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Study objective: The aim was to quantify and compare the environmental and financial impact of two diets: a heart-healthy Australian diet (HAD) and the typical Australian diet (TAD). Design: The study involved a secondary analysis of two modelled dietary patterns used in a cross-over feeding trial. Setting: The evaluation focused on two-week (7-day cyclic) meal plans designed to meet the nutritional requirements for a reference 71-year-old male (9000 kJ) for each dietary pattern. Main outcome measures: The environmental footprint of each dietary pattern was calculated using the Global Warming Potential (GWP*) metric, taking into account single foods, multi-ingredient foods, and mixed dishes. Prices were obtained from a large Australian supermarket. Results: The HAD produced 23.8 % less CO2 equivalents (CO2e) per day (2.16 kg CO2e) compared to the TAD (2.83 kg CO2e per day). Meat and discretionary foods were the primary contributors to the environmental footprint of the TAD, whereas dairy and vegetables constituted the largest contributors to the HAD footprint. However, the HAD was 51 % more expensive than the TAD. Conclusion: Transitioning from a TAD to a HAD could significantly reduce CO2 emissions and with benefits for human health and the environment. Affordability will be a major barrier. Strategies to reduce costs of convenient healthy food are needed. Future studies should expand the GWP* database and consider additional environmental dimensions to comprehensively assess the impact of dietary patterns. Current findings have implications for menu planning within feeding trials and for individuals seeking to reduce their carbon footprint while adhering to heart-healthy eating guidelines.

Introduction: Despite the prevalence of depression and anxiety worldwide, their aetiologies remain unclear, and they can be difficult to diagnose and treat. Changes in salt-taste perception have been found in both conditions. Single-nucleotide polymorphisms (SNPs) in the salt-taste-related gene, TRPV1, have been associated with alterations to salt-taste perception, preference, and sodium consumption. Diet quality is a known modifier of depression and anxiety and recently, sodium intake has been studied in mental health. However, the relationships between salt-taste genetics, depression, anxiety, and these dietary factors are yet to be elucidated. Methods: Data from the well-characterized cross-sectional Retirement Health and Lifestyle Study (n = 536, ≥65 y) were used to explore the relationships between the salt-taste SNP TRPV1-rs8065080, levels of depression and anxiety (Hospital Anxiety and Depression Scale, HADS), estimated sodium intake, and diet quality in this secondary analysis. Standard least-squares regression and nominal logistic regression modelling were used to compare continuous and categorical variables, respectively, with analyses stratified by sex. Results: Presence of the TRPV1-rs8065080 variant allele (C) was found to increase the likelihood of having depression (HADS) in the total population and in males. The associations remained significant after adjusting for sodium intake, three diet quality indices, and demographic variables, suggesting that TRPV1-rs8065080 genotype is driving the association with depression. Discussion/Conclusion: Future studies should explore extra-oral functions of the SNP and salt-taste receptors in the brain and the roles of neurotransmitters common to both depression and salt taste to improve the management of this increasingly prevalent and difficult-to-treat condition.

Abstract Background Teachers form a large and essential workforce globally. Their wellbeing impacts personal health-related outcomes with flow on effects for the health, and wellbeing of their students. However, food and nutrition (FN) interventions that include teachers, typically neglect the impact of personal FN factors on a teachers’ ability to achieve optimal nutrition-related health and wellbeing, and successfully fulfil their professional FN roles as health promoters, gate keepers, educators’, and role models. The aim of this review was to scope FN constructs that have been studied internationally regarding teacher FN-related health and wellbeing. Methods Six databases were searched, and papers extracted in June/July 2021. Eligibility criteria guided by the population, concept, context mnemonic included studies published after 2000, in English language, with an aspect of personal FN-related health and wellbeing, among in-service (practising) and pre-service (training), primary, and secondary teachers. Screening studies for inclusion was completed by two independent researchers with data extraction piloted with the same reviewers and completed by lead author, along with complete descriptive and thematic analysis. Results Ten thousand six hundred seventy-seven unique articles were identified with 368 eligible for full text review and 105 included in final extraction and analysis. Sixty-nine descriptive studies were included, followed by 35 intervention studies, with the main data collection method used to assess both personal and professional FN constructs being questionnaires (n = 99 papers), with nutrition knowledge and dietary assessment among the most commonly assessed. Conclusion FN constructs are used within interventions and studies that include teachers, with diversity in constructs included and how these terms are defined. The evidence from this scoping review can be used to inform data collection and evaluation in future epidemiological and interventional research that addresses teacher FN-related health and wellbeing.

