PURPOSE:Storytelling has long conveyed knowledge, wisdom, and values across generations, making it a powerful tool for shifting perspectives and encouraging behaviour change. By engaging audiences emotionally, it creates a shared space where diverse viewpoints coexist, fostering empathy and understanding. This is especially valuable in public health, where translating scientific evidence into relatable, actionable knowledge is essential. The First 1,000 Days storytelling initiative in Burnie, Northwest (NW) Tasmania, demonstrated the benefits of community-driven narratives in improving the health and well-being of children from conception to age two. This study explored how storytelling could function as a core strategy within the broader initiative, while examining parents' lived experiences in workshops designed to empower healthier lifestyles. METHODS:Early years practitioners and parents collaborated around four pillars-connection, nutrition, caring, and moving. Participants shared and reshaped personal narratives linked to each area. Facilitators emphasized dignity, autonomy, and inclusivity, creating a safe environment, particularly for disadvantaged participants. RESULTS:Participants combined expert knowledge with lived experience, building capacity to promote early childhood development across their networks and communities. CONCLUSION:This initiative illustrates how co-created storytelling effectively bridges lived experience and professional expertise, fostering reflection, empowerment, and sustainable, community-driven change in early childhood and maternal health.

INTRODUCTION/BACKGROUND:Competence in fundamental movement skills (FMS) is associated with higher physical activity levels across childhood and adolescence, influencing lifelong movement behaviours. Despite these benefits, most children globally fail to meet recommended physical activity levels from an early age and are increasingly affected by unhealthy body composition and chronic conditions such as obesity and type 2 diabetes (T2D). This article synthesises current evidence on early-life movement behaviours and interventions promoting physical activity during the first 2000 days, a critical developmental period shaping long-term health. MATERIALS AND METHODS:A comprehensive search of peer-reviewed randomized controlled trials (RCTs) published between 2020 and 2025 in Medline and Scopus identified studies examining physical activity, motor skill development, and related health outcomes in children aged 0-5 years. Findings were organized into five themes: (1) movement behaviours and early health; (2) historical development of guidelines; (3) global consensus and gaps; (4) early-years interventions; and (5) emerging implications. RESULTS:Eighteen studies met inclusion criteria. Evidence highlighted the importance of physical activity, adequate rest, and limited sedentary behaviour for early development. Most studies focused on preschoolers, with fewer addressing infants and toddlers. Interventions were largely from high-income contexts and varied in design and measurement tools. Integrating physical literacy showed promise. DISCUSSION:Early movement experiences shape body composition and chronic disease risk. Focusing on the first and next 1000 days may foster lifelong healthy habits. Future work should enhance equity, diversity, and measurement consistency in interventions.

A culture of health or healthy living can be envisioned as a society where well-being, including essential aspects like sleep, stress management, social connections, and leisure - is not merely an aspiration but a tangible reality for diverse communities, free from systemic inequities. However, the concept of a healthy lifestyle, and by extension a culture of healthy living, varies widely across the globe, shaped by cultural norms, government policies, and social structures. Defining a universally acceptable "culture of healthy living" for every population or subgroup is inherently complex, making it more practical to focus on addressing the barriers and leveraging the enablers associated with leading a healthy life. At its core, discussing the foundational elements of a healthy life - such as diet and nutrition, physical activity, mental health, and access to healthcare - is crucial. To ensure the sustainability of healthy living practices, a multifaceted approach is needed, emphasizing these pillars alongside equity. Existing global initiatives offer promising frameworks to tackle these challenges, highlighting the importance of collaboration, innovation, and systemic change. By fostering mutual support and collective action, we can advance toward a global culture of healthy living that benefits all individuals and communities, leaving no one behind.

Food choices and dietary behaviors are inherently complex and influenced by numerous interconnected factors including individual preferences such as taste, meal timing, and social interactions, alongside external elements like affordability, cultural norms, marketing, and policy environments. The physical contexts of food consumption - homes, schools, workplaces, and neighborhoods- further shape these behaviors, as do societal expectations and generational food literacy. Underpinning these dynamics are food systems, which are influenced by health, ethical, and sustainability considerations throughout the food production and consumption continuum. Cultural influences, encompassing traditions, rituals, and shared beliefs, play a pivotal role in shaping dietary practices. Distinctions between "cultural food" and "food culture" illustrate the deep integration of cuisine within identity and daily life. Historical events, globalization, and modernization have reshaped food traditions, leading to the adoption of new eating patterns and the erosion of others. Religion, socioeconomic status, and social networks also critically impact dietary behaviors, while contemporary challenges such as the nutrition transition and fast-food culture contribute to rising chronic disease burdens. Addressing these issues requires culturally tailored interventions and a focus on food environments, integrating modern tools like social media to promote healthier, community-oriented behaviors while recognizing the social and emotional roles of food.

