bluuebunny/crossref_metadata_2025 huggingface dataset:
Māori kai sovereignty to achieve food security
Authors: Roskruge N.R.
Published: May 2024

The FAO states that the term food sovereignty focuses on food for the people by placing people’s need for food at the centre of policies and insists that food is more than just a commodity. Food Sovereignty also promotes knowledge and skills by building on traditional knowledge; using research to support and pass on this knowledge to future generations; and rejecting technologies that undermine local food systems. It is essentially a movement that “recognizes that control over the food system needs to remain in the hands of producers, and is clearly focused primarily on small-scale agriculture of a non-industrial nature, preferably organic”(1). In Māori terms, Kai Sovereignty is drawn first from the relationship of foods to our needs; it is expressed through whakapapa, and has an overarching contribution to food security. Traditional foods abound in Aotearoa. The relationships are longstanding, expressive and contribute to our wellbeing in various ways(2). But the true cultural value of traditional foods is diminishing as new foods, lifestyles and experiences succeed them. Kai sovereignty therefore is at risk of being relegated to historical discourse. The FAO acknowledgement of the intergenerational role of traditional knowledge to support food sovereignty aligns well to the Māori experience. This knowledge covers a myriad of food relationships including foraging, producing, harvesting, processing, cooking and manaakitanga. We are in a renaissance period that seeks to rediscover our relationship with the pātaka, the food store. So much knowledge has been lost, but much also remains. How we draw that together in a way that acknowledges the whakapapa or historical relationship alongside the present and future. The right to achieving kai sovereignty is yet to be properly understood within our communities. The first steps lie in the knowledge space; sharing and acknowledgement of our food traditions before they are lost or misinterpreted.
Design of a multidimensional diet quality score for a global sustainable healthy diet based on plant food variety, intake of animal products and dietary contribution of ultra-processed foods (SUSDIET)
Authors: Machado P. , Denniss E. , McNaughton S.A. , Livingstone K.M. , Lawrence M.
Published: May 2024

A range of metrics have been developed and used to measure components of dietary patterns (e.g., adequacy, quality, diversity). However, no existing dietary metric simultaneously captures the three key dimensions of sustainable healthy diets recommended by the Food and Agriculture Organization of the United Nations and the World Health Organization: food processing; dietary diversity; and intake of animal products(1). This study aimed to identify indicators of a global sustainable healthy diet and translate these features into a multidimensional diet quality score (SUSDIET). Informed by our scoping review(1), a Delphi method was adopted in the form of a three-round online survey of 13 national and international experts in nutritional epidemiology, environmental health, dietary assessment and/or food and nutrition policy. Surveys were conducted between November 2022 and May 2023. Participants were asked about procedures to establish an operational definition for a global sustainable healthy diet. Based on consensus from global experts, we developed the SUSDIET, a food-based diet quality score incorporating variety of plant foods, intake of animal products, and dietary contribution of ultra-processed foods (the ‘dimensions’). Categories and amounts of foods consumed were informed by the Global Diet Quality Score(2), EAT Lancet Planetary Health(3) and a meta-analysis of the relationship between ultra-processed foods and all-cause mortality(4). The variety of plant foods is measured based on 12 food groups (citrus fruits, deep orange fruits, other fruits, dark green leafy vegetables, cruciferous vegetables, deep orange vegetables, other vegetables, legumes, deep orange tubers, nuts and seeds, whole grains, white roots and tubers), animal intake based on 5 food groups (egg, dairy, poultry, fish and seafood, red meat), and ultra-processed foods as one food group. Three categories of consumed amounts (in grams per day) are defined for variety of plant foods and animal intake, scoring as 0, 0.5 or 1. Ultra-processed food consumption is scored as 0 or 1 using ≤10% or >10% of total dietary intake as cut-offs. The components of each dimension are weighted so the three dimensions equally range from 0-5. SUSDIET overall score ranges from 0-15 (up to 5 points per dimension), with a higher score indicating a more healthy and sustainable diet. SUSDIET will be of immediate use for research aiming to assess the impact of diets on both health and environmental sustainability outcomes among the general adult population. This multidimensional diet quality score can also be used to inform and assess the effectiveness of policy actions that promote sustainable healthy diets, including the monitoring and surveillance of diets globally.
Feeding our Future: school food and local agriculture in the Pacific
Authors: Burkhart S.
Published: May 2024

