Early life, or the neonatal period, is perhaps the most challenging time for ruminant livestock, as they adapt to the extra-uterine environment, undergo important physiological maturation, and navigate harsh ambient conditions. Maternal influences during gestation, especially energy and protein nutrition in late pregnancy, can alter many processes that affect the neonatal period. These processes include fetal growth and development, gestation length, difficulty of parturition, and maternal behavior, which interact to affect offspring vigor at birth. Moreover, colostrum and early milk production and composition are affected by gestational nutrition, and these along with the previous factors affect the neonate’s ability to obtain transfer of passive immunity, thermoregulate, perform basal metabolism, and ultimately survive to weaning. Often, the long-term effects of maternal nutrition during gestation on offspring are attributed solely to the prenatal environment, but it is critical to also consider influences of early life on later productivity and health. More research is needed to integrate these neonatal outcomes with prenatal and postnatal mechanisms as well as later ruminant livestock performance. Better understanding of the maternal environment’s effects on the neonatal period provides opportunity for improved management of ruminant livestock dams and offspring.

Accurate assessment of an individual’s diet is vital to study the effect of diet on health. Image-based methods, which use images as input, may improve the reliability of dietary assessment. We developed an iOS application that uses computer vision to identify food from images. This study aimed to assess the accuracy of energy intake (EIapp) estimates from the application by comparing them to estimated energy expenditure (EE) and to the EI estimates from a validated dietary assessment tool, the 24-h recall (EIrecall). Participants were recruited from a randomised controlled trial called He Rourou Whai Painga. Participants recorded all intake over 7 d using the application, which provided a mean daily EI; this was compared to the EI estimated by two 24-h recalls. The EI from the application and the recalls were compared to EE, estimated using indirect calorimetry and wrist-worn accelerometry. EI estimates from the application and the 24-h recalls were lower than EE, with a mean bias of -1814 kJ (95% CI -3012 to -615, p = 0.005) and -1715 kJ (95% CI -3237 to -193, p = 0.029), respectively. The mean bias between EI from the application and the 24-h recall was 783 kJ (95% CI -875 to 2441, p = 0.33). This suggests that the EI estimates from the application are comparable to the 24-h recall method, a validated and widely used tool in nutritional research.

Nutritional status has been compromised by ongoing war and restrictions on food deliveries in the Gaza Strip. We developed a mathematical model that outputs retrospective estimates and scenario-based projections of acute malnutrition prevalence among children given caloric intake and other factors. We present here the model and its application to the crisis in Gaza.

We extended an existing mechanistic model for weight change as a function of energy balance, calibrating it to represent variability in growth curves observed in pre-war Gaza. We simulated open cohorts of children exposed to time-varying caloric intake, infant exclusive breastfeeding prevalence, incidence of infectious disease and coverage of malnutrition treatment, while allowing for adult caloric sacrifice to supplement child intake in times of food scarcity.

The model accurately replicates growth standards, pre-war growth patterns and expected parameter dependencies. It suggests that a considerable increase in acute malnutrition occurred in northern Gaza during early 2024. Projections for late 2024 include a serious nutritional emergency if relatively pessimistic assumptions are made about food availability. The model may hold considerable promise for informing decisions in humanitarian response but requires further validation and development.

This paper examines associations between maternal exposure to a radio programme, Bhanchhin Aama (Mother Knows Best), and the programme’s most promoted maternal and child nutrition-related practices, using the Nepal Demographic and Health Survey (NDHS) from 2022. We limited our sample to mothers of children less than 2 years (n = 1,933). The primary exposure variable was whether the mother listened to the Bhanchhin Aama radio programme. The five primary outcomes were: maternal dietary diversity, maternal use of modern family planning methods, exclusive breastfeeding (EBF) of children less than 6 months, dietary diversity among children 6 to 24 months, and participation in growth monitoring and promotion among children 0 to 24 months. Descriptive analyses followed by logistic regression models, adjusted for potentially confounding factors and clustering, were conducted. Maternal exposure to Bhanchhin Aama was associated with nearly 70% higher odds of meeting both maternal (OR: 1.67; p: <0.001; CI: 1.26–2.21) and child minimum dietary diversity (OR: 1.70; p: 0.005; CI: 1.18–2.45), as well as 83% higher odds of a child participating in growth monitoring and promotion (OR: 1.83; p: 0.001; CI: 1.28–2.63). No associations were found for use of modern family planning methods and EBF. These findings suggests that radio programmes may be an effective tool to improve some maternal and child nutrition-related practices. Further research is needed to understand why certain behaviours are modifiable from this type of intervention versus others that are not and for which population groups this intervention would be most effective.

