Search Results (206)

Background: The majority of Australian children exceed the World Health Organization’s recommended dietary intake of free sugar, particularly through the consumption of sugar-sweetened beverages. Front-of-pack nutrition labels increase perceived risk and deter the consumption of sugar-sweetened beverages. However, past studies of young children have focused almost exclusively on a parent’s choice of beverage for children. This study investigated the influence of four label designs (text-based warning, tooth decay pictorial, teaspoons of sugar, and Health Star Rating) on the beverage choices of N = 1229 Australian children (aged 4–11 years) and their parents. Methods: In an online vending machine scenario, parent–child dyads were separately asked to select which beverage they would choose for themselves before and after being randomised to one label condition. The beverages displayed included 100% fruit juice, soft drink, soft drink with a non-nutritive sweetener, flavoured milk, plain milk and bottled water. Beverage healthiness was determined by a 1–10 rating based on a review by a panel of experts (10 dietitians and nutritionists). Results: Mixed-model ANOVAs showed that for parents, each label design performed comparably; however, for children, small but significant differences were seen in the effectiveness of different label designs, with the teaspoons of sugar label, text-based warning, and tooth decay pictorial found to be more impactful in promoting healthier drink choices than the Health Star Rating. Conclusions: These findings can inform public health advocacy efforts to improve food labelling and could be incorporated into educational resources to help children understand the nutritional profiles of different sugary drinks. Full article

Background: Dietary intake during the first year of life is a key determinant of a child’s growth and development. ORIGINS is a longitudinal birth cohort study investigating factors that contribute to a ‘healthy start to life’ and the prevention of non-communicable diseases. Methods: This descriptive cross-sectional study aims to describe the dietary intakes of one-year-old children participating in ORIGINS and compare these to the Australian Dietary Guidelines and Nutrient Reference Values (NRVs). Between 2020 and 2023, dietary intake data were collected on 779 one-year-old children using a Food Frequency Questionnaire (FFQ). The analysis explored milk intake (breastmilk, infant formula, and cow’s milk), the introduction to solids, macronutrient, micronutrient, and food group intakes. Results: The results indicated that 41.5% were still being breastfed at one year of age, while 58.0% continued to receive formula milk. While the cohort met NRV cut-offs for most micronutrients, iodine intake fell below requirements, and sodium intake exceeded recommendations. Diet quality, based on the food group intake, did not meet recommendations, with children over-consuming fruit and discretionary foods, while under-consuming vegetables and cereals and grains foods. Conclusions: These findings highlight areas for improvement in the dietary intake of one-year-old children. Full article

Background/Objectives: Plant-based diets are associated with human and planetary health. However, the overall quality of these diets may depend on the proportion of ultra-processed foods (UPFs). This study investigates the association between UPF consumption and plant-based diet quality in Australian adults. Methods: Analysis was conducted on 9111 participants (aged ≥ 19 years) from the National Nutrition and Physical Activity Survey 2011–2012. Food items reported from a 24 h recall were classified using the NOVA system, and the contribution of UPFs to total energy intake was calculated. Plant-based diet quality was examined using the overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI). Multiple linear regression models were used to examine the association between the UPF intake and PDI, hPDI, uPDI, and their score components. Results: The proportion of energy from UPFs was positively associated with the uPDI (β = 0.80; 95% CI 0.72, 0.89) and negatively associated with the PDI (β = −0.13; 95% CI: −0.22, −0.04) and the hPDI (β = −0.65; 95% CI: −0.73, −0.57). All score components of the PDI, hPDI and uPDI, except whole grains, legumes and fruit juices, significantly contributed to these associations. The sugars and syrups group contributed most to the positive association between UPFs and the uPDI (β = 6.47; 95% CI: 6.07, 6.87) and the negative association of UPFs and the hPDI (β = −6.47; 95% CI: −6.07, −6.87). Conclusions: Higher consumption of UPFs was associated with a lower plant-based diet quality. These findings have implications for the design of dietary interventions that encourage the consumption of minimally processed plant-based foods. Full article