Agent-based modelling (ABM) is a promising research tool for studying complex healthy behaviours such as active commuting. This scoping review systematically examined the current literature on the use of ABM in active commuting intervention research, identifying key model components, methodological strengths and limitations. A comprehensive search identified 43 studies for analysis. Findings revealed a growing utilisation of ABM in recent years with considerable variations in model structures, agent attributes, behaviours, environmental representations, and types of interventions evaluated. Overall, ABM has been utilised to study active commuting behaviours across diverse populations and geographical contexts by incorporating individual-level heterogeneity and simulating interactions between agents and their environments. It also facilitated the in-silico evaluation of interventions such as infrastructure modifications, policy changes, financial incentives, and health promotion initiatives on their potential impact on active commuting behaviours. Nevertheless, challenges remain such as the limited theoretical grounding for agent behaviours, translation of findings to real-world settings and lack of standardised model reporting and validation methods. Addressing these gaps would enhance ABM’s credibility and applicability as a decision-support tool for public health practitioners and policymakers to promote active commuting to combat physical inactivity and improve population health.

Introduction: This study explores the perspectives of parents and primary schoolchildren on active school commuting (ASC) in northwest Tasmania, Australia and highlights the unique challenges and opportunities of promoting ASC in regional settings. Methods: Using a constructivist framework and reflexive thematic analysis, we conducted semistructured interviews with 11 parents and 13 children to capture their experiences with both active and passive commuting. Results: Deciding between active and passive mode of school commuting involves a balance between perceived risks and benefits. Parents prioritised safety and logistical considerations, often adopting risk-averse attitudes due to concerns about traffic, crime, and adverse weather. These issues, coupled with long commuting distances, time constraints, hilly terrain, and limited transport options, made driving the default choice. In contrast, children valued the enjoyment, independence, and environmental interactions offered by ASC and expressed confidence in navigating the journey. Parents were open to ASC if infrastructure improvements, such as safer pathways and crossing guards, and earlier school opening hours were implemented. Hybrid commuting approaches like "drive part-way, walk part-way," combined with walking school bus programs, were identified as promising solutions to address safety concerns and logistical barriers. Children's enthusiasm for ASC provides an opportunity to shift parental perceptions and promote ASC as a positive, enriching experience. Conclusions: Our study has highlighted several challenges and opportunities for ASC promotion in a regional setting and the need for context-specific interventions. Future research should involve local stakeholders and explore co-designed interventions tailored to regional barriers and contexts.

Background: The period following childbirth is marked by dynamic changes in maternal physiology and the growth trajectory of the newborn. We aimed to elucidate the changes and associations in body composition of infants and their mothers during the first year postpartum. Methods: This pilot study assessed infant body composition using the PEA POD air displacement plethysmography (ADP) system (birth–6 months) and deuterium dilution (9–12 months). Maternal body composition was assessed using the BOD POD ADP system at 12 months postpartum. Mothers were grouped by prepregnancy body mass index (BMI) <25 kg/m2 (lean) or ≥25 kg/m2 (overweight/obese: OW/OB), and data were analysed using linear regression. Results: Twenty-nine infant–mother pairs were assessed. Infant percent fat mass (%FM) increased from birth to 6 months (9.3% vs. 24.2%; p < 0.001) and then gradually declined. At birth and 3 months, %FM was significantly higher in infants born to OW/OB mothers compared to their lean counterparts. A significant positive association (β = 0.3; p = 0.040) was observed between maternal %FM and infant %FM at 1 year post-delivery after controlling for the mother’s prepregnancy BMI. Conclusions: Infants born to OW/OB mothers have increased %FM at birth and 3 months, which may have consequences for their health throughout childhood and into adulthood. Moreover, maternal prepregnancy BMI is a significant predictor of maternal postpartum weight status and body composition and impacts the relationship between maternal and infant body composition at 12 months postpartum. While the findings of our pilot study underscore the importance of encouraging women of childbearing age to maintain a healthy BMI before conception, further research is needed to substantiate these results.

