Assessment of diet in large epidemiological studies can be costly and time consuming. An automated dietary assessment system could potentially reduce researcher burden by automatically coding food records. myfood24 (Measure Your Food on One Day) an online 24-h dietary assessment tool (with the flexibility to be used for multiple 24 h-dietary recalls or as a food diary), has been developed for use in the UK population. Development of myfood24 was a multi-stage process. Focus groups conducted with three age groups, adolescents (11–18 years) (n = 28), adults (19–64 years) (n = 24) and older adults (≥65 years) (n = 5) informed the development of the tool, and usability testing was conducted with beta (adolescents n = 14, adults n = 8, older adults n = 1) and live (adolescents n = 70, adults n = 20, older adults n = 4) versions. Median system usability scale (SUS) scores (measured on a scale of 0–100) in adolescents and adults were marginal for the beta version (adolescents median SUS = 66, interquartile range (IQR) = 20; adults median SUS = 68, IQR = 40) and good for the live version (adolescents median SUS = 73, IQR = 22; adults median SUS = 80, IQR = 25). Myfood24 is the first online 24-h dietary recall tool for use with different age groups in the UK. Usability testing indicates that myfood24 is suitable for use in UK adolescents and adults.

Current academic literature suggests that school gardening programmes can provide an interactive environment with the potential to change children’s fruit and vegetable intake. This is the first cluster randomised controlled trial (RCT) designed to evaluate whether a school gardening programme can have an effect on children’s fruit and vegetable intake. The trial included children from 23 schools; these schools were randomised into two groups, one to receive the Royal Horticultural Society (RHS)-led intervention and the other to receive the less involved Teacher-led intervention. A 24-hour food diary (CADET) was used to collect baseline and follow-up dietary intake 18 months apart. Questionnaires were also administered to evaluate the intervention implementation. A total of 641 children completed the trial with a mean age of 8.1 years (95% CI: 8.0, 8.4). The unadjusted results from multilevel regression analysis revealed that for combined daily fruit and vegetable intake the Teacher-led group had a higher daily mean change of 8 g (95% CI: −19, 36) compared to the RHS-led group -32 g (95% CI: −60, −3). However, after adjusting for possible confounders this difference was not significant (intervention effect: −40 g, 95% CI: −88, 1; p = 0.06). The adjusted analysis of process measures identified that if schools improved their gardening score by 3 levels (a measure of school gardening involvement - the scale has 6 levels from 0 ‘no garden’ to 5 ‘community involvement’), irrespective of group allocation, children had, on average, a daily increase of 81 g of fruit and vegetable intake (95% CI: 0, 163; p = 0.05) compared to schools that had no change in gardening score. This study is the first cluster randomised controlled trial designed to evaluate a school gardening intervention. The results have found very little evidence to support the claims that school gardening alone can improve children’s daily fruit and vegetable intake. However, when a gardening intervention is implemented at a high level within the school it may improve children’s daily fruit and vegetable intake by a portion. Improving children’s fruit and vegetable intake remains a challenging task. ISRCTN11396528

Background: Screening with low-dose computed tomography (LDCT) reduces lung cancer mortality; however, the most effective strategy for optimising participation is unknown. Here we present data from the Yorkshire Lung Screening Trial, including response to invitation, screening eligibility and uptake of community-based LDCT screening.Methods: Individuals aged 55–80 years, identified from primary care records as having ever smoked, were randomised prior to consent to invitation to telephone lung cancer risk assessment or usual care. The invitation strategy included general practitioner endorsement, pre-invitation and two reminder invitations. After telephone triage, those at higher risk were invited to a Lung Health Check (LHC) with immediate access to a mobile CT scanner.Results: Of 44 943 individuals invited, 50.8% (n=22 815) responded and underwent telephone-based risk assessment (16.7% and 7.3% following first and second reminders, respectively). A lower response rate was associated with current smoking status (adjusted OR 0.44, 95% CI 0.42–0.46) and socioeconomic deprivation (adjusted OR 0.58, 95% CI 0.54–0.62 for the mostversusthe least deprived quintile). Of those responding, 34.4% (n=7853) were potentially eligible for screening and offered a LHC, of whom 86.8% (n=6819) attended. Lower uptake was associated with current smoking status (adjusted OR 0.73, 95% CI 0.62–0.87) and socioeconomic deprivation (adjusted OR 0.78, 95% CI 0.62–0.98). In total, 6650 individuals had a baseline LDCT scan, representing 99.7% of eligible LHC attendees.Conclusions: Telephone risk assessment followed by a community-based LHC is an effective strategy for lung cancer screening implementation. However, lower participation associated with current smoking status and socioeconomic deprivation underlines the importance of research to ensure equitable access to screening.

