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Objective: To perform a systematic review of completion rates of cardiac rehabilitation (CR) in adults aged 18 to 50 yr and describe how core components were reported, measured, and tailored to those under 50 yr., Review Methods: Database search of MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and the Cochrane Library based on keywords, including articles from January 1, 1990. The last search was performed on April 21, 2023. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses protocol, eligible articles contained adults (aged between 18 and 50 yr) who had participated in a CR program., Summary: Out of the articles screened (n = 24,517), 33 reports across 31 independent studies were considered eligible (n = 1958 patients aged ≤50 yr). Cardiac rehabilitation completion rates ranged from 64% to 100%; however, only 5 studies presented a completion rate definition. The length of the program ranged from 7 d to 20 wk, with most (65%) ranging between 6 and 12 wk. While the studies included in this systematic review indicated relatively high rates of completing CR, these are likely to overrepresent the true completion rates as few definitions were provided that could be compared to completion rates used in clinical practice. This systematic review also found that all interventions prescribed exercise (eg, aerobic alone or combined with resistance training or yoga) but had very limited inclusion or description of other integral components of CR (eg, initial assessment and smoking cessation) or how they were assessed and individualized to meet the needs of younger attendees., Competing Interests: All authors declare no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Issue Addressed: Universities are a crucial setting to address and promote optimal mental health of young Australians. However, there is a lack of knowledge of universities' views of current implementation of health and wellbeing initiatives. Therefore, we examined the views of Australian universities on the implementation of health and wellbeing policies and programs within Australian universities., Methods: An online survey of Australian universities asked respondents to rate their level of agreement with five statements pertaining to the implementation of health and wellbeing policies and programs for students within Australian universities using a 5-point Likert scale (strongly agree to strongly disagree)., Results: Eleven universities completed the survey (28.2% response rate). All respondents (n = 11) agreed that universities play a crucial role in supporting the health and wellbeing of their students and report access to sufficient expertise to do this. Approximately three-quarters (8/11) agreed that universities know what policies and programs to implement to support their students' health and wellbeing. There was less agreement that universities have sufficient resources (2/11 agree) or access to sufficient information about the health and wellbeing of their student population (3/11 agree) to support the implementation of health and wellbeing policies and programs., Conclusions: Australian universities demonstrated strong organisational commitment to supporting the health and wellbeing of their students but highlighted some key barriers to implementation. SO WHAT?: Findings from this preliminary research highlight potential barriers and facilitators to the implementation of health and wellbeing policies and programs in Australian universities, and potential foci for future research., (© 2023 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

University students are recognized as a high-risk population group who experience greater rates of poor health outcomes and mental ill-health. Commencing university is recognized as a major life transition, where students experience new financial, academic, environmental, and social pressures that can cause changes in their normal behaviors. This study explored trends in health-risk behaviors and psychological distress in commencing university students over four survey years. First-year undergraduate students, aged 17-24, from an Australian university were included. A secondary analysis was performed on data collected via cross-sectional surveys on four occasions (2016, 2017, 2019, 2020). Crude logistic regression models were utilized to investigate the association between meeting guidelines and survey year. Odds ratios for the pairwise comparison between each year are reported. In this analysis, 1300 (2016), 484 (2017), 456 (2019), and 571 (2020) students were included. Analyses showed two clear trends: students' probability of being at high/very high risk of psychological distress (35-55%) and consuming breakfast daily (44-55%) consistently worsened over the four survey years. These findings suggest that the odds of psychological distress and daily breakfast consumption worsened over time, whilst the proportion of students engaging in some health-risk behaviors was high, highlighting the importance of early intervention during the transition to university.

