Background: The prevalence of obesity has increased substantially over recent decades and is associated with considerable health inequalities. Although the causes of obesity are complex, key drivers include overconsumption of highly palatable, energy-dense, and nutrient-poor foods, which have a profound impact on the composition and function of the gut microbiome. Alterations to the microbiome may play a critical role in obesity by affecting energy extraction from food and subsequent energy metabolism and fat storage.Objective: We report the study protocol and recruitment strategy of the PRedictors linking Obesity and the gut MIcrobiomE (PROMISE) study, which characterizes the gut microbiome in 2 populations with different metabolic disease risk (Pacific and European women) and different body fat profiles (normal and obese). It investigates (1) the role of gut microbiome composition and functionality in obesity and (2) the interactions between dietary intake; eating behavior; sweet, fat, and bitter taste perception; and sleep and physical activity; and their impact on the gut microbiome, metabolic and endocrine regulation, and body fat profiles.Methods: Healthy Pacific and New Zealand (NZ) European women aged between 18 and 45 years from the Auckland region were recruited for this cross-sectional study. Participants were recruited such that half in each group had either a normal weight (body mass index [BMI] 18.5-24.9 kg/m2) or were obese (BMI ≥30.0 kg/m2). In addition to anthropometric measurements and assessment of the body fat content using dual-energy x-ray absorptiometry, participants completed sweet, fat, and bitter taste perception tests; food records; and sleep diaries; and they wore accelerometers to assess physical activity and sleep. Fasting blood samples were analyzed for metabolic and endocrine biomarkers and DNA extracted from fecal samples was analyzed by shotgun sequencing. Participants completed questionnaires on dietary intake, eating behavior, sleep, and physical activity. Data were analyzed using descriptive and multivariate regression methods to assess the associations between dietary intake, taste perception, sleep, physical activity, gut microbiome complexity and functionality, and host metabolic and body fat profiles.Results: Of the initial 351 women enrolled, 142 Pacific women and 162 NZ European women completed the study protocol. A partnership with a Pacific primary health and social services provider facilitated the recruitment of Pacific women, involving direct contact methods and networking within the Pacific communities. NZ European women were primarily recruited through Web-based methods and special interest Facebook pages.Conclusions: This cross-sectional study will provide a wealth of data enabling the identification of distinct roles for diet, taste perception, sleep, and physical activity in women with different body fat profiles in modifying the gut microbiome and its impact on obesity and metabolic health. It will advance our understanding of the etiology of obesity and guide future intervention studies involving specific dietary approaches and microbiota-based therapies.Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618000432213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370874International Registered Report Identifier (IRRID): RR1-10.2196/14529

Background/Objectives: To assess associations between dietary fibre intake, adiposity, and odds of metabolic syndrome in Pacific and New Zealand European women. Methods: Pacific (n = 126) and New Zealand European (NZ European; n = 161) women (18–45 years) were recruited based on normal (18–24.9 kg/m²) and obese (≥30 kg/m²) BMIs. Body fat percentage (BF%), measured using whole body DXA, was subsequently used to stratify participants into low (<35%) or high (≥35%) BF% groups. Habitual dietary intake was calculated using the National Cancer Institute (NCI) method, involving a five-day food record and semi-quantitative food frequency questionnaire. Fasting blood was analysed for glucose and lipid profile. Metabolic syndrome was assessed with a harmonized definition. Results: NZ European women in both the low- and high-BF% groups were older, less socioeconomically deprived, and consumed more dietary fibre (low-BF%: median 23.7 g/day [25–75-percentile, 20.1, 29.9]; high-BF%: 20.9 [19.4, 24.9]) than Pacific women (18.8 [15.6, 22.1]; and 17.8 [15.0, 20.8]; both p < 0.001). The main source of fibre was discretionary fast foods for Pacific women and whole grain breads and cereals for NZ European women. A regression analysis controlling for age, socioeconomic deprivation, ethnicity, energy intake, protein, fat, and total carbohydrate intake showed an inverse association between higher fibre intake and BF% (β= −0.47, 95% CI = −0.62, −0.31, p < 0.001), and odds of metabolic syndrome (OR = 0.91, 95% CI = 0.84, 0.98, p = 0.010) among both Pacific and NZ European women (results shown for both groups combined). Conclusions: Low dietary fibre intake was associated with increased metabolic disease risk. Pacific women had lower fibre intakes than NZ European women.

