Nutritional requirements of individuals vary across the lifecycle, according to activity, age and gender. To optimize human health, consideration of nutritional priorities at each stage is needed. This conference brought together multidisciplinary experts in maternal and child nutrition and health, cardiometabolic and plant-based nutrition and dietitians involved in the care of vulnerable populations, plus nutritional metabolism, health and ageing. The presentations highlighted the most important nutrition research in these areas, updating knowledge and suggesting how dietary advice and policy could be adapted to incorporate research findings. With the global increase in non-communicable disease (NCD) and nutrition being considered as a key modifiable risk factor for the prevention and management of NCD, this conference was much needed.

Chinese immigrants living in Western countries are at a higher risk of developing chronic diseases compared to those in China, due to the development of unhealthy dietary patterns during the process of acculturation(1). Australia, with 2.3% of its population being Chinese-born(2), serves as a representative country to explore Chinese immigrants’ food choice determinants. Food choice determinants have been widely researched, with numerous factors identified such as affordability, taste preferences and hunger/satiety. Contento (2018) developed a comprehensive framework which identified and categorised over 30 determinants into four socio-ecological groups(3). Therefore, the focus of current research is not the identification of food choice determinants but to explore the interactions among these determinants. Understanding the cultural influence on food choice is vital for target groups with a shared ethnic background. This study aimed to qualitatively explore the similarities and differences in food choice determinants between Chinese people in mainland China and those living in Australia. Ethical approval for this study was obtained from Monash University Human Research Ethics Committee. Eighteen participants were recruited for semi structured in-depth interviews from June 2021 to March 2022, with eight from Australia and ten from mainland China. Convenience and snowball sampling methods were employed to ensure a diverse sample regarding socio-economic background, occupation, health status, age, and education level. Interviews were conducted in Mandarin via in-person or video/voice calls and were audio-recorded and transcribed verbatim. Thematic analysis and investigator triangulation were used for data analysis. Four themes were identified. (a) Food choice determinants were influenced by nutrition perceptions and personal food philosophy. Chinese Australian immigrants were influenced by Western nutrition beliefs to a greater extent than their counterparts living in mainland China. Non-scientific or controversial nutrition beliefs were common. Personal food philosophy (e.g., eating food is for survival only, or for enjoyment, or for health) profoundly influences food choices. (b) Chinese people adjusted their dietary habits in response to clinical symptoms or self-observed physiological changes, such as, gaining weight or digestive issues. (c) Convenience was a predominant food choice determinant due to factors like long working hours, lack of motivation to cook, lack of cooking skills, time restrictions, and viewing cooking as a chore. (d) Different food environments in China and Australia lead to distinctive food choices. Chinese Australians were more price-sensitive, had more food safety concerns, and cooked more frequently at home than mainland Chinese, due to differences in food affordability, accessibility and information exposure between these two countries. Importantly, nostalgia for childhood foods had a unique influence on certain food choice behaviours in Chinese Australians. These cultural characteristics in food choice determinants should be considered by health educators, nutrition professionals, and policymakers when developing culturally appropriate health interventions for Chinese people.

