Rachael M. Taylor

Poor sleep and suboptimal diet are common during pregnancy and contribute to adverse maternal and infant outcomes. While sleep‐diet associations are documented in general populations, evidence in pregnancy is scarce. This study investigated associations between sleep quality and duration and diet quality and dietary intake among Australian pregnant women. Data from two Australian pregnancy cohorts (Newcastle1000 and ORIGINS; n = 1070) were collected at 18–20 weeks gestation (2017–2024). Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), and dietary intake and diet quality using the Australian Eating Survey and Australian Recommended Food Score (ARFS). Generalised linear models examined associations between sleep quality (continuous PSQI score) and sleep duration (< 7 h, 7–9 h, > 9 h) and dietary variables, adjusting for age, income, pre‐pregnancy BMI, mental health, physical activity, and cohort. Participants were aged 32.3 ± 4.3 years; with a pre‐pregnancy BMI of 25.9 ± 5.7 kg/m ² and 95.3% were English‐speaking. Most participants reported poor sleep quality (72.9%; PSQI global score 6.4 ± 2.8) and suboptimal diet quality (ARFS 35.5 ± 8.9). Poor sleep quality was associated with higher saturated fat intake (Exp(β) = 1.004, 95% CI: 1.000,1.008, p = 0.046). Short sleep duration (< 7 h) was associated with lower diet quality ( β = −2.60, 95% CI: −3.95, −1.25, p < 0.001) and lower fibre intake (Exp(β) = 0.945, 95% CI: 0.900,0.992, p = 0.022). No other significant associations were observed in adjusted models. Poor sleep quality and short sleep duration were associated with less favourable dietary patterns during pregnancy. This highlights the need for further research to inform integrated interventions that consider sleep quality and duration alongside strategies to support healthier eating patterns and improve maternal and infant health outcomes.

The provision of Medical Nutrition Therapy (MNT) is recommended as a component of best practice care for the management of diabetes. The objectives of this umbrella review were to: (1) Describe the characteristics of the reviews identified and included in the review, (2) identify re-occurring (in ≥3 reviews) themes related to barriers and facilitators for healthcare professionals providing and patients living with diabetes receiving MNT for diabetes management, and (3) map these identified factors to the Capacity, Opportunity, Motivation–Behavior Wheel (COM-B) model and the Theoretical Domains Framework (TDF). The COM-B model assumes an individual’s behavior change is dependent on 3 elements: capability, opportunity, and motivation. The TDF identifies 14 behavior change factors that are influenced by the 3 elements of the COM-B model. A search of the literature was conducted using 4 databases for reviews published from inception to July 2023. Reviews that met the following criteria were included in the review: Sample: adults living with diabetes, GPs, clinicians or dietitians; Phenomena of interest: MNT; Design: Systematic reviews, reviews of reviews, meta-analyses; Evaluation: Perceived barriers and facilitators for providing or receiving MNT in primary care; Research type: quantitative, qualitative, or mixed-methods research. Two independent reviewers completed the data extraction. Identified barriers and facilitators were mapped to the COM-B model and TDF. Of 294 articles that were identified from the literature search strategy, 7 reviews were included. Most reviews (5 of 7) had ≥90% of the included studies from high-income countries. The patient “barrier” themes identified were time constraints and negative interactions with healthcare professionals, while the “facilitator” theme included positive interactions with the health service and providers. For healthcare professionals, the “barrier” themes identified were time constraints, limited resources, and miscommunication, while “facilitator” themes were having confidence in providing dietary advice and involving patients in clinical decisions. To improve the provision of MNT for adults with diabetes, interventions are required that target the TDF domain: Environment Context and Resources. Ensuring that patients understand what is provided from dietetic services and that they receive a referral to consult with a dietitian will be important for supporting the provision of MNT in clinical practice. These review findings are only relevant in the context of high-income countries, and further research is needed in low- and middle-income countries. OSF Preregistration. https://osf.io/hm7qp

Introduction: With the growing use of GLP‐1/GIP receptor agonist medications, their impact on dietary intake and quality remains unclear. This systematic review examined how randomized controlled trials (RCT) prescribing liraglutide, semaglutide, or tirzepatide assessed and reported dietary intake and quality as outcome measures, alongside weight loss and/or glycemic control, and identified gaps in the use and methodological quality of dietary assessment methods. Methods: Medline, Embase, Cochrane, Scopus, and CINAHL were systematically searched between January 2008–January 2025 (adults) and January 2014–January 2025 (children/adolescents). The review was registered with the Open Science Framework (DOI: 10.17605/OSF.IO/XPNGY ). Results: Forty‐three articles from 41 unique RCTs, comprising 50,690 participants ( n = 688 children/adolescents, n = 50,002 adults) were included. Except for two studies targeting adults (one published and one unpublished data from an included study), this review found no other studies that assessed or reported dietary intake or changes in diet. Both reported a reduction in the total energy intake and altered macronutrient distribution in the medication plus diet group, although one was not significantly different from medication alone. Quality of assessment methods used was categorized as “poor” and “acceptable,” respectively. These results highlight a critical gap in the literature. Conclusion: Only 2/41 studies (≈5%) reported or assessed dietary intake or evaluated diet changes secondary to GLP‐1/GIP RA medication use. This review highlights a major gap in the evidence requiring urgent attention. More high‐quality research, using validated dietary assessment methods as outcome measures in RCTs is needed to understand how these medications impact diet and diet quality, nutrient intake, and chronic disease risk.