There is a substantial research base for addictive eating with development of interventions. The current 3-arm RCT aimed to investigate the efficacy of the TRACE (Targeted Research for Addictive and Compulsive Eating) program to decrease addictive eating symptoms and improve mental health. Participants (18-85 yrs) endorsing ≥3 addictive eating symptoms were randomly allocated to 1) active intervention, 2) passive intervention, or 3) control group. Primary outcome was change in addictive eating symptoms 3-months post-baseline measured by the Yale Food Addiction Scale. Depression, anxiety and stress were also assessed. A total of 175 individuals were randomised. Using Linear Mixed Models, from baseline to 3-months, there was significant improvement in symptom scores in all groups with mean decrease of 4.7 (95% CI: -5.8, -3.6; p < 0.001), 3.8 (95% CI: -5.2, -2.4; p < 0.001) and 1.5 (95% CI: -2.6, -0.4; p = 0.01) respectively. Compared with the control group, participants in the active intervention were five times more likely to achieve a clinically significant change in symptom scores. There was a significant reduction in depression scores in the active and passive intervention groups, but not control group [-2.9 (95% CI: -4.5, -1.3); -2.3 (95% CI: -4.3, -0.3); 0.5 (95% CI: -1.1, 2.1), respectively]; a significant reduction in stress scores within the active group, but not passive intervention or control groups [-1.3 (95% CI: -2.2, -0.5); -1.0 (95% CI: -2.1, 0.1); 0.4 (95% CI: -0.5, 1.2), respectively]; and the reduction in anxiety scores over time was similar for all groups. A dietitian-led telehealth intervention for addictive eating in adults was more effective than a passive or control condition in reducing addictive eating scores from baseline to 6 months. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12621001079831., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: To evaluate the association between health behaviors with academic performance among tertiary education students., Methods: Six databases were searched until July 2020 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and academic performance., Results: Thirty-four studies were included (18 assessed sleep, 16 alcohol intake, 12 illicit drug use, 10 physical activity, 8 diet, 4 smoking, 2 sedentary behavior). A consistent negative association with academic performance was demonstrated for sleep (12/18 studies), alcohol intake (13/16) and illicit drug use (9/12). Most (7/10) studies found no association between physical activity and academic performance., Conclusion: Findings suggest interventions to mitigate the influence of poor sleep, high alcohol intake, and illicit drug use on academic performance may be needed. Further research of other health behaviors, along with their co-occurrence, with academic performance, is required.

Background: Yeast extract spreads and tomato-based sauces (i.e., ketchup) are consumed regularly by the Australian population. Therefore, there is a need to explore the contribution of these condiments to nutrient intakes among Australians., Methods: The present study comprises a secondary analysis of data from the 2011-2012 Australian National Nutrition and Physical Activity Survey. Dietary intake data were undertaken for 12,153 Australians aged ≥ 2 years, using 24-h recalls. Yeast extract spreads and tomato-based sauces were categorised based on how they were defined in the Australian Food and Nutrient (AUSNUT) 2011-2013 database. Kruskal-Wallis H tests and the post-hoc Dunn's test with Bonferroni correction were applied to test whether a significant difference existed in the percentage contribution of yeast extract spreads and tomato-based sauces to intakes of select nutrients., Results: In total, 19.6% (n = 2384) of the population sample consumed yeast extract spreads and/or tomato-based sauces during the 24-h recall. The percentage contribution of yeast extract spreads to daily intakes of sodium, potassium, thiamine, riboflavin, niacin, folate, magnesium, iron, zinc and iodine were significantly higher in line with a greater quantity of yeast extract spread consumed (p < 0.05). The percentage contribution of tomato-based sauces to daily intakes of sodium, potassium, riboflavin, niacin, folate, beta-carotene, magnesium, iron, zinc and iodine was increased significantly with a greater quantity of tomato-based sauces consumed (p < 0.05)., Conclusions: Consumption of yeast extracts and tomato-based sauces contribute to greater intake of key nutrients, such as B-vitamins and beta-carotene, and may assist in meeting key nutrient reference values. However, consumption of these sauces and condiments also resulted in greater intakes of sodium, contributing to population intakes exceeding recommendations. Reducing sodium content of frequently consumed condiments may potentially assist in lowering population intakes, at the same time as preserving intakes of other important nutrients., (© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Background: There is a lack of understanding of the potential utility of a chatbot integrated into a website to support healthy eating among young adults. Therefore, the aim was to interview key informants regarding potential utility and design of a chatbot to: (1) increase young adults' return rates and engagement with a purpose-built healthy eating website and, (2) improve young adults' diet quality., Methods: Eighteen qualitative, semi-structured interviews were conducted across three stakeholder groups: (i) experts in dietary behaviour change in young adults (n = 6), (ii) young adult users of a healthy eating website (n = 7), and (iii) experts in chatbot design (n = 5). Interview questions were guided by a behaviour change framework and a template analysis was conducted using NVivo., Results: Interviewees identified three potential roles of a chatbot for supporting healthy eating in young adults; R1: improving healthy eating knowledge and facilitating discovery, R2: reducing time barriers related to healthy eating, R3: providing support and social engagement. To support R1, the following features were suggested: F1: chatbot generated recommendations and F2: triage to website information or externally (e.g., another website) to address current user needs. For R2, suggested features included F3: nudge or behavioural prompts at critical moments and F4: assist users to navigate healthy eating websites. Finally, to support R3 interviewees recommended the following features: F5: enhance interactivity, F6: offer useful anonymous support, F7: facilitate user connection with content in meaningful ways and F8: outreach adjuncts to website (e.g., emails). Additional 'general' chatbot features included authenticity, personalisation and effective and strategic development, while the preferred chatbot style and language included tailoring (e.g., age and gender), with a positive and professional tone. Finally, the preferred chatbot message subjects included training (e.g., would you like to see a video to make this recipe?), enablement (e.g., healthy eating doesn't need to be expensive, we've created a budget meal plan, want to see?) and education or informative approaches (e.g., "Did you know bananas are high in potassium which can aid in reducing blood pressure?")