Vegan and vegetarian dietary patterns are known to beneficially modulate risk factors for cardiovascular disease; however, the current literature does not differentiate between various plant-based diets(1). This study aimed to examine the association between various plant-based diets and plasma lipids and glycaemic indices compared to a regular meat-eating diet. A cross-sectional study of Australian adults (n = 230) aged 30–75yrs habitually consuming the following were recruited: vegan, lacto-vegetarian, pesco-vegetarian, semi-vegetarian, or regular meat-eater. Multivariable regression analyses was used to adjust for covariates. Compared to regular meat-eaters, vegans had significantly lower total cholesterol (−0.77 mmol/L, 95% CI −1.15, −0.39, p < 0.001), low-density lipoprotein cholesterol (LDL-C, −0.71 mmol/L, 95% CI −1.05, −0.38, p < 0.001), non-high-density lipoprotein cholesterol (non-HDL-C, −0.75 mmol/L, 95% CI −1.11, −0.39, p < 0.001), total cholesterol/HDL-C-ratio (−0.49 mmol/L, 95% CI −0.87, −0.11, p = 0.012), fasting blood glucose (FBG, −0.29 mmol/L, 95% CI −0.53, −0.06, p = 0.014), haemoglobin A1C (−1.85 mmol/mol, 95% CI −3.00, −0.71, p = 0.002) and insulin (−1.76 mU/L, 95% CI −3.26, −0.26, p = 0.021) concentrations. Semi-vegetarians had significantly lower LDL-C (−0.41 mmol/L, 95% CI −0.74, −0.08, p = 0.041) and non-HDL-C (−0.40 mmol/L, 95% CI −0.76, −0.05, p = 0.026) and lacto-ovo vegetarians had significantly lower FBG (−0.34 mmol/L, 95% CI −0.56, −0.11, p = 0.003) compared to regular meat-eaters. There were no differences in HDL-C and triglycerides between plant-based and regular-meat diets. Plasma lipaemic and glycaemic measures as a collective were more favourable among vegans, whereas among lacto-ovo vegetarians and semi-vegetarians, only some measures were favourable.

This review will provide an overview of the immune system and then describe the effects of frailty, obesity, specific micronutrients and the gut microbiota on immunity and susceptibility to infection including data from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic where relevant. A key role for the immune system is providing host defence against pathogens. Impaired immunity predisposes to infections and to more severe infections and weakens the response to vaccination. A range of nutrients, including many micronutrients, play important roles in supporting the immune system to function. The immune system can decline in later life and this is exaggerated by frailty. The immune system is also weakened with obesity, generalised undernutrition and micronutrient deficiencies, which all result in increased susceptibility to infection. Findings obtained during the SARS-CoV-2 pandemic support what was already known about the effects of ageing, frailty and obesity on immunity and susceptibility to infection. Observational studies conducted during the pandemic also support previous findings that multiple micronutrients including vitamins C, D and E, zinc and selenium and long-chain n-3 fatty acids are important for immune health, but whether these nutrients can be used to treat those already with coronavirus disease discovered in 2019 (COVID-19), particularly if already hospitalised, is uncertain from current inconsistent or scant evidence. There is gut dysbiosis in patients with COVID-19 and studies with probiotics report clinical improvements in such patients. There is an inverse association between adherence to a healthy diet and risk of SARS-CoV-2 infection and hospitalisation with COVID-19 which is consistent with the effects of individual nutrients and other dietary components. Addressing frailty, obesity and micronutrient insufficiency will be important to reduce the burden of future pandemics and nutritional considerations need to be a central part of the approach to preventing infections, optimising vaccine responses and promoting recovery from infection.

Maintaining a healthy weight during pregnancy is critical for both women's and children's health. Excessive gestational weight gain (GWG) can lead to complications such as gestational diabetes, hypertension and caesarean delivery. Insufficient GWG can cause fetal growth restriction and increase infant mortality risk. Additionally, postpartum weight retention raises risk of obesity, type 2 diabetes and other chronic diseases for both mother and child. This review seeks to identify current obstacles in weight management research during and after pregnancy and explore evidence-based strategies to overcome them. Pregnancy offers a window of opportunity for health behaviour changes as women are more receptive to education and have regular contact with health services. Staying within Institute of Medicine's recommended GWG ranges is associated with better maternal and fetal outcomes. Systematic review evidence supports structured diet and physical activity pregnancy interventions, leading to reduced GWG and fewer complications. Health economic evaluation indicates significant returns from implementation, surpassing investment costs due to decreased perinatal morbidity and adverse events. However, the most effective way to implement interventions within routine antenatal care remains unclear. Challenges increase in the postpartum period due to competing demands on women physically, mentally and socially, hindering intervention reach and retention. Flexible, technology-supported interventions are needed, requiring frameworks such as penetration-implementation-participation-effectiveness and template-for-intervention-description-and-replication for successful implementation. Greater research efforts are necessary to inform practice and investigate fidelity aspects through pragmatic implementation trials during the pregnancy and postpartum periods. Understanding the best ways to deliver interventions will empower women to maintain a healthy weight during their reproductive years.