Utilising local and traditional foods in schools presents a significant opportunity within our region to ensure food and nutritional security, support local livelihoods by driving markets and employment opportunities, increasing food literacy, and help students to understand the role of, and develop a preference for these foods. School meals programs (SMP) are increasingly touted as a strategy for food system transformation(1), however, are not widely used in the Pacific Islands(2). Yet, there is increasing interest and momentum towards understanding school food and nutrition environments and the use of SMP in this region, especially with models that support and promote the integration of local, traditional climate-resilient, nutrient rich foods. When a large scale SMP may not be possible, other school food and nutrition activities can be utilised to support nutritious food choice. Evidence collected over the last five years provides information on the current situation, activities, and capacity for providing food in schools across the Pacific Islands (2,3,4). Activities across the region vary from national SMP to gardening programs, nutrition education, providing canteens/tuckshops and other ad hoc activities, for example events for World Food Day. Some activities have a requirement for the use of local food, while some prioritise local foods in gardening programs and work with local farmers. Recently it has been shown that youth are exposed to, and have access to significant amounts of ultra-processed foods (UPF) around schools(3). Mapping of the foods available to students within a 400m radius of 88 schools in Fiji found that sugar sweetened beverages were available in 80%, and lollies/confectionary in just over 60% of outlets. Fresh fruit was available in just over 20% of outlets, while fresh vegetables were available in less than 20% of outlets(3). While there are many challenges to providing local, traditional, nutritious foods in schools, including access to financial, human, and physical resources, stakeholders have told us that one of the most significant is how modernisation and colonisation of food systems have resulted in a preference for hyperpalatable UPF and how this makes it more challenging to incorporate local produce in a way that is accepted by students. This provides an opportunity to further explore and share ways to integrate local, traditional, climate-resilient, nutrient rich foods in schools to support children and adolescents to value, utilise, prefer, and advocate for these foods. There is a need to support the utilisation of traditional, local foods in schools by advocating for policy (at various levels, right from a school level upwards) that drives the use of these foods and creates more supportive school food environments.
Inflammatory Bowel Diseases and Nutrition
Authors: Schultz M.
Published: May 2024

Inflammatory Bowel Diseases (IBD) are chronic intestinal disorders, characterised by periods of quiescent disease and episodes of heightened disease activity. The diseases mainly affect the gastrointestinal tract. Often, patients experience a limited quality of life as a result of dietary restrictions, fatigue and other factors leading to mood disturbances, malnutrition, and inactivity amongst others. This presentation will give an overview of work done to identify factors leading the above findings which in our view are to some degree modifiable. We will look at availability and expertise of dietitians supporting patients with IBD, dietary and lifestyle modifications aiming to reduce the Burden of Disease.
Diet, Gut Physiology, and the Microbiota-Gut-Brain Axis
Authors: Roy N.C.
Published: May 2024

Diet is a large influencer of the gut microbiota composition and function across the lifespan. However, information on whether and how diet can affect the brain via bidirectional communication between the gut and the central nervous system (the microbiota-gut-brain axis) is emerging. Immune, endocrine, humoral, and neural connections between the gastrointestinal tract and the central nervous system are important to this axis. The gut microbiota can produce cytokines, neurotransmitters, neuropeptides, chemokines, endocrine messengers, and microbial metabolites (e.g., short-chain fatty acids, branched chain amino acids, and peptidoglycans), some of which can enter the brain, influencing the function of brain cells. Animal studies investigating the potential of nutritional interventions on this axis have advanced our understanding of the role of diet in this bidirectional communication. This includes insights into microbial metabolites, immune, neuronal, and metabolic pathways amendable to dietary modulation. However, several aspects of the gastrointestinal tract and brain of animal models differ to humans, and it is important to consider these differences and similarities when evaluating the transability of the findings to the human context. Randomised clinical trials using dietary interventions in humans in this field are limited but have high potential application for clinical nutrition. In particular, several microbiota-targeted interventions have been explored as potential approaches for mental health. These approaches include probiotics, prebiotics, etc. as well as dietary approaches(1,2,3). However, there are limited clinical interventions with whole-dietary approaches. Most human studies used faecal samples to infer changes in microbiota parameters occurring in the gastrointestinal tract and do not consider the physiological changes in gastrointestinal physiology (e.g., transit time) that can directly or indirectly affect the diversity and composition of the gut microbiome. Future research considerations should include better characterisation of the participants at baseline (dietary patterns, gastrointestinal phenotype, and gut microbiota composition) to identify potential responders to dietary interventions. In addition to gut microbiota assessment, evaluations of physiological parameters, brain function and behavioural measurements should be considered as part of the study protocol. In this presentation, the current state of the literature triangulating the diet, the gut microbiota, and host behaviour/brain processes will be addressed. Future research considerations will also be discussed.
Swapping white for high-fibre bread exceeds fibre target and improves microbiome diversity
Authors: Wang Y. , Wymond B. , Belobrajdic D.
Published: May 2024