Obesity has significant implications regarding the welfare of companion animals. Data regarding obesity in exotic companion mammals (ECM) are sparse. The aim of this study was to investigate obesity in pet rabbits (Oryctolagus cuniculus), guinea pigs (Cavia porcellus), and rats (Rattus norvegicus) in Estonia, and to survey husbandry practices and owner awareness. Husbandry data were collected from patients visiting the Estonian University of Life Sciences’ small animal clinic via anonymous questionnaires over an eleven-month period. Three hundred and fifty-one questionnaire responses and body condition score (BCS) data for 177 patients (71 rabbits, 73 guinea pigs, 33 rats) were collected. Twenty-eight percent of rabbits, 23% of guinea pigs and 28% of rats were overweight (BCS > 3/5). Male rats were more likely to be overweight than females and there was a negative correlation between age and body condition. There was an increased likelihood of male guinea pigs being underweight. Owner questionnaires revealed that 20% of rabbit owners, 14% of guinea pig owners and 11% of rat owners believed their pets to be overweight while 58% of owners had not received husbandry advice from a veterinarian. Obesity is a significant welfare issue in the Estonian ECM population and several detrimental husbandry practices were identified, including inappropriate feeding, insufficient physical activity, individual housing. Further studies might investigate veterinarian awareness of the issues at hand and tendencies for other species.

Lipids are essential for child development. Nutritional recommendations are numerous, evolving over time and are often based on expert opinions more than evidence-based medicine. The objective of this review is to critically analyse the evolution of current nutritional recommendations, identify existing knowledge gaps and propose avenues for improvement to optimise infant nutrition and development. A narrative literature review on Pubmed, EMBASE and Cochrane databases (2001–22) was conducted with the keywords: ‘alpha-linolenic acid, arachidonic acid, children, cholesterol, docosahexaenoic acid, eicosapentaenoic acid, guidelines, infant, long-chain (LC) PUFA, linoleic acid, lipids and dietary intakes, newborn, palmitic acid and toddler’. Among 861 articles identified, 133 were selected. The main current recommendations are issued by the French Agency for Food Safety (AFSSA), French Agency for Food, Environmental and Occupational Health and Safety (ANSES) and the Food and Agriculture Organization and World Health Organization (FAO-WHO). In infants from 0 to 3 years of age the main challenge is to increase lipid intake while maintaining an optimal omega 6/omega 3 ratio. Current recommendations are focused on polyunsaturated fatty acids, emphasising the intake of linoleic, eicosapentaenoic and docosahexaenoic acids without any specific recommendation for arachidonic acid before the age of 6 months. Points of interest, but without any recommendation, are the incorporation of milk fat, cholesterol, monounsaturated fatty acids, and saturated fatty acids for infants under 6 months. In conclusion, this article identifies knowledge gaps regarding the structural aspect of lipids and the integration of new categories of lipids in future recommendations to promote the quality of infant formulas.

Human milk and direct breastfeeding provide the optimal, biologically normative nutrition for hospitalised infants, with well-established benefits for immune, gut, cardiac, brain, and maternal health. Despite these benefits, human milk and breastfeeding rates for infants with CHD in high-resource countries are typically low, and there are no formal guidelines to drive CHD breastfeeding practice. Our aim is to (1) summarise the evidence on breastfeeding for infants with CHD, (2) discuss key barriers to and facilitators of breastfeeding in this population, (3) identify critical research and practice gaps to improve breastfeeding care in CHD, and (4) provide recommendations for clinical practice and future research.

Primary breastfeeding barriers for infants with CHD include (1) concern for dysphagia/aspiration, (2) concerns related to weight gain, (3) clinical instability/sickness, (4) developmental considerations, (5) general breastfeeding challenges, and (6) workflow and implementation issues, with racism and health disparities also contributing. The evidence to support these barriers is limited and often conflicting. Breastfeeding facilitators for preterm infants are well described, but facilitators may require modification for infants with CHD. Most lactation interventions have not been tested in CHD populations. Current evidence does not support automatic withholding of breastfeeding from infants with CHD; rather, the benefits of breastfeeding likely outweigh many potential concerns. There is a critical need for research and quality improvement to identify interventions that equitably and effectively support breastfeeding for infants with CHD and to evaluate the effect of breastfeeding on short- and long-term physical, psychological, and developmental outcomes for infants and families.