Background/Objectives: Food matching aligns food consumption and food composition data to quantify intakes of a food component or category. A systematic approach to food matching is required to obtain the highest quality match and, therefore, most accurately quantify the intake of the food component under investigation. This study aims to provide a tool to assess adherence with the Australian Dietary Guideline food group recommendations by the development of a food matching method that links dietary intake data from a food frequency questionnaire to food group data in the Australian Dietary Guideline database. Methods: Two researchers trained in food composition independently applied a stepwise approach to link the Dietary Questionnaire for Epidemiological Studies Version 2 food frequency questionnaire and the Australian Dietary Guideline database. Food preparation methods, mixed dishes and Australian Dietary Guideline database representative foods were considered to ensure the highest quality result. Average values were calculated for foods for which multiple items were matched. Results: The Australian Dietary Guideline Adherence Tool (ADG-AT) was produced, providing the number of servings of the five Australian Dietary Guideline food groups and discretionary foods per 100 g of food for 5742 food items. Conclusions: The ADG-AT produced in this study allows convenient evaluation of Australian Dietary Guideline adherence in studies using the Dietary Questionnaire for Epidemiological Studies food frequency questionnaire to collect dietary intake data. This informs the identification of dietary risk factors for nutritional inadequacy and chronic disease. The systematic methods used in this study can be reapplied to different dietary intake collection tools and food composition databases. Full article

Evidence to inform the incorporation of environmental sustainability into public health nutrition policy and dietetics practice needs to be relevant to the local dietary, cultural, environmental, and food system context. Global recommendations and evidence from other countries may not be directly applicable. As this information is scattered across multiple research publications in Australia, a systematic review was undertaken to consolidate evidence and identify practical recommendations. Following the PRISMA 2020 guidelines, the search strategy sought to identify studies based on Australian dietary intake data obtained by surveys combined with an environmental assessment. Theoretical or conceptual studies were deemed out of scope. Included studies were grouped for synthesis based on content relating to total dietary energy intake, nutrient adequacy, foods and food groups, and dietary patterns. Out of 765 records, 14 studies met the eligibility criteria. These studies addressed a variety of research questions using a variety of modelling approaches and environmental indicators. Current evidence suggests encouraging consumption of nutrient-dense foods, especially those that enhance satiety, along with discouraging consumption of nutrient-poor processed foods that contribute little to satiety and can lead to excessive dietary energy intake. Limiting total intake or diversity of protein-rich foods can increase risks of inadequate intake of micronutrients. For lower environmental impact dietary patterns, intake of vitamins A, B6, and B12, and minerals Ca, Mg, Se, and Zn can be below estimated average requirements. The practical implication is that foods that are rich and bioavailable sources of these nutrients need to be prioritized in any strategy to reduce dietary environmental impacts. Full article

Background/Objectives: Ultramarathon runners exceed the physical activity guidelines and in doing so are constantly exposed to physical and metabolic demands, requiring strategic dietary practices to support training, performance, and recovery. This study aimed to assess the diet quality and nutrient intake in runners enrolled in an Australian-based ultramarathon. Methods: A 3-day food diary was collected using the Australian smartphone application ‘Easy Diet Diary’ during both peak and taper periods. Macronutrient and micronutrient intakes were analysed using the AUSNUT 2011–2013 food composition database within the Foodworks professional software, and diet quality was evaluated using the Healthy Eating Index for Australians (HEIFA-2013). Results: A total of 26 runners participated in the study. The results revealed that, although runners met or exceeded protein recommendations, their carbohydrate intake fell short of endurance-specific guidelines, whilst total dietary fat intake exceeded recommendations (excluding long-chain polyunsaturated fatty acids). Diet quality scores averaged 63.1 out of 100, reflecting moderate alignment with dietary recommendations. Fruit, vegetable, and wholegrain food groups were inadequately consumed. Conclusions: The findings indicate that ultramarathon runners who easily exceed physical activity recommendations, may paradoxically consume suboptimal diets, characterized by insufficient intake of core food groups such as whole grains and fruits, alongside excessive consumption of discretionary items. This dietary pattern may not only elevate their risk of chronic disease but also impair optimal performance by compromising recovery and adaptation to training. Further research is warranted to better understand the dietary behaviors and nutritional needs of this population. Full article

