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Indigenous Solomon Islanders, like many living in Pacific Small Island Developing States (PSIDS), are currently experiencing the global syndemic—the combined threat of obesity, undernutrition, and climate change. This mixed-method study aimed to assess nutrition transitions and diet quality by comparing three geographically unique rural and urban indigenous Solomon Islands populations. Participants in rural areas sourced more energy from wild and cultivated foods; consumed a wider diversity of foods; were more likely to meet WHO recommendations of >400 g of non-starchy fruits and vegetables daily; were more physically active; and had significantly lower body fat, waist circumference, and body mass index (BMI) when compared to urban populations. Urban populations were found to have a reduced ability to self-cultivate agri-food products or collect wild foods, and therefore consumed more ultra-processed foods (classified as NOVA 4) and takeout foods, and overall had less diverse diets compared to rural populations. Clear opportunities to leverage traditional knowledge and improve the cultivation and consumption of underutilized species can assist in building more sustainable and resilient food systems while ensuring that indigenous knowledge and cultural preferences are respected. [ABSTRACT FROM AUTHOR]

Background: Malnutrition in patients admitted to hospital may have detrimental effects on recovery and healing. Malnutrition is preceded by a state of malnutrition risk, yet malnutrition risk is often not detected during admission. The aim of the current study was to investigate the magnitude and potential predictors of malnutrition risk in older adults, at hospital admission.Methods: A cross-sectional was study conducted in 234 older adults (age ≥ 65 or ≥ 55 for Māori or Pacific ethnicity) at admission to hospital in Auckland, New Zealand. Assessment of malnutrition risk status was performed using the Mini Nutritional Assessment Short-Form (MNA®-SF), dysphagia risk by the Eating Assessment Tool (EAT-10), muscle strength by hand grip strength and cognitive status by the Montreal Cognitive Assessment (MoCA) tool.Results: Among 234 participants, mean age 83.6 ± 7.6 years, 46.6% were identified as at malnutrition risk and 26.9% malnourished. After adjusting for age, gender and ethnicity, the study identified [prevalence ratio (95% confidence interval)] high dysphagia risk [EAT-10 score: 0.98 (0.97-0.99)], low body mass index [kg/m2: 1.02 (1.02-1.03)], low muscle strength [hand grip strength, kg: 1.01 (1.00-1.02)] and decline in cognition [MoCA score: 1.01 (1.00-1.02)] as significant predictors of malnutrition risk in older adults at hospital admission.Conclusion: Among older adults recently admitted to the hospital, almost three-quarters were malnourished or at malnutrition risk. As the majority (88%) of participants were admitted from the community, this illustrates the need for routine nutrition screening both at hospital admission and in community-dwelling older adults. Factors such as dysphagia, unintentional weight loss, decline in muscle strength, and poor cognition may indicate increased risk of malnutrition. [ABSTRACT FROM AUTHOR]

Background: The number of people of advanced age (85 years and older) is increasing and health systems may be challenged by increasing health-related needs. Recent overseas evidence suggests relatively high levels of wellbeing in this group, however little is known about people of advanced age, particularly the indigenous Māori, in Aotearoa, New Zealand. This paper outlines the methods of the study Life and Living in Advanced Age: A Cohort Study in New Zealand. The study aimed to establish predictors of successful advanced ageing and understand the relative importance of health, frailty, cultural, social & economic factors to successful ageing for Māori and non-Māori in New Zealand.Methods/design: A total population cohort study of those of advanced age. Two cohorts of equal size, Māori aged 80-90 and non-Māori aged 85, oversampling to enable sufficient power, were enrolled. A defined geographic region, living in the Bay of Plenty and Lakes District Health Board areas of New Zealand, defined the sampling frame. Rūnanga (Māori tribal organisations) and Primary Health Organisations were subcontracted to recruit on behalf of the University. Measures--a comprehensive interview schedule was piloted and administered by a trained interviewer using standardised techniques. Socio-demographic and personal history included tribal affiliation for Māori and participation in cultural practices; physical and psychological health status used standardised validated research tools; health behaviours included smoking, alcohol use and nutrition risk; and environmental data included local amenities, type of housing and neighbourhood. Social network structures and social support exchanges are recorded. Measures of physical function; gait speed, leg strength and balance, were completed. Everyday interests and activities, views on ageing and financial interests complete the interview. A physical assessment by a trained nurse included electrocardiograph, blood pressure, hearing and vision, anthropometric measures, respiratory function testing and blood samples.Discussion: A longitudinal study of people of advanced age is underway in New Zealand. The health status of a population based sample of older people will be established and predictors of successful ageing determined. [ABSTRACT FROM AUTHOR]