A Palaeolithic diet is an efficacious dietary approach for glycaemic control in type 2 diabetes. Causal mechanisms are body weight loss and glucometabolic effects from differences in included food groups, macronutrient composition, fibre content, and glycaemic load. The aim was to test the hypothesis that characteristic food group differences between a Palaeolithic and a diabetes diet would cause an effect on glycaemic control when weight was kept stable and diets were matched for macronutrient composition, fibre content and glycaemic load. Adult participants with type 2 diabetes and increased waist circumference were instructed to follow two diets, with or without the food groups cereal grain, dairy products, and legumes, during two periods of 4 weeks separated by a 6-week washout period in a random-order crossover design. The Palaeolithic diet included fruit, vegetables, tubers, fish, shellfish, lean meat, nuts, eggs and olive oil, and excluded cereal grains, dairy products and legumes. The diabetes diet included fruit, vegetables, fish, shellfish, lean meat, nuts, eggs, olive oil, and substantial amounts of whole grains, low-fat dairy products and legumes. Dietary energy content was adjusted throughout the study to maintain stable body weight. There were no differences between diets on HbA1c or fructosamine among the 14 participants. Body weight was kept stable, and the two diets were successfully matched for macronutrient composition and glycaemic load but not for fibre content. Characteristic food group differences and the accompanying differences in fibre content between a Palaeolithic and a diabetes diet do not cause an effect on glycaemic control.

Household food production is considered a key avenue for improving food security and nutritional status, particularly for low-income people from developing countries. However, little is known about what aspects of home garden production enhance nutritional outcomes. This paper aims to assess how home gardens influence nutritional status while considering the impact of various child, maternal, and household characteristics such as birthweight, age, education, and income. We also examined the impact of distance to the market mediating this association. We conducted a cross-sectional study of 403 children (24-60 months) and their mothers (18-45 years) in Batticaloa district, Sri Lanka using a pre-tested structured questionnaire. Maternal and child anthropometric measures were taken, and children were classified as stunted, wasted and underweight based on the WHO references, and BMI was calculated for mothers(1). Logistic regression was used to analyse the factors associated with the dependent variable, nutritional outcomes. Food production diversity was not associated with maternal or child nutritional outcomes. The only production variable associated with child nutritional outcome was livestock ownership, and it was negatively associated with child wasting (P < 0.01). Surprisingly, increased market distance improved the child undernutrition (P <0.05). Higher levels of maternal education were significantly associated with reducing stunting and underweight in children (P < 0.01). Childbirth weight showed a negative association with a child underweight (P < 0.01), and we also observed a small negative effect of a child’s age on stunting. These findings suggest that while home gardens can be an entry point, improving nutrition may require a multifaceted approach that addresses a broader range of factors.

‘I just don’t know what to eat!’ is a frequent statement from people seeking nutrition support. With a magnitude of information available, confusion and limited confidence is a common complaint. People face myriad challenges in their attempts to have a healthy diet, including cost and time constraints, challenging food environments, and limited knowledge and skills(1). Challenges about eating well are often raised, yet enablers to eating well are not as readily discussed. Intention for healthy behaviours, self-efficacy and social support are examples of favourable elements which support healthy diets(1,2). As such, existing knowledge, skills, and positive influences should also be considered. As part of a wider qualitative study, and using an interpretive description approach, we sought to identify enablers to healthy eating perceived by people engaged with Green Prescription (GRx) and Active Families programmes. Nineteen clients aged 18 years and over, engaged with six GRx services were interviewed between May and October 2023. Eighteen whānau (family) members, (19-53 years) attending Active Families sessions facilitated in the Waitematā area participated in focus group discussions during May-August 2024. Participants were asked in these discussions (kōrero) to share what helps them and their whānau to eat well. Braun and Clarke’s(3) thematic analysis approach was used to analyse responses from these kōrero through data familiarisation, coding, and cyclical review of thematic relationships. Several themes were identified in this analysis: ‘confidence in personal skills,’ ‘supportive environments’, and ‘being open and willing’. Personal skills such as planning meals, managing household budget and efforts to procure ‘good’ food were identified as strengths. These wider food skills have been suggested as potentially more important to enhancing dietary behaviours than cooking skills(4). Participants relayed experiences of developing skills that improved their confidence in eating well including growing, gathering and preserving food, experimenting with recipes, and knowing where to find affordable, nutritious food. Environments where people learned food and cooking skills and household members supported their endeavours to eat well were described as influential to encourage people in their efforts. Participants also expressed that being open to trying new foods and ways of eating led to inspiration and new knowledge. This attitude resulted in increased variety in the diet and further enhanced confidence to seek recipes and food information and spurred on efforts to make changes. People who have sought nutrition advice have often expressed challenges and uncertainty impacting their efforts to eat well. Nevertheless, there are also strengths which have meaningful impact on their eating. In nutrition advice provision, it would be beneficial to thoroughly explore the strengths people exhibit to support healthy eating. Identifying these insights may powerfully effect people’s confidence to eat well and identify more effective support and information provision.