The current UK food composition tables are limited, containing ~3300 mostly generic food and drink items. To reflect the wide range of food products available to British consumers and to potentially improve accuracy of dietary assessment, a large UK specific electronic food composition database (FCDB) has been developed. A mapping exercise has been conducted that matched micronutrient data from generic food codes to “Back of Pack” data from branded food products using a semi-automated process. After cleaning and processing, version 1.0 of the new FCDB contains 40,274 generic and branded items with associated 120 macronutrient and micronutrient data and 5669 items with portion images. Over 50% of food and drink items were individually mapped to within 10% agreement with the generic food item for energy. Several quality checking procedures were applied after mapping including; identifying foods above and below the expected range for a particular nutrient within that food group and cross-checking the mapping of items such as concentrated and raw/dried products. The new electronic FCDB has substantially increased the size of the current, publically available, UK food tables. The FCDB has been incorporated into myfood24, a new fully automated online dietary assessment tool and, a smartphone application for weight loss.

The UK government has called for industry reformulation of foods that contribute most to sugar consumption in children’s diets, including yogurts. The aim of this work was to comprehensively survey yogurt products available in UK supermarkets in 2019 to determine whether sugar contents had been reduced since our baseline survey in 2016. Product information was collected for 893 unique yogurt, fromage frais and dairy dessert products, and nutrient contents were analysed in comparison to those previously examined. Examining all products, there was a highly significant (p < 0.0001) reduction in the median total sugar contents in 2019 compared to those in 2016: median (interquartile range): 10.4 g/100 g (6.6, 13.0) versus 11.9 g/100 (8.8, 13.6). However, notable product turnover was evident; while 60% of the 2019 products surveyed could be matched by brand and name to 2016, 40% were new. In scrutinising paired products closely, only 32% (173 of 539) had reduced sugar contents with a smaller mean difference of −0.65 g/100 g (p < 0.0001), suggesting that the overall median had dropped as a result of higher sugar products being discontinued. Categories showing the most improvements were children’s, drinks and fruit yogurts. Although only 15% of the 2019 products contained ≤5 g/100 g sugars, considered a ‘low-sugar’ product for labelling, this was an improvement over the 9% identified in 2016. Our results yield important insights into current market trends and demonstrate that the median sugar content of UK yogurt products has been reduced by 13% in two years. These data independently evidence modest, but encouraging changes in response to public policy initiatives aimed at preventing childhood obesity.

Our aim was to develop and evaluate a German adaptation of myfood24, a fully automated, web-based 24-h dietary recall (24HDR). To complete a self-administered 24HDR with myfood24, users have to search and enter consumed foods within the underlying database by a free text search. The adaptation process thus mainly consisted of the development of an appropriate food database. myfood24-Germany was evaluated in 92 adults aged 17–78 years (study 1). Participants completed four non-consecutive 24HDRs and answered an evaluation questionnaire after the final recall. The System Usability Scale Score (SUS Score, 0–100) was calculated. Users’ search behavior was examined with screen recordings in 15 adults aged 20–60 years (study 2). Participants had to enter three sample meals presented as food packaging or pictures. The final database included 11,501 food items (7203 generic and 4298 branded items) with up to 131 nutrients. In study 1, the median completion time for a 24HDR was 15 min. The median SUS score of 78 indicated good usability. The majority of participants considered the overall user-friendliness as good (46%) or very good (21%), and 75% were willing to use myfood24-Germany regularly. Both studies showed that finding and choosing an appropriate item within the database was a major challenge. A German version of myfood24 was successfully developed. The user evaluation indicated a short completion time, good usability and acceptability of the tool, and confirmed its feasibility for repeated short-term application.