Teacher food and nutrition (FN) practices influence their personal health and wellbeing outcomes, with implications for students. As educators, teachers role model FN practices to students and act as health promoters. Our team’s recent scoping review outlined the lack of standardised methods used to assess FN constructs in teachers, with limited validated and composite tools available that measure FN constructs, especially culinary factors, alongside measures of wellbeing(1). The importance of teacher FN education, to facilitate effective school health promotion, is highlighted by the World Health Organization and the United Nations Education Scientific and Cultural Organization. Therefore, understanding the scope of teacher FN practices in relation to teacher wellbeing is critical, yet limited evidence currently exists. This research aims to examine baseline data on teacher FN practices and potential FN predictors of teacher health and wellbeing from the Australian longitudinal teacher FN-related health and wellbeing study. The Teacher Food and Nutrition Questionnaire (TFNQ) consists of nine sub-scales and 21 single-item measures using pre-defined food, nutrition, and wellbeing constructs. This provides a composite evaluation tool to collate data on teacher FN practices for comparison with wellbeing outcomes, including stress and burnout. Descriptive statistics and Pearson correlation coefficient (r) were used to assess relationships between food, nutrition, and wellbeing constructs, and linear regression to determine slope of significant relationships using diet quality (i.e., the Fruit and Vegetable Variety index), wellbeing (i.e., burnout) and professional FN confidence as outcome variable(s) of interest. A total of n = 112 secondary teachers completed the baseline TFNQ (September 2023). Of these, the majority were female (87.5%), aged 31–45 years (52%), with 90% on full time contracts. Mean diet quality score was 92.0 (maximum score (MS) of 190), with sub-scale score for vegetable (63.2/122 MS) and fruit (28.9/68 MS) intake. Of the wellbeing measures, burnout (16.3/24 MS), stress (7.3/10 MS) and coping (6.2/10 MS) were measured alongside teacher food skills confidence (105.7/133 MS) and food agency (40.9/55 MS). Teacher FN confidence to role model healthy FN practices was moderately correlated to food agency r = −0.43 (p < 0.001), and personal subjective wellbeing ‘satisfied’ r = 0.41 (p < 0.001). A moderate correlation was observed between vegetable intake and food skills confidence r = 0.42 (p < 0.001), with a moderate negative correlation observed between food agency and teacher burnout r = −0.43 (p < 0.001). Overall, these baseline data confirm teacher diet quality is suboptimal, with teacher food agency and/or food skills confidence demonstrating moderate correlations with all three study outcomes of teacher wellbeing, diet quality and professional FN confidence. These data provide a snapshot of secondary teachers’ FN practices and wellbeing. Results inform development of professional development to support FN behaviours as a contributing factor for optimal teacher health and wellbeing.

Despite the healthful nature of plant-based diets (PBDs) there is potential for nutrient inadequacies(1). This study aimed to compare dietary intakes and nutritional adequacy in Australians following plant-based diets compared a regular meat-eating diet (RME) in a cross-sectional study of adults (n = 240) aged 30–75yrs. Participants were habitually consuming dietary patterns for ≥ 6 months; vegan, lacto-vegetarian, pesco-vegetarian, semi-vegetarian or RME (n = 48 per group). Dietary intake was assessed using a validated food frequency questionnaire and dietitian-administered diet histories. Multivariable regression was used to adjust for potential lifestyle and demographic confounders. Compared to RMEs, vegans and lacto-ovo vegetarians had significantly lower dietary intakes of protein (percentage energy intake, EN%), saturated fat, trans fat, cholesterol, vitamin B12, iodine, riboflavin, niacin, sodium, and long chain omega-3 polyunsaturated fatty acids (LCn-3PUFA), and higher carbohydrate (EN%), dietary fibre, vitamin E, folate, magnesium, iron, and n-6PUFA, whereas, pesco-vegetarians and semi-vegetarians had intermediate intakes. Individuals adhering to PBD consumed significantly more vegetables, fruit (vegan only), legumes/nuts, and less discretionary choices compared to RMEs. All dietary patterns met adequate intake for protein, exceeded for fat, were below for carbohydrate (EN%) and had adequate serves of fruit and vegetables, but not grains. Including plant-based alternatives, vegans, lacto-ovo vegetarians, and semi-vegetarians had inadequate serves of ‘meat/poultry/eggs/beans/nuts’, and semi-vegetarians and RMEs had inadequate serves of dairy. Vegans and lacto-vegetarians had nutritional inadequacies in vitamin B12, LCn-3PUFA, iodine, and in addition calcium among vegans, pesco-vegetarians in iodine, and semi-vegetarians and RMEs in LCn-3PUFA. PBDs, specifically vegans and lacto-ovo vegetarians, while significantly higher in beneficial nutrients and wholefood groups than RMEs, may lead to nutritional inadequacies if not planned appropriately.