A majority of Australians consume a limited range of different dietary fibres and insufficient total dietary fibre(1). This contributes to low intestinal microbial diversity and impaired microbial function, such as capability in producing beneficial metabolites like short-chain fatty acids (SCFA). This diet-induced dysbiosis is associated with poor gastrointestinal health and a broad range of non-communicable diseases(2). Our study aimed to determine whether one dietary change, substitution of white bread with a high fibre bread improves faecal microbial diversity and butyrate-producing capability. Twenty-six healthy adults completed a randomised, cross-over, single-blinded intervention. Over the two intervention phases separated with a 4-wk washout, participants consumed either 3 slices of a high fibre bread (Prebiotic Cape Seed Loaf with BARLEYmax®) or control white bread as part of the usual diet, each for 2 weeks. At the beginning and end of each intervention period, participants completed a 24-h diet recall, a gut symptoms rating questionnaire and provided a faecal sample for microbiome analysis. The composition of faecal microbiome was characterised using 16S rRNA amplicon sequencing (V3-V4) and a marker of butyrate synthesis capability, the faecal content of butyryl-CoA:acetate CoA-transferase (BCoAT) gene was assessed using Real-time PCR. The high fibre bread intervention increased the servings of whole grain from 1.5 to 4 per day and increased total dietary fibre intake to 40 g/d which was double the amount of fibre consumed by participants at baseline or during the white bread intervention. Compared to white bread, the high fibre bread increased richness and evenness (Shannon, p = 0.014) of the gut microbiota and increased the relative abundance of SCFA producing taxa Lachnospiracae ND3007 group (p <0.001, FDR = 0.019). In addition, the high-fibre bread tended to increase relative abundance of butyrate-producing genus Roseburia, and microbial BCoAT gene content compared to white bread. In conclusion, the substitution of white bread with high-fibre bread improved the diversity of gut microbiota, specific microbes involved in SCFA production and may enhance the butyrate production capability of gut microbiota in healthy adults.
Evidence based lifestyle interventions in Polycystic Ovary Syndrome
Authors: Moran L.
Published: May 2024

Polycystic ovary syndrome (PCOS) is a common endocrine condition which affects up to 13% of reproductive-aged women and is associated with reproductive, metabolic and psychological features. Women with PCOS have a higher prevalence of longitudinal weight gain in population-based cohort studies compared to women without PCOS. On meta-analysis, women with PCOS also have an increased prevalence of overweight, obesity and central obesity, compared with controls. PCOS is therefore associated with an elevated prevalence of overweight and obesity which further worsen metabolic, reproductive and psychological dysfunction. Given the association between overweight and obesity and metabolic, reproductive and psychological dysfunction in women, weight management is a logical treatment strategy. This can be defined as prevention of excess weight gain, achieving a modest weight loss and sustaining a reduced weight long-term. This is best achieved through lifestyle management which traditionally refers to a complex multidisciplinary approach that combines dietary modification, physical activity and behavioural interventions. Lifestyle interventions and modest weight loss (5-10% of initial body weight) are associated with improvements in outcomes including central adiposity, hyperandrogenism, insulin resistance and cardiovascular risk factors. In PCOS specifically for dietary interventions, the majority of evidence indicates no differences between dietary approaches Lifestyle management advice should therefore follow general population guidance which states that lifestyle intervention can be achieved through a variety of dietary approaches providing these are tailored to dietary preferences and ensure the nutritional and health status of the individual patient with referral to a nutrition professional where possible. These recommendations are summarised in the 2023 International Evidence-based Guidelines on the Assessment and Management of PCOS. 1 These guidelines are now being translated and implemented internationally.
Can the Mediterranean diet be a key to unlocking women’s reproductive health?
Authors: Mantzioris E.
Published: May 2024

The traditional Mediterranean Diet (MedDiet) is consistent with a dietary pattern and time-honoured eating behaviours by populations living in the olive-tree growing areas of the Mediterranean basin before the mid-1960’s. The MedDiet is described in the literature as a plant-based dietary pattern, consistent with a high intake of vegetables, fruits, nuts, legumes, wholegrains cereals, and daily use of extra-virgin olive oil incorporated into all meals; moderate consumption of fish, shellfish, fermented dairy products (cheese and yogurt), and wine (typically during meals); and a low or infrequent consumption of meat and processed meat products, processed cereals, sweets, vegetable oils, and butter(1). Being predominately plant-based, the MedDiet is naturally low in saturated fat, and rich in several functional components, including vitamins and minerals, carotenoids, unsaturated fatty acids, and phenolic compounds, depicted by antioxidant and anti-inflammatory properties. As a result of its putative beneficial health effects, the MedDiet is one of the most widely evaluated dietary patterns in the scientific literature(2). In both observational and intervention studies, there is a large and consistent body of evidence to support that a MedDiet is protective against chronic and inflammatory conditions, including cardiovascular disease, metabolic syndrome, management and prevention of type 2 diabetes, central adiposity, cancer, neurodegenerative conditions, and frailty(3). The effect of the MedDiet on women’s reproductive health is an emerging area in the literature. There have been a range of studies (observational and interventional) examining outcomes related to menarche, menstrual cycle, pregnancy, infertility, lactation, and menopause. The MedDiet has also been studied for the management of conditions such as polycystic ovary syndrome and endometriosis. These conditions are often associated with hormonal imbalances, inflammation, and oxidative stress, all of which can be influenced by the diet’s key components. The MedDiet may be a promising nutritional strategy for promoting women’s reproductive health. However, more extensive, and rigorous studies, including randomized controlled trials and longitudinal investigations, are necessary to establish a causal relationship between the MedDiet and women’s reproductive health outcomes. While the adoption of a MedDiet in non-Mediterranean populations is appealing, consideration needs to be given about potential barriers and enablers towards adherence(4). Furthermore, while the primary focus has been on nutritional strategies within the framework of the Mediterranean Diet, equal attention must be given to the eating behaviours and lifestyle factors associated with it.
Dietary fibre intake, adiposity, and metabolic disease risk in Pacific and New Zealand European women
Authors: Renall N. , Merz B. , Douwes J. , Corbin M. , Slater J. , Tannock G.W. , Firestone R. , Kruger R. , Breier B.H. , Te Morenga L.
Published: May 2024

