Community cafés are non-profit ventures tackling food insecurity (FI) locally and equitably, primarily using pay-as-you-feel models(1). FI is most prevalent in low-income and other vulnerable groups(2), in whom poor diets and worse health also intersect(3). Despite recognition that FI is largely driven by poverty and inequity(4), FI individuals are often negatively judged(5), risking further marginalisation. Community approaches to tackling both food waste and FI include community cafés, which frequently utilise surplus foods(1) to produce fresh meals and/or donate surplus food to those in need. Beyond a nutritional impact, community cafés have the potential to offer marginalised groups a safe space and a feeling of inclusion, benefitting their mental health and wellbeing. The aim of this study was to explore the social impact of community cafés.

Two linked community cafés in a London borough were evaluated to explore their social impact on clients. Both operated using pay-as-you-feel; neither required proof of need. Evaluations were undertaken using mixed methods on 9 site visits (November 2022 - April 2023). Bespoke questionnaires (n = 72) and 4 interviews were completed by clients, and 40 interviews with volunteers. Thematic analysis of qualitative data and Kruskal Wallis analysis (posthoc Dunn’s and Bonferroni correction) of quantitative data were carried out.

Both cafés relied on surplus food. Their primary priorities were tackling food waste and the environment followed by addressing FI. Qualitative and quantitative data from interviews and questionnaires revealed that for many clients, social and food provision were equally important. This was especially true for older clients; significantly more of those aged ≥65 compared with those aged 18-24 yr visited for social reasons (p = 0.02). The most highly rated aspects of provision for clients were the friendliness of the people and the helpfulness of the staff (98.7 and 97.1% respectively). Being able to meet and talk was identified as important by 70.1% of clients. Anecdotally, this was especially important to marginalised groups like migrants and refugees. Since referral to the cafés was not needed, clients included individuals utilising them for environmental reasons as well as those affected by FI. This allowed mixing among groups who would not ordinarily meet. Volunteers also highlighted this as key to enable them to hear the stories of those they served. The mixed clientele not only helped build community but helped reduce stigma, since FI was not the sole reason for attending. For volunteers, the open and accepting nature of community provision which did not require referral or proof of need, was valued.

The data suggest that community cafés have important value beyond nutrition, enabling formation of community networks and increasing understanding of the lived experience of those with FI.

The role of the sarcopenic obesity (SO) phenotype for disease risk prediction has been tested in several observational studies, but results have been contrasting due to the application of different diagnostic models(1–3). This study applies the newly proposed the European Society for Clinical Nutrition and Metabolism (ESPEN)-European Association for the Study of Obesity (EASO) definition of SO(4) to a representative population of adults aged 50 years and older to evaluate its performance in the identification of prevalent cases of SO and its association with measures of cognitive function.

Data from individuals aged 50-85 years was collected from the National Health and Nutrition Examination Survey 1999-2002 waves. At the screening phase of the SO definition following the definition of the European Society for Clinical Nutrition and Metabolism and the European

Association for the Study of Obesity (ESPEN-EASO), body mass index and waist circumference were used to evaluate obesity, while sarcopenia cases were identified using the SARC-F questionnaire (a self-report questionnaire to screen sarcopenia). Sarcopenia was diagnosed based on knee extensor isometric strength per weight (KES/W) and a percentage of appendicular lean mass per weight, while fat mass percent measured by Dual-energy X-ray absorptiometry was used to determine obesity. Cognitive function in older participants was assessed using the Digit Symbol Substitution Test (DSST), while memory-related question was used for middle-aged individuals or older participants without DSST scores.

Participants aged 50–85 years were men (44.7%) with a mean age of 66.7 years, and most participants aged 60 years and over (87.4%). The prevalence of SO was 32.5%, 20.9% and 15.3% at screening, diagnosis phase I, and diagnosis phase II of the ESPEN-EASO definition, respectively. The prevalence of cognitive impairment was 14.8% in participants aged 50-59 years and 29.5% in participants aged 60-85 years. There were associations between SO and cognitive impairment at diagnosis phase I (Odds ratio (OR): 1.6, 95%CI (confidence interval) 1.1-2.4) and phase II (OR: 1.9, 95%CI 1.1-3.3). These associations were significant among participants aged 60-85 years (phase I, OR: 2.2, 95%CI 1.4-3.4; phase II, OR: 2.8, 95%CI 1.6-4.8), but not among those aged 50-59 years.

The new ESPEN-EASO definition of SO identified a high prevalence of SO cases. A significant association between SO and poor cognitive function in older individuals was observed.

In the UK, men and women can expect to spend approximately half of their remaining years from the age of 65 in good health. Nutritional needs change with age, with diet offering the potential to prevent and/or lessen the impact of poor health. Furthermore, specific Food Based Dietary guidelines (FBDGs) are required as older adults have specific nutrient needs.

There are gaps in the evidence on the role of dietary habits and/or specific nutrients in healthy ageing(1). Much of the prior work focuses on those with chronic illness and disease. There is a limited evidence base addressing the issues of healthier older people living in the community(2), and it is important to prevent and/or correct nutritional deficiencies before the consequences become too difficult to treat. The objective was to identify a diet that meets the nutritional requirements for adults aged over 64-years-old with smallest divergence to the current average diet.

This study applied diet optimisation modelling (a method of finding the optimum diet under certain conditions/constraints) using national food and nutrient intake data from the National Diet and Nutrition Survey (years 1-11). Linear models were prepared using the open-source software R. Two models were developed for observed and recommended energy intake.

Constraints were included for energy, carbohydrate, free sugars, protein, salt, fat, saturated fat, alcohol, calcium, and red and processed meat. Constraints were informed by the Eatwell Guide (the UK’s Food Based Dietary guidelines), government age*gender specific recommendations, and proposed recommendations from a literature review(3). The linear model method was developed and trialled using data for a sub-population (women aged over 74 years n =469).

