BACKGROUND:Cardiovascular disease (CVD) is a major cause of mortality and morbidity. The number of young adults with at least one CVD risk factor has increased over the past two decades. Evidence suggests that addictive eating behaviours cluster with other CVD risk behaviours, including poor diet, lack of physical activity and poor sleep quality. The primary aim of this pilot study is to determine the feasibility (adherence to the programme), acceptability and engagement of an innovative intervention comprising of five telehealth sessions ranging from 20 to 45 min with an Accredited Practising Dietitian over 8 weeks aimed at improving CVD risk factors in young Australian adults aged 18-35 years with addictive eating behaviours. METHODS:A total of 53 young adults with ≥ 3 symptoms of addictive eating assessed via the Yale Food Addiction Scale 2.0 and a body mass index > 18.5 kg/m2 were recruited. Adherence to the programme was assessed through the number of participants completing the telehealth sessions. Acceptability (including overall satisfaction, appropriateness and effectiveness of recruitment materials) was assessed via semi-structured phone interviews with participants upon study completion. Engagement with the programme website was assessed with Wix Analytics and comprised of website access and webpage dwell time. Changes in dietary intake, food addiction symptoms, physical activity, sleep quality, mental health (depression, anxiety and stress), and CVD blood biomarkers were also assessed and compared between groups and over time. RESULTS:Nine of the 27 participants randomised to the intervention group did not adhere to the programme by completing all five telehealth sessions. Twenty-one (56.8%) participants completed the semi-structured phone interview, with all reporting an overall 'positive' experience with the programme. Based on the total number of participants provided with website access in the intervention (n = 21) and control (n = 16) groups, the percentage who logged in to the website at least once was 95.2% and 18.8% respectively. The intervention group was superior compared to the control group for improvements in percent from fat (-4.87%/day [95% CI: -8.04, -1.70], p = 0.005), saturated fat (-1.77%/day [95% CI: -3.33, -0.20], p = 0.03) and non-core foods (-9.20%/day [95% CI: -17.53, -0.87], p = 0.03) from baseline to 8 weeks. While other outcomes (i.e., changes in food addiction symptoms, physical activity, sleep, mental health, stress and CVD biomarkers - triglycerides) improved significantly over time, there were no between-group differences. CONCLUSIONS:A CVD intervention targeting addictive eating behaviours successfully recruited young adults, a recognised population group difficult to reach. The telehealth programme was found to be feasible and demonstrated improvements in dietary outcomes.

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.

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.

Objective: To explore young adult's experiences of how starting university influenced their physical activity, diet, sleep, and mental well-being, and barriers and enablers to health behavior change. Participants: University students aged 18-25 years. Methods: Three focus groups were conducted in November 2019. Inductive thematic approach was utilized to identify themes. Results: Students (female: n = 13, male: n = 2, other gender identity: n = 1, 21.2 (1.6) years) reported mental well-being, physical activity levels, diet quality and sleep health were negatively affected. Stress, study demands, university timetabling, not prioritizing physical activity, cost and availability of healthy foods, and difficulty falling asleep were key barriers. Health behavior change interventions aiming to support mental well-being need to include both information and support features. Conclusions: There is a significant opportunity to improve the transition to university for young adults. Findings highlight areas to target in future interventions to improve physical activity, diet, and sleep of university students.

Abstract The food environment has changed dramatically over the last decade, paralleling the rise in the prevalence of obesity, and mental health conditions. The consumption of certain foods, particularly those high in refined carbohydrates, fats, sugar and/or salt, are speculated to trigger an addictive-like response in some individuals over time. Alongside this, foods that are described as highly- or ultra-processed, hyper-palatable, or those engineered to a particular bliss point, often get discussed in association with addictive eating. There is currently a lack of consistency in the evidence to identify whether specific foods, nutrients, or ingredients could trigger an addiction-like response in humans. A synthesis of existing research to date shows preliminary findings that highly processed, hyper-palatable foods with high levels of fat, salt, and sugar are likely to have the highest addictive potential. Given the associations with increased intakes of energy-dense, nutrient-poor foods, it is not surprising that reviews of the food addiction literature have shown associations between individuals with food addiction and increased weight status and mental ill health.

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.

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.