Issue Addressed: Unhealthy food and drinks are widely available in New Zealand school canteens. The aim of this study was to assess primary school canteen food menus against the newly implemented Ministry of Health 'Food and Drink Guidance for Schools'., Methods: A convenience sample of 133 primary school canteen menus was collected in 2020 as part of the baseline evaluation of the Healthy Active Learning initiative across New Zealand. A menu analysis toolkit was developed to assess menus in accordance with the Ministry of Health's 'Food and Drink Guidance for Schools' which classifies food items into three food categories: 'green', 'amber' and 'red'., Results: Most menu items belonged to the less healthy amber (41.0%) and red (40%) food categories. Low decile schools had a lower percentage of green food items (8.6%) and a higher percentage of red food items (48.3%) compared to high decile schools. Sandwiches, filled rolls and wraps were the most commonly available items, followed by baked foods and foods with pastry. Over half of the in-house canteen menu items were classified as 'red' foods (55.3%)., Conclusions: Most school canteens were not meeting the guidelines for healthy food and drink provision outlined by the Ministry of Health. Improving the food environment for children in socio-economically deprived areas needs to be prioritised to reduce inequities. SO WHAT?: This study highlights the unhealthy food environments in New Zealand schools and emphasises the need for more robust national policies and mandated school guidance., (© 2023 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Fijis' older population aged 55 years and over makes up 14% of the total population and is expected to reach 20% by 2050. This narrative review aimed to examine the health and nutrition status of the aging population of Fiji and sociodemographic determinants. A search strategy was conducted throughout databases, and gray literature from relevant websites was searched. Due to the limited evidence regarding the nutrition, health, and socio-economic factors that impact the aging population in Fiji the inclusion criteria were broad and included both genders (male and female), all publications up until December 2022, all study designs, and gray literature (government/institutional reports, conference proceedings, guidelines, Act, and Policies) . There was no filter for date applied in the search criteria. Studies that did not meet the search criteria were excluded. 20 documents including published articles were included for analysis and result synthesis. Life expectancy at birth for the Fiji population is 68 years. A significant annual increase in mortality rate from endocrine, nutritional, and metabolic diseases has been observed in women aged 75+ but not older men. Women of low-income status are more at risk than men. However, as most investigations aggregate those ≥18 years, there is a lack of information on older adults (≥65 years) health and nutrition status. To improve the health status of older adults, an understanding of the nutritional status of older adults is warranted, especially concerning lifestyle and sociodemographic determinants., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction There is a high prevalence of malnutrition among older adults entering residential aged care (RAC). Aim To determine whether 60 mL of a compact oral nutrition supplement (ONS; daily total: 576 kcal, 35 g protein) consumed four times daily with medication rounds improves malnutrition status, body weight, and body composition measures among older adults in RAC. Methods Residents (n  = 20; mean age: 86.7 ± 6.8 years; 50% female) screened for malnutrition (20% malnourished, 80% at risk of malnutrition) using the Mini Nutritional Assessment-short form were recruited during April-June 2021. Participants received 60 mL of an ONS four times daily using the Medication Pass Nutrition Supplement Programme (Med Pass). The ONS intake and participant compliance were recorded. Body mass index, fat, and muscle mass (bioelectrical impedance), malnutrition risk, depressive symptoms, and quality of life were assessed at baseline and following the 18-week intervention. Results Median overall compliance was 98.6%. An ONS intake did not significantly increase mean ± s.d. any body composition measures or improve health and wellbeing outcomes; however, it resulted in increased body weight and body mass index (BMI; 13/20 (65%) participants), body fat mass and percentage (10/16 (63%) participants) and muscle mass (9/16 (56%) participants). Malnutrition risk scores improved in 65% (13/20) of participants, resulting in 10% being assessed as malnourished, 65% at risk of malnutrition, and 25% with normal nutrition status. Discussion Delivery of a compact oral nutrition supplement with the medication round was accepted by residents. Its efficacy in improving malnutrition risk and body composition among residents warrants further investigation.