Low levels of cooking skills, confidence and home cooking are related to poorer dietary outcomes and are a common barrier to adequate vegetable consumption. Convenience cooking products may play a role in lowering the levels of confidence and creativity required to prepare home-cooked meals. It has previously been reported that those who use convenience cooking products have lower levels of cooking confidence and creativity and lower vegetable intakes compared to those who do not use these products. However, the relationship between these outcomes and the frequency of use of convenience cooking products has not been assessed. Therefore, a balanced demographic panel of Australian adults (n = 1034) was surveyed on the frequency of convenience cooking product use, vegetable intake and variety, and opinions and habits regarding vegetable intake. Those who used the products more regularly had higher cooking confidence and creativity, and higher vegetable variety scores, compared to less regular users (p < 0.05). However, the frequency of use of convenience cooking products was not associated with higher vegetable intake and did not influence views around the ease of eating vegetables. Therefore, these products may be a tool for assisting those with lower levels of cooking skills in accessing a higher variety of vegetables, but vegetable quantity in these products may need to be revised to assist consumers in better meeting intake recommendations.

Abstract Background Nutrition education programs in schools have been effective in improving children’s knowledge and behaviours related to food and nutrition. However, teachers find it challenging to implement such programs due to overcrowded curricula. Integrating nutrition with core subjects such as mathematics could potentially address time constraints and improve the learning of both. The primary aim of this randomized controlled trial (RCT) is to evaluate the impact of a cross-curricular nutrition and mathematics program on primary school students’ portion size estimation skills. Secondary aims include impact on their nutrition knowledge, attitudes towards mathematics and evaluating the quality of the lessons. Methods Twelve Year 3–4 classes from Catholic schools in New South Wales, Australia will be randomised to intervention (n = 6) or control (n = 6) groups. Teachers in the intervention group will receive a professional development workshop and resources to teach 4–5 lessons on portion size and measurements across 1–4 weeks. Outcome measures include portion size estimation skills, nutrition knowledge and attitudes towards mathematics, with data collected during three school visits (pre-intervention, immediately post-intervention, 4 weeks post-intervention). Additionally, teaching quality will be assessed in both intervention and control groups and process evaluation undertaken using teacher interviews and student focus groups. Discussion This RCT uses an innovative approach to improve both nutrition and mathematics related learning outcomes among primary school children. It has the potential to impact teaching practices regarding integration of nutrition into curricula and enhance the implementation of nutrition education interventions. Trial registration Australian and New Zealand Clinical Trials Register ACTRN12619001071112 31/07/2019.

As food choices are usually processed subconsciously, both situational and food environment cues influence choice. This study developed and tested a mobile app to investigate the association between physical and digital environments on snack choices. SnackTrack was designed and used to collect data on the snack choices of 188 users in real-life settings during an 8-week feasibility trial. The app asks users to take a photo of the food they are planning to consume and to provide additional information regarding the physical environment and context in which this food was eaten. The app also displayed various user interface designs (i.e., different background images) to investigate the potential effects of images on snack choice. Preliminary results suggest that the time of snack obtainment did not have a significant effect on the healthfulness of the snacks chosen. Conversely, it was found that unhealthy background images appeared to encourage healthier snack choices. In conclusion, despite consumers having the knowledge to make healthy choices, environmental cues can alter food choices. SnackTrack, a novel tool to investigate the influence of physical and digital environments on consumers’ food choices, provides possibilities for exploring what encourages (un)healthy eating behaviours.