The Tohu Manawa Ora | Healthy Heart Award programme helps early learning services across Aotearoa create an environment that promotes nutritional health and physical activity. It achieves a sustainable change to the environment by using a ‘whole-service’ approach, through governance and management, learning and teaching, collaboration and professional development. The programme aims to foster happy tamariki with awareness of how to have hearts fit for life, ensuring healthier futures for whānau across Aotearoa New Zealand. To evaluate and understand the impact and social value of the Tohu Manawa Ora | Healthy Heart Award programme on fostering healthy habits and creating supportive environments in early learning settings across Aotearoa New Zealand the Heart Foundation undertook this evaluation with ImpactLab. Two hundred and fifteen early learning services and 33,717 tamariki across Aotearoa New Zealand, who were enrolled in or had achieved a Tohu Manawa Ora | Healthy Heart Award, were used to determine the impact and social value of the programme. This was achieved through using a social value calculation which integrates multiple data sources and analytical methods. Firstly, impact values derived from the programme were combined with evidence from global literature on the effectiveness of similar health promotion programmes. Secondly, the size of the opportunity for participants—early learning services across Aotearoa New Zealand—to achieve more positive health outcomes was assessed. Thirdly, the number of people supported by the programme was considered. Every year, the Tohu Manawa Ora | Healthy Heart Award programme delivers $6,163,581 of measurable good to society in New Zealand. Outcomes for tamariki of improved oral health, physical activity and reduced diabetes and improved physical activity for whānau directly contribute to the social value. Improved health equity, nutrition, increased food exposure and physical activity, promotion of lifelong wellbeing and positive health behaviours, reduced cardiovascular disease and sugar consumption indirectly contributed to the social value. This means that every dollar invested in the Tohu Manawa Ora | Healthy Heart Award programme delivers $4.50 of measurable good to New Zealand. The Tohu Manawa Ora | Healthy Heart Award programme delivers significant measurable social value to Aotearoa New Zealand. Growth, development and continued funding of the programme should continue to further positively impact the future of tamariki and their whānau in Aotearoa New Zealand.

Breastfeeding is the recommended way to feed infants. However, a safe and nutritious substitute for human milk is needed for infants when breastfeeding is not possible. As infants are a vulnerable population group, infant formula products are regulated by prescriptive provisions for composition and labelling. Any changes to the composition of these products must be established as safe prior to being permitted. As our knowledge of human milk expands, infant formula ingredients are developed to better replicate it. Food Standards Australia New Zealand (FSANZ) has assessed the addition of ingredients for the addition to infant formula products including human identical milk oligosaccharides (HiMOs) isolated using precision fermentation methodology. These ingredients are considered to be nutritive substances as their addition to food is intended to achieve specific nutritional purposes. In accordance with the Ministerial Policy Guidelines, FSANZ must assess both the safety and the health effect of nutritive substances for their use in infant formula. FSANZ risk assessments are undertaken by a multidisciplinary team covering toxicological and nutritional considerations using the best available scientific evidence. FSANZ assessments of the health effects concluded that the use of HiMOs in infant formula products would have a beneficial outcome for infants and align with the equivalent role of these substances in human milk(1,2). The weight of evidence supports health effects through an increase in the abundance of Bifidobacterium spp. in the infant gut microbiota, anti-pathogenic effects, inflammatory suppression and facilitation of appropriate immune responses and antigenic memory. FSANZ safety and technical assessments concluded that there are no public health and safety concerns associated with adding HiMOs to infant formula products(1, 2). The permitted levels are comparable to levels in human milk and are chemically and structurally identical to the naturally occurring forms. Food Standards Australia New Zealand, Canberra, 2606, Australia Based on the available evidence and intended purpose, a number of HiMOs have been permitted for use in infant formula products including 2′- fucosyllactose, lacto-N-neotetraose, difucosyllactose, lacto-N-tetraose, 3'-sialyllactose sodium salt, 6'-sialyllactose sodium salt. Evidence continues to emerge on the beneficial effects of HiMOs on infant health.

