Search Results (274)

Background: Dietary assessment in inflammatory bowel disease (IBD) is moving away from individual food and nutrient analyses and towards dietary patterns (e.g., Mediterranean diet, Western diet) and diet quality assessment that are increasingly implicated in IBD onset and course. However, an IBD-specific diet quality index (DQI) does not exist. This review aimed to identify current DQIs and assess their suitability for an IBD population. Methods: MEDLINE and EmCare databases were systematically searched for a-priori, food-based DQI reflecting current dietary guidelines and/or nutrition science. Data extracted were adapted from optimal DQI criteria, including quality measures of adequacy, moderation, variety and balance and DQI evaluation. Results: Twenty-four DQI were identified. No DQI included all optimal DQI criteria. The Dietary Guideline Index 2013 (DGI-2013) most closely met the criteria, followed by the Dutch Healthy Diet Index-2015 (DHD-Index 2015), Planetary Health Diet Index (PHDI) and Healthy Eating Index for Australian Adults-2013 (HEIFA-2013). Most DQI assessed adequacy (22/24, 92%) and moderation (21/24, 88%), half assessed balance (12/24) while few assessed variety (8/24, 33%). Application of other optimal DQI criteria varied. Food frequency questionnaire (13/24) and 24 h diet recall (12/24) were the most common dietary assessment methods used. Most DQI (17/24, 71%) were validated; however, not for an IBD population. Few were evaluated for reliability (6/24) or reproducibility (1/24). Conclusions: No DQI meets all optimal criteria for an IBD-specific DQI. The DGI-2013 met the most criteria, followed by the DHD Index-2015, PHDI and HEIFA-2013 and may be most appropriate for an IBD population. An IBD-specific DQI is lacking and needed. Full article

Background/Objectives: Higher energy density (ED; kJ/g) and higher levels of processing of foods and beverages have been associated with childhood obesity and reduced diet quality. This study described and examined the distribution of ED and levels of processing of new food and beverage products intended for Australian children (0–4 years, 5–12 years). Methods: This study used 2013–2023 data from the Mintel Global New Products Database. Products were classified by ED (low ≦ 4.184 kJ/g, medium > 4.184 kJ/g and <12.552 kJ/g, or high ≧ 12.552 kJ/g) and level of processing (using the NOVA classification system; unprocessed/minimally processed foods; processed culinary ingredients; processed foods; ultra-processed foods (UPFs)). Non-parametric statistics were used to examine ED and level of processing by age and ‘Food’ and ‘Drink’ groups. Results: Of the 1770 products analysed, 56% were classified as high-ED and 81% as UPF. Among ‘Food’ products intended for children ‘5–12 years’, 93% were classified as UPFs. The differences in ED classification between non-UPFs and UPFs were significant for ‘Food’ products intended for children aged ‘0–4 years’ (p < 0.001) but not for children aged ‘5–12 years’ (p = 0.149). Conclusions: The prevalence of high-ED and UPFs in the Australian packaged food supply demonstrates the need to tighten regulations around products intended for children. The regulation of low-ED UPFs (i.e., recognised by Australian Dietary Guidelines as ‘healthy’) may also be required. Full article

Amidst a period of sustained inflation and rising living costs, food insecurity is a growing concern in Australia and is correlated with poor diet quality and increased rates of non-communicable diseases. Currently there is a gap in knowledge of the impact of increasing cost-of-living pressures on the affordability of a healthy diet. As affordability plays a key role in food security, this cross-sectional study aimed to examine the costs, affordability, and differential of habitual (unhealthy) and recommended (healthy) diets within the Illawarra region of Australia and compare results to 2022 findings. The Healthy Diets Australian Standardised Affordability and Pricing tool was applied in six locations in the Illawarra, with two randomly selected each from a low, moderate, and high socioeconomically disadvantaged area. Costs were determined for three reference households: a family of four, a single parent family, and a single male. Affordability was determined for the reference households at three levels of income: median gross, minimum-wage, and welfare dependent. Data was compared to data collected in 2022 using the same methods and locations. Recommended diets cost 10.3–36% less than habitual diets depending on household type, but remained unaffordable for welfare dependant households and family households from socioeconomically disadvantaged areas, where diets required 25.5–45.9% of household income. Due to income increases, affordability of both diets has marginally improved since 2022, requiring 0.5–4.8% less household income. This study provides updated evidence that supports the urgent need for policies, interventions, and monitoring to widely assess and improve healthy diet affordability and decrease food insecurity rates. Possible solutions include increasing welfare rates above the poverty line and utilising nudge theory in grocery stores. Full article