Single nucleotide polymorphisms (SNPs) in taste receptors influence dietary choices that contribute to health and quality of life. Individual differences in sour taste perception and preference have been linked to heritable genetics, yet the impact of sour taste receptor SNPs on sour taste is under-researched, and studies on sour taste SNP associations to diet and health are lacking. Therefore, this study explored the relationships between the sour taste SNP KCNJ2-rs236514 and estimated macronutrient, vitamin and mineral intakes, and markers of metabolic health. Associations were explored in 523 participants aged 65 years and older with data analysed using standard least squares and nominal logistic regression modelling with post hoc student's t-tests and Tukey's HSD. Associations were found between the presence of the KCNJ2-rs236514 variant allele (A) and lower intakes of energy, total fat, monounsaturated fat and saturated fat. The lower fat intakes were significant in female carriers of the variant allele (A), along with lower water intake. Lower retinol, riboflavin, folate, calcium and sodium intakes were found in the KCNJ2-A allele carriers. In females, the variant allele was associated with lower sodium intake before and after Bonferroni adjustment. Higher body mass index, waist and waist-to-hip ratio measures were found in males carrying the variant allele. Lower levels of liver function biomarkers were associated with the presence of the KCNJ2-A allele. Overall and in males, the variant's association to lower gamma-glutamyl transferase (GGT) levels remained significant after Bonferroni adjustments. These novel findings suggest the sour taste SNP, KCNJ2-rs236514, may be modifying macronutrient, vitamin and mineral intakes, and markers of metabolic health. Research on the extra-oral functions of this SNP may improve health outcomes for those with overweight, obesity and liver disease.

The quality with which teachers deliver school-based nutrition programs may impact program effectiveness. The current study examined teaching quality of two programs, Taste Lessons (n = 15 Grade 6 and 7 teachers) and CUPS (n = 3 Year 3 and 4 teachers) via lesson observation using the Quality Teaching Model (QTM). Taste Lessons is a well-established Dutch program on healthy eating and CUPS is a novel Australian program that contains lessons in which nutritional content is integrated with mathematical concepts. The QTM evaluates three dimensions of teaching (Intellectual Quality, Quality Learning Environment and Significance), each containing six elements of classroom practice. Each element was coded using a 1–5 scale (1 – ‘not evident’ to 5 - ‘highly evident’) to describe the degree to which the lesson exhibits high levels of the element. Both programs were of moderate to high teaching quality and lowest scores were observed for Metalanguage, Student direction, Cultural knowledge and the use of Narrative. The QTM can be an effective tool to assess the teaching quality of nutrition education programs by examining classroom practice.

Culinary education programs are generally designed to improve participants’ food and cooking skills, with or without consideration to influencing diet quality or health. No published methods exist to guide food and cooking skills’ content priorities within culinary education programs that target improved diet quality and health. To address this gap, an international team of cooking and nutrition education experts developed the Cooking Education (Cook-EdTM) matrix. International food-based dietary guidelines were reviewed to determine common food groups. A six-section matrix was drafted including skill focus points for: (1) Kitchen safety, (2) Food safety, (3) General food skills, (4) Food group specific food skills, (5) General cooking skills, (6) Food group specific cooking skills. A modified e-Delphi method with three consultation rounds was used to reach consensus on the Cook-EdTM matrix structure, skill focus points included, and their order. The final Cook-EdTM matrix includes 117 skill focus points. The matrix guides program providers in selecting the most suitable skills to consider for their programs to improve dietary and health outcomes, while considering available resources, participant needs, and sustainable nutrition principles. Users can adapt the Cook-EdTM matrix to regional food-based dietary guidelines and food cultures.

Australians’ vegetable intakes are low, and strategies are needed for improvement. Popular convenience cooking products (meal bases and recipe bases, ready-made marinades, and convenience cooking sauces) address common cooking and vegetable consumption barriers (cost, time, and cooking skills). However, relationships between their usage and vegetable intakes have not been established. Therefore, Australian adults were surveyed on convenience cooking product use, vegetable intake and variety, behaviours when barriers to vegetable inclusion arise, and vegetable choice factors. Of 842 participants, 36.7% used meal and recipe bases, 28.1% marinades, and 47.2% cooking sauces, with most following the back-of-pack recipes at least sometimes. A total of 12.5% of participants used products from all three categories. Factors associated with lower vegetable intakes were meal and recipe base and cooking sauce use, using a higher number of product categories, and always following back-of-pack recipes. Factors associated with lower vegetable variety were the use of meal and recipe bases and cooking sauces. Factors in vegetable choice, and behaviours when not including a listed vegetable (due to not having or liking the vegetable, or an inability to eat it) did not vary by usage habits. These results provide insights into current vegetable intakes of those using convenience products, providing a baseline for future changes in the product design and recommendations.

