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Background: There are high rates of child dental caries in Aotearoa, New Zealand. Education focuses on sugary drink consumption, primarily soft drinks. However, fruit beverages are commonly provided to young children by parents. Frequency of consumption of fruit beverages is adversely associated with dental caries and tooth wear. Objectives: To investigate oral health awareness and practices around fruit beverages in parents and caregivers of young children in Auckland, New Zealand. Methods: 147 parent and primary caregivers of children aged between 1-10 years participated in a cross-sectional survey in 2015. Participants were recruited from early childhood health and education institutions throughout Auckland and completed a questionnaire on awareness of dental behaviours and activities around fruit beverages. Descriptive statistics described the data and associations were calculated using Chi-square. Results: Participants reported a higher consumption of fruit beverages by children over the weekend compared to weekdays (60% v 33% =1 time/day respectively). The parents and caregivers demonstrated awareness of both protective oral health practices, and harmful behaviours, around fruit beverage consumption. There was no association between parental awareness of harmful fruit beverage behaviours and protective dental practices. Two individual associations were found. Parents who rated "juice with meals is harmful" highly were likely to be higher in "milk and water only given" practices. Likewise, a high rating for "juice drunk every 20-30 min" was more likely to be higher in "I dilute the juice with water" practice. Dental practitioners were the primary source of oral health advice for their children. Conclusions: Parental awareness around protective and harmful behaviours of fruit beverage consumption varied. The focus of oral health promotion activities to parents of young children around sugary drinks should include the harmful effects, and protective oral health practices, of fruit beverages. [ABSTRACT FROM AUTHOR]

Globally, bread is a staple food and thus a promising vehicle for the delivery of nutrients from vegetables including carotenoids. The aim of this pilot/feasibility, pre-post experimental study was to measure skin (Veggie Meter™) and plasma carotenoid concentrations 1 week before (week -1), immediately prior to (week 0), and after (week 2) 14 days of daily consumption of 200 g pumpkin- and sweetcorn-enriched bread (VB). At each measurement point, total vegetable and fruit intake and specific carotenoid-rich foods were assessed by questionnaire. Participants ( n  = 10, 8 males, 2 females) were aged between 19 and 39 years and weighed 90 ± 20 kg. Vegetable and fruit intake was low and less than one serving/day of foods containing carotenoids. Prior to the intervention, measures of carotenoid-containing foods and skin or plasma carotenoids were not different when measured a week apart. Consumption of the VB did not result in statistically significant changes in either the skin or plasma carotenoid measurements. Plasma carotenoid concentrations and the carotenoid reflection scores had a large and positive ( r  = .845, 95% CI 0.697, 0.924) association. The relationship between the number of servings of carotenoid-rich foods with the plasma carotenoid and carotenoid reflection scores was positive and of moderate strength. In conclusion, carotenoid status was not measurably changed with the consumption of 200 g VB each day for 2 weeks. Subjective carotenoid-rich food intake was positively associated with objective biomarkers of carotenoids. The Veggie meter™ has the potential to provide portable measurement of circulating carotenoids and be indicative of intake of carotenoid-rich foods., Competing Interests: There is no conflict of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Bread is a commonly consumed staple and could be a viable medium to deliver plant-based ingredients that demonstrate health effects. This review brings together published evidence on the bioactive properties of bread formulated with plant-based ingredients. Health effects associated with the consumption of bread formulated with plant-based functional ingredients was also reviewed. Bioactive properties demonstrated by the functional ingredients fruits and vegetables, legumes, nuts and tea incorporated into bread include increased phenolic and polyphenolic content, increased antioxidant activity, and extension of bread shelf-life by impairment of lipid and protein oxidation. Acute health effects reported included appetite suppression, reduced diastolic blood pressure, improvements in glycaemia, insulinaemia and satiety effect. These metabolic effects are mainly short lived and not enough for a health claim. Longer term studies or comparison of those who consume and those who do not are needed. The incorporation of plant-based functional ingredients in bread could enhance the health-promoting effects of bread., (© 2022. The Author(s).)