Background Young adulthood is a critical period where there is an increased weight gain trajectory. Understanding the weight management support needs of young adults with excess weight is essential to enable the delivery of appropriate and tailored services and prevent the development of comorbidities. This study sought to determine the current health service usage, weight management practices and support needs, in young adults with excess weight. Methods A mixed-methods convergent parallel design was employed. A cohort of community-dwelling young adults (18–35 years), with excess weight (BMI ≥ 25), residing in the UK and Australia participated in an online, longitudinal survey. Cross-sectional data was analysed descriptively, including quantitative measures of health service usage and weight management practices. Responses to an open-ended question asking what support participants would find most helpful were analysed using Thematic Template Analysis. Convergence and divergence across sociodemographic characteristics were explored. Results The sample (n = 410) included 204 women, 201 men and five non-binary people with a mean age of 28.3 and BMI of 35.8. Most participants reported a white ethnicity (80%) and resided in the UK (83%). Half reported a below median gross household income (49%). Most (73%) reported currently trying to manage their weight and 63% were using commercial weight management products or self-directed diets. Only 12% of participants reported accessing healthcare services for weight management support or treatment, yet qualitative responses indicated a desire for support from a dietitian or psychologist. Five themes indicated a need for structured but tailored resources, simplicity, addressing internal and external barriers, access to holistic professional support, and access to networks vs a preference for self-reliance. Conclusions Young adults with excess weight are using commercial products and self-led diets but many desire specialist healthcare professionals to support their weight management. Young adults appear to prefer online resources and support that are simplistic, structured and individually tailored to their diverse cultural preferences, routines, environments, and comorbidities. Furthermore, findings indicate unmet psychological support needs amongst young adults with excess weight in the UK and Australia. Protocol Whatnall, M., Fozard, T., Kolokotroni, K.Z., Marwood, J., Evans, T., Ells, L.J. and Burrows, T., 2022. Understanding eating behaviours, mental health and weight change in young adults: protocol paper for an international longitudinal study. BMJ open, 12(9), p.e064963.

Aims Dietary modification is essential for the secondary prevention of cardiovascular disease. However, there are limited published evidence syntheses to guide practice in the cardiac rehabilitation (CR) setting. This systematic review's objective was to assess effectiveness and reporting of nutrition interventions to optimize dietary intake in adults attending CR. Methods and results Randomized controlled trials (RCTs) of nutrition interventions within CR were eligible for inclusion and had to have measured change in dietary intake. MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and The Cochrane Library were searched from 2000 to June 2020, limited to publications in English. Evidence from included RCTs was synthesized descriptively. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. This review is registered on PROSPERO; CRD42020188723. Of 13 048 unique articles identified, 11 were eligible. Randomized controlled trials were conducted in 10 different countries, included 1542 participants, and evaluated 29 distinct dietary intake outcomes. Five studies reported statistically significant changes in diet across 13 outcomes. Most nutrition interventions were not reported in a manner that allowed replication in clinical practice or future research. Conclusion There is a gap in research testing high-quality nutrition interventions in CR settings. Findings should be interpreted in the light of limitations, given the overall body of evidence was heterogenous across outcomes and study quality; 6 of 11 studies were conducted more than 10 years old. Future research should investigate strategies to optimize and maintain nutrition improvements for patients attending CR. Registration PROSPERO; CRD42020188723.

ObjectiveTo evaluate the association between health behaviors with mental health among tertiary education students.MethodsSix 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.Results33 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.ConclusionFindings 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.

ISSUE ADDRESSEDUniversities 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.METHODSAn 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).RESULTSEleven 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.CONCLUSIONSAustralian 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.