Computer games have previously been used to improve nutrition knowledge in children. This paper describes the acceptability and feasibility of a serious game, “VitaVillage”, for improving child nutrition knowledge. VitaVillage is a farming-style game in which the player undertakes quests and completes questions aimed at increasing several aspects of nutrition and healthy eating knowledge. Children aged 9–12 years in two primary schools (control vs. intervention) completed a nutrition knowledge questionnaire at baseline (T1) and after 1 week (T2). Participants at the intervention school (n = 75) played VitaVillage for 20 minutes on two occasions. Control participants (n = 94) received no nutrition education. Likeability question scores and written feedback from intervention participants was reported qualitatively. Paired sample t-tests were used to compare T1 and T2 nutrition knowledge changes between control and intervention participants. Engagement with VitaVillage improved children’s overall nutrition knowledge (Mean increase of 2.25 points between T1 and T2, Standard Deviation (SD) 6.31, p = 0.035) compared to controls. The game was liked overall (mean score 77 (SD 24.6) on scale of 0–100) and positive feedback was given. Results indicate that VitaVillage has the potential to be successful as a nutrition education tool. In the future, VitaVillage’s content and gameplay will be revised, extended and evaluated for its long-term impact on eating behaviour and knowledge changes.

Background: Most Australians do not meet vegetable intake recommendations. Vegetables are most often consumed in evening meals. However, they often require preparation and therefore cooking skills. Convenience cooking products such as meal bases/concentrates and ready-made sauces are increasingly common and popular and may help address the barriers to vegetable consumption in terms of cost and time. These products also typically provide recipes, which include vegetables, and as such, may help address the barriers of cooking skills, confidence, and creativity. However, the relationships between the use of these products, cooking confidence, and cooking creativity remain unknown. Methods: Australian adults were surveyed (snowball recruitment, n = 842) on their use of convenience cooking products (meal bases/recipe concentrates, simmer sauces, marinades, and other cooking sauces), cooking confidence (7 item scale) and creativity (6 item scale), and demographic information. Results: Overall, 63.2% of participants reported using convenience cooking products. Those using these products had lower mean cooking skills confidence and creativity scores than those who did not, in all product categories assessed. Among users, those who reported "always" following the recipes provided had lower mean cooking confidence and creativity scores than those who followed the recipes less regularly. Conclusions: Therefore, improving the vegetable content of recipes provided with these products may be a tool to increase vegetable intake by users with lower cooking skills (confidence and creativity). This may complement traditional approaches such as education in improving vegetable intake.

Abstract Background Accurate estimation of food portion size is a difficult task. Visual cues are important mediators of portion size and therefore technology-based aids may assist consumers when serving and estimating food portions. The current study evaluated the usability and impact on estimation error of standard food servings of a novel augmented reality food serving aid, ServAR. Methods Participants were randomised into one of three groups: 1) no information/aid (control); 2) verbal information on standard serving sizes; or 3) ServAR, an aid which overlayed virtual food servings over a plate using a tablet computer. Participants were asked to estimate the standard serving sizes of nine foods (broccoli, carrots, cauliflower, green beans, kidney beans, potato, pasta, rice, and sweetcorn) using validated food replicas. Wilcoxon signed-rank tests compared median served weights of each food to reference standard serving size weights. Percentage error was used to compare the estimation of serving size accuracy between the three groups. All participants also performed a usability test using the ServAR tool to guide the serving of one randomly selected food. Results Ninety adults (78.9% female; a mean (95%CI) age 25.8 (24.9–26.7) years; BMI 24.2 (23.2–25.2) kg/m2) completed the study. The median servings were significantly different to the reference portions for five foods in the ServAR group, compared to eight foods in the information only group and seven foods for the control group. The cumulative proportion of total estimations per group within ±10%, ±25% and ±50% of the reference portion was greater for those using ServAR (30.7, 65.2 and 90.7%; respectively), compared to the information only group (19.6, 47.4 and 77.4%) and control group (10.0, 33.7 and 68.9%). Participants generally found the ServAR tool easy to use and agreed that it showed potential to support optimal portion size selection. However, some refinements to the ServAR tool are required to improve the user experience. Conclusions Use of the augmented reality tool improved accuracy and consistency of estimating standard serve sizes compared to the information only and control conditions. ServAR demonstrates potential as a practical tool to guide the serving of food. Further evaluation across a broad range of foods, portion sizes and settings is warranted.