The aim of this study was to explore associations between habitual dietary fibre intake, adiposity, and biomarkers of metabolic health in Pacific and New Zealand European women who are known to have different metabolic disease risks. Pacific (n = 126) and New Zealand European (NZ European; n = 161) women (18-45years) were recruited to the PROMISE cross-sectional study(1) based on normal (18-24.9kg/m2) and obese BMI (≥30kg/m2). Body fat percentage (BF%), measured using whole body DXA, was used to stratify participants into low (<35%) or high (≥35%) BF% groups. Habitual dietary intake was calculated using the National Cancer Institute method, involving a 5-day-food-record and a semi-quantitative FFQ. Fasting blood was analysed for glucose, insulin, and lipid profile. NZ European women in the low- and high-BF% groups were older, less socioeconomically deprived, and consumed more dietary fibre (median 23.7g/day [25-75-percentile, 20.1, 29.9]; 20.9 [19.4, 24.9]) than Pacific women (18.8 [15.6, 22.1]; 17.8 [15.0, 20.8]; both p<0.001), respectively. Pacific women consumed a higher proportion of their total fibre intake from discretionary fast foods, in contrast NZ European women consumed more dietary fibre from wholegrains. Regression analysis controlling for ethnicity, age, socioeconomic deprivation, energy intake, protein, total carbohydrate, and fat intake showed significant inverse associations between higher dietary fibre intake and BF% and visceral fat% (β = −0.47, 95% CI = −0.62, −0.31, p<0.001; β = −0.61, [−0.82, −0.40], p<0.001, respectively) among both Pacific and NZ European women. LDL-C (β = −0.04, [−0.06, −0.01]) was inversely associated with fibre intake following further adjustment for BF%-groups in NZ European women. Despite differences in intake, dietary fibre was inversely associated with adiposity and metabolic disease risk in both Pacific and NZ European women. However younger woman living in areas of higher socio-economic deprivation who consumed a higher proportion of total dietary fibre intake from discretionary fast foods were more likely to have low dietary fibre intakes than older, wealthier women. These women were also more likely to be Pacific women. Increasing habitual dietary fibre intake could help to reduce adiposity and metabolic disease risk; so implementing policies that make health-promoting high fibre foods more affordable, ensuring households have sufficient income to purchase nutritious food and limiting the amount of unhealthy food marketing that low income communities are exposed to should be public health priorities.
FAO’s approach to addressing non-communicable diseases
Authors: Nyemah Nyemah J.
Published: May 2024

Non-Communicable Diseases (NCDs) constitute the most notable single killer of the population of Pacific Small Island Developing States (SIDS). It is therefore not surprising that the leaders of Pacific SIDS recognize NCDs as a crisis(1). But just as it is in many parts of the world, addressing NCDs in the Pacific is a complex challenge for many reasons. For example, and in the midst of recurrent climate change disasters, it would be fair to wonder if Pacific SIDs and development stakeholders – and academia included - have not become overwhelmed in obtaining more clarity about the main causes of NCDs, and tackling them with the relevant prioritization, policy environments that address economic and market forces, coordinated interventions, good examples from leaders, actions driven leadership, not blaming the victims, and a lot more. Maybe it is too uncritical and simplistic to continue to make the historical argument that the population of Pacific SIDS are obese, overweight, suffer from micronutrient deficiencies, stunting, and so forth because they choose poor diets and physical inactivity, or simply because all of this is cultural.

The foregoing context demands more criticality and contributes to the rise of several philosopher kings who so easily describe NCDs as a disease that requires a health approach in absolutism. But if we were to invest more into obtaining deeper insights about the causes of NCDs in the Pacific, there could be a possibility for stakeholders to increasingly advocate for a systems approach to addressing NCDs in the Pacific. A systems approach would for example, recognize that as economic development receives more investments, people will conversely reduce walking in favor of vehicle transportation, children will spend less time playing outside in favor of watching television, more highly processed food of high salt, sugar and fat contents will be marketed and affordable than locally grown food, people will work in the service sector to the detriment of traditional gardening. A systems approach would account for a combination of biomedical, food systems, educational, religious, socio-cultural, recreational, etc… approaches.