Bread, a frequently consumed food, is an ideal vehicle for addition of ingredients that increase nutrient density and add health benefits. This experimental cross-over study sought to test the effect of a vegetable-enriched bread (VB) in comparison to commercial white bread (WB) and wheatmeal bread (WMB) on serum glucose, insulin response and subjective appetite suppression. On three separate occasions, 10 participants (23 ± 7 years) visited the laboratory and consumed after an overnight fast, in random order, a 75 g serve of WB, WMB or VB. Venous blood samples drawn twice before (0 min) and at 15, 30, 45, 60, 90 and 120 min after consumption of the bread were analysed for glucose and insulin. Participants rated their subjective feelings of hunger, fullness, satisfaction and desire to eat on a 150 mm Likert scale. The mean glucose iAUC over 120 min was not different among the breads. The mean insulin iAUC for the VB was significantly lower than the WB and WMB; difference VB and WB 12,415 pmol/L*minutes (95% CI 1918, 22,912 pmol/L*minutes, p = 0.025) and difference VB and WMB 13,800 pmol/L*minutes (95% CI 1623, 25,976 pmol/L*minutes p = 0.031). The VB was associated with a higher fullness feeling in the participants over the 120-min period. The consumption of VB was associated with less insulin release and higher satiety over 120 min which may be related to the higher fibre content and texture of VB. The role of vegetable and fruit fibres such as pectin in bread and insulin response should also be further explored.

Characteristics of food that influence liking and ease-of-chewing and swallowing are not well-understood. Reformulation of bread to improve nutrient density may improve liking, ease-of-chewing and swallowing which could improve dietary intake particularly with aging. The study aimed to compare objectively and subjectively four breads of increasing nutrient density: $1 white (WB) and wheatmeal (WMB) commercial breads and two in-house formulations of vegetable-enriched breads (VB75 or VB100) which incorporated drum-dried pumpkin and sweet corn flours for physical, sensory and ease-of-chewing and swallowing properties. Each bread underwent instrumental texture analysis. The commercial and vegetable-enriched breads were not different by hardness or springiness but the vegetable breads were up to 25% less cohesive, less gummy and less chewy than the commercial breads. Questionnaires and Likert scale (150 mm) responses were completed by 50 physically active volunteers aged 50+ years. Overall liking of the VB75 and VB100 was rated 40% higher than the white and wheatmeal breads. Vegetable-enriched breads were rated as almost 50% easier to chew (mean ± SD; WB 70.53 ± 39.46 mm, WMB 77.68 ± 33.13 mm, VB75 104.78 ± 30.69 mm, VB100 107.58 ± 24.90 mm) and swallow (WB 70.29 ± 37.98 mm, WMB 77.53 ± 34.88 mm, VB75 104.63 ± 28.25 mm, VB100 104.90 ± 25.54 mm). Vegetable-enriched breads compared to white and wheatmeal breads were instrumentally and subjectively less gummy, cohesive and chewy than commercial breads and have the potential to both improve nutrition and "ease of swallowing" in older people. New areas of research should explore other underutilized vegetables for bread enrichment and their ability to aid swallowing and improve nutrition status., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Amoah, Cairncross and Rush.)

Background: Since 2004, Sport Waikato has delivered Project Energize, a through-school nutrition and physical activity program to primary schools in the Waikato. As part of the program's continued assessment and quality control, the programme was evaluated in 2011 and 2015. This paper's aim was to compare the cardiorespiratory fitness (time to run 550 m (T 550 )) levels of children participating in Project Energize in 2011 and 2015., Methods: In the 2011 evaluation of Project Energize, gender specific- T 550 -for-age Z scores (T 550 AZ) were derived from the T 550 of 4832 Waikato children (2527 girls; 2305 boys; 36% Māori) aged between 6 and 12 years. In 2015, T 550 was measured for 4798 (2361 girls; 2437 boys; 32% Māori) children, representative of age, gender and school socioeconomic status (SES). The T 550 AZ for every child in the 2015 study and 2011 evaluation were derived and differences in T 550 between 2015 and 2011 by gender, SES and age were determined using independent t-tests. Multiple regression analysis predicted T550 Z score and run time, using year of measurement, gender, ethnicity, age and school SES., Results: With and without adjustment, children in 2015 ran 550 m faster than in 2011 (adjusted Z score 0.06, time 11 s). Specifically, girls ran at a similar speed in 2015 as 2011 but boys were faster than in 2011 (Z score comparison P  < 0.001, mean difference 0.18 95%CI 0.12, 0.25). Regression analysis showed time taken to run 550 m was 11 s less in 2015 compared with 2011. Boys ran it 13 s faster than girls (Z score 0.07) and for each 1 year age increase, children were 8 s slower (Z score 0.006). For each 10% decrease in SES, children were 3 s slower (Z score 0.004) and Māori children were 5 s slower than Non-Māori children (Z score 0.15)., Conclusions: The findings from this study support the continuation of the delivery of Project Energize in the Waikato region of New Zealand, as cardiorespiratory fitness scores in 2015, compared to 2011, were improved, particularly for lower SES schools and for Māori children. Ethnically diverse populations, schools with higher deprivation and girls, continue to warrant further attention to help achieve equity., Competing Interests: Competing interestsThe authors report no conflict of interest., (© The Author(s) 2020.)