Differences in sour-taste thresholds have been identified in cognition-related diseases. Diet is a modulator of cognitive health, and taste perception influences dietary preferences and habits. Heritable genetics and polymorphisms in the KCNJ2 gene involved in the transduction of sour taste have been linked to variations in sour taste and non-gustatory functions. However, relationships between sour taste genetics, mild cognitive impairment, and diet quality are yet to be elucidated. This study investigated the associations between the presence of the KCNJ2-rs236514 variant (A) allele, diet quality indices, and mild cognitive impairment evaluated by the Mini-Mental State Examination (MMSE), in a secondary cross-sectional analysis of data from the Retirement Health & Lifestyle Study. Data from 524 elderly Australians (≥65y) were analyzed, using standard least squares regression and nominal logistic regression modeling, with demographic adjustments applied. Results showed that the presence of the KCNJ2-A allele is associated with increased proportions of participants scoring in the range indicative of mild or more severe cognitive impairment (MMSE score of ≤26) in the total cohort, and males. These associations remained statistically significant after adjusting for age, sex, and diet quality indices. The absence of association between the KCNJ2-A allele and cognitive impairment in women may be related to their higher diet quality scores in all indices. The potential link between sour taste genotype and cognitive impairment scores may be due to both oral and extra-oral functions of sour taste receptors. Further studies are required on the role and relationship of neurotransmitters, sour taste genotypes and sour taste receptors in the brain, and dietary implications, to identify potential risk groups or avenues for therapeutic or prophylactic interventions.

Childhood eating behaviours can track into adulthood. Therefore, programmes that support early healthy eating, including school-based nutrition education programmes, are important. Although school-based programmes may be beneficial in improving nutrition knowledge, impact on actual fruit and vegetable (FV) intake is generally limited as FV intake is also influenced by the home environment. The current study includes secondary analyses of data from an evaluation study on Dutch nutrition education and examined the role of caregivers’ health promotion behaviours (HPB) in influencing healthy eating behaviours in primary school children (n = 1460, aged 7–12 years) and whether caregivers’ HPB contribute to programme effectiveness. Children’s nutrition knowledge, FV intake and caregivers’ HPB (FV/sugar-sweetened beverages/sweets provision to take to school, cooking together and talking about healthy food at home) were measured by child-reported questionnaires at baseline, during, and 6 months post-programme. Results indicated that caregivers’ HPB was positively associated with children’s healthy eating behaviours and that programme effectiveness was highest in those in the lower HPB subcategory. In conclusion, children with less encouragement to eat healthily at home potentially benefit more from school-based nutrition education programmes than children receiving more encouragement. This highlights the important role of the home environment in supporting healthy eating behaviour in children.

A healthy diet is important for optimal child growth and development. School-based opportunities to encourage children to achieve healthy eating behaviors should be explored. Nutrition education programs can provide school children with classroom-based nutrition education and access to fruits and vegetables (FV). However, the effectiveness of specific program components implemented separately has not yet been comprehensively evaluated. The current study examined effectiveness of individual components of two programs targeting primary school children (n = 1460, n = 37 schools) aged 7–12 years. Nutrition knowledge and FV consumption were measured using a student questionnaire, and presence of school food policies was measured in the teachers’ questionnaire. A quasi-experimental design with three arms compared: (1) schools that implemented both programs: FV provision + education (n = 15), (2) schools that implemented the FV provision program only (n = 12), (3) schools that did not implement either program (n = 10). Outcomes were assessed pre-intervention (T0), during the intervention (T1), and 6 months post-intervention (T2). Results indicated a significant increase in nutrition knowledge for children attending schools that had participated in both programs, compared to control schools (p < 0.01), but no significant increase in FV intake. In schools without food policies, FV provision alone contributed to an increase in child FV intake (p < 0.05).