As one of the development stakeholders, the Food And Agriculture Organization of the United Nations (FAO) joins efforts with others to address NCDs in the Pacific(2). The entry point for FAO is through promoting the production and consumption fresh, safe, nutritious and healthy foods. My intervention at the 2023 Joint Conference of the Nutrition Societies of New Zealand will provide insights into FAO’s work from this vantage point.
The barriers and enablers to providing healthy food in New Zealand secondary school canteens
Authors: Coady O. , Smith C. , Styles S.
Published: May 2024

Establishing healthy lifelong eating habits in young people is important for short and long-term health(1). Schools are ideal setting to improve diet. However, research shows that many school food environments are unhealthy(2). In New Zealand (NZ), the canteen is a popular food provision, particularly in secondary schools. This research aimed to explore the barriers and enablers to providing healthy food and beverages in NZ secondary school canteens. In 2022, 6 secondary schools were purposively selected to participate in semi-structured interviews about foods and beverages sold in schools’ canteens and the factors that influenced this. In total, 11 stakeholders representing six schools and one staff member of an external catering company completed interviews. The interviews were transcribed and analysed using a reflexive thematic analysis approach(3). Four themes were developed. Theme 1 Action-oriented school policies that are based on healthy eating principles can facilitate healthier canteens highlighted the use and characteristics of policies. The subtheme highlighted that Mandatory policies are more enforceable. Theme 2 Multiple component opt-in programs or interventions facilitate a healthier school food provision shows that opt-in government interventions (e.g. Ka Ora, Ka Ako, the NZ free school lunch initiative) with funding, monitoring, and incentives can improve food provision. The subtheme Health-enhancing changes inthe school environment has flow-on effect to canteens showed that these changes can affect the entire school food environment. Theme 3 Healthy canteens get lost in the “pecking order” of what’s important highlights that while schools and key stakeholders may believe healthy eating is important, other factors related to well-being and education were more important to prioritise within the school’s limited resources. Theme 4 People’s values, attitudes and beliefs may help and hinder the healthiness of canteens and explores the role champions have in influencing the healthiness of the canteen. Champions were those with a positive, proactive attitude, value healthy eating and are capable. Subtheme 1 Meet student preferences while providing healthy food was a common barrier many champions worked hard to overcome. The final subtheme identified how A collaborative approach within schools and their communities can overcome barriers to healthy canteens. Government mandates and interventions can positively impact the canteen and other food provisions. This research supports a recommendation for schools to create and implement school policies around food encompassing a whole-school approach.
Mealtime and food provision environments in primary schools – an opportunity for nutrition intervention?
Authors: Kempler J. , Margerison C. , Nanayakkara J. , Booth A.
Published: May 2024

Mealtime environments and food provision contexts in primary school influence students’ food behaviours(1) and are an opportunity for nutrition intervention(2). This study aims to explore primary school food provision contexts including eating environments and food provision models and policies. A quantitative cross-sectional online survey of Australian primary school teachers undertaken between August 2022-July 2023 collected data about: (1) designated eating times and locations for lunch and snacks; (2) teacher use of mealtimes for food and nutrition education; and(3) presence of food services and food-related policies. Descriptive statistics were generated using Stata 17.0 statistical software. Participants were 239 teachers recruited via social media advertising and education/nutrition networks. The majority of teachers reported their school provided allocated time for children to eat a morning snack (n = 201, 84%) and lunch (n = 234, 98%). Around three quarters of teachers reported an allocated eating time of 10 minutes or less for morning snack (n = 146, 73%) and 15 minutes or less for lunch (n = 174, 74%). Teachers stated lunch was most commonly eaten in the classroom with time to finish in the yard (n = 90, 38%) or in the yard as a group (n = 70, 30%). It was most common for morning snack to be eaten in the classroom (n = 119, 59%). Most teachers stated they had the opportunity to eat lunch with their students at least sometimes (n = 159, 67%). Of these teachers, 31% (n = 50) reported they used this time to teach students about food and nutrition, for example, in a pedagogical lunch. Of 109 teachers who did not use lunch time to teach students about food and nutrition, 43% (n = 69) stated they would be interested in doing this in the future. When asked about the availability of food services at their school, 62% (n = 147) of teachers reported their school had a canteen, 28% (n = 67) reported their school offered lunch orders via an external food outlet and 35% (n = 83) reported their school had a breakfast program. Only 34% of teachers reported their school had policies about the foods available from school food services. From these findings we conclude that a variety of mealtime and food provision contexts exist within Australian primary schools, and that there is opportunity to leverage eating occasions and food provision models and policies for nutrition intervention. This includes the opportunity to utilise mealtimes for delivering food and nutrition education, for example, through the concept of a pedagogical lunch.
Development of the iOTA Model®; a dietary optimisation tool for assessing nutrient adequacy, environmental impact and acceptability of diets in New Zealand
Authors: Tavan M. , Smith N. , McNabb W.
Published: May 2024