In the observed/baseline diets the average daily energy intake for women over 74 years was 1517kcal, fibre was 17g, vitamin b12 9µg, fruit and vegetables 308g, and red and processed meat 52g. As a percentage of total energy, fat comprised 28%, protein 14%, saturated fat 12%.

Attempts to optimise with fibre and folate target levels at 30g and 400 µg increased fruit and vegetable intake (>500g). Optimising the diets with energy constrained at current levels reduced intake fat (-4 percentage points [%pt]), and vitamin b12 (-3µg). Intake increased for protein (+3%pt), calcium (+95mg), and fruit and vegetable intake (+211g). Constraining energy at 1840kcal resulted in protein increasing (7%pt), and fruit and vegetable intake (+394g). Fibre and folate levels were 22g and 310µg, respectively.

Preliminary results indicate that protein intakes in women aged over 74 years are sufficient to meet current FBDGs, but not the proposed level of 1.2g/kg without an increase in energy intake. In optimised diets maintaining the same energy intake, desired fibre and folate levels could only be achieved with greater, and potentially less acceptable divergence from the existing diet.

Community-dwelling older adults experience a high prevalence of malnutrition(1), leading to frailty, loss of independence and poorer health including increased mortality and healthcare resource use (HRU)(2). Consumption of a high-quality diet is associated with better health-related outcomes(3). We previously found significantly improved mini nutritional assessment (MNA) and depression scores following 3-weeks of daily meal provisions to healthy community-dwelling elderly participants(4). However, <30% of UK councils provide meal delivery services. This study aimed to determine the impact of longer term (12-weeks) daily provision of nutrient-dense meals (>40% daily energy requirements and >50% recommended daily protein intake) to under-nourished, independently living, community-dwelling elderly adults on physical and psychological outcomes. We hypothesised the meal intervention would significantly improve nutritional outcomes, physical wellbeing and function, and psychological wellbeing.

Participants (n = 56) were randomised (stratified for baseline MNA score and cohabiting or living alone) to receive 12-weeks of meal provisions followed by 12-weeks control (meals first group, n = 28) or, a 12-week control followed by 12-weeks of meal provisions (meals second group, n = 28). Forty-nine participants completed the study (16 males, 33 females; 81.8±7.4 years). MNA, body composition, physical function, self-esteem, and depression were evaluated before and after each 12-week period (baseline, 12-weeks, and 24-weeks). The effect of meal provision was assessed by testing pre-post meal intervention change in both groups via paired t-test. Group effects were combined via meta-analysis (STATA ver17). The retention of the meal provision effect was tested in the meals first group, by testing the change from the end of meal provision versus 12-weeks followup control via paired t-test.

Meal provisions significantly improved energy and protein intakes (mean effect 311kcal Cohen’s D = 0.52 (95% CI 0.22 to 0.82), p<0.001; 0.24 g.kg-1 Cohen’s D = 0.52 (95% CI 0.19 to 0.81), p<0.001, respectively), MNA score (mean effect 2.6 points Cohen’s D = 1.14 (95% CI 0.78 to 1.50), p<0.001), and handgrip strength (mean effect 1.5kg Cohen’s D = 0.36 (95% CI 0.06 to 0.66), p = 0.02), but did not change levels of depression or self-esteem. Energy and protein intake decreased by 85% and 94% respectively upon return to habitual diet for the 12-week follow up. Sixty-eight percent of the favourable effect of the meal intervention on MNA score remained after the 12-week follow-up period, whilst handgrip strength reverted to baseline.

Provision of nutrient-dense meals to community-dwelling elderly adults for 12-weeks improved nutritional status and handgrip strength, indicative of reduced frailty risk. Benefits were not retained on withdrawal of the intervention, suggesting a need for sustained interventions in this cohort to meet nutritional needs. Future research is needed to identify optimal meal delivery service designs to support expansion of home-delivered meals to all eligible older adults to improve health-related outcomes and consequently reduce HRU.

Healthy midlife cognitive function (CF) reduces the risk of cognitive decline in older age. Evidence suggests that chrononutrition behaviours, such as time-restricted eating (TRE), positively affect CF possibly through a bioenergetic switch towards ketone use by the brain, DNA repair, and antiinflammatory action(1,2). However, misalignment between preferred and actual food intake timing might disrupt the circadian rhythm, negatively affecting CF(3). This study investigated associations between chrononutrition behaviours, including eating misalignment, and cognitive outcomes in adults aged 45-65 living in Cyprus.

The following behaviours were derived from the Chrononutrition Profile Questionnaire(4), as a weighted aggregate score of working and non-working days: breakfast skipping, largest meal of the day, morning latency (time between waking and first eating event), evening eating (last eating event in the waking day), evening latency (time between last eating event and sleep onset), night eating (waking in the night to eat) and eating window (time between the first and last eating event)(4).

Misalignments were calculated by subtracting reported aggregate behaviour from preferred. Computerized neurocognitive remote testing was used to derive standard normalized age-matched scores for composite memory, psychomotor speed, cognitive flexibility, complex attention, and global neurocognitive index(5). Education, marital status, smoking, body mass index, chronic disease diagnosis, Greek-Orthodox fasting, sleep, physical activity, and Mediterranean diet adherence were also assessed, the latter three using validated questionnaires.

Cognitive outcome scores were divided into tertiles and analyzed using ordinal logistic regression. Each chrononutrition variable, divided into categories(6,7), was independently regressed against each cognitive outcome, with the significant pairs then examined in multivariable models, adjusting for sociodemographic variables that were independently significantly associated with each cognitive outcome.

Two-hundred-seven participants were analyzed (58% female, median age: 52 yrs, 75.6% University graduates). Morning latency misalignment was associated with higher neurocognitive index (Odds Ratio (OR) of eating later than preferred by 30-90min: 2.28; 95% confidence interval (CI): 1.10-4.71 & OR of eating later than preferred by > 90min: 1.95; 95% CI: 1.03-3.68) and with higher cognitive flexibility score (OR of eating later than preferred by 30-90 min: 2.21; 95% CI: 1.07-4.60). An eating window longer than preferred by >120 mins was associated with a lower psychomotor speed score (OR: 0.16; 95% CI: 0.04−0.06). Evening eating between 20:00-22:59 vs. before 20:00 was associated with a higher complex attention score (OR: 2.04; 95% CI: 1.06-3.93).