BACKGROUND:Accurate anthropometric measurement is important within epidemiological studies and clinical practice. Traditionally, self-reported weight is validated against in-person weight measurement. OBJECTIVES:This study aimed to 1) determine the comparison of online self-reported weight against images of weight captured on scales in a young adult sample, 2) compare this across body mass index (BMI), gender, country, and age groups, and 3) explore demographics of those who did/did not provide a weight image. METHODS:Cross-sectional analysis of baseline data from a 12-mo longitudinal study of young adults in Australia and the UK was conducted. Data were collected by online survey via Prolific research recruitment platform. Self-reported weight and sociodemographics (for example, age, gender) were collected for the whole sample (n = 512), and images of weight for a subset (n = 311). Tests included Wilcoxon signed-rank test to evaluate differences between measures, Pearson correlation to explore the strength of the linear relationship, and Bland-Altman plots to evaluate agreement. RESULTS:Self-reported weight [median (interquartile range), 92.5 kg (76.7-112.0)] and image-captured weight [93.8 kg (78.8-112.8)] were significantly different (z = -6.76, P < 0.001), but strongly correlated (r = 0.983, P < 0.001). In the Bland-Altman plot [mean difference -0.99 kg (-10.83, 8.84)], most values were within limits of agreement (2 standard deviation). Correlations remained high across BMI, gender, country, and age groups (r > 0.870, P < 0.002). Participants with BMI in ranges 30-34.9 and 35-39.9 kg/m2 were less likely to provide an image. CONCLUSIONS:This study demonstrates the method concordance of image-based collection methods with self-reported weight in online research.

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. 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. 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?”). 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.

AIMS:To evaluate relationships between diet quality and cardiovascular outcomes. METHODS:Six databases were searched for studies published between January 2007 and October 2021. Eligible studies included cohort studies that assessed the relationship between a priori diet quality and cardiovascular disease mortality and morbidity in adults. The Academy of Nutrition and Dietetics Checklist was used to assess the risk of bias. Study characteristics and outcomes were extracted from eligible studies using standardised processes. Data were summarised using risk ratios for cardiovascular disease incidence and mortality with difference compared for highest versus lowest diet quality synthesised in meta-analyses using a random effects model. RESULTS:Of the 4780 studies identified, 159 studies (n = 6 272 676 adults) were included. Meta-analyses identified a significantly lower cardiovascular disease incidence (n = 42 studies, relative risk 0.83, 95% CI 0.82-0.84, p < 0.001) and mortality risk (n = 49 studies, relative risk 0.83, 95% CI 0.82-0.84, p < 0.001) among those with highest versus lowest diet quality. In sensitivity analyses of a high number of pooled studies (≥13 studies) the Mediterranean style diet patterns and adherence to the heart healthy diet guidelines were significantly associated with a risk reduction of 15% and 14% for cardiovascular disease incidence and 17% and 20% for cardiovascular disease mortality respectively (p < 0.05). CONCLUSIONS:Higher diet quality is associated with lower incidence and risk of mortality for cardiovascular disease however, significant study heterogeneity was identified for these relationships.

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/m2. 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).

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).

INTRODUCTION:Codesign is a meaningful end-user engagement in research design. The integrated knowledge translation (IKT) framework involves adopting a collaborative research approach to produce and apply knowledge to address real-world needs, resulting in useful and useable recommendations that will more likely be applied in policy and practice. In the field of food addiction (FA), there are limited treatment options that have been reported to show improvements in FA symptoms.OBJECTIVES:The primary aim of this paper is to describe the step-by-step codesign and refinement of a complex intervention delivered via telehealth for adults with FA using an IKT approach. The secondary aim is to describe our intervention in detail according to the TIDieR checklist.DESIGN:This study applies the IKT process and describes the codesign and refinement of an intervention through a series of online meetings, workshops and interviews.PARTICIPANTS:This study included researchers, clinicians, consumers and health professionals.PRIMARY OUTCOME MEASURE:The primary outcome was a refined intervention for use in adults with symptoms of FA for a research trial.RESULTS:A total of six female health professionals and five consumers (n=4 female) with lived overeating experience participated in two interviews lasting 60 min each. This process resulted in the identification of eight barriers and three facilitators to providing and receiving treatment for FA, eight components needed or missing from current treatments, telehealth as a feasible delivery platform, and refinement of key elements to ensure the intervention met the needs of both health professionals and possible patients.CONCLUSION:Using an IKT approach allowed for a range of viewpoints and enabled multiple professions and disciplines to engage in a semiformalised way to bring expertise to formulate a possible intervention for FA. Mapping the intervention plan to the TIDieR checklist for complex interventions, allowed for detailed description of the intervention and the identification of a number of areas that needed to be refined before development of the finalised intervention protocol.

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.

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 (8 = 3.954, p = 0.002) and a lower %E from unprocessed foods (8 =-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 (8 =1.693, p < 0.001) and %E from unprocessed foods was lower (8 =-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.