Based on the World Health Organization’s definition(1), sustainable healthy diets are “dietary patterns that promote all dimensions of an individuals’ health and well-being; have low environmental pressure and impact; are accessible, affordable, safe and equitable; and are culturally acceptable”. Over the past decade, there has been an increasing interest in the environmental sustainability of diets, but little attention has been paid to the nutrient adequacy, consumer acceptability and affordability of such diets. Such knowledge is particularly scarce in New Zealand where approximately 40% of adults and 20% of children may live under severe to moderate food insecurity(2,3). The iOTA Model® is a dietary optimisation tool designed to fill this gap by bringing the various aspects of diet sustainability together and providing evidence-based knowledge on not just the environmental impact of food but also its economic and nutritional sustainability at a national level. The iOTA Model® was constructed using mixed integer linear programming by integrating New Zealand-specific dietary data. This underlying data was obtained from various open-access sources including but not limited to New Zealand’s Food Composition Database, New Zealand Total Diet Study and the nutrient reference values published by the Ministry of Health. Diet-related greenhouse gas emissions were also incorporated into the model based on the data obtained from the scientific literature. Results derived from the preliminary development of the iOTA Model® suggest that meeting nutrient adequacy is possible with minimal dietary pattern changes in New Zealand. It is also evident that adhering to dietary guidelines may provide 26% reduction in dietary greenhouse gas emissions. This is consistent with the findings of previous studies showing that following dietary guidelines alone assists reduction of dietary greenhouse gas emissions. Further features such as digestibility and bioavailability considerations have also been incorporated as part of the iOTA Model®, allowing for a more accurate estimation of nutrient supply. The model will be available as an open-access tool and will allow users to explore various sustainability implications of their diet.
Identifying the barriers and facilitators to fruit and vegetable consumption in rural Australian adults
Authors: Carroll B.T. , McNaughton S.A. , Marchese L.E. , Livingstone K.M.
Published: May 2024

Within rural Australia, only 47% and 9% of adults meet recommendations for fruit and vegetable intake, respectively, which is a leading contributor to the increased risk of non-communicable disease. Previous literature has identified barriers and facilitators to increasing fruit and vegetable intake in rural Australian settings, such as having greater access to fresh produce(1). However, this literature is limited by observing fruit and vegetables as a single food group and small sample sizes. This study aimed to determine the barriers and facilitators to meeting fruit and vegetable recommendations (as separate food groups) in rural Australian adults. It was hypothesised that barriers and facilitators to consumption of fruits and vegetables would be identified at the individual, social-environmental and physical-environmental levels of a socio-ecological framework and these would differ between fruit and vegetables(2). Data from the 2019 Active Living Census were used, completed in the Loddon Campaspe region of north-west Victoria, Australia. Data were available at the level of the individual (socio-demographic characteristics, health behaviours, education level, financial stability), social-environment (household size), and physical-environment (use of community gardens). Information on fruit and vegetable consumption was collected using two open-ended questions asking how many serves were consumed each day. Survey weighting was used to account for the survey design. Descriptive statistics were reported for continuous (mean and standard errors [SE]) and categorical (frequencies) data. Multivariate logistic regression analyses were used to determine odds ratios (OR) and 95% confidence intervals (CI) for meeting fruit and vegetables recommendations according to barriers and facilitators at the individual, social-environmental and physical-environmental level. A total of 13,464 adults with complete data were included in the analysis (51% female; mean age 48 (0.17) years). Mean fruit intake was 2.85 (0.02) serves per day and mean vegetable intake was 1.56 (0.01) serves per day. A total of 48% of participants consumed the recommended two serves of fruit daily, while 19% consumed the recommended five serves for vegetables. Multivariate analyses determined distinct barriers and facilitators to consumption between fruit and vegetables. For example, a larger household size facilitated meeting vegetable recommendations (OR: 1.41; 95% CI: 1.22, 1.63), but not fruit, and greater alcohol consumption was a barrier to meeting fruit recommendations (OR: 1.47; 95% CI: 1.31, 1.64), but not vegetables. Common facilitators across both fruit and vegetables included higher age, lower BMI, being a non-smoker, and engaging in more vigorous activity. The results of this research will help inform future policies to increase both fruit and vegetable intake in rural communities, therefore contributing to efforts to improve the health of rural Australians.
Changes in liver health biomarkers following consumption of energy restricted diets containing almonds compared with carbohydrate-rich snack foods for 9 months
Authors: Coates A.M. , Afzali O. , Childs J. , Carter S. , Lamb K. , Matheson M. , Yandell C. , Buckley J.D. , Tan S-Y. , Rogers G.B. , Hill A.M.
Published: May 2024