Pregnant women are at higher risk of contracting listeriosis, which can lead to serious perinatal complications. This study evaluated associations between Listeria monocytogenes exposure, infant perinatal outcomes, and hospital resource use in a cohort of 1604 Australian mother–infant dyads. Maternal L. monocytogenes exposure was estimated from self‐reported intake of foods from a validated food frequency questionnaire that potentially harbor L. monocytogenes . Infant outcomes obtained from hospital medical records included birth mode, preterm birth, birthweight, and admission to special care nursery (SCN)/neonatal intensive care unit (NICU). Infant hospital resource use was measured by infant length of stay (LOS), LOS in SCN/NICU, and days excluding SCN/NICU. Multinomial, negative binomial, and hurdle models, were performed to examine Listeria Food Exposure Score (LFES) associations with infant outcomes, total LOS, and LOS excluding and within SCN/NICU. All models were adjusted for covariates including smoking, parity, maternal age, BMI, and SEIFA IRSAD decile. Mean (SD) maternal age was 32.0 (5.0) years, and median (IQR) gestation was 39.0 (38.1, 40.0) weeks. Although adjusted results showed a statistically significant association between LFES and reduced infant LOS excluding SCN/NICU ( β = 0.99; 95% CI: 0.979, 0.998, p < 0.03), the effect size was minimal, with minor clinical significance. There were no significant associations with infant birth mode, preterm birth, low birthweight, size for gestational age, macrosomia, admission to NICU/SCN, total LOS in hospital, and SCN/NICU (all p > 0.05). Future research should explore these associations among ethnically diverse women at earlier stage of pregnancy and include the assessment of food safety practices in the analyses.

Objective: This longitudinal analysis in Australian women evaluated change in diet quality and food and nutrient intakes from the third trimester of pregnancy to 1‐year postpartum with comparison to national nutrition recommendations. Associations between diet quality, sociodemographic and health characteristics were also investigated. Methods: This study was an analysis of data from the ORIGINS pregnancy cohort (2017–2023). Participants included were those with complete dietary data at both timepoints, aged ≥ 19 years, and not pregnant 1‐year postpartum. Dietary intake was assessed using the Australian Eating Survey food frequency questionnaire, and diet quality using the Australian Recommended Food Score (ARFS). Participants self‐reported sociodemographic data, and health data were obtained from hospital medical records. Paired sample t ‐tests analysed change in diet quality and dietary intake, and linear regression estimated associations between maternal characteristics and diet quality. Food group and nutrient intakes were compared to recommendations in the Australian Guide to Healthy Eating and Nutrient Reference Values. Results: Of 337 women (33.1 (4.5) years, 49.9% Australian‐born, 51.3% university educated), mean (95% CI) diet quality was suboptimal during pregnancy and 1‐year postpartum (ARFS 34.0 (33.0, 35.0) vs. 34.8 (33.8, 35.8) points out of 73, p = 0.038). Higher serves of vegetables and meat, energy intake from protein, and intake of retinol equivalents, and less fruit, dairy, carbohydrate, saturated fat, iodine and folate were consumed 1‐year postpartum ( p < 0.05). Alignment with recommendations was low during pregnancy and 1‐year postpartum for food groups, macronutrients and key micronutrients. Lower diet quality during and after pregnancy was linked to not having had a university education, and a higher pre‐pregnancy BMI. Postpartum, younger age and lower income was also associated with poorer diet quality and having a BMI in the overweight category before pregnancy ( p < 0.05). Conclusion: These findings highlight persistent nutritional inadequacies and social disparities, and the urgent need for targeted, evidence‐based nutrition interventions to improve diet quality and nutrient intakes in pregnant and postpartum women, particularly younger women with lower education and income, and those with a higher pre‐pregnancy BMI.

To review the impact of culinary nutrition interventions delivered online, in improving participants' cooking and/or food skills. A systematic search strategy was developed to identify eligible studies across five electronic databases. Experimental studies with an online culinary nutrition intervention were included. Study characteristics and outcomes were extracted from eligible studies by one reviewer and checked by a second. A narrative synthesis of results from eligible studies were prepared including descriptive statistics. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A total of 29 (15 pre-post, 5 quasi-experimental, 6 randomized controlled trials) studies were included. Significant improvements were reported in cooking and/or food skill outcomes self-efficacy (5 of 11 studies), confidence (3 of 7), cooking and/or food skills (3 of 8), knowledge (2 of 7), cooking intentions or frequency (1 of 5), and attitudes and behaviors (3 of 6). Study findings were mixed for the impact of culinary nutrition interventions on cooking and/or food skills. The precise effect of these interventions delivered online is limited by the quality and duration of the intervention. Systematic review registration OSF DOI: https://doi.org/10.17605/OSF.IO/HT29W.

