What Do We Know about the Diets of Pacific Islander Adults in Papua New Guinea? A Scoping Review.

While a large proportion of the population in Papua New Guinea (PNG) maintain a subsistence lifestyle, exposure to modernisation and industrialisation since European contact has influenced a transition towards Western diets. This review aimed to scope and summarise the published research on dietary intake among Pacific Islander adults in PNG. Four electronic databases and grey literature were searched. Two reviewers completed the screening and data extraction. Fourteen studies were included from the Highlands (n = 7), Southern (n = 5), Momase (n = 1) and both the Highlands/Southern region (n = 1). No studies were from the Islands region. The majority of the studies were published prior to the year 2000 (n = 9). Geographical region and degree of urbanisation had an impact on dietary intake. Urban areas reported higher intakes of energy, protein and fat compared to rural areas. In the Southern region, a variety of foods, including sago, taro, kaukau, cooked banana, coconut and cassava contributed to energy intake, while kaukau was the main energy and protein source in the Highlands. The main foods contributing to protein in the Southern region were fresh fish, land animals and purchased animals. This review highlights an evidence gap regarding dietary intake research. Within the context of international initiatives, there is an urgent call for research aimed at understanding the social and cultural contextualisation of dietary behaviours in PNG.

Iron Content of Wheat and Rice in Australia: A Scoping Review.

With a shift towards plant-based diets for human and planetary health, monitoring the mineral content of staple crops is important to ensure population nutrient requirements can be met. This review aimed to explore changes in the iron content of unprocessed wheat and rice in Australia over time. A comprehensive systematic search of four electronic databases and the gray literature was conducted. A total of 25 papers published between 1930 and 2023 that measured the iron content of unprocessed wheat and rice were included. Triticum aestivum was the most common wheat type studied, including 26 cultivars; iron content ranged from 40 to 50 µg/g in the 1930s and 1970s and was more variable after this time due to the introduction of modern cultivars, with most values between 25 and 45 µg/g. The iron content of rice (Oryza sativa) was more consistent at 10-15 µg/g between the 1980s and 2020s. Variations over the years may be attributed to environmental, biological, and methodological factors but these were not well documented across all studies, limiting the interpretation of findings. As the number of individuals following plant-based diets continues to rise, the ongoing monitoring of the mineral content in commonly consumed plant-based foods is warranted.

The association between diet quality and chrononutritional patterns in young adults.

PURPOSE: Young adults eat erratically and later in the day which may impact weight and cardiometabolic health. This cross-sectional study examined relationships between chrononutritional patterns and diet quality in two young adult populations: a university and community sample. METHODS: Three days of dietary data were collected including food images captured using wearable cameras. Chrononutritional variables were extracted: time of first and last eating occasions, caloric midpoint (time at which 50% of daily energy was consumed), number of eating occasions per day, eating window, day-to-day variability of the above metrics, and evening eating (≥20:00h). The Healthy Eating Index for Australian Adults scored diet quality. Statistical analyses controlled for gender, body mass index, and socio-economic status. RESULTS: No significant associations between chrononutritional patterns and diet quality were found for all participants (n = 95). However, differences in diet quality were found between university (n = 54) and community (n = 41) samples with average diet quality scores of 59.1 (SD 9.7) and 47.3 (SD 14.4), respectively. Of those who extended eating ≥20:00 h, university participants had better diet quality (62.9±SE 2.5 vs. 44.3±SE 2.3, p < 0.001) and discretionary scores (7.9±SE 0.9 vs. 1.6±SE 0.6, p < 0.001) than community participants. University participants consumed predominately healthful dinners and fruit ≥20:00h whereas community participants consumed predominately discretionary foods. CONCLUSION: For the general young adult population, meal timing needs to be considered. Food choices made by this cohort may be poorer during evenings when the desire for energy-dense nutrient-poor foods is stronger. However, meal timing may be less relevant for young adults who already engage in healthy dietary patterns.

Snacking Behaviours of Australian Young Adults: Secondary Analysis of the MYMeals Cross-Sectional Study.

