9.9). Higher aMED scores (one-unit increase) were significantly associated with lower FSS scores (adjusted β = -0.08; 95% CI: -0.14, -0.03; p = 0.004) and with 17% lower odds of having high fatigue (FSS > 5), with an adjusted odds ratio of 0.83 (95% CI: 0.71, 0.98; p = 0.029). These findings suggest that adherence to a Mediterranean diet may play a protective role in reducing fatigue severity in people with MS over a 6-year period. Further research could explore associations between a Mediterranean diet and other MS related outcomes in this study population.

Choline is an essential nutrient required in increased amounts during periods of rapid growth such as pregnancy and early life(1). It is a precursor for acetylcholine synthesis, a key neurotransmitter involved in muscle coordination and memory, and betaine, a major methyl donor. Choline is also a component of phosphatidylcholine, a phospholipid that makes up to 50% of neural tissue, most of which is accrued in late pregnancy and early life. Choline can be synthesised in the liver; however, de novo synthesis is not sufficient to meet needs and exogenous choline must come from diet. Australia’s National Health and Medical Research Council (NHMRC) has established Adequate Intakes (AI) for choline. During pregnancy and lactation, the AI for choline is set at 440 and 550 mg/d. For young children 0–3 years of age, the AI is set at 125–200 mg/day. We and others have shown that pregnant and lactating Australian women have low choline intakes with few exceeding their AI (1–40%). There are no data on the choline intakes of children under 2 years. In 2021, we published the first ever Australia-wide study on nutrient intakes in children under two years, and, in 2024, updated it to include choline. Using a 24-hour food record with repeats in a subsample of the population (~30%), we estimated usual choline intake distributions and its dietary sources in n = 761 children 6–24 months. Average choline intakes for infants 6–12 months and toddlers 12–24 months were 142 ± 1.9 and 181 ± 1.2 mg/day, respectively. Only one third of infants and one quarter of toddlers exceeded their respective AIs of 125 and 200 mg/day. Breastfeeding rates were high with 78% of infants and 44% of toddlers still receiving breastmilk. In both groups, breastmilk was the leading source of choline contributing 56% and 32% among consumers(2). Animal-source foods (meat, chicken, fish, and eggs) rich in choline and other essential nutrients were consumed by less than one third of children and in small amounts. Given choline’s role in neurodevelopment, the low intakes observed in pregnant and lactating women and young children suggest dietary intakes may need improvement. Moreover, the impact of low choline intake on neurodevelopmental outcomes remains unknown and warrants further investigation.

Cognitive function is pivotal for athletic success, encompassing decision-making processes, concentration, and overall performance. Sports beverages include carbohydrates for energy and sodium to enhance rehydration(1). Research has suggested they offer numerous advantages for mental function during exercise(2). The intensity of exercise also has a significant impact on an athletes cognitive ability. High-intensity exercise gradually enhances arousal to an optimal level, shifting from a state of rest to high-alert, consequently leading to improved cognitive performance, confirmed by measurement via an electroencephalogram(3). This aim of this study was to examine the acute effect of a beverage containing carbohydrate and sodium on cognitive performance, including interference control, response inhibition, working memory and cognitive flexibility, following moderate-intensity continuous exercise (MICE) or high-intensity interval exercise (HIIE). Healthy experienced recreational runners were recruited. Baseline data was collected before the first trial. Participants (n = 11) underwent four trials in a randomised crossover design. A combination of 8 KM MICE running (64–76% of maximum heart rate) and 8 KM HIIE running (77–93% of maximum heart rate) were completed, while ingesting either SB (carbohydrate: 6.2%, sodium: 21 mEq/L) or plain water (W); average intake: 308 ± 188 ml. Computer-based cognitive performance tests (Simon task, Go and No-Go task, N-Back task & Stroop task) were conducted after the completion of each exercise session, where response time and accuracy were measured. Paired T-tests were used to determine where the differences existed within the treatments and vs the baseline. A significant impairment of Simon effect was seen in MICE+SB and HIIE+SB compared to baseline (p = 0.022, p = 0.005). Response time in congruent stimuli was significantly improved in HIIE+SB compared to baseline and to MICE+SB (p = 0.008, p = 0.021). Response time in incongruent stimuli was significantly improved in HIIE compared with MICE in both SB and W ingestion (p = 0.001, p = 0.042) and significantly impaired in MICE+SB compared with baseline (p < 0.001). In the Go and No-Go task, no significant differences were observed in response inhibition. In the N-Back task, working memory response time was significantly improved in MICE+SB compared with baseline (p = 0.019). Response time in the Stroop task in incongruent stimuli was significantly improved in MICE+SB and HIIE+W compared to baseline (p = 0.039, p = 0.047). In conclusion, beverages containing carbohydrate and sodium were found to generally improve cognitive performance. In addition, HIIE can be considered a practical approach to improve acute cognitive performance. However, further studies are required to more accurately investigate the optimal combination of exercise intensity and beverage carbohydrate concentration required to maximise cognitive performance.