The first 1000 days (F1D), from conception to a child’s second birthday, constitute a critical window for shaping long-term health, development, and wellbeing. While conventional approaches often rely on external interventions to support young families, the Positive Deviance (PD) framework offers a compelling alternative: identifying and amplifying successful behaviours already present within communities facing similar constraints. This paper explores how PD can be harnessed to foster sustainable, community-led change during the F1D. By uncovering local success stories, promoting participatory engagement, and strengthening caregiver self-efficacy, PD enables communities to co-create solutions that are culturally relevant and contextually grounded. However, effective application of PD requires careful attention to structural inequities, ethical storytelling, and rigorous methodological standards to avoid inadvertently shifting responsibility onto individuals. When implemented thoughtfully, PD reveals “what works” in resource-limited settings, empowering communities to build child-inclusive environments rooted in local expertise and resilient practices.

Background/Objectives: Physical activity (PA) and energy intake (EI) are central targets of community initiatives to reduce the prevalence of childhood obesity. The general effects of PA and EI in influencing energy balance and body composition are clear. However, the independent impacts of PA and EI on the adiposity of children growing up amidst westernized lifestyles are inconclusive, as few studies have employed sufficiently robust methodology to provide solid independent associative data. Methods: We carried out a systematic review of the research addressing the independent associations of adiposity with each of PA and EI in free-living town or city-dwelling children and adolescents. Acceptable publications included objective measures of fat mass and PA, best standard practice EI assessments, and appropriate statistical modeling. Results: Of approximately 700 publications explored, only four satisfied all the pre-set methodological standards. All four studies involved predominantly White participants from westernized cities and had the same outcomes. Adiposity was strongly independently and negatively related to PA, but there was no evidence of any independent relationship between adiposity and EI. Potential misreporting was considered, especially under-reporting by participants with greater adiposity, butpost-hoc assessments were unable to find any evidence that this influenced the outcomes. Conclusions: In general, children with higher adiposity consumed no more food and beverage energy than their leaner counterparts, but they were less active. However, despite some support for the validity of the commonly used and validated EI assessments, their subjective nature raises the possibility that inaccuracy masked relationships. Additional well-designed research is needed, and notwithstanding the vital role that sound nutrition plays in the healthy development of our youth, the consistency of outcomes of the well-executed studies in this review suggests that campaigns targeting youth obesity would benefit from strategies focusing strongly on increasing PA.

Chronic health conditions including obesity, cardiovascular diseases, type 2 diabetes, and depression are rising in Australia, and are often addressed reactively in adulthood rather than proactively during childhood. Evidence highlights the first 2000 days (from conception to five years of age) as a critical window for prevention, where movement, active play, proper nutrition, and adequate sleep are key to reducing chronic disease risk. Despite this, limited longitudinal data on children’s growth and development hinders effective intervention. Up to one in four Australian children are living with overweight or obesity, with poor movement behaviours, sedentary lifestyles, unhealthy diets, and inadequate sleep as primary contributors. Active play fosters motor skill development and lifelong health but faces barriers like overprotective caregiving and sedentary environments. Actionable strategies to enhance activity levels in this age group include providing educator training, developing online resources, fostering communities of practice, improving infrastructure, and advocating for policy changes. A coordinated effort by parents, caregivers, educators, and health professionals is essential to prioritise movement in early childhood, laying the foundation for healthier growth and reducing the burden of chronic diseases.

Introduction:Emerging evidence highlights the value of place-based approaches in improving community health, including preventing childhood obesity. These approaches leverage local knowledge, build trust, and support co-designed initiatives. This case study presents a project in North-West Tasmania that combined capacity building and collective impact strategies to promote optimal early childhood development during the first 1000 days (F1D), with academic researchers playing a supportive role. Methods:The project aimed to raise health literacy among parents and caregivers in Burnie, Circular Head and Devonport. It employed a comprehensive strategy informed by theories on F1D importance, health equity, health literacy, and systems thinking, along with place-based and asset-based frameworks. A broad group of stakeholders were engaged, and a mapping of local assets guided the implementation. Results:Key early activities included stakeholder engagement and community asset mapping, concluding in early 2024, followed by storytelling workshops and academic evaluations. Community campaigns and learning products were co-designed and activated during the balance of 2024. Discussion:The project exemplified the key principles of collective impact: establishing a shared agenda, defining success measures, coordinating aligned activities, maintaining open communication, and creating a backbone structure for support and data coordination. It offered valuable lessons for future policy and program development by emphasizing the importance of context-specific adaptation and community-led design.

Despite heightened recognition of the importance of cardiorespiratory fitness (CRF) to cardiovascular (CV) health, along with updated international consensus guidelines for physical activity (PA) and sedentary behavior (SB), significant proportions of the global adult population are physically inactive, and do not meet the threshold for CRF. Physical inactivity is considered a surrogate for low CRF given that the former is defined as not reaching the recommended minimum level of PA per week to derive a health benefit. Physical inactivity remains a major global public health problem despite decades of work by various United Nations agencies, and members of the international community to improve PA levels. Given the common coupling between physical inactivity and poor health status, it is reasonable to suggest that for a significant proportion of the global population, CRF is compromised by physical inactivity. This poses a longer-term risk to morbidity and mortality. Here we provide an indicative summary of the global status of CRF and PA and reference the implications for global health. We briefly reference opportunities moving forward, including reinforcement of the importance of engaging in movement from an early age, discouraging SB, and taking a life course approach to optimise healthy living for all.