The dual burden of malnutrition is characterised by the coexistence of undernutrition alongside overweight/obesity and diet-related noncommunicable diseases. It is a paradox which disproportionately affects women and is applicable to those who become pregnant after weight loss surgery. Obesity before and during pregnancy is associated with increased risk of adverse perinatal outcomes in both mother and child. Overall lifestyle interventions targeting weight loss in the preconception period have not proven effective, with people, and women in particular, increasingly seeking weight loss surgery. In women with severe obesity, surgery may normalise hormonal abnormalities and improve fertility. In those who become pregnant after surgery, evidence suggests a better overall obstetric outcome compared to those with severe obesity managed conservatively; however, there is heightened risk of maternal nutritional deficiencies and infants born small for gestational age. Specifically, pregnancy soon after surgery, in the catabolic phase when rapid weight loss is occurring, has the potential for poor outcomes. Lifelong micronutrient supplementation is required, and there is considerable risk of malnutrition if nutritional aftercare guidelines are not adhered to. It is therefore recommended that pregnancy is delayed until a stable weight is achieved and is supported by individualised advice from a multidisciplinary team. Further research is required to better understand how weight loss surgery affects the chances of having a healthy pregnancy and to ultimately improve nutritional management and patient care. In this review, we aim to summarise the evidence and guidance around nutrition during pregnancy after weight loss surgery.

Discretionary foods that are energy-dense and nutrient-poor contribute to over one third of total energy intake in Australian children and adults, and the typical portion sizes of many discretionary foods have increased significantly in the last two decades(1). The portion size norms (described as a typical perception of how much of a given food people choose to eat at a single eating occasion) are likely to have increased concurrently, with larger sizes now being considered the new normal(2). Public health interventions are urgently needed to reduce the portion size norms and consumption of discretionary foods(3), but the acceptability of such interventions remains unknown. Therefore, this qualitative study aimed to gain insights into consumers’ attitudes towards potential interventions targeted at promoting portion control of discretionary foods. Four online focus group sessions were conducted via Zoom with healthy Australian adults who regularly consume discretionary foods. A question guide was developed to gather participants’ perspectives around four potential public health interventions; reduction of the default serving sizes, increasing serving size options, changes to package sizes, and improving serving size labelling. A female facilitator moderated all focus groups, with a second moderator present to capture other relevant details. Collected data were analysed using a hybrid approach combining deductive and inductive thematic analyses. A total of 35 participants completed the study (19 females, mean age 38 ± 14 years). Participants identified the current food environment as promoting overconsumption; larger serving sizes were reported to be more ubiquitous and better value for money than smaller size options. An overall positive attitude towards the proposed interventions was noted. Out of the four proposed interventions, participants considered the most acceptable intervention to be providing a wider range of serving size options while maintaining a consistent unit price. Other acceptable interventions included reducing the default serving sizes with concurrent price reduction; education and clear guidance around portion size selection (for example, the involvement of health professionals to promote portion control, along with relevant recommendations of appropriate portion sizes from health authorities); more practical on-pack serving size suggestions; and innovative package designs that enable better portion control without contributing to food and plastic waste. In conclusion, participants identified a need for and were in support of interventions aimed at the portion control of discretionary foods. Further research should focus on examining the feasibility and effectiveness of the potential interventions to reduce the purchasing and consumption of large serving sizes. More efforts from public health authorities are required to develop practical and tailored recommendations for consumers around appropriate portion sizes for discretionary foods. Collaboration with the food industry and policy makers is also necessary for implementing public health interventions to reduce the excessive intake of discretionary foods.