Background: Weight-regain is commonly experienced after bariatric surgery. This qualitative enquiry aimed to explore participants' self-reported enablers and barriers to prevent future weight-regain post-surgery., Methods: Eligible adults were recruited at 12-months post-bariatric-surgery at Counties Manukau, Auckland. Participants were invited to attend data collection at their 18-month group nutrition-education session, and to participate in a focus group at 21-months post-surgery. Thematic analysis was used to evaluate patient experiences., Results: Participants (n = 28) were mostly female (73.2 %), New Zealand European (41.5 %), and had gastric sleeve surgery (92.3 %). Five key themes emerged from the analysis: A Life Changing Health Journey - participants experienced a decrease in obesity-related comorbidities and a subsequent decrease in medications. Weight change and food intolerances impacted quality of life. Challenge of managing a New Healthy Lifestyle - financial stress, buying healthier foods and social events were new challenges, often centred on food. Changing Eating Behavior - all participants struggled managing eating behaviors. Mindset Changes - post-surgery most participants had a positive mindset, increased confidence, and feelings of happiness. However, many struggled with mindset around weight and food. A need for On-going Support - most felt under-supported and expressed a need for longer, specific follow-up care., Conclusion: Post-surgery group education sessions provided participants with increased support from both health professionals and peers on the same journey, to overcome struggles such as binge eating or identifying new coping strategies. Findings provide important insights into the challenges patients with bariatric surgery face and key learnings to develop specific supports for future care practices., Competing Interests: Declaration of competing interest All other authors declare that they have no conflicts of interest., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Advanced-age adults may be at risk of iron, folate, and vitamin B 12 deficiency due to low food intake and poor absorption. This study aimed to investigate the intake and adequacy of iron, folate, and vitamin B 12 and their relationship with respective biomarker status. Face-to-face interviews with 216 Māori and 362 non-Māori included a detailed dietary assessment using 2 × 24-h multiple pass recalls. Serum ferritin, serum iron, total iron binding capacity, transferrin saturation, red blood cell folate, serum folate, serum vitamin B 12 and hemoglobin were available at baseline. Regression techniques were used to estimate the association between dietary intake and biomarkers. The Estimated Average Requirement (EAR) was met by most participants (>88%) for dietary iron and vitamin B 12 (>74%) but less than half (>42%) for folate. Increased dietary folate intake was associated with increased red blood cell (RBC) folate for Māori ( p = 0.001), non-Māori ( p = 0.014) and serum folate for Māori ( p < 0.001). Folate intake >215 µg/day was associated with reduced risk of deficiency in RBC folate for Māori ( p = 0.001). Strategies are needed to optimize the intake and bioavailability of foods rich in folate. There were no significant associations between dietary iron and vitamin B 12 intake and their respective biomarkers, serum iron and serum vitamin B 12 .

Aim: To investigate factors associated with nutrition risk among older Māori., Method: Māori aged 75-79 years living in the Northland and Bay of Plenty regions of New Zealand were assessed for nutrition risk using the validated screening tool 'Seniors in the Community: Risk Evaluation for Eating and Nutrition' (SCREENII). Demographic, physical and sociocultural data were collected., Results: Of the 67 participants, two thirds (63%) were identified to be at high-risk for malnutrition. More than half (56%) used te reo Māori (Māori language) for everyday conversation and those who rated language and culture as moderately important to wellbeing were at lower nutrition risk. Controlling for age, gender and living arrangements, participants who rated traditional foods as important, were able to access them, had a higher waist-to-hip ratio and an absence of depressive symptoms, were at lower nutrition risk., Conclusions: Cultural factors associated with nutrition risk are related to an indigenous view of health. Participants with a higher waist-to-hip ratio were at lower nutrition risk and this may be a protective factor for older Māori. Interventions to improve the nutrition status of older Māori need to be based on a holistic Māori worldview and acknowledge the importance of traditional Māori foods.