We examined content posted on TikTok on the topic of kai Māori (traditional food and associated customs of the indigenous people of Aotearoa New Zealand) to inform strengths‐based approaches to health promotion in Māori communities. We conducted a content analysis of 100 unique TikTok videos labelled with the hashtags #kai and #Maori and coded content characteristics and viewer engagement for each video. Twenty foods were determined to be key Māori identity foods from this analysis. We also undertook a reflexive thematic analysis of the content of all videos and user engagement from a sample of 40 videos. Three themes relating to the value of kai Māori were identified: Mauri ora (kai as an expression of pride in Māori identity), Ahikā kai (a means of keeping traditions alive) and Tūhononga (a means of connecting with Te Ao Māori). Māori used TikTok to celebrate Māori identity by sharing and discussing content about kai Māori that was informative and often humorous or self‐deprecating. Health promotion in Māori communities should draw on the values of kai as more than food. Kai has an important role in strengthening wellbeing through facilitating cultural connections and linking healthy lifestyles with traditional practices like collecting seafood. Glossary of Māori words: Ahikā kai: keeping Māori traditions alive; Ahuriri: Napier, Aotearoa New Zealand; Aotearoa NZ: Aotearoa New Zealand; aroha: love; atua: deity, ancestor; ehe: e hē: an expression of no in Ngāi Tūhoe Iwi [tribe] dialect; hāngī: food cooked in an earth steam oven or gas steamer; he kai reka tenei: this food is yum or sweet; he tīno reka: very yummy; he reka: yum, sweet; huhu: huhu grub, Prionoplus reticularis; kai: food; kai Māori: traditional food and associated customs; kaimoana: food from the sea including fish and shellfish; kaitiaki: custodians, guardians; kānga wai/ kānga pirau: fermented ‘rotten’ corn; kamokamo: squash, vegetable marrow; kao: no; karakia: blessing, giving thanks; kare: an endearment; karengo /parengo: seaweed; kaupapa Māori: a Māori approach, Māori philosophy and principles guide practice; kia ora: hello, greetings, thank you; kina: sea urchin; koro:grandfather; kumara: sweet potato; kupu: word; kūtai: mussels; inanga: whitebait; mahinga kai: traditional food gathering place; mana whenua: Māori people who have customary authority and rights over identified land; manaakitanga: the act of showing support, caring for others; Māoritanga: Māori culture, way of life; mātua: parents; marae: a place of cultural significance to gather and meet; mauri: spirit, life essence; mauri ora: strong pride in having a unique Māori identity; meke: too much, good; mirimiri: to rub; moana: ocean; Ngāpuhi: northern iwi [tribe] of Aotearoa; noa: ordinary, unrestricted; ora: to be alive, healthy and well; Pākehā: New Zealanders of European descent; paraoa: fry bread; patu: traditional club used in warfare; paua: abalone; pikopiko: young fern shoots; pipi: shellfish, clam; puha: a sow thistle green; Rakiura: Stewart Island; rangatahi: Māori youth; rawe: excellent; reka: sweet; rēwana: fermented bread made with potato; Tā: Sir, Knight; tamariki Māori: Māori children; Tangaroa: the Māori atua (god) for the oceans; tapu: restricted, to be sacred, under atua protection; tautoko: show support; Te Ao Māori: the Māori world and its traditions; te taiao: the natural world; Te Whare Tapa Whā: a model of Māori health developed by Tā Professor Mason Durie; tēnā koe: greetings (speaking to an individual); tikanga: traditional customs or practices; tinana: body, physical self; tino reka: an expression of deliciousness; tino reka te kai: the kai is yum; tītī: mutton bird Puffinus griseus; toa: brave, accomplished, competent; toheroa: large clam;f toroi / whakamara: a fermented dish of cooked mussels and puha; tuatua: shellfish, clam; tūhononga: connecting with Te Ao Māori; tuna: eel; tūpuna / tīpuna: ancestors, grandparents; wahine: woman; Whaea: Mother, Aunty; whakaiti: look down on; whakapapa: lineage, genealogy, ancestry; a central concept in Māori culture of identity, relation and connection to people, place, and culture; whānau: family group, including extended family; whanaunga: relative, kin; whanaungatanga: relationship building; whenua: land, ground