Sufficient sleep is necessary for optimal health, daytime performance and wellbeing and the amount required is age-dependent and decreases across the lifespan. Sleep duration is usually affected by age and several different cultural, social, psychological, behavioural, pathophysiological and environmental factors. This review considers how much sleep children and adults need, why this is important, what the consequences are of insufficient sleep and how we can improve sleep. A lack of the recommended amount of sleep for a given age group has been shown to be associated with detrimental effects on health including effects on metabolism, endocrine function, immune function and haemostatic pathways. Obesity has increased worldwide in the last few decades and the WHO has now declared it a global epidemic. A lack of sleep is associated with an increased risk of obesity in children and adults, which may lead to future poor health outcomes. Data from studies in both children and adults suggest that the relationship between sleep and obesity may be mediated by several different mechanisms including alterations in appetite and satiety, sleep timing, circadian rhythm and energy balance. Moreover, there is evidence to suggest that improvements in sleep, in both children and adults, can be beneficial for weight management and diet and certain foods might be important to promote sleep. In conclusion this review demonstrates that there is a wide body of evidence to suggest that sleep and obesity are causally related and recommends that further research is required to inform policy, and societal change.

Childhood obesity persists at historically high rates globally, including an increasing number of children with severe obesity(1–3). Despite the growing demand of families with children needing treatment, effective interventions are largely unavailable or inaccessible(4,5). Using technology to transform such services that are conventionally delivered in person and offering electronic health (e-Health) interventions, may address limitations of current childhood obesity treatment. A randomised control trial (RCT) with a waitlisted control group evaluated the effectiveness of a 10-week family-focused web-based healthy lifestyle program with health coaching sessions, for treating childhood overweight and obesity, over 10 weeks. Outcome measures included change in children’s body mass index (BMI) z-score, waist circumference, dietary intake, physical activity, and quality of life, collected online at baseline and end of the web-based program (10 weeks). A total of 148 children (125 families) aged 7–13 years, with BMI ≥ 85th percentile, living in Victoria, Australia, were recruited and randomised to intervention (Cohort 1) or waitlist control (Cohort 2), of which 102 children (85 families) completed the RCT. Cohort 2 received no intervention during the control period. A clinically meaningful decrease in BMI z-score, in the context of weight maintenance and height growth, was observed in Cohort 1 compared to a negligible change found in Cohort 2 (mean difference in change in BMI z-score Cohort 1 vs Cohort 2 = −0.1; 95% confidence interval, −0.2, –0.0). Compared with Cohort 2, Cohort 1 adopted health-supporting lifestyle behaviours, such as improved diet quality and increased physical activity; and reported a clinically significant improvement in children’s quality of life at 10 weeks. Cohort 2 demonstrated similar changes in outcome measures after receiving the web-based program. Findings from this study furthers the growing body of evidence on the potential of e-Health interventions to upscale childhood obesity treatment. E-Health interventions, including a low-intensity program that requires minimal contact time with health professionals online, can enhance the effectiveness of conventional treatment services.

This review aims to emphasise the impact of poor nutrition on children’s health and psychological well-being, urging those involved in childhood obesity or nutrition services to broaden their intervention approach. Poor nutrition and childhood obesity affect physical and psychological health. The stress of living with obesity further impacts quality of life, well-being and self-esteem. Children living with obesity may experience adverse childhood events and stress, and young people are able to recall the impact of psychosocial issues such as experiencing stigma and discrimination. Food is often a coping mechanism for managing negative emotions, perpetuating cycles of emotional coping and unhealthy eating behaviours. UK guidelines recommend family-based, multi-component weight management interventions for children living with obesity. Interventions mainly target health behaviours and utilise behaviour change techniques attempting to directly improve diet and physical activity as behavioural outcomes. Whilst these interventions may show some improvements in psychological well-being, there is limited consideration or understanding of the underlying mechanisms of action which indirectly influence engagement and the sustainability of the behaviour change. Lack of attention and inclusion of psychosocial variables in intervention implementation may help explain the variable effectiveness reported across childhood obesity interventions. In conclusion, enhancing the effectiveness of childhood obesity interventions requires a broader approach that fully incorporates psychosocial factors. Those responsible for commissioning, designing and implementing these interventions should adopt a holistic approach that addresses psychological and emotional needs while incorporating underlying mechanisms of action. This shift in focus could result in more sustainable and comprehensive treatment for childhood obesity.