Snacking outside main meals may contribute to the high intakes of discretionary foods (i.e., unhealthful foods) among young adults. This study assessed the snacking behaviours of Australian young adults including the contribution of snacking to energy and nutrient intakes, the main foods consumed, and portion sizes. A secondary analysis of the MYMeals study of adults aged 18-30 years who consumed at least one snack food during the recording period (n = 889) was conducted. All food consumed over 3 consecutive days was recorded using a purpose-designed smartphone app. Snack foods contributed 13.2% of energy, 23.4% of total sugars, and 16.2% of saturated fat. Females consumed more energy (13.8% vs. 12.2%, p = 0.007) and total sugars (25.8% vs. 20.8%, p = 0.009), from snacking than males. Fruit (20.2%), chocolate (9.9%), cake-type desserts (8.4%), sweet biscuits (6.1%), and ice-cream-type desserts (5.6%) were the most frequently consumed snacks by young adults. The median portion sizes for the top five snack foods consumed were fruit-106 g (IQR: 73), chocolate-26 g (IQR: 36), cake-95 g (IQR: 88), sweet biscuits-26 g (IQR: 29), and ice cream-75 g (IQR: 42). The current findings may inform population-wide strategies to encourage healthful snacks such as fruit, inform portion control by individuals, and persuade the food industry to reduce the serving size of discretionary snack foods such as cake.

Participant Perceptions in a Long-term Clinical Trial of Autosomal Dominant Polycystic Kidney Disease.

Rationale & Objective: The development of new therapies for autosomal dominant polycystic kidney disease requires clinical trials to be conducted efficiently. In this study, the factors affecting the recruitment and retention of participants enrolled in a 3-year randomized controlled trial in autosomal dominant polycystic kidney disease were investigated. Study Design: Qualitative study. Setting & Participants: All participants (N=187) were invited to complete a 16-item questionnaire at the final study visit of the primary trial. Participants were recruited to complete a semistructured interview using purposeful sampling according to age, self-reported gender, and randomization group. Analytical Approach: Descriptive statistics were used for demographic data and questionnaires. The interview transcripts underwent inductive thematic coding. Results: One hundred and forty-six of the 187 randomized participants (79%) completed the post-trial questionnaire, and 31 of the 187 participants (21%) completed the interview. Most participants (94%) rated their global satisfaction with the trial as high (a score of 8 or more out of 10). Altruism, knowledge gain, and access to new treatments were the main motivators for recruitment. The main reasons for considering leaving the study were concerns about the risk of intervention and family or work issues. Strategies that favored retention included flexibility in attending different study sites, schedule flexibility, staff interactions, and practical support with parking and reminders. The main burden was time away from work with lost wages, and burden associated with magnetic resonance imaging scans and 24-hour urine output collections. Limitations: The study population was restricted to participants in a single nondrug clinical trial, and the results could be influenced by selection and possible social desirability bias. Conclusions: Participants reported high levels of satisfaction that occurred as a function of the trial meeting participants' expectations. Furthermore, retention was a balance between the perceived benefits and burden of participation. Consideration of these perspectives in the design of future clinical trials will improve their efficiency and conduct. Plain-Language Summary: Advances in the clinical practice of autosomal dominant polycystic kidney disease (ADPKD) require affected individuals to voluntarily participate in long-term multicenter randomized controlled trials (RCTs). In this qualitative post hoc study of a 3-year RCT of increased water intake in ADPKD, altruism, knowledge gain, and access to a nondrug treatment positively influenced the decision to volunteer. Ongoing participation was enabled by building flexibility into the study protocol and staff prioritizing a participant's needs during study visits. Although participants completed the required tests, most were considered burdensome. This study highlights the importance of incorporating protocol flexibility into trial design; the preference for interventions with a low risk of adverse effects; and the urgent requirement for robust surrogate noninvasive biomarkers to enable shorter RCTs in ADPKD.

Development and validation of an online tool to assess perceived portion size norms of discretionary foods.