., Conclusion: Findings can guide chatbot designers and nutrition behaviour change researchers on potential chatbot roles, features, style and language and messaging in order to support healthy eating knowledge and behaviours in young adults., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Introduction: Approximately 15%-20% of the adult population self-report symptoms of addictive eating. There are currently limited options for management. Motivational interviewing-based interventions, containing personalised coping skills training, have been found to be effective for behaviour change in addictive disorders (eg, alcohol). This project builds upon foundations of an addictive eating feasibility study previously conducted and co-design process involving consumers. The primary aim of this study is to examine the efficacy of a telehealth intervention targeting addictive eating symptoms in Australian adults compared with passive intervention and control groups., Methods and Analysis: This three-arm randomised controlled trial will recruit participants 18-85 years, endorsing ≥3 symptoms on the Yale Food Addiction Scale (YFAS) 2.0, with body mass index >18.5 kg/m 2 . Addictive eating symptoms are assessed at baseline (pre-intervention), 3 months (post-intervention) and 6 months. Other outcomes include dietary intake and quality, depression, anxiety, stress, quality of life, physical activity and sleep hygiene. Using a multicomponent clinician-led approach, the active intervention consists of five telehealth sessions (15-45 min each) delivered by a dietitian over 3 months. The intervention uses personalised feedback, skill-building exercises, reflective activities and goal setting. Participants are provided with a workbook and website access. The passive intervention group receives the intervention via a self-guided approach with access to the workbook and website (no telehealth). The control group receives personalised written dietary feedback at baseline and participants advised to follow their usual dietary pattern for 6 months. The control group will be offered the passive intervention after 6 months. The primary endpoint is YFAS symptom scores at 3 months. A cost-consequence analysis will determine intervention costs alongside mean change outcomes., Ethics and Dissemination: Human Research Ethics Committee of University of Newcastle, Australia provided approval (H-2021-0100). Findings will be disseminated via publication in peer-reviewed journals, conference presentations, community presentations and student theses., Trial Registration Number: Australia New Zealand Clinical Trials Registry (ACTRN12621001079831)., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Background: Dietary assessment commonly focuses on particular foods/food groups as indicators of overall dietary intake. Accompaniments such as sauces are not often a focus. The present study describes daily intakes of sauces, condiments and seasonings (SCS) using the most recent Australian National Nutrition and Physical Activity Survey (NNPAS), as well as the contribution to total energy and selected nutrient intakes., Methods: NNPAS dietary data were collected by one 24-h recall for 12,153 individuals aged ≥ 2 years (53% female, 29% aged 31-50 years). SCS (i.e., any food items not normally consumed as a food itself, consumed as an addition to a dish after cooking/preparation to enhance flavour) were identified/coded within the dietary data and reported in terms of how they were consumed, primary composition, and contribution to total daily energy and selected macro- and micronutrient intakes., Results: Most participants (85.1%) reported consuming at least one SCS on the day of the recall (median [interquartile range], 2 [1-4]). SCS were predominantly consumed within main meals (breakfast, lunch, dinner) (73.9%), and were predominantly sugar/sugar products (e.g., white sugar) (35.0%), or fats and oils (e.g., butter) (25.9%). SCS contributed a median (interquartile range) of 3.8% (1.1-7.9) of total energy, 5.3% (0.0-15.5) of fat, 2.3% (0.1-6.6) of carbohydrate and 0.2% (0.01-1.2) of protein intake. SCS made the largest contribution towards vitamin E (females median 3.6%; males median 3.4%) and sodium intakes (females median 3.0%; males median 2.9%)., Conclusions: Although SCS contribute a small proportion of total energy and nutrient intakes in the Australian population, the contribution is more substantial for some nutrients and population groups., (© 2022 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Objective: To evaluate the association between health behaviors with mental health among tertiary education students., Methods: Six databases were searched until September 2021 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and mental health. Two independent reviewers screened records for inclusion, extracted data and completed risk of bias assessments., Results: 33 studies were included (14 assessed sleep, 14 alcohol intake, 13 physical activity, 8 smoking, 6 sedentary behavior, 4 diet, 1 illicit drug use). A consistent association between poor sleep, and physical inactivity with increased risk of poor psychological wellbeing, and between poor sleep and increased mental ill-health related outcomes was demonstrated., Conclusion: Findings suggest interventions to address poor sleep and physical inactivity among students may positively impact mental health. Further research of other health behaviors, and their association with mental health, is required.