The obesity prevalence among the Chinese population has increased more than three-fold over the last twenty years.(1) A cross-sectional study involving 15.8 million Chinese adults revealed that in 2023 one in every two Chinese adults was categorised as overweight or obese.(2) Chinese individuals face a higher health risk of developing chronic disease at comparable Body Mass Index levels to Caucasians.(3) Thus, it is urgent to address the increasing obesity prevalence in this population. People’ s perception towards obesity is likely to play an important role in influencing their weight management behaviour.(4) For Chinese people, the unique Confucianism ideology, collectivist society, and modern mass media information exposure may have a profound influence on how Chinese people develop their perceptions about weight issues. It is therefore valuable to understand Chinese people’s obesity-related perceptions as this may inform more culturally appropriate interventions for weight management. To the authors’ knowledge, this is the first bilingual systematic review which aimed to synthesise published literature exploring the perceptions of Chinese adults towards overweight and obesity. Four English databases and two Chinese databases (Medline, APA PsycINFO, Social Science Premium Collection, Scopus, Wanfang Chinese Journal Database, and Chinese Electronic Periodical Services) were searched from inception to 17 Jun 2023. Studies were included if they were published in English or Chinese, investigated perceptions towards overweight and obesity, and focused on Chinese adults living in or outside of Mainland China. All retrieved citations were screened by two reviewers independently. A narrative synthesis method was employed. Forty-eight studies (n = 20 in English, n = 21 in simplified Chinese, n = 7 in Traditional Chinese) were included, involving n= 73910 participants. Females were more often researched. Also, the overall sample consisted more younger and more highly educated people, with 22 studies including solely university students. The collective quality or risk of bias of the studies was suboptimal. Three overarching themes emerged from this review: (i) Chinese adults tend to misperceive their weight status, largely stemming from limited awareness of BMI and societal norms idealizing thinness, leading to high dissatisfaction with body weight and high motivation to pursue weight loss. Females perceived a stricter weight ideal than males; (ii) Despite a pronounced motivation for weight management, study participants lacked practical knowledge regarding sustainable strategies. Non-scientific weight-loss methods and unproductive perceptions were prevalent among this population; (iii) Chinese adults perceived dealing with obesity as a lonely journey, influenced by the pervasive negative societal attitude towards obesity and the prevailing mindset emphasizing personal responsibility for weight-related issues. This review provides a comprehensive profile of perceptions towards obesity among Chinese adults over the last two decades and discusses methodology implications and future research directions.

The review aims to explore the potential benefit and risk of high-protein diets (HPD) regarding the comorbidity of sarcopoenia and CVD in the setting of cardiac rehabilitation (CR). CR is standard care for individuals who have experienced a cardiac event, but the current practice of predominantly aerobic exercise, a lower-fat diet and weight loss poorly addresses the issue of sarcopoenia. HPD, especially when combined with resistance exercise (RE), may be valuable adjuncts to current CR practice and benefit both muscle and cardiovascular health. Meta-analyses and randomised controlled trials of HPD and CVD risk show beneficial but variable effects regarding weight loss, the lipid profile, insulin resistance and lean body mass in those living with or high risk of CVD. Meta-analyses of prospective cohort studies on hard CVD endpoints favour lower- and plant-protein diets over higher animal protein, but the evidence is inconsistent. HPD augment the strength and muscle gaining benefits of RE in older populations, but there are no published data in those living with CVD providing promising opportunities for CR research. HPD raise concern regarding renal and bone health, the microbiome, branched chain amino acids and environmental sustainability and findings suggest that plant-based HPD may confer ecological and overall health advantages compared to animal-based HPD. However, incorporating RE with HPD might alleviate certain health risks. In conclusion, a largely plant-based HPD is deemed favourable for CR when combined with RE, but further research regarding efficacy and safety in CR populations is needed.