BACKGROUND: Perceived portion size norms (typical perception of how much of a given food individuals choose to eat at a single occasion) may have shifted towards larger sizes due to the ubiquity of large serving sizes. However, there is a lack of validated tools to assess such norms for energy-dense and nutrient-poor discretionary foods. This study aimed to develop and validate an online tool to examine the perceived portion size norms of discretionary foods. METHODS: An online image-series tool of 15 commonly consumed discretionary foods was developed, with eight successive portion size options included for each food. Using a randomised-crossover design, adult consumers (18-65 years) completed the validation study in a laboratory session (April-May 2022) by reporting their perceived portion size norms for each food twice, once based on food images on a computer and another time based on equivalent real food portion size options at food stations in the laboratory. Agreement between methods for each test food was examined using cross-classification and intra-class correlation (ICC). RESULTS: A sample of 114 subjects were recruited (mean age 24.8 years). Cross-classification indicated >90% of selections were matched in the same or adjacent portion size option. ICC was 0.85 across all foods, demonstrating a good level of agreement. CONCLUSION: This novel online image-series tool developed to examine perceived portion size norms of discretionary foods showed good agreement with equivalent real food portion size options and may be valuable to investigate perceived portion size norms of common discretionary foods in future studies.

Yarning about Diet: The Applicability of Dietary Assessment Methods in Aboriginal and Torres Strait Islander Australians-A Scoping Review.

Conventional dietary assessment methods are based predominately on Western models which lack Aboriginal and Torres Strait Islander knowledges, methodologies, and social and cultural contextualisation. This review considered dietary assessment methods used with Aboriginal and Torres Strait Islander populations and assessed their applicability. Four electronic databases and grey literature were searched with no time limit applied to the results. Screening, data extraction and quality appraisal were undertaken independently by two reviewers. Out of 22 studies, 20 were conducted in rural/remote settings, one in an urban setting, and one at the national population level. The most frequently used and applicable dietary assessment method involved store data. Weighed food records and food frequency questionnaires had low applicability. Modifications of conventional methods were commonly used to adapt to Indigenous practices, but few studies incorporated Indigenous research methodologies such as yarning. This highlights an opportunity for further investigation to validate the accuracy of methods that incorporate qualitative yarning-based approaches, or other Indigenous research methodologies, into quantitative data collection. The importance of developing validated dietary assessment methods that are appropriate for this population cannot be understated considering the high susceptibility to nutrition-related health conditions such as malnutrition, overweight or obesity, diabetes, and cardiovascular disease.

Evidence of low vitamin D intakes in the Australian population points to a need for data-driven nutrition policy for improving population vitamin D status.

BACKGROUND: Nearly one in four Australian adults is vitamin D deficient (serum 25-hydroxyvitamin D concentrations [25(OH)D] < 50 nmol L-1 ) and current vitamin D intakes in the Australian population are unknown. Internationally, vitamin D intakes are commonly below recommendations, although estimates generally rely on food composition data that do not include 25(OH)D. We aimed to estimate usual vitamin D intakes in the Australian population. METHODS: Nationally representative food consumption data were collected for Australians aged ≥ 2 years (n = 12,153) as part of the cross-sectional 2011-2013 Australian Health Survey (AHS). New analytical vitamin D food composition data for vitamin D3 , 25(OH)D3 , vitamin D2 and 25(OH)D2 were mapped to foods and beverages that were commonly consumed by AHS participants. Usual vitamin D intakes (µg day-1 ) by sex and age group were estimated using the National Cancer Institute method. RESULTS: Assuming a 25(OH)D bioactivity factor of 1, mean daily intakes of vitamin D ranged between 1.84 and 3.25 µg day-1 . Compared to the estimated average requirement of 10 µg day-1 recommended by the Institute of Medicine, more than 95% of people had inadequate vitamin D intakes. We estimated that no participant exceeded the Institute of Medicine's Upper Level of Intake (63-100 µg day-1 , depending on age group). CONCLUSIONS: Usual vitamin D intakes in Australia are low. This evidence, paired with the high prevalence of vitamin D deficiency in Australia, suggests that data-driven nutrition policy is required to safely increase dietary intakes of vitamin D and improve vitamin D status at the population level.

Systematic review of the portion size norm of discretionary foods.