Nutrition interventions to support young adults are needed due to low diet quality. The aims were to explore the (1) circumstances and (2) barriers regarding dietary habits of the young adult users of the No Money No Time (NMNT) healthy eating website with the lowest diet quality scores. An online cross-sectional survey was conducted from August-September 2022 with a sample of NMNT users aged 18-35 years with low diet quality (defined as Healthy Eating Quiz score 0-38/73). The survey included demographics (e.g., gender), circumstances (6-item US Food Security Survey, Cooking and Food Skills Confidence Measures), and challenges and resources used in relation to healthy eating (open-responses). Theoretical thematic analysis was used to analyse open-response questions and derive main themes. The study sample ( n = 108; 71.3% female, median age 28; 28.7% food insecure) had a mean (standard deviation) Cooking Skills score 70.2 (17.5)/98, and median (interquartile range) Food Skills score 96.0 (83.5-107.5)/133. The main challenges regarding healthy eating were (1) time and (2) cost, and the main resources to support healthy eating were (1) online resources (e.g., websites, Google) and (2) recipes. Findings identify possible targets for future interventions to support healthy eating in this vulnerable group (e.g., supporting cooking and food skills).

Exploring potentially addictive foods and food components is a recent research focus. Few studies have evaluated this based on level of food processing using the NOVA classification system. This study compared intakes of ultra-processed foods in young adults with and without food addiction. Secondary analysis of online cross-sectional survey data was conducted. The sample included 735 young Australian adults (18-35 years). Dietary intake was assessed by food frequency questionnaire and coded using NOVA to determine percentage energy (%E) from each of the four NOVA categories (unprocessed; processed culinary ingredients; processed; ultra-processed). Food addiction was assessed using the Yale Food Addiction Scale (YFAS). Linear regression models, adjusted for age, gender and body mass index (BMI), were developed to examine the association between %E from NOVA categories with food addiction status and number of symptoms. Sample mean age was 24.7 ± 4.2 years, 85% were female, 67% within healthy weight BMI range, and 20% classified as food addicted. Participants consumed 34.3 ± 13.4 %E from ultra-processed foods. Young adults classified as food addicted consumed a higher %E from ultra-processed foods (β = 3.954, p = 0.002) and a lower %E from unprocessed foods (β = -2.743, p = 0.010) than those classified as not food addicted. For each additional food addiction symptom reported, the %E from ultra-processed foods was higher (β = 1.693, p < 0.001) and %E from unprocessed foods was lower (β = -1.238, p < 0.001). Results demonstrate an association between YFAS assessed food addiction and higher intakes of ultra-processed foods, providing an important new perspective on the relationship between self-reported diet and food addiction in young adults. Future research should evaluate the relationship between food addiction, ultra-processed food intakes and health in longitudinal studies in order to inform potential treatment approaches., Competing Interests: Declaration of competing interest The authors certify that there are no conflicts of interest to declare. All authors have reviewed and approved the final manuscript and accept full responsibility for all aspects of the work described., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Diet quality is influenced by demographics and can change over time. This study aimed to (1) compare diet quality among adolescents/adults who completed the online Healthy Eating Quiz (HEQ) by demographic characteristics, and (2) to evaluate change in score over time for repeat completers. HEQ data collected between July 2016 and May 2022 were analysed, including demographics (age, gender, vegetarian status, socio-economic status, number of people main meals are shared with, country), and diet quality calculated using the Australian Recommended Food Score (ARFS) (range 0−73) for respondents aged ≥ 16 years. Differences in ARFS by demographic characteristics and change in score over time, adjusted for age, gender and vegetarian status, were tested by linear regression. The participants (n = 176,075) were predominantly female (70.4%), Australian (62.8%), and aged 18−24 years (27.7%), with 4.0% (n = 7087) repeat completers. Mean ± SD ARFS was 33.9 ± 9.4/73. Results indicate that ARFS was significantly lower among males and significantly higher with increasing age group, higher socio-economic status, in vegetarians, those who shared main meals with others, and those living in Australia (p-values < 0.001). Mean change in ARFS over time (2.3 ± 6.9) was significantly higher for those with lower baseline scores (p < 0.001). Publicly available, brief dietary assessment tools have the potential to improve diet quality at the population level.