Background and Objectives: Proper nutrition and hydration are essential for the health, growth, and athletic performance of student-athletes. Adequate energy availability and sufficient intake of macro- and micronutrients support adolescent development, prevent nutrient deficiencies, and reduce the risk of disordered eating. These challenges are particularly relevant to student-athletes, who are vulnerable to nutrition misinformation and often exhibit limited nutrition knowledge. This study aimed to evaluate the feasibility and acceptability of the ‘Eat 2 Win’ nutrition education pilot program for high school student-athletes and assess changes in nutrition knowledge using the Nutrition for Sport Knowledge Questionnaire—Adolescents (NSKQ-a). Methods: Fifty-five high school student-athletes (14.1 ± 2.2 years; 53% male, 47% female) from the Bremer State High School Sports Academy participated in the ‘Eat 2 Win’ program. The curriculum was tailored to align with the nutritional needs of Australian high school student-athletes and included three interactive workshops on sports nutrition concepts, practical cooking classes, and online learning modules. Sessions were delivered onsite at the school over three consecutive weeks, once per week. Twenty-four participants (43.6%) completed all program components. Results: The program was feasible and well-accepted by participants. Nutrition knowledge, assessed in 16 participants using the NSKQ-a, revealing an overall knowledge increase of 9.7%, with sub-category improvements ranging from 3.1% to 34.4%. Conclusions: The ‘Eat 2 Win’ pilot program improved student-athletes’ nutrition knowledge, particularly in macronutrients and hydration. Participant feedback highlighted enjoyment and positive impacts. Targeted nutrition education programs like ‘Eat 2 Win’ can empower student-athletes to make informed dietary choices by addressing knowledge gaps, debunking nutrition myths, and fostering positive dietary behaviours. Future programs should emphasize energy intake, practical skills, and accessible, actionable information. Full article

Background/Objectives: The rise in chronic metabolic diseases has led to the exploration of alternative diets. The carnivore diet, consisting exclusively of animal products, has gained attention, anecdotally, for imparting benefit for inflammatory conditions beyond that possible by other restrictive dietary approaches. The aim was to assess the micronutrient adequacy of four versions of the carnivore diet against national nutrient reference values (NRVs). Methods: This study assessed the nutrient adequacy of the carnivore diet against national NRVs from the Australian National Health and Medical Research Council (NHMRC) and New Zealand Ministry of Health. Four meal plans for hypothetical average Australian adults were developed and analysed using Foodworks.online (Version 1, Xyris Pty Ltd., Brisbane, Australia, 2024), dietary software. Two female and two male plans were included; one set including dairy products and the other set including offal. Results: The carnivore diet met several NRV thresholds for nutrients such as riboflavin, niacin, phosphorus, zinc, Vitamin B6, Vitamin B12, selenium, and Vitamin A, and exceeded the sodium threshold. However, it fell short in thiamin, magnesium, calcium, and Vitamin C, and in iron, folate, iodine and potassium in some cases. Fibre intake was significantly below recommended levels. Conclusion: The carnivore diet may offer benefits for managing certain chronic conditions. Whether the metabolic contexts from consuming such a diet facilitates a lower requirement of certain nutrients, or whether it poses risks of micronutrient inadequacies remains to be determined. Tailored nutritional guidance and supplementation strategies are recommended to ensure careful consideration of micronutrient intake to prevent deficiencies. Full article

Background: Few studies have explored the relationship between habitual dietary patterns and disease activity in people with Inflammatory Bowel Disease (IBD). This cross-sectional study explored the association between dietary patterns and clinical and objective markers of inflammation in adults from the Australian IBD Microbiome Study. Methods: Dietary patterns were derived using principal component analysis (PCA) of baseline food frequency questionnaire data. Food intake was quantified using 3-day food record data. Associations between dietary intake and both clinical disease activity index (CDAI) and faecal calprotectin (FCP) were analysed. Results: Participants included 412 adults (IBD = 223, Healthy controls (HC) = 189). Both cohorts consumed poor-quality diets with inadequate servings of most food groups compared to Australian reference standards. IBD participants without FCP inflammation had significantly higher fibre intake than those with moderate FCP. In the Crohn’s Disease group, high adherence to ‘High plant diversity’ and ‘Meat eaters’ dietary patterns were associated with increased CDAI and FCP, respectively. In the combined IBD cohort, high adherence to a ‘Vegan-style’ dietary pattern was associated with increased FCP. Conclusions: There is a need for dietary modifications among Australian adults, both with and without IBD, to improve dietary fibre intake and adherence to dietary guidelines. Dietary patterns characterised by a high intake of plant foods or meat products were both positively associated with indicators of active IBD. It is possible that some participants with active IBD were modifying their diet to try to manage their disease and reduce symptoms, contributing to the association between healthier dietary patterns and active disease. Further clinical and longitudinal studies are needed to expand upon the findings. This study offers a unique contribution by utilising FCP as an objective marker of intestinal inflammation and applying dietary pattern analysis to investigate the relationship between diet and inflammatory markers. Full article