Parkinson’s disease (PD) is the second most prevalent neurodegenerative disease globally(1) whereby there is a loss of dopaminergic neurons in the brain and a deficiency of dopamine. PD is characterised by dyskinesia, rigidity, tremor and postural instability, and non-motor symptoms which include neuropsychiatric, sleep and autonomic dysfunction which often occur before motor symptoms(2). Several of these motor and non-motor symptoms can adversely affect nutritional status(3) and a significant number of people with PD are at risk of malnutrition(4). Observational studies have examined the relationship between dietary intake, symptoms and disease progression yet there is a lack of randomised controlled trials of dietary interventions. This presentation will examine the evidence base and suggest future directions for nutrition research in this important area.

The estimated global preterm birth rate in 2020(1) was more than 10% of livebirths or 13.4 million infants. Despite the importance of neonatal nutrition in optimising growth, neurodevelopment, and later metabolic disease risk, there is inconsistency in nutrition recommendations for preterm infants(2). Incomplete or inconsistent reporting of outcomes in nutrition intervention studies is part of the reason for the lack of consensus on optimal nutrition. To reduce uncertainty in measuring or reporting nutritional intake and growth outcomes in preterm studies, a consensus process is needed to identify relevant measures for patients, parents/caregivers, researchers, and health professionals. We aimed to develop a minimum reporting set (MRS) for measures of nutritional intake and growth in preterm nutrition studies. We collaborated with a group of international researchers from 13 countries and registered this study at the COMET initiative (registration number 3185). The target population was individuals born preterm at any gestational age and study location whose nutritional intake was assessed before first hospital discharge and whose growth was assessed at any age. Measures reported in preterm nutrition studies were systematically reviewed and used to develop the real-time Delphi survey(3) using Surveylet (Calibrum) software, including 13 questions about nutritional intake and 14 about growth outcomes. We used a snowball process to recruit participants from the consumer, healthcare provider, and researcher stakeholder groups with expertise in preterm infants, nutrition, and growth to rate the importance of each measure on a 9-point Likert scale. Participants initially rated the survey items without seeing other participants’ responses, saved and refreshed the page to see the anonymous responses of other participants, and had the option to change their rating and provide reasons for their answers. Participants’ final scores for each item will be used to identify the consensus criteria for that item(3). To date, we have recruited 246 participants from 31 countries across 5 continents, including 58 (24%) consumers, 156 (63%) healthcare professionals, and 26 (11%) researchers. Preliminary findings indicate that 12 measures of nutritional intake and 4 of growth have met the criteria for inclusion in the MRS. However, participant recruitment and survey responses are ongoing. A final consensus meeting is planned for November 2024 to confirm the MRS.

We investigated the coverage of childhood vitamin A supplementation (VAS) across India from 2005–2006 to 2019–2021 and further explored how it related to childhood mortality. Data collected from mothers through standard questionnaires during the latest three rounds of the National Family Health Survey (2005–2006, 2015–2016 and 2019–2021) were used. Information on VAS in children aged 9–35 months was available from 2015–2016 to 2019–2021. Information on VAS among children aged 9–59 months was available from 2005–2006 to 2015–2016. Childhood VAS coverage was determined nationally and subnationally (viz. individual states, geography, socio-demographic index and developmental groups). Nearly 40 % eligible children aged 9–59 months and 30 % eligible children aged 9–35 months missed VAS during recent times. But improvements in VAS coverage were noticed over the years: from 18·6 % (2005–2006) to 60·5 % (2015–2016) among children aged 9–59 months and from 64·5 % (2015–2016) to 71·2 % (2019–2021) among children aged 9–35 months. There were coverage disparities, with Western India documenting the highest and Northeastern India documenting the lowest coverage values. During simple linear regression analysis, childhood mortality between 1 and 5 years of age varied inversely as a function of VAS coverage among children aged 9–59 months, with the association being less pronounced in 2015–2016 (β = −0·47) than in 2005–2006 (β = −0·40). However, this relationship disappeared when we accounted for potential confounders (viz. childhood immunisation and socio-economic factors) through multivariate analysis, suggesting that the role of VAS in promoting childhood survival may be limited during present times.