Introduction: Understanding the complexities of change in eating behaviours, mental health, well-being and weight is crucial to inform healthcare and service provision, particularly in light of the exacerbating effects of the COVID-19 pandemic. This study aims to address the need for more comprehensive cross-sectional and longitudinal evidence, by tracking eating behaviours, mental health, health related behaviours and weight over a 12-month period, in a sample of young adults (18-35 years) in the UK and Australia., Methods and Analysis: Online surveys administered via the Prolific online research platform will be used for data collection at baseline, 6 months and 12 months. The survey (approximately 45 min) measures demographics, the impact of COVID-19, body mass index (BMI), weight management and health service usage, eating behaviours, personality, mental health, and health-related behaviours. An optional substudy component at each time point aims to validate self-reported weight in the main survey through images. Study inclusion criteria are; aged 18-34 years at baseline, BMI ≥20 kg/m 2 , and residing in the UK or Australia. A target of 500 participants at baseline was set, recruited through Prolific, and with recruitment stratified by BMI, sex and country. The proposed analyses include creating static predictive models using baseline data (eg, using latent class analysis, factor analysis or similar), and mapping changes longitudinally (eg, using multivariate regressions). These analyses will enable changes in the study measures to be identified, as well as predictors and outcomes of change., Ethics and Dissemination: Ethical approval was granted by Leeds Beckett University, UK (reference number 86004) and the University of Newcastle, Australia (reference number H-2022-0110). Study findings will be disseminated through scientific journals, conferences, institute websites and social media, and briefings tailored to policy, practice and the public, with the intention to help inform the future development of health and well-being care and support for young adults across Australia and the UK., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aim: This rapid review of reviews aimed to determine the extent of research undertaken on the effectiveness of dietary interventions for individuals with a mental disorder., Methods: Three databases (MEDLINE, Embase, Cochrane Reviews and Cochrane Trials) were searched to February 2021 for systematic reviews including experimental studies assessing the effectiveness of dietary interventions with physical or mental health related outcomes in adults or children with one or more of: severe mental illness, depression or anxiety, eating disorders, or substance use disorder. Results are presented descriptively., Results: The number of included reviews was 46 (67% in severe mental illness, 20% in depression and anxiety, 7% in eating disorders, and 7% in substance use disorders). Most reviews were published since 2016 (59%), and included studies conducted in adults (63%). Interventions in the eating disorders and severe mental illness reviews were predominantly education and behaviour change, whereas interventions in the substance use disorders, and depression and anxiety reviews were predominantly supplementation (e.g. omega-3). Twenty-eight and twelve of the reviews respectively reported mental health and dietary outcomes for one or more included studies. Most reviews in severe mental illness, and depression and anxiety reported conclusions supporting the positive effects of dietary intervention, including positive effects on weight-related or mental health outcomes, and on mental health outcomes, respectively., Conclusions: A larger number of systematic reviews were identified which evaluated dietary interventions in individuals with severe mental illness, and depression and anxiety, compared with substance use disorders, and eating disorders. Dietary intervention is an important component of the treatment that should be available to individuals living with mental disorders, to support their physical and mental health., (© 2022 The Authors. Nutrition & Dietetics published by John Wiley & Sons Australia, Ltd on behalf of Dietitians Australia.)