CONTEXT: Portion size norm is described as the perception of how much of a given food people choose to eat. Reducing the portion size norm of foods that are high in saturated fat, added sugar, and added salt toward smaller sizes might be a potential strategy to promote appropriate portion size selections. However, an overview of existing portion size norms for discretionary foods has yet to be established. OBJECTIVE: The aim of this systematic review was to examine the portion size norm of discretionary foods and assess the methodologies used to investigate the norm. DATA SOURCES: The literature search was conducted in 6 databases following the PRISMA guidelines (from inception to January 2022). DATA EXTRACTION: Forty studies were eligible and grouped into 3 categories by portion size norm measures: normal (n = 26), appropriate (n = 8), and preferred portion sizes (n = 3). Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. DATA ANALYSIS: A wide range of portion sizes were considered normal for each food type, with means/medians varying from 2- to 4-fold among studies. Studies differed considerably in design, with variables including the setting, food type, food presentation, the manner in which portion-size-related questions were formulated, and the range and number of displayed serving size options. The quality of reviewed studies was mixed (25 studies had low or moderate risk of bias, 15 had high risk of bias), and the method of assessing portion size was not validated in 15 of 33 quantitative studies. CONCLUSION: The assessment of portion size in future studies should be conducted using tools that are validated for the population of interest so that more definitive conclusions can be drawn regarding portion size norms for discretionary foods. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42021249911.

Macronutrient (im)balance drives energy intake in an obesogenic food environment: An ecological analysis.

OBJECTIVE: The protein leverage hypothesis (PLH) postulates that strong regulation of protein intake drives energy overconsumption and obesity when human diets are diluted by fat and carbohydrates. The two predictions of the PLH are that humans (i) regulate intake to maintain protein within a narrow range and that (ii) energy intake is an inverse function of percentage energy from protein because absolute protein intake is maintained within narrow limits. METHODS: Multidimensional nutritional geometry was used to test the predictions of the PLH using dietary data from the Australian National Nutrition and Physical Activity Survey. RESULTS: Both predictions of the PLH were confirmed in a population setting: the mean protein intake was 18.4%, and energy intake decreased with increasing energy from protein (L = -0.18, p < 0.0001). It was demonstrated that highly processed discretionary foods are a significant diluent of protein and associated with increased energy but not increased protein intake. CONCLUSIONS: These results support an integrated ecological and mechanistic explanation for obesity, in which low-protein highly processed foods lead to higher energy intake because of the biological response to macronutrient imbalance driven by a dominant appetite for protein. This study supports a central role for protein in the obesity epidemic, with significant implications for global health.

A Comparison of the Australian Dietary Guidelines to the NOVA Classification System in Classifying Foods to Predict Energy Intakes and Body Mass Index.

NOVA classification distinguishes foods by level of processing, with evidence suggesting that a high intake of ultra-processed foods (UPFs, NOVA category 4) leads to obesity. The Australian Dietary Guidelines, in contrast, discourage excess consumption of "discretionary foods" (DFs), defined according to their composition. Here, we (i) compare the classification of Australian foods under the two systems, (ii) evaluate their performance in predicting energy intakes and body mass index (BMI) in free-living Australians, and (iii) relate these outcomes to the protein leverage hypothesis of obesity. Secondary analysis of the Australian National Nutrition and Physical Activity Survey was conducted. Non-protein energy intake increased by 2.1 MJ (p < 0.001) between lowest and highest tertiles of DF intake, which was significantly higher than UPF (0.6 MJ, p < 0.001). This demonstrates that, for Australia, the DF classification better distinguishes foods associated with high energy intakes than does the NOVA system. BMI was positively associated with both DFs (−1. 0, p = 0.0001) and UPFs (−1.1, p = 0.0001) consumption, with no difference in strength of association. For both classifications, macronutrient and energy intakes conformed closely to the predictions of protein leverage. We account for the similarities and differences in performance of the two systems in an analysis of Australian foods.

Wearable Cameras Reveal Large Intra-Individual Variability in Timing of Eating among Young Adults.

Studies have shown that young adults follow less structured eating patterns compared with older cohorts. This may have implications for dietary assessment methods which rely on memory and structured meal patterns. Our aim was to describe the intra-individual variation of eating times in young adults aged 18−30 years. Participants (n = 41) wore an Autographer camera that captured first-person perspective images every 30 s for three consecutive days. All images were timestamped and those showing food consumption were used to extract data such as the timing of the first and last eating occasions (EOs), number of EOs per day, and length of eating window. Intra-individual variability was calculated from these data using composite phase deviation (CPD) and coefficient of variation (CV). The number of individuals with high or very high variability was 28 and 18 for timing of first and last EOs, respectively (CPD > 1.70), and 27 and 17 for number of EOs and eating window, respectively (CV > 20%). In this sample of young adults, the lack of regularity in eating patterns should be considered when selecting a dietary assessment method.