The study findings on delaying the first eating episode and having a shorter eating window support previous findings that TRE is associated with better CF(2,3). The association of evening eating with better CF might be related to unexplored aspects of the overall diet quality and the evening meal or other residual confounders and needs further exploration.

The population of older individuals worldwide is increasing and achieving a good quality of life in older age is vital(1). However, anorexia of ageing, a phenomenon often associated with delayed gastric emptying and reduced oral processing abilities(2), can negatively affect older adults’ health, quality of life and contribute to undernutrition(2). In younger populations, slower gastric emptying has been associated with greater satiation and satiety(3), and slower eating rates with reduced food intake and postprandial euglycemia(4); however, little is known about these associations in the older adult population. This study investigated individual variations in food oral processing and their influence on postprandial glycaemic and insulin responses, gastric emptying, food and energy intake, in healthy adults, aged ≥65 years.

Participants attended a single visit day, after an overnight fast. A fixed-portion breakfast meal was provided and consumption was video-recorded for behavioural-annotation to quantify specific oral processing behaviours. Postprandial glucose and insulin responses were assessed via mixedcapillary fingerprick samples, and gastric emptying was measured with the 13C-octanoic acid breath test(5). Three hours post breakfast, an ad libitum lunch was provided, where eating rate and food intake were measured. Food and drink intake for the rest of the day was assessed using a weighed food diary. Participants were classified as slower and faster eaters using a median of eating rate (g/min) of the breakfast meal, with an even number of males and females in each group. Repeated measures ANOVA and multiple regression analysis were used to explore the relationship between ad libitum intake and the parameters outlined above.

Eighty-eight older adults were recruited, 44 males and 44 females, with mean age 73.7 ( ± 5.3) years.

For the three hours postprandially, both glucose and insulin changed significantly over time (Fglucose =150.779, p <0.001 and Finsulin =111.645, p <0.001), but no differences observed between faster and slower eaters (p >0.05). Similarly, gastric emptying did not differ between faster and slower eaters (p >0.05). At the ad libitum meal, eating rate of the meal was the only significant predictor of energy intake (r=0.685, p <0.001), after accounting for age, gender and the postprandial (post breakfast) metabolic responses, gastric emptying and subjective satiety.

This study found no effect of eating rate on postprandial glycemia or gastric emptying in older adults, but showed significant association of eating rate during the meal on food and energy intake. These findings could provide implications in the design of texture-appropriate foods for this age group for future meal interventions.

As the global population ages, understanding the factors influencing older adults’ health and wellbeing becomes increasingly important. Aging can lead to various health complications, including reduced muscle strength, affecting daily activities such as food consumption(1). The decline in oromasticatory muscle function can cause chewing difficulties that limit food choices(2). Given that adequate nutrition is essential for maintaining the quality of life, this study aims to examine the relationship between self-perceived chewing ability and objectively measured biting force to understand the extent of their effect on nutrient intake.

A total of 148 community-dwelling older adults aged 64 to 90 years old (median age 71±8 years) from urban (Bangkok Metropolitan Region) and rural (Chonburi Province) areas of Thailand participated. Maximum biting force (Newtons, N) of the posterior teeth was instrumentally measured, and participants rated the chewing difficulty of 20 commonly consumed foods as easy, difficult, or cannot be chewed at all. Foods were grouped into five difficulty levels by principal component analysis of the ratings and masticatory ability scores (0 to 10) were calculated. Food intake was obtained from 24-hour dietary recalls through interviews and body mass index (BMI) data was obtained.

Participants were grouped into tertiles of low (median=73 N; IQR=37–127), moderate (median=336 N; IQR=241–387), and high (median=512 N; IQR=477–512) biting force. A Kruskal-Wallis test revealed that those with low biting force had significantly (p < 0.01) lower self-assessed masticatory ability scores (median=7.69) compared to those with high biting force (median=8.86). Significant differences in the daily intakes of dietary potassium, magnesium, and vitamins B1, B2, B6, and C were observed between the high and low biting force groups (p < 0.01).

However, multiple regression analyses adjusted for age, sex, education, and location did not show significant predictive power for any nutrient intake from either biting force or masticatory ability, except for positive associations with vitamins C and B2, and fruit intake. A unit increase in mastication ability was associated with an increase in daily intake of 0.21 milligrams of vitamin C (95% CI=3.03, 33.64; p=0.02) and 0.19 milligrams of vitamin B2 (95% CI=−0.01, 0.13; p=0.03).

Additionally, a unit increase in biting force was associated with an increase in daily fruit intake of 0.17 grams (95% CI=−0.02, 0.28; p=0.08). No relationships with BMI were observed for either biting force or masticatory ability.

Higher biting force in older adults improves self-perceived masticatory ability, leading to a higherquality diet with foods rich in vitamins B2 and C, such as meat and fruits. Targeted interventions to enhance biting force could help prevent malnutrition.

Food processing, defined as a range of processes which convert fresh food into safe products, is of interest to nutrition professionals including dietitians given associations between consumption of highly processed products and health(1). Given such products contribute between 51-68% to UK diets(2), dietetic practice is now likely to encompass this topic. This study aimed to explore dietitians’ involvement in professional practice around the topic of processed foods and health, and their perceptions of individual products displaying label information (nutrition and ingredients).

An online survey was developed using (5-point likert scale) items adapted from other surveys(3,4) to evaluate levels of professional involvement (1 = never, 5 = daily) and confidence (1 = not confident, 5 = very high) around this topic. For three products displaying label information (tinned tomatoes, Quorn Mince, wholemeal bread), respondents’ perceptions of; level of processing (i.e. ranging from

“minimally processed” to “highly/ultra-processed”) and recommended frequency of consumption (FoC) (1 = should be avoided, 5 = several times a day) were evaluated. Ethical approval was granted before survey invites were sent via email to over 10,000 members of the British Dietetic Association between November 2023 and January 2024. Data analysis quantified percentages of all responses (%) and Kruskal-Wallis and Wilcox Pairwise tests were performed to explore differences in respondents’ overall responses across, and between pairs of products.