Domestic cooking education programs are typically designed to improve an individual’s food and cooking skills, although not necessarily diet quality. Currently, there are no comprehensive models to guide the planning, implementation and evaluation of domestic cooking education programs that focus on improving diet and health. Our aim was to address this through development of the Cooking Education (“Cook-EdTM”) model, using the PRECEDE-PROCEED model as the underlying Cook-EdTM framework. A review of the food and cooking skills education literature informed the content of the Cook-EdTM model. Cook-EdTM was critiqued by experts in consumer behaviour, cooking and nutrition education research and education until consensus on model content and format was reached. Cook-EdTM leads cooking program developers through eight distinct stages, engaging key stakeholders in a co-design process from the outset to tailor programs to address the need of individuals and inform the development of program content, program delivery, and evaluation. A Cook-EdTM scenario applied in practice is described. The proposed Cook-EdTM model has potential to be adapted for use in domestic cooking education programs delivered in clinical, community, school or research settings. Further research will establish Cook-EdTM’s utility in enhancing program development and in improving food and cooking skills, dietary patterns and health outcomes.

Introduction: Quantifying Home Cooking EnviRonments has applications in nutrition epidemiology, health promotion, and nutrition interventions. This study aimed to develop a tool to quantify household cooking environments and establish its content validity, face validity, and inter-rater agreement. Methods: The Home Cooking EnviRonment and equipment Inventory observation form (Home-CookERI™) was developed as a 24-question (91-item) online survey. Items included domestic spaces and resources for storage, disposal, preparation, and cooking of food or non-alcoholic beverages. Home-CookERITM was piloted to assess content validity, face validity, and usability with six Australian experts (i.e., dietitians, nutrition researchers, chefs, a food technology teacher, and a kitchen designer) and 13 laypersons. Pilot participants provided feedback in a 10 min telephone interview. Home-CookERI™ was modified to an 89-item survey in line with the pilot findings. Inter-rater agreement was examined between two trained raters in 33 unique Australian households. Raters were required to observe each item before recording a response. Home occupants were instructed to only assist with locating items if asked. Raters were blinded to each other’s responses. Inter-rater agreement was calculated by Cohen’s Kappa coefficient (κ) for each item. To optimize κ, similar items were grouped together reducing the number of items to 81. Results: Home-CookERITM had excellent content and face validity with responding participants; all 24 questions were both clear and relevant (X2 (1, n = 19; 19.0, p = 0.392)). Inter-rater agreement for the modified 81-item Home-CookERI™ was almost-perfect to perfect for 46% of kitchen items (n = 37 items, κ = 0.81–1), moderate to substantial for 28% (n = 23, κ = 0.51–0.8), slight to fair for 15% (n = 12, κ = 0.01–0.5), and chance or worse for 11% of items (n = 9, κ ≤ 0.0). Home-CookERITM was further optimized by reduction to a 77-item version, which is now available to researchers. Conclusion: Home-CookERI™ is a comprehensive tool for quantifying Australian household cooking environments. It has excellent face and content validity and moderate to perfect inter-rater agreement for almost three-quarters of included kitchen items. To expand Home-CookERI™ applications, a home occupant self-completion version is planned for validation.

In NSW, Australia, the views of primary-school aged children and their parents in regard to the importance of nutrition education at school are unclear. The aim of the current study was to explore children’s knowledge of nutrition and eating habits and to identify gaps that future school nutrition education programs could target. Students aged 9 to 12 years and their parents (n = 21 dyads) were invited to participate in semi-structured interviews, complete a nutrition knowledge questionnaire, and perform a “healthy-unhealthy” food sorting task in a University food laboratory. Among the children, nutrition knowledge scores concerning “serves & portions” of common foods were lowest, identifying a gap in knowledge related to portion size. All children categorized fruits, vegetables, cola, and water correctly as “healthy” or “unhealthy” in the sorting task, but not for the sausage and muesli bar, suggesting that further support categorising processed foods may be needed. The interviews indicated that parents do actively try to teach their children about nutrition, although they reported feeling uncertain about their own level of nutrition knowledge. Children and parents indicated that there is very little nutrition education in school and more is needed. This research could be used to inform future curriculum components related to nutrition education for primary school children.