The Contribution of Nutrients of Concern to the Diets of 18-to-30-Year-Old Australians from Food Prepared Outside Home Differs by Food Outlet Types: The MYMeals Cross-Sectional Study.

Young adults are frequent consumers of food prepared outside the home (FOH). In a cross-sectional survey, the MYMeals study, we showed FOH provided one-third of meals and snacks for young Australian adults, yet it contributed higher proportions of energy and nutrients of concern, such as saturated fat and sodium. This study aimed to determine the detailed proportional contribution of nutrients of concern from the nine food outlet types captured in the MYMeals study. Young adults residing in New South Wales (NSW), Australia, (n = 1001) used a validated smartphone app to report all types and amounts of food and beverages consumed for three consecutive days, as well as their preparation location. The proportions of daily energy, macronutrients, sodium, total sugars, and saturated fat were calculated for each of the nine following outlet types: bakeries or patisseries, coffee chains, cold-drink chains, fast-food chains, ice creamery or frozen yoghurt outlets, independent cafes or restaurants, pubs (hotels) and clubs, service stations or convenience stores, and others not fitting the above categories. Of all FOH outlet types, independent cafes or restaurants contributed the most energy (17.5%), sodium (20.0%) and saturated fat (17.8%) to the total diet, followed by fast-food chains (12.0% energy, 15.8% sodium, and 12.0% saturated fat) and other outlets, with smaller proportions. For males, the proportion of energy and nutrients contributed by fast-food outlets was higher than for females (14.8% versus 9.8% energy). Menu labelling at independent cafes and restaurants is recommended, comprising, in addition to the energy labels already in use in fast-food restaurants, the labelling of nutrients of concern. The feasibility of this recommendation warrants further exploration.

Changes in Package Sizes of Savoury Snacks through Exploration of Euromonitor and Industry Perspectives.

Portion sizes of many energy-dense and nutrient-poor foods and drinks have increased in the past decade, whereas our understanding of the pattern of changes in package sizes remains limited. This study aimed to determine changing trends in sales and package sizes of savoury snacks in Australia, the USA, Japan and Hong Kong, and to investigate industry perspectives for these changes. Sales data (units per capita) between 2006−2020 on savoury snacks were extracted from the Euromonitor International database. Industry perspectives on package size changes were extracted systematically from selected databases, company reports and related websites following the PRISMA-ScR guidelines. The findings showed that sales per capita of savoury snacks of all package sizes increased across all four countries/regions between 2006−2020. Although changes in the proportion of smaller (<100 g) versus larger (>100 g) package size sales in each country/region over time were modest, Japan and Hong Kong exhibited a consistently higher proportion of smaller package sales compared with Australia and the USA (83.3%, 64.4%, 44.3%, 20.2%, respectively). Industry perspectives showed that increasing consumer health consciousness, demands for convenience and portion control were the main contributors to decreasing package sizes of savoury snacks. Industry reports from 2020 showed an increase in larger package size sales due to consumer purchasing behaviour amidst the COVID-19 pandemic.

Vitamin D Fortification of Milk Would Increase Vitamin D Intakes in the Australian Population, but a More Comprehensive Strategy Is Required.