Energy restricted diets improve liver function(1) and habitual nut consumption has been associated with a lower prevalence of fatty liver(2). This study examined the effect of incorporating almonds in an energy restricted diet on liver health biomarkers. One Hundred and forty adults (42M:98F, 47.5 ± 10.8 years, BMI 30.7 ± 2.3 kg/m2) enrolled in a 9-month (9M) dietary intervention comprising 3 months (3M) weight loss (30% energy restriction) followed by 6 months (6M) of weight maintenance. Participants were randomly assigned to consume almonds (n = 68, AED) or isocaloric carbohydrate-rich snacks (n = 72, CRD) which provided 15% of total daily energy. At baseline (BL), 3M and 9M, fatty liver index (FLI) scores (0-100)(3) were calculated using body mass index (BMI), waist circumference (WC), fasting serum gamma-glutamyl transferase (GGT) and triglyceride (TAG) levels, and other liver health biomarkers were assessed by ultrasound (volume, visual appearance and elastography (a marker of stiffness due to fibrosis)). Intention to treat analyses were conducted using mixed effects modelling (fixed effects group and time, with participants as the random effect). Significant reductions from BL occurred over time (all p<0.001 for 3M and 9M) with no difference between groups (AED vs CRD, P>0.05) in BMI (3M: −2.44 ± 0.20 vs −2.32 ± 0.20, 9M: −2.83 ± 0.19 vs −2.81 ± 0.19 kg/m2), WC (3M: −8.04 ± 0.79 vs −7.00 ± 0.81, 9M: −8.72 ± 0.83 vs −9.14 ± 0.81 cm), TAG (3M: −0.24± 0.08 vs −0.22 ± 0.09, 9M: −0.37 ± 0.09 vs −0.21 ± 0.09 mmol/L), FLI score (3M: −23.8 ± 2.0 vs −17.6 ± 2.1, 9M: −23.8 ± 2.0 vs −17.6 ± 2.1), and liver volume (3M: −134.56 ± 38.30 vs −100.96 ± 37.25, 9M: −113.68 ± 37.42 vs −110.64 ± 35.47cm3). Significantly greater reductions occurred for AED compared to CRD at 3M and 9M in GGT (p = 0.003) (3M: −9.68 ± 1.93 vs −0.01 ± 2.00, 9M: −7.75 ± 2.06 vs −2.78 ± 2.15 IU/L) and liver visual assessment scores (p = 0.03) (3M: −0.58 ± 0.24 vs −0.45 ± 0.23, 9M: −1.33 ± 0.23 vs −0.50 ± 0.22). There were no significant changes in liver elastography over time or between groups. Energy restriction improved body composition and reduced the extent of fatty liver and liver size but did not change liver stiffness. The inclusion of almonds in an energy restricted diet demonstrated additional benefits to some liver health biomarkers providing support for almonds being incorporated into lifestyle interventions to improve liver function.
Anthocyanins attenuate vascular and inflammatory responses to a high fat high energy meal challenge in overweight older adults: A cross-over, randomised, double-blind clinical trial
Authors: do Rosario V. , Charlton K.E. , Chang C. , Francois M. , Roodenrys S. , Kent K. , Weston-Green K.
Published: May 2024

Postprandial metabolic imbalances are important indicators of later developing cardiovascular disease (CVD)(1). This study investigated the effects of food anthocyanins on vascular and microvascular function, and CVD associated biomarkers following a high fat high energy (HFHE) meal challenge in overweight older adults. Sixteen subjects (13 female, 3 male, mean age 65.9 SD 6.0 and body mass index 30.6 kg/m 2 SD 3.9) participated in a crossover, randomised, controlled, double-blind clinical trial (Australian New Zealand Clinical Trials Registry # ACTRN12620000437965). Participants consumed a HFHE breakfast meal (65g total fat; 33g saturated fat) together with a 250 mL dose of either intervention (Queen Garnet Plum providing 201 mg anthocyanins) or control (apricot) juice. A wash-out period of 14 days occurred between meal challenges, with a 4-day run-in period for juice consumption before each challenge. Blood samples and blood pressure measures were collected at baseline, 2 h and 4 h following the HFHE meal. Vascular function, assessed using flow mediated dilatation (FMD), and microvascular cutaneous vascular reactivity, measured using Laser Speckle Contrast Imaging (LSCI), were evaluated at baseline and 2 h after the HFHE meal. Participants had a higher 2 h postprandial FMD (+1.14%) and a higher microvascular post-occlusive reactive hyperaemia (+0.10 perfusion units per mmHg) when allocated to the anthocyanin compared to the control arm (P = 0.019 and P = 0.049, respectively). C-reactive protein was lower 4 h postprandially in the anthocyanins (1.80 mg/L, IQR 0.90) vs control arm (2.30 mg/L, IQR 1.95) (P = 0.026), accompanied by a trend for lower concentrations of interleukin-6 (P = 0.075). No significant postprandial differences were observed between treatments for blood pressure, triacylglycerol, total cholesterol, serum derivatives of reactive oxidative metabolites, tumor necrosis factor α, interleukin-1 β, or maximum microvascular perfusion following iontophoresis of acetylcholine. Fruit-based anthocyanins attenuated the potential postprandial detrimental effects of a HFHE challenge on parameters of vascular and microvascular function, and inflammatory biomarkers in overweight older adults. Anthocyanins may reduce cardiovascular risk associated with endothelial dysfunction and inflammatory responses to a typical high fat ‘Western’ meal.
Evaluating the effect of replacing wheat flour with legume flour on ileal amino acid digestibility in healthy adults with an ileostomy
Authors: Belobrajdic D. , Brook H. , James-Martin G. , Weerakkody R. , Stockman R.
Published: May 2024