Risks associated with sub-optimal dietary intake are one of the leading factors contributing to mortality and morbidity worldwide(1). Regular and comprehensive data on the intakes of individuals play a key role in informing the development of public health nutrition policy and programs. In low- and lower-middle-income countries (LLMICs), proxy measures of individual intake, such as food balance sheets, are often used. To-date there has been limited application of technology-assisted dietary assessment methods due to resource constraints(2). This study reports on the relative validity of the Voice-Image Solution for Individual Dietary Assessment (VISIDA) system in a sample of Cambodian women and children. The VISIDA system is a dietary assessment system developed specifically for LLMICs. Intake data is collected in the form of image-voice food records (via a smartphone app) where images and voice recordings of food for consumption are collected prior to eating along with any leftovers at the end of the meal. The image-voice food records are then uploaded to the VISIDA web application and processed by trained analysts to produce estimates of individual nutrient intake. Mothers and one of their children (aged ≤ 5 years) from Siem Reap province, Cambodia were recruited. Intake data was collected for each participant using two dietary assessment methods over three recording periods. The mother used the VISIDA image-voice smartphone app to collect intake data on three days for herself and her child in week 1, with this repeated in week 4. In between VISIDA recording periods, intake data was collected on the mother and her child using interviewer-administered 24-hour recalls collected on three days. A linear mixed model approach was used to evaluate differences between the estimated nutrient intakes for the recording periods for mothers and children. The nutrient intakes for a total of 119 mothers and 91 children were included in the analysis. For both mothers and children, intakes for the majority of nutrients were higher from the 24-hour recalls than intakes reported using the VISIDA system. When 24-hour recall intakes were compared to each VISIDA recording period, mothers had a higher number of nutrients with differences that were statistically significantly than children. In general, the VISIDA system produced lower estimates of nutrient intakes for Cambodian mothers and children when compared to intakes from 24-hour recalls. Further evaluations of the VISIDA system in other LLMICs would provide additional insights into the performance of this method for assessing individual dietary intakes in this context.

Observational studies suggest higher intake of cruciferous vegetables (e.g., broccoli, cauliflower, kale) is associated with lower chronic disease risk(1,2). Glucosinolates (GSL) and cysteine sulfoxides such as S-methyl cysteine sulfoxide (SMCSO) are sulfur-containing compounds found in high amounts in these vegetables(3). Currently, no data exists on SMCSO levels in Australian-grown cruciferous vegetables and limited data exists for glucosinolates (GSL). The levels of SMCSO retained in cruciferous vegetables after various domestic cooking methods is unknown, and measurement of SMCSO and GSL levels in cooked Australian-grown cruciferous vegetables is limited. This study sought to (1) quantify SMCSO and GSL in Australian-grown cruciferous vegetables and (2) identify the most preferable cooking methods to retain levels in these vegetables. Using liquid chromatography mass spectrometry, we quantified SMCSO and ten GSL in seven cruciferous vegetables before and after steaming. We further quantified levels in broccoli before and after microwaving, stir-frying, and boiling. Each cooking method; steaming (3 minutes), microwaving (2 minutes), boiling (3 minutes), stir-frying (4 minutes); was chosen so vegetables remained firm and not overcooked to mimic healthy cooking recommendations(4). Student t-tests were used to compare the differences in raw and steamed levels for all vegetables, and analysis of variance with Tukey post-hoc assessed the differences in raw and cooked broccoli (i.e., steamed, microwaved, boiled, stir-fried). Overall, SMCSO contributed greater dry weight (0.6–1.9%) than total GSL combined (0.3–1.2%). SMCSO levels from lowest to highest were Chinese cabbage < white cabbage < cauliflower < kale < red cabbage < broccoli < Brussels sprouts (6–19 mg/g dry weight [DW]) and GSL levels were cauliflower < Chinese cabbage < red cabbage < kale < broccoli < white cabbage < Brussels sprouts (3–12 mg/g DW). SMCSO increased after steaming (1–24%) in all vegetables except white cabbage (−31%), kale (−18%), and Chinese cabbage (−5%), but only reached statistical significance in Brussels sprouts (+16%, p < 0.05). Most vegetables increased total GSL (ranging 1–34%) after steaming, except kale (−38%) and Chinese cabbage (−8%). Stir-frying and boiling broccoli led to significant losses in SMCSO (−34% and −50%, respectively) and in the two dominant GSL in broccoli; glucoraphanin (−47% and −52%, respectively) and glucobrassicin (−46% and –51%, respectively) (all p < 0.05). We have quantified SMCSO and GSL levels in a selection of Australian-grown cruciferous vegetables (broccoli, kale, Brussels sprouts, cauliflower, red, white, and Chinese cabbages) before and after cooking. SMCSO and GSL levels were relatively stable after light steaming. Additionally, light steaming or microwaving were the most preferable methods to retain SMCSO and GSL levels in broccoli. Boiling or stir-frying broccoli were the least favourable. These results have important implications when estimating intake of these beneficial sulfur-containing compounds.