BACKGROUND/OBJECTIVES:An appreciation of infant body composition is helpful to understand the 'quality' of growth in early life. Air displacement plethysmography (ADP) using PEA POD and the deuterium dilution (DD) technique are commonly used body composition approaches in infants. We evaluated the comparability of body composition assessed using both techniques with two-compartment (2C) and three-compartment (3C) models in 6-month-old infants. SUBJECTS/METHODS:Infant fat mass (FM) and percent fat mass (%FM) obtained from a 2C model using PEA POD (2C-PP) and a 2C model using the deuterium dilution technique (2C-DD) were compared to those derived from a 3C model, and to each other, using Bland-Altman analysis and Deming regression. RESULTS:Measurements were available from 68 infants (93% Caucasian, 53% male). The mean biases were not significant between any of the method comparisons. However, significant constant and proportional biases were identified in 2C-DD vs 3C and 2C-PP vs 2C-DD, but not in the 2C-PP vs 3C comparison. Furthermore, we observed significant associations between the mean differences and infants' percent total body water (%TBW). CONCLUSIONS:While no significant between-method mean differences were found in body composition estimates, some comparisons revealed significant constant and proportional biases and notable associations between the mean differences and %TBW were observed. Our results emphasise the importance of method choice, ensuring methodological uniformity in long-term studies, and carefully considering and regulating multiple pre-analytical variables, such as the hydration status of the participants.

Background Given the importance of infancy for establishing growth trajectories, with later-life health consequences, we investigated longitudinal body composition among infants from six economically and ethnically diverse countries. Methods We recruited mother-infant dyads using the WHO Multicenter Growth Reference Study criteria. We measured fat-free mass (FFM) in 1393 (49% female) infants from birth to 6 months of age (Australia, India, and South Africa; n = 468), 3–24 months of age (Brazil, Pakistan, South Africa, and Sri Lanka; n = 925), and derived fat mass (FM), fat mass index (FMI), and fat-free mass index (FFMI). Height-for-age (HAZ), weight-for-age (WAZ), and weight-for-length (WHZ) Z-scores were computed. Sex differences were assessed using a t-test, and country differences using a one-way analysis of covariance. We further compared subsamples of children with average (−0.25 > HAZ < +0.25), below-average (≤−0.25) and above-average (≥+0.25) HAZ. Results HAZ performed well between 0 and 6 months, but less so between 3 and 24 months. The stunting prevalence peaked at 10.3% for boys and 7.8% for girls, at 24 months. By 24 months, girls had greater FMI (10%) than boys. There were significant differences in FFM (both sexes in all countries) and FM (Brazilian boys, Pakistani and South African girls) by 24 months of age between infants with average, above-average, and below-average HAZ. Conclusion In a multi-country sample representing more ideal maternal conditions, body composition was heterogeneous even among infants who exhibited ideal length. Having a mean HAZ close to the median of the WHO standard for length reduced FFM between-country heterogeneity but not FM, suggesting that other factors may influence adiposity.

Despite widespread acknowledgement of the multifarious health benefits of physical activity (PA), including prevention and control of obesity, an overwhelming majority of children and adolescents are not sufficiently active to realise such benefits. Concurrently, young people are significantly impacted by the rapid global rise of sedentarism, and suboptimal dietary patterns during key phases of development. Regrettably, the cumulative effects of unhealthy behaviours during the growing years predisposes young people to the early stages of several chronic conditions, including obesity. Clear and consistent approaches are urgently needed to improve eating and activity behaviours of children and adolescents. Based on existing evidence of "best bets" to prevent and control obesity and its comorbidities, we present a set of non-negotiable strategies as a 'road map' to achieving prevention and improving the health of children and adolescents.

Issue Addressed: The capacity of communities to develop effective obesity prevention initiatives varies and should be a focus for obesity prevention intervention planning and investment. This research aimed at engaging and consulting local community stakeholders to identify determinants, needs, strategic priorities and capacity to act on overweight and obesity prevention in North-West (NW) Tasmania.Methods: A series of semi-structured interviews and thematic analyses was implemented to explore the knowledge, insights, experiences and attitudes of stakeholders.Results: Mental health and obesity were identified as major concerns and were often reported to share similar determinants. This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information).Conclusions: This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information).So What?: Broad upstream socio-economic, cultural and environmental determinants underpin the conditions by which the local community develops overweight/obesity and/or health and wellbeing outcomes. Including stakeholder consultations as a significant technique within a comprehensive plan of action aimed at achieving a sustainable, long-term strategy for obesity prevention and/or health promotion, should be considered in future programs.