Aims: New Zealand dietary guidelines recommend children from two years of age consume low- or reduced-fat milk. We aimed to investigate the predictors of type of milk consumption in preschool children., Methods: Data were drawn from a cross-sectional study which enrolled preschool children (2-<5 years, n=1,329) from throughout New Zealand., Results: Cows' milk was consumed regularly by 88% of children. Of these, 26% consumed plain low- or reduced-fat milk, while 74% consumed full-fat milk. The adjusted odds of consuming plain low- or reduced-fat milk were increased in older children: three-year old (OR=1.80, 95% CI 1.29-2.50); four-year old (OR=1.93, 95% CI 1.38-2.72) versus two-year old children, and were decreased in Māori (OR=0.56, 95% CI 0.36-0.88) and Pacific children (OR=0.32, 95% CI 0.12-0.86) compared with New Zealand European children. Approximately 18% of children were overweight/obese. The odds (adjusted for socio-demographic characteristics) of consuming plain low- or reduced-fat milk were increased in overweight children (OR=1.74, 95% CI 1.20-2.54) than normal weight children., Conclusions: The type of milk consumed by preschool children varies with child demographics and anthropometry. Further research is warranted to investigate caregivers/parents' knowledge about dietary guidelines and to determine the causal relationship between obesity and milk type consumption. The findings of the current study may have important implications for developing and shaping interventions and in helping shape public health policy and practice to promote cows' milk consumption in preschool children., Competing Interests: HM was funded to write this manuscript with a summer studentship from Fonterra Cooperative Group (Auckland, New Zealand). The funder had no input into the collection and analysis of the data, and provided peer review of the writing of the manuscript. Te Ra Whakaora study was funded by the New Zealand Health Research Council (Auckland, New Zealand).

Gastrointestinal (GI) metastasis from a primary breast carcinoma is uncommon, with the rectum being one of the least reported sites in the literature. We report a case of a 79-year-old woman who underwent treatment for an infiltrative lobular carcinoma of the right breast with nodal involvement, and 10 years later developed recurrence in the form of rectal metastasis. Spread to the GI tract is most commonly seen with lobular breast carcinomas. Any patient with a history of breast cancer presenting typically or atypically with abdominal symptoms or altered bowel habit should raise a high index of suspicion for recurrent or metastatic disease., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Vitamin D deficiency has adverse health effects in young children. Our aims were to determine predictors of vitamin D status and then to use these factors to develop a practical tool to predict low 25(OH)D concentrations in preschool New Zealand children. A cross-sectional sample of 1329 children aged 2 to <5 years were enrolled from throughout New Zealand in late-winter to spring 2012. 25-Hydroxyvitamin D (25(OH)D) was measured on dried blood spot (DBS) samples collected using finger-prick sampling. Caregivers completed a questionnaire. Mean (SD) DBS 25(OH)D concentration was 52(19)nmol/L. 25(OH)D < 25 nmol/L was present in 86(7%), 25(OH)D < 50 nmol/L in 642(48%), 25(OH)D 50- < 75 nmol/L in 541(41%) and 25(OH)D > 75 nmol/L in 146(11%) of children. Factors independently associated with the risk of 25(OH)D < 25 nmol/L were female gender (OR 1.92,95%CI 1.17-3.14), other non-European ethnicities (not including Māori or Pacific) (3.51,1.89-6.50), had olive-dark skin colour (4.52,2.22-9.16), did not take vitamin D supplements (2.56,1.06-6.18), had mothers with less than secondary-school qualifications (5.00,2.44-10.21) and lived in more deprived households (1.27,1.06-1.53). Children who drank toddler milk (vitamin D fortified cow's milk formula marketed to young children) had a zero risk of 25(OH)D < 25 nmol/L. The predictive tool identified children at risk of 25(OH)D < 25 nmol/L with sensitivity 42%, specificity 97% and ROC area-under-curve 0.76(95%CI 0.67-0.86, p < 0.001). Predictors of low vitamin D status were consistent with those identified in previous studies of New Zealand children. The tool had insufficient predictive ability for use in clinical situations, and suggests a need to promote safe, inexpensive testing to determine vitamin D status in preschool children., (© 2016 John Wiley & Sons Ltd.)