Low vitamin D status (serum 25-hydroxyvitamin D (25(OH)D) concentration < 50 nmol/L) is prevalent in Australia, ranging between 15% and 32% in the adolescent and adult populations. Vitamin D intakes are also low across the population and were recently estimated at 1.8−3.2 µg/day on average, assuming equal bioactivity of the D vitamers. In combination, these findings strongly suggest that data-driven nutrition policy is needed to increase vitamin D intake and improve status in the Australian population. Food fortification is a potential strategy. We used up-to-date vitamin D food composition data for vitamin D3, 25(OH)D3, vitamin D2, and 25(OH)D2, and nationally representative food and supplement consumption data from the 2011−2013 Australian Health Survey, to model a fortification scenario of 0.8 µg/100 mL vitamin D for fluid dairy milks and alternatives. Under the modelled fortification scenario, the mean vitamin D intake increased by ~2 µg/day from baseline to 4.9 µg/day from food only (7.2 µg/day including supplements). Almost all individual intakes remained substantially below 10 µg/day, which is the Estimated Average Requirement in North America. In conclusion, this modelling showed that fortification of fluid milks/alternatives with vitamin D at the current permitted level would produce a meaningful increase in vitamin D intake, which could be of potential benefit to those with a low vitamin D status. However, this initial step would be insufficient to ensure that most of the population achieves the North American EAR for vitamin D intake. This approach could be included as an effective component of a more comprehensive strategy that includes vitamin D fortification of a range of foods.

The association of social and food preparation location context with the quality of meals and snacks consumed by young adults: findings from the MYMeals wearable camera study.

PURPOSE: This study examined the association of social contexts and food preparation location with the quality of meals and snacks (predominately from the five food groups (FFG) versus discretionary foods) in a sample of young Australian adults (18-30 years old) using wearable camera technology. METHODS: A sub-sample from the cross-sectional MYMeals study wore a wearable camera that captured images every 30 s for three consecutive days. Eating episodes from 133 participants (55% female) were classified across 4 domains: food quality (observed proportion of FFG and discretionary items), preparation location, social interaction, and screen use. Socio-economic status (SES) was assigned using residential postcode and gender self-reported. Associations of contexts and demographic factors with food quality stratified by meal type were determined using mixed binary logistic regression models. RESULTS: Of the 1840 eating episodes identified, 1775 were included in analysis (n = 8 preparation location and n = 57 food components that could not be identified were excluded). Food prepared at home was more likely to be from the FFG at lunch (OR = 4.8 95% CI 2.7-8.6), dinner (OR = 14.8 95% CI 7.6-28.6), and snacks (OR = 3.2 95% CI 2.2-4.8). Participants from higher SES areas were more likely to consume breakfasts (OR = 3.2 95% CI 1.4-7.4) and lunches (OR = 1.9 95% CI 1.0-3.7) predominately from the FFG. Females were more likely to consume lunches (OR = 2.0 95% CI 1.1-3.8) that was largely from the FFG. Social interaction and screen use were not associated with meal or snack quality. CONCLUSION: Wearable cameras have verified the importance of addressing meals and snacks prepared outside of home as an important contributor of discretionary food.

Enhancing Nutrition Care Through Real-Time, Sensor-Based Capture of Eating Occasions: A Scoping Review.

As food intake patterns become less structured, different methods of dietary assessment may be required to capture frequently omitted snacks, smaller meals, and the time of day when they are consumed. Incorporating sensors that passively and objectively detect eating behavior may assist in capturing these eating occasions into dietary assessment methods. The aim of this study was to identify and collate sensor-based technologies that are feasible for dietitians to use to assist with performing dietary assessments in real-world practice settings. A scoping review was conducted using the PRISMA extension for scoping reviews (PRISMA-ScR) framework. Studies were included if they were published between January 2016 and December 2021 and evaluated the performance of sensor-based devices for identifying and recording the time of food intake. Devices from included studies were further evaluated against a set of feasibility criteria to determine whether they could potentially be used to assist dietitians in conducting dietary assessments. The feasibility criteria were, in brief, consisting of an accuracy ≥80%; tested in settings where subjects were free to choose their own foods and activities; social acceptability and comfort; a long battery life; and a relatively rapid detection of an eating episode. Fifty-four studies describing 53 unique devices and 4 device combinations worn on the wrist (n = 18), head (n = 16), neck (n = 9), and other locations (n = 14) were included. Whilst none of the devices strictly met all feasibility criteria currently, continuous refinement and testing of device software and hardware are likely given the rapidly changing nature of this emerging field. The main reasons devices failed to meet the feasibility criteria were: an insufficient or lack of reporting on battery life (91%), the use of a limited number of foods and behaviors to evaluate device performance (63%), and the device being socially unacceptable or uncomfortable to wear for long durations (46%). Until sensor-based dietary assessment tools have been designed into more inconspicuous prototypes and are able to detect most food and beverage consumption throughout the day, their use will not be feasible for dietitians in practice settings.