Social media platforms such as Instagram and TikTok have transformed how individuals seek and engage with dietary advice, leading to the rapid propagation of unverified nutrition information that can result in poor dietary choices, contribute to disordered eating and broader health issues(1). This study aims to measure the accuracy and frequency of nutrition misinformation, identify the types of thematic misinformation, and understand user engagement metrics on Instagram and TikTok. A mixed-methods approach was employed, analysing 500 posts (250 from each platform) collected over a six-month period from September 15, 2023, to March 15, 2024, using keywords like healthy eating, healthy food, diet, and weight loss. Posts were evaluated using a modified, previously developed, Social Media Evaluation Checklist(2) and evidence coding framework to measure accuracy. Results indicated a higher prevalence of misinformation on TikTok compared to Instagram, with a significant portion (p < 0.05) of users lacking relevant credentials. The most common characteristic was cooking/recipes and meal plans. TikTok posts with mostly accurate and completely inaccurate information had higher engagement than Instagram posts. TikTok had a larger proportion of completely inaccurate posts (10.8%), mainly related to weight loss. Descriptive statistics for engagement metrics showed TikTok posts had significantly (p < 0.05) higher likes and comments compared to Instagram posts across various accuracy levels. For Instagram, completely accurate posts had a mean of 4,318 likes and 40 comments, while mostly accurate posts had a mean of 25,153 likes and 186 comments. For TikTok, completely accurate posts had a mean of 146,327 likes and 423 comments, mostly accurate posts had a mean of 75,804 likes and 483 comments. An independent t-test revealed significant (p < 0.05) differences in likes and comments between platforms for posts with varying accuracy levels. The study highlights the need for social media platforms to verify the qualifications of individuals providing nutrition advice and implement measures to promote accurate information. Further research is necessary to develop effective strategies to mitigate the spread of misinformation via social media platforms and its impact on public health.

The aim of this review is to provide an overview of the history in support of the role of dietary saturated fatty acids (SFA) in the development of cardiovascular disease (CVD), and the controversy and consensus for the evidence in support of guidelines to remove and replace SFA with unsaturated fatty acids. The review will also examine the existence, origins, and implications for CVD risk of variability in serum LDL-cholesterol in response to these guidelines. While the quality of supporting evidence for the efficacy of restricting SFA on CVD risk has attracted controversy, this has helped to increase understanding of the inter-relationships between SFA, LDL-cholesterol and CVD, and reinforce confidence in this dietary recommendation. Nevertheless, there is significant inter-individual variation in serum LDL-C in response to this dietary change. The origins of this variation are multi-factorial and involve both dietary and metabolic traits. If serum biomarkers of more complex metabolic traits underlying LDL-responsiveness can be identified, this would have major implications for the targeting of these dietary guidelines to LDL-responders, to maximise the benefit to their cardiovascular health.