Recent research on vitamin D in young children has expanded from bone development to exploring immunomodulatory effects. Our aim was to investigate the relationship of vitamin D status and allergic diseases in preschool-aged children in New Zealand. Dried capillary blood spots were collected from 1329 children during late-winter to early-spring for 25(OH)D measurement by LC-MS/MS. Caregivers completed a questionnaire about their child's recent medical history. Analysis was by multivariable logistic regression. Mean 25(OH)D concentration was 52(SD19) nmol/L, with 7% of children <25 nmol/L and 49% <50 nmol/L. Children with 25(OH)D concentrations ≥75 nmol/L (n = 29) had a two-fold increased risk for parent-report of doctor-diagnosed food allergy compared to children with 25(OH)D 50-74.9 nmol/L (OR = 2.21, 1.33-3.68, p = 0.002). No associations were present between 25(OH)D concentration and presence of parent-reported eczema, allergic rhinoconjunctivitis or atopic asthma. Vitamin D deficiency was not associated with several allergic diseases in these New Zealand preschool children. In contrast, high 25(OH)D concentrations were associated with a two-fold increased risk of parental-report food allergy. This increase supports further research into the association between vitamin D status and allergic disease in preschool children.

Prevention of childhood obesity is a global priority. The school setting offers access to large numbers of children and the ability to provide supportive environments for quality physical activity and nutrition. This article describes Project Energize, a through-school physical activity and nutrition programme that celebrated its 10-year anniversary in 2015 so that it might serve as a model for similar practices, initiatives and policies elsewhere. The programme was envisaged and financed by the Waikato District Health Board of New Zealand in 2004 and delivered by Sport Waikato to 124 primary schools as a randomised controlled trial from 2005 to 2006. The programme has since expanded to include all 242 primary schools in the Waikato region and 70 schools in other regions, including 53,000 children. Ongoing evaluation and development of Project Energize has shown it to be sustainable (ongoing for >10 years), both effective (lower obesity, higher physical fitness) and cost effective (one health related cost quality adjusted life year between $18,000 and $30,000) and efficient ($45/child/year) as a childhood 'health' programme. The programme's unique community-based approach is inclusive of all children, serving a population that is 42% Māori, the indigenous people of New Zealand. While the original nine healthy eating and seven quality physical activity goals have not changed, the delivery and assessment processes has been refined and the health service adapted over the 10 years of the programme existence, as well as adapted over time to other settings including early childhood education and schools in Cork in Ireland. Evaluation and research associated with the programme delivery and outcomes are ongoing. The dissemination of findings to politicians and collaboration with other service providers are both regarded as priorities.

This research determined the potential for methylmercury or Aroclor 1268 to disrupt reproduction and sexual differentiation in Fundulus heteroclitus. The research determined whether fish that are exposed to mercury or Aroclor 1268 survive and successfully reproduce; whether offspring of exposed fish hatch, survive, produce eggs, and fertilize them; and whether the second-generation offspring of exposed fish hatch and survive. Fundulus heteroclitus were exposed to mercury or Aroclor 1268 via contaminated food. Endpoints evaluated included survival, growth, fecundity, fertilization success, hatch success, larval survival, sex ratios, and the prevalence of gonadal abnormalities. In general, polychlorinated biphenyls were highly bioavailable and accumulated well through feeding. The only statistically significant effect observed as a result of treatment with Aroclor 1268 was an increase in growth in the offspring of exposed fish. Mercury was accumulated in a dose-dependent fashion via food exposures. Exposure to mercury in food increased mortality in male F. heteroclitus, which possibly occurred as a result of behavioral alterations. Increased mortality was observed at body burdens of 0.2 to 0.47 microgram/g. Offspring of F. heteroclitus fed mercury-contaminated food were less able to successfully reproduce, with reduced fertilization success observed at egg concentrations of 0.01 to 0.63 microgram/g, which corresponds with parent whole-body concentrations of 1.1 to 1.2 micrograms/g. Offspring of exposed fish also had altered sex ratios, with treatment at moderate concentrations producing fewer females and treatment at the highest concentration producing more females than expected. Alterations in sex ratios were observed at concentrations of less than 0.01 microgram/g in eggs or between 0.44 and 1.1 micrograms/g in parents. Offspring of mercury-exposed fish also had increased growth in moderate treatments, when egg concentrations were less than 0.02 microgram/g, or when parent whole bodies contained 0.2 to 0.47 microgram/g. In summary, exposure to mercury reduced male survival, reduced the ability of offspring to successfully reproduce, and altered sex ratios in offspring. Both direct effects on exposed fish and transgenerational effects were observed.