Aim: This scoping review aimed to explore the extent of the evidence of experimental studies evaluating the cost effectiveness of dietary interventions in individuals with mental disorders., Methods: Five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Scopus) were searched to October 2020 for cost-analysis studies of interventions aiming to improve dietary intake in people with mental disorders. No restriction was placed on participant age, mental disorder type or intervention design. Results are presented narratively., Results: Of 2753 articles identified, 13 articles reporting on eight studies were included. Studies were RCTs (n = 5), cluster RCT (n = 1), cluster preference RCT (n = 1), and pre-post test (n = 1). Seven studies were in community settings (eg, outpatient clinics), and one study in the community housing setting. All studies were in adults, seven included male and female participants, and one included only females. Defined mental disorder diagnoses included serious/severe mental disorders (n = 3), major depression (n = 2), schizophrenia, schizoaffective disorder or first-episode psychosis (n = 1), any mental disorder (n = 1), and bulimia nervosa (n = 1). Five interventions were multi-behaviour, two were diet only and one was eating disorder treatment. Cost analyses included cost-utility (n = 3), cost-effectiveness (n = 1), cost-utility and cost-effectiveness (n = 3), and a costing study (n = 1). Two studies (25%) reported positive results in favour of cost effectiveness, and four studies reported a mix of positive and neutral results., Conclusions: There is limited evidence evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Additional studies in various settings are needed to confirm cost effectiveness of different interventions., (© 2021 Dietitians Australia.)

Childhood obesity is a public health concern. Electronic and mobile health (e-&mHealth) approaches can facilitate the delivery of interventions for obesity prevention and treatment. Synthesizing reviews of e-&mHealth interventions to improve weight and weight-related behaviors (physical activity, sedentary behavior, and diet) is useful to characterize the current scope of the literature and identify opportunities for future reviews and studies. Using a scoping review methodology, we aimed to evaluate the breadth and methodological quality of systematic reviews and meta-analyses of e-&mHealth interventions targeting weight and weight-related behaviors in children and adolescents aged <19 years. A systematic search of seven databases was conducted, including reviews published between 2000 and 2019. Review characteristics were extracted, and methodological quality was assessed using the AMSTAR 2 tool. Forty-five systematic reviews and meta-analyses were included. All reviews evaluated intervention efficacy (100%), but few assessed other aspects (20% in total) such as cost-effectiveness. Smartphone applications (47%), text messages (44%), and websites (35%) were the main modalities. Weight (60%), physical activity (51%), and diet (44%) were frequently assessed, unlike sedentary behavior (8%). Most reviews were rated as having critically low or low methodological quality (97%). Reviews that identify the effective active ingredients of interventions and explore metrics beyond efficacy are recommended., (© 2021 World Obesity Federation.)

The symptoms of addictive eating are often debated, with some overlap in symptoms with substance addictions or other disorders such as binge eating disorder. This study explored the levels of agreement with symptoms of addictive eating among different health professions, the conditions they provide advice for, and the population group/s they work with. An online cross-sectional survey was conducted in February-April 2020 including 142 health professionals (87% female, 65% residing in Australia, 28% each working in private practice/hospital settings). Of these, 47% were dietitians, 20% psychologists/psychotherapists/counsellors, 16% other health practitioners (e.g., social workers), 13% health researchers, and 5% medical professionals. Agreement with 11 statements relating to addictive eating symptoms was assessed on a scale of 1/strongly disagree to 5/strongly agree (e.g., certain foods produce physiological effects in the brain rewards system). Differences in agreement by health profession were assessed by one-way analysis of variance. There were significant differences in agreement with individual statements between health professions. Psychologists, psychotherapists, and counsellors reported lower agreement to statements relating to physiological effects in the reward system, withdrawal symptoms, and over-eating to alleviate stress/anxiety, than other professions ( p < 0.05). Those providing advice for disordered eating only reported lower agreement across statements compared with those providing advice for overweight/obesity or both ( p < 0.001). There were minimal differences based on the population group/s that health professionals work with. There is some agreement among health professionals regarding addictive eating symptoms, however, this differs by profession and the conditions they treat. This study provides a novel perspective on health professionals' views on addictive eating symptoms, and there is a need for more research to explore the concepts further.