Eating out-of-home is associated with higher energy intakes in children. The continued high prevalence of childhood obesity requires a greater understanding of child menu options and eating out frequency to inform appropriate regulatory initiatives. The majority of studies to date have focused on menus from fast-food outlets with few focused on non-fast-food outlets. This study aimed to describe parents’ reports of their child(ren)’s (aged up to 6 years) frequency of consuming foods at non-fast-food outlets, observations of child menus at these outlets, and their purchasing behaviours and future preferences regarding these menus; and if their responses were influenced by sociodemographic characteristics. Ninety-five parents completed a 15-item cross-sectional survey. Overall, children from 54% of families consumed food from non-fast-food outlets at least monthly. Of the 87 parents who reported that their child eats at a non-fast-food restaurant, 71 had children who ordered from child menus every time (7%, n = 5), often (29%, n = 22), sometimes (42%, n = 32) or rarely (16%, n = 12), with a further 7% (n = 5) never ordering from these menus. All parents indicated that they would like to see a higher proportion of healthy child menu items than is currently offered. Parents’ responses were not influenced by sociodemographic characteristics. Parents’ views support implementation of initiatives to increase availability of healthy options on child menus at non-fast-food outlets.

The increase in packaged food and beverage portion sizes has been identified as a potential factor implicated in the rise of the prevalence of obesity. In this context, the objective of this systematic scoping review was to investigate how healthy adults perceive and interpret serving size information on food packages and how this influences product perception and consumption. Such knowledge is needed to improve food labelling understanding and guide consumers toward healthier portion size choices. A search of seven databases (2010 to April 2019) provided the records for title and abstract screening, with relevant articles assessed for eligibility in the full-text. Fourteen articles met the inclusion criteria, with relevant data extracted by one reviewer and checked for consistency by a second reviewer. Twelve studies were conducted in North America, where the government regulates serving size information. Several studies reported a poor understanding of serving size labelling. Indeed, consumers interpreted the labelled serving size as a recommended serving for dietary guidelines for healthy eating rather than a typical consumption unit, which is set by the manufacturer or regulated in some countries such as in the U.S. and Canada. Not all studies assessed consumption; however, larger labelled serving sizes resulted in larger self-selected portion sizes in three studies. However, another study performed on confectionary reported the opposite effect, with larger labelled serving sizes leading to reduced consumption. The limited number of included studies showed that labelled serving size affects portion size selection and consumption, and that any labelled serving size format changes may result in increased portion size selection, energy intake and thus contribute to the rise of the prevalence of overweight and obesity. Research to test cross-continentally labelled serving size format changes within experimental and natural settings (e.g., at home) are needed. In addition, tailored, comprehensive and serving-size-specific food literacy initiatives need to be evaluated to provide recommendations for effective serving size labelling. This is required to ensure the correct understanding of nutritional content, as well as informing food choices and consumption, for both core foods and discretionary foods.

Nutrition and Health Claims (NHCs) have been found to influence perceptions of food and consumption behaviour. While previous quantitative research has identified factors that may explain these effects, the current study aimed to address the dearth of in-depth exploration as to the underlying reasons why and how claims may impact upon perceptions and behaviour and the relationships between key factors. Seventy-eight participants took part in 10 focus groups. Discussions were transcribed verbatim and Nvivo 11 was used for thematic analysis. Six themes were developed from the data: 1. Target populations for NHCs; 2. Influence of NHCs on purchasing behaviour; 3. Characteristics/perceptions of products displaying NHCs; 4. Believability of NHCs; 5. Superior yet superficial knowledge; 6. Consumption of products displaying NHCs. Knowledge was a key factor influencing how much individuals believe claims (Believability of NHCs) and their perceptions (Characteristics/perceptions of products displaying NHCs). These perceptions and the characteristics of products displaying claims also impacted believability, as well as purchasing behaviour and consumption. Future research should be cognisant of the role of knowledge and characteristics or perceptions of products in the relationship between NHCs and consumer behaviour, and modelling of these relationships would allow their relative strength to be identified.