Changes in Dietary Total and Nonheme Iron Intake Is Associated With Incident Frailty in Older Men: The Concord Health and Aging in Men Project.

BACKGROUND: Nutritional intake could influence the development of frailty. The aim was to evaluate the associations between dietary iron intakes and changes in dietary iron intakes with frailty. METHODS: Cross-sectional analyses involved 785 men with Fried frailty phenotype (FP) and 758 men with Rockwood frailty index (FI) data aged 75 years and older at nutrition assessment from the Concord Health and Ageing in Men Project prospective cohort study. Of these, 563 men who were FP robust or prefrail, and 432 men who were FI nonfrail were included in the longitudinal analyses for more than 3 years. Dietary intake was assessed at both timepoints using a validated diet history questionnaire. The dietary calculation was used to derive heme iron and nonheme iron intakes from total iron intakes. The associations were evaluated through binary logistic regression. RESULTS: Incidence of FP frailty was 15.3% (n = 86). In longitudinal analyses, maintaining total iron intakes (medium tertile -2.61-0.81 mg/d), increases in total iron and nonheme iron intakes (high tertiles ≥0.82 mg/d and ≥0.80 mg/d), and changes in nonheme iron intake (1 mg increment) were associated with reduced risks of incident FP frailty (OR: 0.47 [95% confindence interval (CI): 0.24, 0.93, p = .031], OR 0.48 [95% CI: 0.23, 0.99, p = .048], OR 0.41 [95% CI: 0.20, 0.88, p = .022], and OR 0.89 [95% CI: 0.82, 0.98, p = .017]). CONCLUSION: Maintaining or increases in total dietary iron and increases or changes in dietary nonheme iron intakes more than 3 years were associated with reduced incidence of FP frailty in older men.

Australian Ready Meals: Does a Higher Health Star Rating Mean Lower Sodium Content?

Ready meals are typically a high sodium product and excessive sodium increases the risk for chronic disease. The study aimed to explore the association between sodium content, Health Star Rating (HSR) and the Healthy Food Partnership (HFP) sodium reduction target for ready meals. Median (IQR) sodium content in mg/100 g and mg/serving were determined overall and for each subcategory (ambient, chilled and frozen). Wilcoxon rank sum test was used to compare the sodium content between ready meals with and without HSR. The Jonckheere trend test was used to assess presence of trend in sodium content by HSR categories. In total, 631 ready meals were included and 311 (49%) met the HFP sodium target (<250 mg per 100 g). The percentage of products displaying the voluntary front-of-pack HSR was 52% and of these, 82% had a star rating ≥3.5. A lower median sodium content (mg/100 g) was consistently observed for products with HSR compared with products without HSR (all p's < 0.05). Except for ambient ready meals, a trend was observed where the higher the HSR category, the lower the sodium content (p < 0.001). A higher proportion of the products with HSR ≥ 4 met the HFP sodium target for ready meals.

Enablers and barriers of harnessing food waste to address food insecurity: a scoping review.

Despite producing sufficient food for the global population, the growing prevalence of food insecurity in developed countries is cause for concern. The millions of metric tons of food wasted each year could be used instead to drastically lower rates of food insecurity and address food sustainability. In this scoping review, we aimed to identify barriers to and enablers of harnessing food waste across food sectors, including food retail, households, and food rescue organizations, to address food insecurity in a developed country, Australia. The findings demonstrate that research on and responsibility for harnessing food waste for food insecurity has predominantly fallen on ill-equipped food rescue organizations. Three primary policy advancements paramount to harnessing food waste to address food insecurity include (1) improving partnerships and subsidies to minimize transportation costs for redistributing imperfect or surplus food from farmers and retailers to those who with food insecurity; (2) enhancing existing partnerships and subsidies to stably involve more nutrition experts in food rescue organizations to improve the quality of foods being redistributed to those facing food insecurity; and (3) initiating interventions and campaigns that combine the following 5 characteristics: free to the participants; address food literacy; use multiple mass-media tools; are age tailored; and frame messages within personal values.