Background: Healthy dietary patterns can support the maintenance of cognition and brain health in older age and are negatively associated with cardiometabolic risk. Cardiometabolic risk factors are similarly important for cognition and may play an important role in linking diet to cognition. Aim: This study aimed to explore the relationship between dietary patterns and cognition and to determine whether cardiometabolic health markers moderate these relationships in older adulthood. Design: A cross-sectional analysis of observational data from the baseline of the ACTIVate study. Participants: The cohort included 426 cognitively normal adults aged 60–70 years. Methods: The Australian Eating Survey (AES) Food Frequency Questionnaire was used to collect data on usual dietary intake, along with additional questions assessing intake of dietary oils. Principal component analysis (PCA) was applied to reduce the dimensionality of dietary data. Cardiometabolic risk was quantified using the metabolic syndrome severity score (MetSSS). Tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used to derive composite scores on four cognitive domains: processing speed, executive function, short-term memory, and long-term memory. Results: Three dietary patterns were identified using PCA: a plant-dominant diet, a Western-style diet, and a meat-dominant diet. After controlling for age, sex, total years of education, energy intake, and moderate-to-vigorous physical activity (MVPA), there was a small, negative association between the meat-dominant diets and long-term memory. Subsequent moderation analysis indicated that MetSSS significantly moderated this relationship. Conclusions: Findings highlight the link between diet, cardiometabolic health, and cognitive function in older, cognitively healthy adults. However, longitudinal studies are needed to confirm observations and evaluate the dynamics of diet, cardiometabolic health, and cognitive function over time. Full article

Meals served to children should not only satisfy hunger and taste preferences but also be nutritionally adequate. Nutrition in early childhood is critical, as children spend a significant portion of their day in kindergarten or preschool, making these settings key contributors to their overall dietary intake. With the rising prevalence of nutrition-related health conditions among children, early interventions are essential for developing and establishing lifelong healthy eating habits. This study assessed the nutritional value and quality of children’s diets in two distinct settings: kindergartens in Wroclaw, Poland, and preschools in Sydney, Australia, evaluating their alignment with the planetary health diet. The research analysed 10-day menu cycles from five kindergartens in Wroclaw and the contents of lunchboxes from five preschools in Sydney’s Upper North Shore area. A total of 100 menus were reviewed in Poland, while 100 children’s lunchboxes were assessed in Australia. Different analytical methods were employed: the Diet 6D software program for the Polish menus and the Food Consumption Score for the Australian lunchboxes. Both methods revealed dietary imbalances, such as excessive intake of protein, vitamin A, salt, and sugar, alongside deficiencies in calcium, vitamin C, and vitamin D. The study concluded that children’s diets should adhere to nutritional guidelines, meeting both Polish and Australian standards, and align with the principles of the planetary health diet. To achieve this, nutritional education is essential for kindergarten staff in Poland, while targeted educational interventions are needed for parents and children in both Poland and Australia, promoting health and environmental sustainability through better nutrition. Full article