Low- and reduced-alcohol beverages become increasingly popular in many countries with different factors driving a change in the beverage market. The aim of the current narrative review is (a) to provide an introduction on low-alcohol wine, and (b) to provide an overview of the literature on research that investigated perception and behaviour related to low-alcohol wine consumption. Wines with reduced alcohol content can be an interesting product for a variety of stakeholders and may offer benefits for consumers while having the potential to reduce alcohol consumption and therefore contribute to the reduction of alcohol-related harm. Additional research and marketing efforts are needed to further increase awareness of the availability and quality of these products.

Nutrition and health claims on foods can help consumers make healthier food choices. However, claims may have a ‘halo’ effect, influencing consumer perceptions of foods and increasing consumption. Evidence for these effects are typically demonstrated in experiments with small samples, limiting generalisability. The current study aimed to overcome this limitation through the use of a nationally representative survey. In a cross-sectional survey of 1039 adults across the island of Ireland, respondents were presented with three different claims (nutrition claim = “Low in fat”; health claim = “With plant sterols. Proven to lower cholesterol”; satiety claim = “Fuller for longer”) on four different foods (cereal, soup, lasagne, and yoghurt). Participants answered questions on perceived healthiness, tastiness, and fillingness of the products with different claims and also selected a portion size they would consume. Claims influenced fillingness perceptions of some of the foods. However, there was little influence of claims on tastiness or healthiness perceptions or the portion size selected. Psychological factors such as consumers’ familiarity with foods carrying claims and belief in the claims were the most consistent predictors of perceptions and portion size selection. Future research should identify additional consumer factors that may moderate the relationships between claims, perceptions, and consumption.

In 2011–2012 approximately 26% of Australian children aged between 5–17 years were reported to be overweight or obese. Furthermore, the increase in prevalence of overweight and obesity among US children parallels reported increases in energy intake and portion sizes of common foods, leading to the recognition that availability of larger portion sizes contributes to the rise in overweight and obesity prevalence. Thus, the aim of this time-series analysis was to investigate whether selected food portion sizes in Australian children aged 2–16 years changed between 2007 and 2011–2012. Portion size data from 24-h recalls collected in Australian nutrition surveys were compared between 2007 and 2011–2012. Portion sizes changed significantly in 23% of items with increases in 15% and decreases in 8%. Changes in portion sizes varied by age, sex, and food group. Changes occurred for many meat-based items, energy-dense, nutrient-poor food items, breads, cereals, and some fruits and vegetables. Vegetable and fruit portion sizes were below the respective serving sizes of 75 g and 150 g in the Australian Guide to Healthy Eating, while portion sizes of some energy-dense, nutrient-poor foods have increased. These findings suggest approaches to increasing consumption of nutrient-dense core foods and reducing energy-dense, nutrient-poor food items in children are warranted.

The term “nutritious” is being increasingly used by product manufacturers but the term is not currently regulated as a nutrition claim. It is unclear how lay consumers and experts define and interpret the term or how they evaluate the “nutritiousness” of various foods. To address this evidence gap, a mixed methods design was applied and both nutrition experts (n = 206) and lay participants (n = 269) provided definitions of the term “nutritious” and evaluated the “nutritiousness” of 20 different snack foods in a cross-sectional survey. Definitions were analysed using Leximancer and snack evaluations were compared both between groups and with nutrient profile scores (UK Ofcom and Australian Health Star Rating). Expert and lay definitions differed considerably, with experts using terms such as nutrient-density, macro- and micronutrients, kilojoules/Calories, while lay consumers used descriptions such as fuel, fresh, natural, body needs, and functioning. Snack evaluations were highly correlated between groups (Rs > 0.89, p < 0.001) and between nutrient profile scores (Rs > 0.75, p < 0.001). However, mean perceptions significantly differed for 18 out of 20 foods with the largest difference for yoghurts (p < 0.05). There are discrepancies between expert and lay perceptions of snack foods and the definition of the term “nutritious”. The results highlight the need for an agreed definition and the potential regulation of the term “nutritious” in food marketing.