A total of 366 dietitians completed the survey. Most (96%) were female with an average of 13 ±9.8 years in practice across specialisms including diabetes, paediatrics, and gastroenterology. In practice, around half of respondents were regularly (weekly or daily) engaged in discussion of processed foods and health (51%) and provided guidance on this topic (46%). Most reported high confidence in discussing (61%) and providing guidance (59%) on processed foods and health. Most strongly agreed/agreed that healthy balanced diets can include some processed (94%) and “highly/ultra” processed (71%) foods, and that nutritional content is more important than level of processing (61%). Most respondents reported high/very high confidence (range: 60%-62%) in their classifications of processing levels for each product. Respondents’ most popular classification of products were: tomatoes “minimally processed” (54%), Quorn mince “highly/ultra-processed” (57%), and bread “processed” (46%), which were significantly different across products (p = <0.01). Perceptions of recommended FoC were also significantly different across products; tomatoes and bread “several times a week” (69%, 58%, respectively), and Mince “several times a month” (40%) (p = <0.01).

Surveyed dietitians reported high involvement and confidence in discussing and providing guidance around processed food and health. Perceptions of individual product’s level of processing varied across three processed products which displayed label information. This is the first insight into dietitians and the topic of processed foods, and further work is warranted to support dietetic practice and training.

Digital competency is defined as “the confident, critical and responsible use of, and engagement with, digital technologies for learning, at work, and for participation in society”(1). Digital competence is an essential skill required in today’s modern society and has become a highly desired skill in employment. The digitalisation of education has broadened the student skillset deemed necessary to being a well-rounded professional(2). Yet little is known on how digital competency is currently taught or assessed in nutrition science education. The aim of this study was to assess the extent to which Irish nutrition science educators conceptualise digital competence and how digital competency education is integrated into nutrition science teaching and learning.

Two semi-structured focus groups with 15 nutrition science educators from three undergraduate nutrition science programmes in Ireland were conducted. Participants completed a baseline digital competency assessment using the MyDigiSkills(3) tool, testing five areas of competence. Focus groups followed a semi-structured interview guide focusing on questions around digital competency, digital skill requirements, teaching and learning digitally, training and upskilling opportunities, and future digital competency education. Focus groups were transcribed and a content analysis conducted whereby the data were coded, categorised and discussed by all authors.

The digital competency assessment tool highlighted higher levels of competence for ‘Information and Data Literacy’ and ‘Communication and Collaboration’ and lower levels of competence for ‘Digital Content Creation’, ‘Safety’, and ‘Problem Solving’. A clear difference was seen between focus group discussions with one focused on a more traditional approach and the other a more modern innovative approach. Participants reported using multiple ways to teach digital competency through presentations, podcasts, development of professional social media accounts, e-portfolios, Twitter chats, blog sessions, media diaries, and recipe analysis tools. Internal and external training opportunities to learn about and develop digital literacy and skills were identified across both groups and barriers to embracing those opportunities highlighted – funding, protection of time, equipment.

This study highlights that digital competency is becoming an important aspect of nutrition science education and educators agreed digital skills are important to teach and ensure graduates can meet the expectation of today’s modern workforce. Educators’ opportunities to upskill and learn about digital competency should focus on improving competence in areas of ‘Content Creation’, ‘Safety’ and ‘Problem Solving’. Improving nutrition educators’ digital competency levels will enhance digital teaching and learning for future students. Funding was reported as a major barrier to improving digital skills causing delays with accessing innovative tools to enhance teaching and learning practices, limiting training days, updated software, and new equipment. These flexible courses help educators understand new technology and update their skills. Future research should focus on removing these barriers for educators upskilling and providing more support for embracing digital innovations in education.

Food manufacturers often employ highly trained Sensory Panellists to conduct sensory evaluations, such as profiling, discrimination and rating testing to understand the impact of any reformulation/process/pack changes and new product launches on consumer experiences. At Marlow Foods, 8-12 Panellists work four days/wk evaluating meat, mycoprotein, and plant-based alternatives for up to four hours/day, between 09:00 and 13:00. As part of Marlow Foods commitment to supporting the wellbeing of all employees, the energy, macronutrients and sodium consumed during evaluation sessions need to be considered within the context of habitual (threedaily) meal patterns. Consequently, these daily tasting sessions should be regarded as an interlude between meals, or as a 'snack period’. The UK government’s recommended calorie guidelines, assuming an energy intake of 2000kcal and weight maintenance, suggests 400kcal for snacks and beverages.(1) This project aimed to determine the Panellists nutritional intake during these evaluation sessions, to compare against energy and nutrient recommendations, and to monitor consumption of nutrients of public health concern (e.g, salt and saturated fat).(2)

To assess average dietary intake during evaluation sessions, details of the foods consumed by the 11 panellists (7 female, 4 male, mean age 51yrs, range 41-63yrs) were collected over 5-weeks. Average daily intakes for energy, total fat, saturated fat, sugar, fibre and salt were calculated from declared back of pack nutrition information and theoretical nutritional values for products in development using FoodChain ID.[3]

Over the 5-week period, the Panellist average daily intake (range,± SDs, % of reference intake (RI)) during evaluation sessions were 192kcal energy (93-292,± 85, 9.6%), 7.3g total fat (2.7-14.5,± 4.5, 10.4%), 1.1g saturated fat (0.6-2.2,± 0.6, 5.7%), 1.5g sugar (0.4-2.3,± 0.9, 1.7%), 7.1g fibre (4.0-12.6,± 4.0, 23.6%) and 1.0g salt (0.4-1.9,± 0.6, 16.6%).