Addictive eating prevalence is estimated at 15-20% in studied populations, and is associated with concurrent mental health conditions and eating disorders as well as overweight and obesity. However, few evidence-based interventions targeting addictive eating are available. The further development of evidence-based interventions requires assessment of intervention feasibility and efficacy. This study aimed to determine the feasibility, including intervention delivery and program acceptability, of FoodFix; a personality targeted intervention for the treatment of addictive eating behaviours in Australian adults. Participants (n = 52) were randomised to intervention (n = 26) or wait-list control groups (n = 26) and received three personalised telehealth sessions with an Accredited Practising Dietitian over seven weeks. Intervention delivery was assessed by tracking adherence to scheduled timing of intervention sessions. Program acceptability of participants was assessed via an online process evaluation survey and program acceptability of intervention providers was assessed via semi-structured phone interviews. In total, 79% of participants adhered to scheduled timing for session two and 43% for session three, defined as within one week (before/after) of the scheduled date. Further, 21% of participants completed the process evaluation survey (n = 11). The majority of participants were extremely/very satisfied with FoodFix (n = 7, 63%). Intervention providers (n = 2) expressed that they felt adequately trained to deliver the intervention, and that the overall session format, timing, and content of FoodFix was appropriate for participants. These findings highlight the importance of assessing intervention feasibility to further understand intervention efficacy.

Despite increasing research on the concept of addictive eating, there is currently no published evidence on the views of health professionals who potentially consult with patients presenting with addictive eating behaviours, or of students training to become health professionals. This study aimed to explore the views and understanding of addictive eating behaviours among health professionals and health professionals in training and to identify potential gaps in professional development training. An international online cross-sectional survey was conducted in February-April 2020. The survey (70 questions, 6 key areas) assessed participants' opinions and clinical experience of addictive eating; opinions on control, responsibility, and stigma relating to addictive eating; and knowledge of addictive eating and opinions on professional development training. In total, 142 health professionals and 33 health professionals in training completed the survey (mean age 38.1 ± 12.5 years, 65% from Australia/16% from the U.K.) Of the health professionals, 47% were dietitians and 16% were psychologists. Most participants ( n = 126, 72%) reported that they have been asked by individuals about addictive eating. Half of the participants reported that they consider the term food addiction to be stigmatising for individuals ( n = 88). Sixty percent ( n = 105) reported that they were interested/very interested in receiving addictive eating training, with the top two preferred formats being online and self-paced, and face-to-face. These results demonstrate that addictive eating is supported by health professionals as they consult with patients presenting with this behaviour, which supports the views of the general community and demonstrates a need for health professional training.

Background: Young adults are a priority population for nutrition interventions because of the high prevalence of unhealthy eating behaviors, high risk of weight gain, and the importance of this life stage for developing lifelong eating behaviors. Innovative intervention strategies are needed to reach and engage young adults, whereas more detailed reporting of intervention development and testing would facilitate progress in this challenging research area., Objective: This paper describes the development of the EATS (Eating Advice To Students) intervention, a targeted, brief Web-based nutrition intervention for young adult (17 to 35 years) university students, and describes the pilot randomized controlled trial (RCT) to assess intervention feasibility., Methods: EATS was developed using the PRECEDE-PROCEED model. The development involved a cross-sectional survey of university students' eating behaviors and determinants, a systematic review of brief nutrition interventions, and consultation with a project steering committee. EATS was developed as a website with 4 components: (1) brief screening quiz with personalized feedback, (2) provision of information, tips, and strategies for each target eating behavior (consumption of vegetables, fruit, discretionary foods, and breakfast) and 2 guided exercises to facilitate behavior change, (3) goal setting, and (4) creating strategies. A pilot RCT with students from the University of Newcastle, Australia, was conducted from February to July 2018. The students were randomized to EATS or a brief Web-based alcohol intervention (attention control). The process evaluation included intervention acceptability (Web-based survey postintervention completion) and objective usage data (collected in real time). Efficacy data (Web-based survey at baseline and 3 months) included diet quality, consumption of target food groups (eg, fruits and vegetables), alcohol intake, self-efficacy to perform target eating behaviors, and well-being., Results: Collection of the 3-month follow-up data was completed in July 2018., Conclusions: EATS presents an innovative solution to many of the difficulties faced in targeting young adults to improve their eating behaviors. Given the strong methodological approach undertaken, this study provides a significant contribution to advance this research area., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618000118202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374365&isReview=true (Archived by WebCite at http://www.webcitation.org/765o5fVwa)., International Registered Report Identifier (irrid): DERR1-10.2196/11992., (©Megan Whatnall, Amanda Patterson, Melinda Hutchesson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.03.2019.)