The colonisation of Australia around 250 years ago resulted in significant disruptive changes to the lifestyle and diet of Aboriginal and Torres Strait Islander peoples. Traditional foods high in micronutrients, including vitamin D, have been largely replaced with energy-dense foods(1). Sun exposure—a primary source of vitamin D—may be reduced due to changes in clothing and housing structure(2). Consequently, there is a high prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D concentration < 50 nmol/L) and low vitamin D intake among Aboriginal and Torres Strait Islander peoples(2,3). There is a need for a public health strategy to improve vitamin D status. Since few foods naturally contain vitamin D (e.g., fish, eggs, and meat), food fortification could be a suitable public health strategy to increase vitamin D intake without changing consumption behaviour. In Australia, besides food mandated for fortification (e.g., edible oil spreads), few foods permitted for voluntary fortification are routinely fortified. We aimed to model vitamin D food fortification scenarios among Aboriginal and Torres Strait Islander peoples. We used nationally representative food consumption data from the 2012–2013 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (n = 4,109) and analytical vitamin D food composition data(4) to model four food fortification scenarios. Scenario 1 modelled the addition of the maximum permitted amount of vitamin D to all foods permitted for fortification in Australia: i) dairy products and alternatives, ii) butter/margarine/oil spreads, iii) formulated beverages (e.g., water with added sugar, vitamins and minerals), and iv) selected ready-to-eat breakfast cereal. Scenarios 2a–c included vitamin D concentrations higher than permitted in fluid milks/alternatives (1 μg/day) and butter/margarine/oil spreads (20 μg/day). Scenario 2a: i) dairy products and alternatives, ii) butter/margarine/oil spreads, iii) formulated beverages. Scenario 2b: as per Scenario 2a plus selected ready-to-eat breakfast cereals. Scenario 2c: as per Scenario 2b plus bread (not permitted for vitamin D fortification in Australia). Vitamin D fortification of a range of staple foods could potentially increase vitamin D intake among Aboriginal and Torres Strait Islander peoples by ~3–6 μg/day. Scenario 2c showed the highest potential median vitamin D intake increase from baseline of 2 μg/day to ~8 μg/day. Across all scenarios, the vitamin D intake of all participants remained below the Australian Tolerable Upper Intake Level of 80 μg/day. Our findings demonstrated that vitamin D fortification of a range of staple foods could potentially increase vitamin D intake among Aboriginal and Torres Strait Islander peoples in Australia. However, the most impactful vitamin D fortification strategy (Scenario 2c) would require a revision of the Australia New Zealand Food Standards Code to permit the addition of higher amounts of vitamin D than currently permitted and the inclusion of bread as a food vehicle for fortification.

Poor diet is a risk factor for chronic noncommunicable diseases and related mortalities(1). The community food environment is one of the determinant factors for dietary quality(2). In high-income countries, the dietary impact of the community food environment is more pronounced in low socioeconomic areas(3). This study aimed to assess the healthiness of food outlets and its association with Socioeconomic Index for Areas (SEIFA) and Local Government Areas (LGA) in the Illawarra Shoalhaven region, Australia. A desk-based cross-sectional study was conducted using a list of registered food outlets obtained from councils of local government areas. Food Environment Score was used to assess the healthiness of food outlets that classify food outlets as healthy, less healthy, and unhealthy(4). The Index of Relative Advantage and Disadvantage (IRSAD) at statistical area level two was used to define SEIFA and was extracted from the Australian Bureau of Statistics (ABS) 2021 census data. Logistic regression was conducted to identify the association between the healthiness of food outlets with LGA and SEIFA. Of the 1924 food outlets, 52.4% (n = 1008) were in Wollongong, 14.1% (n = 272) in Shellharbour, 8.3% (n = 160) in Kiama, and 25.2% (n = 484) in Shoalhaven LGA. Out of 1924 food outlets, 281 (14.6%) were categorised as healthy, 790 (41.1%) as less healthy, and 853 (44.3%) as unhealthy. Wollongong had 2 times more unhealthy food outlets than Shoalhaven as compared to healthy and less healthy food outlets (AOR 2.0 (95% CI: 1.5, 2.5)), Shellharbour had 70% more unhealthy food outlets than Shoalhaven as compared to healthy and less healthy food outlets (AOR 1.7 (1.3, 2.3)), and Kiama had 70% more unhealthy food outlets than Shoalhaven as compared to healthy and less healthy food outlets (AOR 1.7 (1.1, 2.5)). IRSAD 5 had 40% fewer unhealthy food outlets than IRSAD 3 as compared to healthy and less healthy food outlets (AOR 0.6 (0.4, 0.8)) and IRSAD 4 had 50% fewer unhealthy food outlets than IRSAD 3 as compared to healthy and less healthy food outlets (AOR 0.5 (0.3, 0.8)). Large proportion of food outlets were categorised as unhealthy and less healthy. There were disparities in the healthiness of food outlets across LGAs and SEIFA. Intervention strategies need to be designed to increase the availability of healthy food outlets and limit unhealthy food outlets, particularly in low socioeconomic areas.