The average daily energy intakes recorded during the tasting period comfortably fell within the UK government’s recommended allowance for snacks, thereby supporting the notion that Panellists can maintain a healthy, balanced diet whilst consuming this category of food. However, salt intakes in Panellists averaged 16.6% of the RI, reflective of the added salt content in many meat and meat alternative products. This signals the need for a panel nutrition policy, establishing specific nutritional guidelines to ensure responsible balance of projects and thus consumption of nutrients of public health concern (e.g., salt and saturated fat) during evaluation sessions. As next steps, Marlow Foods is developing such a policy and guidelines, to ensure the wellbeing of Panellists while maintaining delivery of robust sensory evaluations.

Shifting towards predominantly plant-based diets is an important tool in addressing population and planetary health, and diversifying protein intakes is part of this.(1) Whilst updating the Eatwell Guide to include a diverse range of protein sources can encourage individuals to adopt more varied and sustainable dietary patterns, understanding healthcare and food professionals’ perspectives on which protein sources to include in dietary guidelines is essential for effective recommendations, which this research aimed to explore.

Between 8-31 March 2024, an incentivised survey was distributed to members of the MyNutriWeb community, made up primarily of healthcare and food professionals. A part of the survey aimed to gain insights about which protein sources respondents recommend when supporting people with their protein consumption, and which should be included if the visual representation of the Eatwell Guide was to be updated.

Of the 865 respondents, the majority (65%) were dietitians and nutritionists, with 12% being students and the remaining respondents representing various other healthcare and food professions. When supporting people with their protein consumption, 92% (of 748 respondents) regularly recommend legumes and pulses, 87% fish, 85% eggs, 72% poultry, 57% soy/tempeh/tofu, 47% unprocessed red meat (e.g. beef, pork, lamb), 34% mycoprotein (e.g. fungi meat alternatives like Quorn) and 2% processed meat (e.g. sausages, bacon, ham, salami, pies, burgers, pâtés, canned meat). When asked which protein sources should be included if the Eatwell Guide protein description was to be updated, 90% (of 643 respondents) selected soy/tempeh/tofu, 88% legumes and pulses, 79% eggs, 78% mycoprotein, 78% fish, 74% poultry, 63% unprocessed red meat and 6% processed meat. 10% also selected ‘other’ and 25 of the 64 additional comments provided mentioned nuts and seeds. In relation to the brief protein description included on the Eatwell Guide visual, 53% (of 635 respondents) responded yes to an update supporting people to consider more fungi and plant-based proteins within their diet, and only 6% responded no. The remaining 41% responded that it depends or other, and the most prominent additional comment was on the need to keep fish, eggs and meat in the description.

This survey reveals a consensus among healthcare and food professionals regarding the importance of including a variety of protein sources in dietary guidelines. Legumes, pulses, fish, and eggs were among the most recommended protein sources, emphasizing the significance of both non-animal and animal-based proteins in a balanced diet. While there was strong support for including more non-animal protein foods such as soy, legumes, and mycoprotein in the Eatwell Guide, respondents also emphasized the importance of retaining animal protein sources. This suggests that a balanced approach, incorporating non-animal (plant and fungi) and animal-based proteins, is widely supported among professionals for promoting healthier and more sustainable eating habits.

Low-calorie sweeteners (LCS), also known as non-nutritive sweeteners, are suggested to reduce sugar and calorie intake, potentially serving as a useful strategy for weight loss and management of type 2 diabetes (T2D)(1). However, inconsistencies in scientific research and conflicting guidelines regarding the benefits and risks of LCS rendered professionals uncertain about their safety and effectiveness in the management of obesity and T2D(2). Dietitians and nutritionists play a crucial role in preventing and managing obesity and T2D. Understanding their perceptions and knowledge of LCS is essential for developing strategies to keep them updated with the latest evidence. This survey aimed to assess the perceptions and knowledge of LCS among HCPC registered dietitians and nutritionists living and working in the UK.

An online cross-sectional survey was distributed to nutritionists and HCPC registered dietitians in the UK through social media and workplaces such as gyms, hospitals, and universities. Participants rated statements on their perceptions and knowledge of LCS use in obesity and T2D management, their risks, benefits, and government regulations. Ordinal logistic regression was used to investigate the impact of educational level and occupation (dietitians versus nutritionists) on the outcomes.

A total of 200 participants (136 dietitians and 54 nutritionists) responded to the survey. While 99% of respondents were familiar with LCS, only 62.5% were confident about advising clients/patients on their appropriate use. Additionally, 69.9% believed that LCS are helpful for weight loss and 67.8% stated that they can help manage T2D. Some respondents viewed LCS negatively: 15.5% considered it harmful, 39% deemed it unsafe, while 42.5% saw its benefits outweighing risks. Interestingly, 41.5% of respondents were not aware of the regulations surrounding the use of LCS. Open-ended questions revealed that some participants expressed concerns about the negative health effects of aspartame, with many considering stevia to be a healthier alternative due to its natural origin. Further analysis revealed that professionals with a doctorate degree in Nutrition/Dietetics were less likely to believe that LCS are bad for health when compared to those with an undergraduate degree (Wald χ2(1) =4.209, p=0.04). Compared to nutritionists, dietitians were more likely to express concerns regarding the impact of LCS on weight gain (p=0.029), yet the latter outcome is limited by the unequal sample size between the 2 groups.

While the majority of respondents recognize LCS as a valuable tool in managing obesity and T2D, a research and educational knowledge gap remains. Perceptions and knowledge of LCS could be further explored in a larger survey. It is crucial for professional and regulatory bodies to disseminate accessible information, ensuring that healthcare professionals provide the public with evidencebased guidance on the use of LCS in addressing obesity and T2D.

Bolus feeding is the administration of feed to a patient as a series of smaller volumes of enteral nutrition given at regular intervals via an enteral feeding tube.(1) It is currently estimated that approximately 2,000 people are receiving home enteral tube feeding (HETF) in Ireland.(2) However, there is limited evidence surrounding the use of bolus feeding in enterally fed patients.

The aim of this study is to investigate Irish dietitians’ attitudes and usage of bolus feeding in their adult patients.