Background/Objectives: Evidence suggests that plant-based dietary patterns are beneficial for cardiometabolic health. However, it is unclear whether the quality of plant-based dietary patterns is differentially associated with cardiometabolic health. This study aimed to examine the association between three plant-based diet quality indices and cardiometabolic health among Australian adults. Methods: Data on 4877 adults (mean 45.1 years) from the cross-sectional Australian Health Survey 2011–2013 were used. Three plant-based diet quality indices (overall, healthful, and unhealthful) were derived from two 24 h dietary recalls. Anthropometric measures and blood pressure were assessed by trained interviewers. High-risk waist circumference was classified as ≥80 cm in females and ≥80 cm in males. Hypertension was defined as >140/90 mmHg. Fasting blood samples were used to estimate lipid profiles and diabetes status (based on plasma glucose or HbA1c). Multivariate logistic regression analyses were used to investigate the association between plant-based diet indices and cardiometabolic markers. Results: The healthy plant-based diet index was associated with lower odds of a high-risk waist circumference (OR 0.98; 95%CI 0.96–0.99), and the unhealthy plant-based diet index was associated with increased odds of having hypertension (OR 1.02; 95%CI 1.00–1.04). No other significant associations were identified between the plant-based diet quality indices and cardiometabolic outcomes. Conclusions: There was some evidence that the quality of plant-based dietary patterns was differentially associated with cardiometabolic health, with healthier plant-based dietary patterns associated with lower odds of a high-risk waist circumference, and less healthy plant-based dietary patterns associated with increased odds of hypertension. These findings support the consideration of the quality of plant foods consumed, and the need for targeted advice for optimising cardiometabolic health among adults. 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

Australia, which has one of the world’s highest per capita meat consumption rates, is hesitant toward adopting alternative proteins. This study examines consumer perceptions of protein alternatives and their perceived safety, nutritional value, health risks, cost and willingness to incorporate them into their diets. Using a mixed-methods approach, a survey of 520 Australians aged 18 to 64 revealed that while alternative proteins are viewed as occasional dietary options, younger consumers—despite their tendency to favour traditional food choices—show interest in plant-based milk and algae-based products. However, across all generations, interest in regular consumption of plant-based meats, insects and cultured meat remains low. These findings highlight evolving attitudes, challenges to market growth, and the importance of fostering greater consumer trust to encourage wider adoption of alternative proteins. Addressing generational differences in adoption and resistance will be essential for expanding market penetration. 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

Climate change is a global priority requiring immediate action. A thorough understanding of the source of greenhouse gas emissions is essential to inform reduction strategies. This study aimed to quantify the climate footprint of two therapeutic diets—one diet for an adult with coeliac disease and one diet for an adult with type 2 diabetes—and then compare the climate footprint of these diets with the standard Australian diet and the Australian adapted EAT Lancet Planetary Health Diet. In addition, potential areas for reductions in greenhouse gas emissions were explored. All diets were developed for a 71-year-old male reference person. The amount of carbon dioxide produced by each diet was determined using the GWP* calculator for the reference person. Both the gluten-free and diabetic diet had a measurable climate footprint and were not considered climate-neutral. The diabetic diet produced 1.35 kg of carbon dioxide equivalents [CO₂e] per day, and the gluten-free diet produced 2.51 kg of CO₂e per day. Meat, dairy, and discretionary foods were the major contributors to the climate footprint of the two therapeutic diets. Substituting lamb for beef and soy milk for cow milk in the Australian context resulted in a 25% reduction in the climate footprint for the diabetic diet and 29% reduction for the gluten-free diet. Dietetic advice to reduce the climate footprint of therapeutic diets for coeliac disease and type 2 diabetes should focus on adapting diets to reduce animal-based products. Full article