Very low energy diets (VLEDs) contain <800 kcal/day and typically comprise formulated meal replacement products with adequate protein and micronutrients. Food-based VLEDs are an alternative approach, but it is uncertain whether they can provide adequate nutrition within an 800 kcal/day restriction. This analysis aimed to assess the nutritional adequacy of food-based VLEDs compared with formula VLEDs. A systematized literature review was conducted to identify balanced food-based VLEDs by searching five scientific databases from inception to 23 March 2023 and online sources between 1 and 7 May 2023. Ultimately, nine diets were analyzed for nutritional content and compared with Codex Alimentarius standards for formula foods, and Australian estimated average requirement and adequate intake (AI) for adults 19–50 years. Optifast^® was used as a comparator. None of the VLEDs met all nutritional benchmarks. Three food-based diets had nutrient profiles similar to formula VLEDs, with one being adequate for all nutrients except thiamine, magnesium and zinc in men and iron in women. All VLEDs, including Optifast^®, did not meet AI for dietary fiber, except one. In general, food-based VLEDs offered more fiber than Optifast^®. In conclusion, food-based VLEDs were inadequate in certain micronutrients but offered more dietary fiber than formula VLEDs. These nutritional deficits do not preclude food-based VLEDs from being recommended, provided they are addressed. Full article

Dietary patterns contribute to overall health and diseases of ageing but are understudied in older adults. As such, we first aimed to develop dietary indices to quantify Mediterranean Diet Score (MDS) utilisation and Ultra-processed Food (UPF) intake in a well-characterised cohort of relatively healthy community-dwelling older Australian adults. Second, we aimed to understand the relationship between these scores and the association of these scores with prevalent cardiometabolic disease and frailty. Our major findings are that in this population of older adults, (a) pre-frailty and frailty are associated with reduced MDS and increased UPF intake; (b) adherence to MDS eating patterns does not preclude relatively high intake of UPF (and vice versa); and (c) high utilisation of an MDS eating pattern does not prevent an increased risk of frailty with higher UPF intakes. As such, the Mediterranean Diet pattern should be encouraged in older adults to potentially reduce the risk of frailty, while the impact of UPF intake should be further explored given the convenience these foods provide to a population whose access to unprocessed food may be limited due to socioeconomic, health, and lifestyle factors. Full article

Poor diet is a major risk factor for non-communicable disease. The aims of this study were to describe temporal patterns and seasonal changes in diet across the year in Australian adults. A total of 375 adults from a prospective cohort study conducted between 1 December 2019 and 31 December 2021 in Adelaide, Australia, were asked to complete the Dietary Questionnaire for Epidemiological Studies at eight timepoints over a year. Average intakes over the previous month of total energy, macronutrients, healthy food groups, and discretionary foods and beverages were derived. Temporal patterns in diet were analysed descriptively. Multilevel linear regression modelling was used to assess seasonal differences in diet. Of the 375 participants recruited, 358 provided sufficient data for analysis. Intake of total energy, all macronutrients, and most discretionary foods and beverages peaked in December. Total energy intake was higher in summer than in autumn, winter, and spring. Fruit intake was higher in summer than in winter. Consumption of alcoholic beverages was higher in summer than in autumn, winter, and spring. Consumption of non-alcoholic beverages was higher in summer than in autumn and winter. This study identified temporal differences in dietary intake among Australian adults. Seasonal effects appear to be driven largely by increases in consumption of foods and beverages over the December (summer) holiday period. These findings can inform the design and timing of dietary interventions. Full article

Pregnancy is an opportunistic time for dietary intake to influence future disease susceptibility in offspring later in life. The ORIGINS Project was established to identify the factors that contribute to ‘a healthy start to life’ through a focus supporting childhood health and preventing disease (including non-communicable diseases). We aim to describe the dietary intakes of pregnant women in this cohort and to compare these to the Nutrient Reference Values (NRVs) and Australian Recommended Food Score (ARFS). The usual food and nutrient intakes of women were collected using the Australian Eating Survey (AES), a semi-quantitative food frequency questionnaire (FFQ). A total of 374 women completed the AES FFQ at both 20 weeks and 36 weeks of gestation between December 2016 and January 2023. Macronutrient, micronutrient, and food group intake were explored using descriptive statistics. Overall, it was found that the energy contribution from carbohydrates was low, while that from fat and saturated fat was high; participants were not meeting the recommendations for several key micronutrients (calcium, iron, iodine, and folate); and they had low diet quality scores for all food groups. These findings suggest that despite the ongoing promotion of healthy eating during pregnancy, further exploration into why dietary guidelines during pregnancy are not being adhered to is warranted. Full article