Survey Monkey was used to create an eighteen-question survey which was distributed by the ‘Irish Nutrition and Dietetic Institute’ in their online newsletter and the ‘Irish Nutrition Jobs’ Facebook page. Descriptive statistics were performed using IBM SPSS® v27 to determine percentages. Dietitians that worked with adult patients and reccommended bolus feeding to patients were eligible to take part in the survey.

Out of 100 respondents, 74 dietitians fit the eligibility criteria for data analysis. Of the 74 participants recommending bolus feeding in adult patients, they primarily worked in hospitals (64%, n = 47) and in the community (35%, n = 26) with 20% (n = 15) specialising in oncology. Just over half (58%, n = 43) of dietitians agreed that the number of patients being bolus fed has increased over the last 5 years with 26% (n = 19) reporting that more than half of their enterally fed patient case load receive bolus tube feeding. The majority of dietitians (99%, n = 73), routinely use the syringing method when administering a bolus feed.

Dietitians commonly recommend bolus feeding in oncology patients (65%, n = 48), those with neurodisability (46%, n = 34) and in adults with gastrointestinal diseases (19%, n = 14). When choosing to administer a bolus feed, 53% (n =39) of dietitians aim for 400kcal per feed, with 200ml ONS being the most popular bolus feed format (62%, n = 46). Almost all dietitians (96%, n = 71), decide to use bolus feeding with their patients as it suits their lifestyles as well as 81% (n = 60) reporting that it is favoured for its convenience.

Many of the dietitians (61%, n = 45) are of the opinion that feeds designed in a format for bolus feeding would improve patient experience. To further improve their training, dietitians reported there is a need for additional practice guidelines (47%, n = 35) and practical workshops (46%, n = 34) on bolus feeding.

This study found that dietitians are recommending bolus feeding for patients more often in the last 5 years (2019-2024). Participants reported that bolus feeding suits patients’ lifestyles as it’s convenient and it suits their social circumstances. There is a need for a specific format for bolus feeding products as well as specific bolus feeds to improve patient experience. Dietitians agree that additional resources such as practical workshops and guidelines are needed to further support them with bolus feeding.

Blended tube feeding for patients requiring enteral nutrition involves the provision of pureed food administered via a gastronomy tube(1). It is relatively new in dietary practice, with several clinical and perceived benefits, which was partly driven by the large prevalence of enteral nutrition intolerance in paediatric patients(2). In response to patient and dietitian preferences, as well as challenges of blended diets, medical nutrition manufacturers have developed commercial tube feed products containing real food ingredients (RFI). There is very limited published literature on these types of tube feeds.

The aim of this study was to understand the attitudes and awareness of dietitians towards recommending tube feeds containing RFI. This was done through investigating the indications behind recommending this type of product, what conditions they are recommended for, and the main barriers and benefits of recommending tube feeds containing RFI to paediatric patients.

A twelve-item online survey was distributed via Irish Nutrition and Dietetic Institute (INDI) and Irish Nutrition Jobs Facebook group to collect data from registered dietitians over six-weeks. Frequencies and Cross-tabulations were performed to analyse categorical variables using IBM SPSS V29.

From the total sample of 23 paediatric dietitians, those who currently recommend tube feeds containing RFI (n = 14) reported that the two main disorders to use this product are, gastrointestinal disorders (n = 13, 93%) or neurological disorders (n = 12, 86%). A primary indication for recommending these products is to improve tolerance (n = 12, 86%), with the main feeding method being bolus pump (n = 13, 93%). Key benefits reported are improvements to GI symptoms (n = 13, 93%) and improved weight gain (n = 5, 36%). Of the total sample, prime barriers found to recommending this type of feed is the low energy dense profile (n = 7, 30%) and insufficient amount of natural ingredients (n = 3, 13%).

This study shows a positive response towards tube feeds containing RFI and gives an insight into the potential benefits that using these innovative tube feeds can have for patients and carers. More case studies using these products are required, for dietitians to fully understand the main benefits and drawbacks of recommending these feeds to their paediatric patients.

Farm advisors provide knowledge and support to farmers, to help them change their on-farm practices or behaviours, with a view to improving the farm’s overall sustainability and competitiveness(1,2). In this way, advisors can be viewed as agents of change(3). In order to fulfil their role as agents of change, advisors must possess sufficient knowledge of human psychology and behavioural science, which is the discipline involved with understanding, predicting and changing behaviour(4,5). Despite this, within advisory education and professional development, it is considered that greater emphasis is given to advisory technical knowledge acquisition, than how to work effectively with others to support learning and change(6). Accordingly, this study aims to implement a behaviour change communication training programme for farm advisors and evaluate its efficacy. As much work within the health and social care field has been undertaken to support health related behaviour change, this study aims to adapt a behaviour change communication training programme originally developed for use within this field to the advisory setting(7,8).

A mixed-methods case study under the pragmatic worldview was conducted. Ethical approval was obtained from the Faculty of Medicine, Health and Life Sciences Research Ethics Committee at Queen’s University Belfast. The programme was adapted from the ‘MAP of Health Behaviour Change Learning Programme’ (MAP) created by NHS Education for Scotland(9). Eight farm advisors completed the programme delivered by health psychologists, which involved the completion of a 40-minute online module and a one-day in-person workshop about the principles of person-centred communication and behaviour change techniques. The Brinkerhoff training evaluation model guided the evaluation(10). Quantitative questionnaire data, including perceived knowledge and confidence, was descriptively analysed. Qualitative data including surveys, logs and focus group/interview data was thematically analysed.

Descriptive analysis found advisors scored highly in perceived knowledge (mean: 5.5) and confidence (mean: 5.5) post-training (measured on 6-point Likert scale). Thematic analysis determined three themes: valuable activities, takeaways, and programme evolution. Advisors valued open discussions and role-playing activities. A key takeaway was how to structure conversations about change; firstly, identifying a person’s stage of change, then delivering behaviour change techniques tailored to that stage. Further training on how to support individuals to explore and build motivation towards change was deemed beneficial.