Chronic health conditions including obesity, cardiovascular diseases, type 2 diabetes, and depression are rising in Australia, and are often addressed reactively in adulthood rather than proactively during childhood. Evidence highlights the first 2000 days (from conception to five years of age) as a critical window for prevention, where movement, active play, proper nutrition, and adequate sleep are key to reducing chronic disease risk. Despite this, limited longitudinal data on children’s growth and development hinders effective intervention. Up to one in four Australian children are living with overweight or obesity, with poor movement behaviours, sedentary lifestyles, unhealthy diets, and inadequate sleep as primary contributors. Active play fosters motor skill development and lifelong health but faces barriers like overprotective caregiving and sedentary environments. Actionable strategies to enhance activity levels in this age group include providing educator training, developing online resources, fostering communities of practice, improving infrastructure, and advocating for policy changes. A coordinated effort by parents, caregivers, educators, and health professionals is essential to prioritise movement in early childhood, laying the foundation for healthier growth and reducing the burden of chronic diseases. Full article

Insect-based dog food is increasingly becoming available in pet food markets, potentially offering environmental and nutritional benefits, depending on insect species and how they are reared, processed, and utilized. However, there is limited understanding of dog owners’ attitudes towards the use of insects as protein alternatives for dogs. An online survey was conducted to explore Australian dog owners’ (n = 201) attitudes towards insect-based pet food, segmenting participants according to their food neophobia, previous insect consumption, and dog-human relationship. Participants’ dog food purchases were highly influenced by perceived health/nutrition, palatability, and product quality, with these factors being of most importance to ‘dog people’ (i.e., participants with closer relationships with their dogs). Participants were reasonably accepting of insect-based pet food made from mealworms and crickets and slightly accepting of products made from black soldier fly larvae. In contrast, participants’ responses to plant-based pet foods were neutral. Food neophiles, and to a lesser extent, insect-eating consumers (i.e., those who had previously eaten insects), were found to be more willing to feed their dogs insects in comparison to non-neophiles and non-insect-eating consumers. Overall, Australian dog owners appear to be supportive of feeding their dogs diets supplemented with insect protein. Insights from this study will help inform the development and marketing of insect-based pet foods. 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

Functional foods are currently receiving increasing popularity in diet modification. Green bananas contain far more dietary fiber (DF) and resistant starch (RS) than mature bananas. The potential for integrating these vital components into food, such as bread, has expanded. Thus, this study aimed to examine the physicochemical and rheological behavior of wheat flour dough after the addition of varying amounts of Australian, green banana flour (GBF) substitutions (5, 10, 15, 25, and 30%). Using MixoLab 2, we recorded the rheological parameters of the dough that had GBF substitutions. Additionally, the flour color (‘L*’, ‘a*’, and ‘b*’ value) and crumb cell structure analysis were evaluated. Although increasing the amount of GBF replacement generally improved dough quality with all banana cultivars, GBF from Cavendish and Ladyfinger showed a greater improvement than Ducasse. Improved dough mixing stability and increased viscosity, starch gelatinization, and retrogradation were all predicted to contribute to longer bread shelf life. RS content of the enriched bread increased significantly with both Ladyfinger and Ducasse (2.6%), while Ladyfinger bread had the highest DF (9.1%). With increasing GBF, L*, a*, and b* values were changed considerably with a strong linear correlation. A MATLAB analysis indicated substantial variations across samples regarding the small, medium, and total air space counts based on 10% banana flour as a standard level of addition. In conclusion, the processing properties and nutritional value of wheat flour can be enhanced by replacing specific proportions of wheat flour with green banana flour without major detrimental effects on dough processing attributes and thus highlight the possibility of utilizing GBF from different banana varieties for use in fine-tuning composite flour developments. 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