Protein-rich animal foods are highly digestible, high-quality sources or protein, whereas the protein quality of plant-based foods can vary considerably. Given the growing interest in alternative non-animal-based sources of protein, it is important to establish the protein digestibility of these new foods and protein concentrates which have important health implications especially for vulnerable groups who don’t consume sufficient dietary protein. The human ileostomy model is ideal for measuring protein digestibility as it enables protein digestion to be quantified independent of protein degradation in the large intestine. The aim of this study was to determine the protein digestibility and quality of a wheat-based food containing legume flours. This randomised, double-blinded, controlled cross-over intervention was conducted in 4 proctocolectomised adults with conventional and well-functioning permanent ileostomies. The study was conducted over 2 weeks and on each testing day, the participant consumed 2 test muffins (125 g each) or 2 protein-free cookies in the morning (breakfast and morning tea) followed by a standardised low-protein lunch and afternoon tea. Test muffins were made using a standard muffin recipe using wheat flour and for 2 of the test muffins 50% of the flour was substituted with soy or lupin flour. An indigestible marker, titanium dioxide was added to the muffins so that the completeness of muffin recovered in ileal digesta could be calculated. The digestible indispensable amino acid score (DIAAS) was determined by comparing concentrations of true ileal digestible indispensable amino acids to recommended amino acid requirements(1). Data was reported as mean ± SD and repeated measures ANOVA was used to compare means between treatment groups with significance reported at P < 0.05. Substituting 50% of wheat flour in muffins with soy or lupin flour doubled the protein content of muffins (soy 11.8 g/100g and lupin 10.6 g/100g) compared to muffins that only contained wheat flour (wheat 5.1 g/100g). However, substituting wheat with legume flour did not affect protein digestibility which was similar for all muffin types; wheat (76.8 ± 7.0%), soy (77.9 ± 7.4%) and lupin (81.6 ± 6.9%) (P = 0.181). The DIAAS values for all muffins were below 75% which is classified as the cut off for a good quality protein food. In conclusion, substitution of wheat-based muffins with soy and lupin flour increased the protein content of wheat-based muffins but protein digestibility and overall protein quality was similar.
Resistant starch content of selected Australian foods
Authors: Hareer L. , Tran C. , O’Neill H. , Genoni A.
Published: May 2024

A growing body of research has identified interactions between microorganisms and nutrients within the gut, collectively referred to as the ‘gut microbiome’(1). Alongside this, distinct structural characteristics/components of dietary fibre have been recognised to exhibit various physiological effects on the body(1). These inherent physiological properties have the potential to result in diverse health benefits through the consumption of resistant starch, a specific form of dietary fibre(2). It is important to note that the laboratory-based techniques employed to assess resistant starch content from current Australian dietary composition data are antiquated and have not been conducted using updated testing methods(3). Results from updated testing methods may contribute to and inform nutritional recommendations to support and improve health outcomes. To assess the resistant starch content of starch-containing Australian foods using the updated Association of Analytical Chemists (AOAC) 2002.02 testing methods approved by Food Standards Australia New Zealand(3). Standardised kits (K-RSTAR) and control flours were used for assaying. Forty commonly consumed and available Australian foods were tested in duplicate for their resistant starch content. Calculated resistant starch values (in grams) were recorded using calculation tools provided by Megazyme. Means, standard deviations, and coefficient of variations between duplicate samples were recorded in a Microsoft Excel spreadsheet. The resistant starch content of foods varied from 0-13.72g/100g for rice crackers, beetroot, and hi-maize pancakes, respectively. Foods with the highest resistant starch were hi-maize flour pancakes, red kidney beans, Lebanese bread, and Cornflakes cereal, which ranged from 2.30-13.72g/100g. The lowest resistant starch foods included beetroot, rice crackers, All Bran cereal, and Nutri-grain cereal, ranging from 0-0.04g/100g. Changes in the foods’ natural chemical, physical, and enzymatic qualities may have led to slight batch variations and deviations from the literature available. This study is the first known Australian study to investigate the resistant starch content of selected Australian foods using the AOAC 2002.02 assay method. This data can be used to assess resistant starch consumption in the Australian population, inform gut microbiome research, and guide clinical practice recommendations for fibre intake.