MAP was shown to be an effective training programme with applications in agriculture. This study offers insights for those involved in advisory education. Incorporating behaviour change communication courses into advisory programmes helps advisors develop knowledge surrounding the psychology behind behaviour change and additional competencies in supporting behaviour change at the farm level.

The current food system is not only unsustainable but also increasingly inequitable, resulting in food insecurity for many people in the United Kingdom and globally(1). The health impacts of the current food system on disadvantaged communities warrants examination to improve ecological public health nutrition strategies(2). Community gardens and kitchens are frequently established by volunteers in the hope that they will serve as alternatives to the current food environment, building healthy food capacity in the community as well as outdoor physical and social activities for urban residents(3). This remains to be explored in deprived communities in Dorset, UK.

This pilot research was conducted in fourteen adults living in disadvantaged areas in Dorset (Hamworthy-Poole). Inclusion criteria were individuals over 18 years old living in low-income households, who were users of community food garden and kitchen initiatives. The individuals usually attend with their family members in the food growing and cooking activities, including young children and older adults in the programmes. Three semi-structured interviews and three focus groups (total n = 14) were undertaken to uncover views on the importance and roles of these community food initiatives in relation to healthy eating and access to locally grown fresh produce. All discussions were digitally recorded, and data were transcribed verbatim. Qualitative data analysis, using Clarke and Braun’s(4)six steps of thematic analysis, was performed via NVivo software.

Four main themes emerged: Tackling food insecurity & sustainability, Utilization of climate friendly & organic Food, Bridging intergenerational gap and Promoting healthy lifestyle. These food initiatives help in addressing food insecurity from the perspective of the participants. The role of community gardens together with cooking sessions can be further recognised as contributors to community development, access to healthy food such as fresh fruits and vegetables and nurturing skills related to nutritious food preparation.

In conclusion, this research provided insights into the perceptions on how we can design a health promotion initiative that is inclusive and sustainable to tackle food insecurity effectively.

Engaging in sedentary activities and consuming energy-dense, nutrient-poor foods increases the risk of developing non-communicable diseases (1). Young adults are one of the largest users of video games in Australia (2). To engage young adults in lifelong healthy behaviours, we need to understand their attitudes and behaviours towards health and healthy eating by examining psychobehavioural characteristics. This cross-sectional study explored the similarities and differences in diet quality of online gamers and non-gamers using a validated psycho-behavioural survey (3).

Online participants (n = 53, 18-30 years) from Australia completed a validated self-administered survey (3) including demographics, self-reported weight and height, searching online, physical activity levels (4), strategic dieting behaviours (5,6), self-identification as gamers or non-gamers (7) and up to three online 24-hour dietary recalls over non-consecutive days using Intake24Australia https://intake24.com/. Diet quality was assessed using the adapted Healthy Eating Index for Australian Adults (HEIFA)-2013 (8). Informed consent was obtained.

Gamers (n = 18, 44%) were more likely to identify as male (14.3% for Non-gamers, p = 0.05) but similar

BMI (Median 23.4kg/m2 (Percentiles = 20.6,29.5) vs 20.76kg/m2 (19.1,24.2), p = 0.10) to NonGamers. Overall differences in Gamers and Non-gamers were not due to gender differences (P>0.05). Gamers were less likely to report significant weight change in the previous 12 months (77.8% vs 42.9% for Non-Gamers, p<0.05) and were more likely to consciously control their weight by dieting than non-gamers (p<0.01). There was no difference in sitting time (Gamers 540min/d (420,601) vs Non-gamers 420min/d (300,600), p = 0.13). Despite being satisfied with the healthiness of their diet (score 9/15, p = 0.99), both groups were somewhat likely to improve the healthiness of their diet (10/15, p = 0.66). Non-gamers had higher intentions to search online for healthy eating and food-related information (p<0.05), healthy recipes, and meal plans (p<0.01). Diet quality was low across both groups (Gamers 50/100 vs Non-gamers 56/100, p = 0.18). Non-gamers reported significantly higher water (398ml (0,981) vs 134ml (0,326) p = 0.031) and beverage (1264ml (761,1558) vs 690ml (505,977) p = 0.010) consumption than gamers.

The findings suggest that online gamers and non-gamers share similar concerns and priorities regarding health. Diet quality was similar, with both groups likely to benefit from targeted interventions to improve dietary intake. Low water consumption is a concern, with campaigns highlighting the benefit of water for cognitive performance more likely to resonate with young adults, particularly gamers. Using a psycho-behavioural survey and co-design methods will provide insights to inform more tailored public health communication strategies for diverse groups such as young adults.

University students often make less healthful dietary choices whilst at university however, do not typically receive advice and support to help them eat more healthily(1,2). A tool which could be provided to students to promote more favourable dietary behaviours is the eNutri web-based app which includes a food frequency questionnaire (FFQ) and delivers automated personalised nutrition advice (PNA) and a diet quality score (DQS) consisting of 11 food/nutrient components(3). The PNA includes scores and general advice for each component and, for the user’s three lowest scoring components, recommends which foods to eat more/less frequently to improve their DQS. As part of a 4-week intervention study, we aimed to explore the perceptions of the eNutri PNA in UK university students.

As part of this intervention, 14 students from the Universities of Reading and Hertfordshire completed the eNutri FFQ and received their PNA. At the end of the study, they rated how much they agreed with statements about the perceived value and benefit (if any) of the eNutri PNA tool, on a 6-point scale ranging from strongly disagree to strongly agree. The percentage of respondents reported is the total number who responded “somewhat agree”, “agree”, or “strongly agree” to each statement.