Background Accurate assessment of body composition during infancy is important, especially for understanding the effects of early growth on later health. This study aimed to develop an anthropometry-based approach to predict body composition in 3–24 month old infants from diverse socioeconomic settings and ethnic groups. Methods An observational, longitudinal, prospective, multinational study of infants from birth to 24 months. Body composition was assessed at 3, 6, 9, 12, 18, and 24 months using deuterium dilution (DD) and anthropometry. Linear mixed modelling was utilized to generate sex-specific fat mass(FM) and fat-free mass(FFM) prediction equations. Length(m), weight-for-length(kg/m), triceps and subscapular skinfolds and Asian ethnicity were used as predictor variables. The study sample consisted of 1896(942 measurements from 310 girls) training data sets, 941(441 measurements from 154 girls) validation data sets from Brazil, Pakistan, South Africa and Sri Lanka, and 349(185 measurements from 124 girls) data sets of infants at 6 months from South Africa, Australia and India of external validation group. Results Sex-specific equations for three age categories (3-9 months; 10-18 months; 19-24 months) were developed and validated and an external validation was performed on the test group. The root mean squared error(RMSE) was similar between validation and test data for assessment of FM and FFM. Root mean squared percentage error(RMSPE) and mean absolute percentage error(MAPE) in validation data were higher for predicting FM but lower for FFM compared to test data. Conclusions Anthropometry-based FFM prediction equations provide acceptable results which have the potential to be developed as a field tool.

A qualitative case study approach with in-depth, semi-structured interviews of key school staff, and student feedback was used to assess a school kitchen and garden program in the regional area of North-West Tasmania, Australia. A detailed program description was produced to conduct a realist evaluation with a Context-Mechanism-Outcome configuration, followed by a program theory evaluation through the construction of a retrospective program logic model. Dedicated kitchen and garden spaces, knowledgeable teachers committed to the program, provision of sufficient materials and consumables, and support from the school and community were found to be the basic requirements to establish a program. Additionally, it is essential to integrate both the kitchen and garden teaching components into the school curriculum. The positive outcomes (e.g., engagement, participation, knowledge, skills, behavioral change) of the program were dependent on the underlying factors, including dedicated support of school leadership, teaching staff, and the parent body for effective student engagement in the teaching spaces and for wider engagement from families and the community. The students' feedback provided supporting evidence of increased food literacy with improvements in their understanding, abilities, and attitudes towards gardening, producing healthy food, and preparing food. This may further lead to enhanced food security for students' families and the broader community.

Abstract Background and Aim Adipocytes secrete a peptide hormone called leptin, which plays a crucial role in controlling appetite and energy expenditure. Alterations in leptin concentrations are associated with CKD‐related cardiovascular problems such as hypertensive heart disease (HHD). Despite the link, data on the precise function of leptin in people with CKD and HHD is scant. Methods An observational cross‐sectional study involving a total of 108 participants (72 CKD patients with HHD and 36 healthy controls). Their demographic and anthropometric information was collected using a standardized questionnaire. Certain clinical measures such as blood pressure and body mass index (BMI) were assessed. Fasting blood samples were analyzed for levels of plasma glucose (FPG), lipids, creatinine, and leptin. Data were analyzed with SPSS v23. Results Leptin, FPG, creatinine and triglyceride levels were all significantly higher in CKD patients with HHD compared to controls (p < 0.01 for all). Furthermore, advanced CKD status (being in stage 5), having a 6‐year diagnosis of HHD, being female, having a higher BMI, and elevation in levels of HDL and FPG contributed significantly to the variance in serum leptin levels in the case group (β = 0.37, 0.22, 0.19, 0.18, 0.27, 0.28; p < 0.05 for all). In the control group, the female gender had the biggest unique effect on circulating leptin levels, followed by BMI and eGFR (β = 0.71, 0.34, −0.22; p < 0.01 for all). Conclusion Patients with CKD who also had HHD reported considerably higher circulating leptin levels. Significantly higher blood leptin levels were shown to be associated with CKD stage 5 in the case group. These results are consistent with the role of leptin in the metabolic complexity seen in CKD patients. There needs to be more research into treatments that aim to lower leptin levels in CKD patients with HHD.