Background: In 2015, the Australian Diabetes Alliance Program (DAP) was implemented in the Hunter New England Local Health District, New South Wales as a collaboration with the Hunter Medicare Local. DAP integrates specialist teams within primary care practices, delivering case conferencing, practice performance reviews, and education sessions. Objective: To report on practice nurses (PNs) perspectives on the impact of the DAP on their skills, knowledge, and approach in delivering care for adults with type 2 diabetes. Methods: Three primary care practices with high rates of monitoring haemoglobin A1c (HbA1c) levels (> 90% of patients annually) and three practices with lower rates of monitoring HbA1c levels (< 80% of patients annually) from DAP provided the sampling frame. Interviews were conducted with six PNs, which were transcribed and analysed using codebook thematic analysis. Results: Overall, DAP was viewed favourably by PNs. Significant improvements in knowledge and skills were reported relating to administering antihyperglycemic agents, insulin, and other injectable therapy, as well as dietary modifications for diabetes management. PNs transferred this knowledge and skills to other patients not participating in DAP. An improvement in the delivery of diabetes care, rather than a change in approach, was also reported by PNs. However, the amount of preparation required for case conferencing in the program was identified as a burden to PNs. Conclusions: PNs were supportive of DAP and identified knowledge gains that were transferable to other patients. The administrative burdens on PNs need to be considered for scalability of the program.

Research conducted over two decades ago indicated that more frequent consumption of foods potentially harbouring Listeria monocytogenes is associated with higher nutrient intakes but also higher risk of miscarriage. However, the influence of potential exposure to Listeria monocytogenes on pregnant women's diet quality is yet to be examined. Additionally, advancements in agricultural practices and food consumption trends in recent years may have led to changes in pregnant women's dietary intake. Therefore, the present study aimed to evaluate the associations between potential L. monocytogenes exposure and dietary quality, and dietary intake in two contemporary cohorts of pregnant women in Australia. A secondary analysis of two combined pregnancy cohorts of women aged ≥ 19 years with a singleton pregnancy from the Newcastle, New South Wales (n = 441) and Perth, Western Australia (n = 1197) was conducted. Potential L. monocytogenes exposure was estimated by the Listeria Food Exposure Score (LFES), dietary intake was assessed using the Australian Eating Survey and diet quality using the Australian Recommended Food Score. Pearson's correlation and linear regression analyses were performed to estimate the associations between potential L. monocytogenes exposure and dietary quality and intake, with adjustment for potential confounders. Data from 1638 women (mean [SD] age 32.0 [5.0] years, 57.8% born in Australia) were included. The median (IQR) gestational age was 35 (34-36) weeks and 43.5% of women had no prior pregnancies. A higher LFES (i.e., more frequent consumption of potential food sources of L. monocytogenes) was significantly associated with higher diet quality score (r = 0.60, p < 0.001), higher intakes of nutrient-dense core foods (r = 0.11-0.43, p < 0.001), and higher micronutrient intakes (r = 0.24-0.52, all p < 0.001). More frequent consumption of foods that potentially harbour Listeria monocytogenes is associated with higher diet quality and nutrient intakes. Further research is needed to identify how to support women to achieve optimal diet quality and nutrient intakes while simultaneously minimising risk of listeriosis.

Background: Research conducted over two decades ago indicated that more frequent consumption of foods potentially harbouring Listeria monocytogenes is associated with higher nutrient intakes but also higher risk of miscarriage. However, the influence of potential exposure to Listeria monocytogenes on pregnant women's diet quality is yet to be examined. Additionally, advancements in agricultural practices and food consumption trends in recent years may have led to changes in pregnant women's dietary intake. Therefore, the present study aimed to evaluate the associations between potential L. monocytogenes exposure and dietary quality, and dietary intake in two contemporary cohorts of pregnant women in Australia.Methods: A secondary analysis of two combined pregnancy cohorts of women aged ≥ 19 years with a singleton pregnancy from the Newcastle, New South Wales (n = 441) and Perth, Western Australia (n = 1197) was conducted. Potential L. monocytogenes exposure was estimated by the Listeria Food Exposure Score (LFES), dietary intake was assessed using the Australian Eating Survey and diet quality using the Australian Recommended Food Score. Pearson's correlation and linear regression analyses were performed to estimate the associations between potential L. monocytogenes exposure and dietary quality and intake, with adjustment for potential confounders.Results: Data from 1638 women (mean [SD] age 32.0 [5.0] years, 57.8% born in Australia) were included. The median (IQR) gestational age was 35 (34–36) weeks and 43.5% of women had no prior pregnancies. A higher LFES (i.e., more frequent consumption of potential food sources of L. monocytogenes) was significantly associated with higher diet quality score (r = 0.60, p < 0.001), higher intakes of nutrient‐dense core foods (r = 0.11–0.43, p < 0.001), and higher micronutrient intakes (r = 0.24–0.52, all p < 0.001).Conclusion: More frequent consumption of foods that potentially harbour Listeria monocytogenes is associated with higher diet quality and nutrient intakes. Further research is needed to identify how to support women to achieve optimal diet quality and nutrient intakes while simultaneously minimising risk of listeriosis.