Of the 14 students, 79% were female with a mean age of 25y (range = 18-37y) and mean BMI of 24.7kg/m2 (range = 19.4-31.9kg/m2). At baseline, the average importance of a healthy diet to the participants (n = 13) was rated at 7.2 out of 10 (with 0 being ‘not important at all’ and 10 being ‘very important’). In total, 57% of respondents indicated that they felt they ‘were eating a healthier diet because of the eNutri advice received’ and only 14% reported that ‘the advice did not motivate them to make changes to their diet’. Furthermore, 64% of respondents indicated that the ‘eNutri PNA gave them confidence in their ability to make changes to their diet’ and that it ‘supported them to do so’. Half of the students agreed that ‘they would want to use eNutri long term to track their progress and receive regular PNA’. In addition, 79% agreed that ‘eNutri should be offered to all university students to help them make healthier food choices’, and that if eNutri was offered to them for free by their university, ‘it would be a valuable student benefit’ and they ‘would want to use it again’.

In general, university students indicated the eNutri PNA tool supported them to eat healthier and providing access to the wider student population would be beneficial to encourage healthy eating at university. These findings along with the quantitative data from the PNA intervention which is currently being analysed will support the development of larger, suitably-powered studies to confirm these findings.

The transition to higher education (HE) constitutes a prime opportunity for intervention to address the sub-optimal dietary behaviours (low intake of fruit and vegetables (F&V), infrequent breakfast consumption [BC]), clinically-relevant gains in body mass, and hazardous alcohol consumption (HAC) patterns that have been reported amongst international HE student cohorts(1,2). To inform such interventions, the current cross-sectional study aimed to explore gender differences in habitual F&V consumption, BC, body mass index (BMI), and HAC among first-year undergraduates at a multi-campus university in Ireland.

A 42-item web-based questionnaire was distributed by e-mail to first-year undergraduate students across the university’s six campuses in semester 1 of 2022/23 (Wave 1) and was repeated in semester 1 of 2023/24 (Wave 2), supplemented by in-class recruitment. Participants met the inclusion criteria if they were a full-time first-year student, and were aged ≥18 years. Participants were asked to quantify their daily servings of F&V (serving defined as 1 piece of fruit, or 3 dessertspoons of vegetables). Habitual BC (days) were reported (weekdays: 0-5, weekend days: 02) and BMI [kg/height(m)2] was calculated from self-reported height and body mass. The AUDIT-C scale (range 0-12) was used to identify HAC on the basis of previously-reported sex-specific threshold scores(3) (females ≥5 and males ≥6). Between-gender differences were examined using Chi-Squared Tests for Independence (categorical data) or Mann-Whitney U Tests (non-parametric continuous data). The level of significance was set at p<0.05.

Overall response rate (W1/W2 combined) was 19.0%, (n = 1910, 54.9% female, mean age 19.7 ± 4.0). Median number of F&V servings per day was 4.0 (IQR±3.0), with 35.7% reporting ≥5 servings. A significantly higher proportion of females reported consuming ≥5 daily servings of F&V, compared to males (38.6% vs. 32.2%, p = 0.007). In total, 36.4% reported consuming breakfast on all weekdays, whilst 54.4% reported consuming breakfast on both weekend days. Males reported significantly more frequent BC than females on all weekdays (43.7% vs. 35.2%) and weekend days (64.4% vs. 53.4%, p<0.01). In terms of BMI, 7.8% of students were classified with underweight (males: 6.6%, females: 8.8%), 61.0% with normal weight (males: 60.7%, females: 61.4%), 22.1% with overweight (males: 24.5%, females: 20.1%) and 9.1% with obesity (males: 8.3%, females 9.8%). The majority (89.9%) of students reported consuming alcohol, and 65.9% exceeded sex-specific HAC thresholds (males: 70.3% vs. females: 62.5%, p<0.01).

The current study has served to highlight sub-optimal dietary behaviours amongst a cohort of firstyear undergraduate students in Ireland. A concerning prevalence of overweight and obesity was also observed, and HAC was prevalent amongst 65.9%. Males appeared to exhibit less favourable behavioural patterns than females in terms of F&V intake and HAC. These findings will inform targeted ‘life-course’ interventions aimed at improving dietary and health related behaviours within the transformative setting of higher education.

Whole grain (WG) consumption has been associated with many health benefits(1–4). However, in the UK, there is a lack of WG intake data with the most recent analysis available spanning the years 2008-2011(5–7). In this study, our aim is to assess the consumption of whole grains among the UK population using data from the National Diet and Nutrition Survey (NDNS) rolling programme covering the years 2008 to 2019.

WG intake trends and sociodemographic patterns from the UK NDNS Rolling Programme, 2008/09 to 2018/19, of 15,655 individuals aged ≥1.5 years who completed a four-day food diary were analysed. WG consumption was assessed by examining the WG content of foods in grams based on product ingredient information. Survey-weighted mean consumption of whole grains overall and by socio-demographic group and health status variables. Survey-weighted Wald tests (for categorical variables such as ethnicity) and trend tests (for ordered variables such as age group) will be used to determine whether intakes of whole grains differ within category.

No statistically significant trend was observed in total WG intake when comparing the intakes from 2008-2012 to 2016-2019, with mean intakes of 29.2g/day (95% CI: 27.8, 30.5) and 28.2g/day(95% CI: 26.8, 29.6), respectively. In 2016-2019 older adults (65y+) had the highest consumption (33.6 g/day [95% CI: 30.5, 36.8]), followed by 19-64y, with an intake of 29.1 g/day (95% CI: 27.1, 31.2). High-fibre cereals, bread, and other cereals including pasta and rice were the primary sources of WG. Between 2008-2012 and 2016-2019, the mean daily intake of high-fibre cereals and bread significantly declined from 11.1g (10.3, 11.9) to 9.3g (8.5, 10.1) and 12.4g (11.6, 13.1) to 10.0g (9.2, 10.8) respectively. Conversely, consumption of other cereals increased from 4.0g (3.3, 4.7) to 6.9g (6.1, 7.6) per day. Individuals with higher incomes, levels of education and healthy weights showed higher mean WG consumption.

Our study showed no statistically significant change in mean whole grain consumption in the UK from 2008/09 and 2018/19. Although, there is absence of dietary WG recommendations in the UK, whole grain intakes are below the recommended levels proposed by many countries.