Objectives: To explore how revitalization of mahinga kai practices (traditional foodways) in Aotearoa New Zealand can advance wellbeing, socioeconomic equity, and food sovereignty for Māori (the indigenous peoples). Background: Food sovereignty resonates strongly with many indigenous peoples, including Māori, yet its meaning is not always clear. This research sought to understand aspirations for indigenous food sovereignty and identify actionable strategies that can be supported through research, policy, and tribal initiatives. Methods: Guided by Kaupapa Māori research principles, the study comprised two phases. Phase 1 involved a focus group exploring whānau Māori experiences of a māra kai (community garden) initiative in relation to wellbeing. Phase 2 examined perspectives and values concerning mahinga kai and food sovereignty. Reflexive thematic analysis was used to identify shared meanings and practices. Results: Three themes identified explained how mahinga kai advances Māori wellbeing: Reclaiming mātauranga (restoring food knowledge and practices disrupted by colonization), Reconnection to ancestral whenua (strengthening whakapapa links between people, ancestors, and land), and Restoration of Papatūānuku (nurturing the earth mother to sustain current and future generations). Food sovereignty was understood not as a return to pre‑European diets, but as an adaptive system that honors tikanga Māori while embracing contemporary realities. Traditional foods remain culturally significant, yet mahinga kai also incorporates introduced species, reflecting that cultural meaning lies in how food is produced, shared, and sustained within Māori values and knowledge systems. The Mahinga Kai Framework: Enacting Food Sovereignty was developed, which organizes principles and outcomes into four interconnected domains: cultural identity, environmental stewardship, system‑level participation, and healthy everyday lifestyles. Together, these domains illustrate how mahinga kai sustains oranga (health and wellbeing). Conclusions: Mahinga kai emerged as a living expression of food sovereignty, deeply grounded in cultural values yet responsive to contemporary realities. The framework demonstrates its potential to advance wellbeing and equity.

Diet is considered one of the key drivers of the world-wide obesity epidemic, and the gut microbiota may play a role in this multifaceted disease due to their mutualistic relationship. This study investigated relationships between habitual dietary intake of New Zealand European and Pacific women and their gut microbiota and body fat content. Pacific (44%) and NZ European (NZE; 56%) women (n = 287) aged 18–45 years were recruited based on body mass index (normal versus obese) and stratified as low (< 35%) or high (≥ 35%) body fat percentage (BF%). Dietary intake was assessed with a 5-day estimated food record and a semi-quantitative food frequency questionnaire, which were used to calculate habitual dietary intake using the National Cancer Institute (NCI) method. BF% was assessed by dual-energy x-ray absorptiometry (DXA). Fasting blood samples were analysed for markers of insulin sensitivity. The DNA from faecal samples was analysed following shotgun sequencing. There were no significant differences in BF% between Pacific and NZE women (p = 0.498). Significant differences in homeostasis model assessment of insulin resistance (HOMA-IR) index were observed between Pacific (3.4 [2.3, 5.9]) and NZE (2.1 [1.5, 3.1], p ≤ 0.001) women, and between; low-BF% (1.9 [1.3, 2.7]) and high-BF% (3.4 [2.5, 5.9], p ≤ 0.001) groups. The highest (27.6g/d [24.9, 30.6]) compared to the lowest tertile (16g/d [13.3, 17.6]) of habitual total dietary fibre (DF) intake was associated with a significantly lower HOMA-IR (2.1 [1.3, 3.1] versus 3.3 [2.1, 5.3] p ≤ 0.001) respectively. Higher DF intake was also associated with significantly lower BF% (β -0.35, p ≤ 0.001), and this relationship became stronger when considering the intake of other macronutrients (β -0.47, p ≤ 0.001). Alpha diversity; observed taxonomic units (OTU's; rs = -0.15, p = 0.011), Pielou's evenness (rs = -0.20, p = 0.001), and Shannon index (rs = -0.22, p ≤ 0.001), were all negatively correlated with BF%. In contrast BF% was positively correlated with the Firmicutes:Bacteroidetes ratio (rs = 0.26, p ≤ 0.001). HOMA-IR index was significantly higher in Pacific and women in the higher BF% group, indicating an increased metabolic disease risk. Higher habitual DF intake was associated with lower BF% and HOMA-IR, suggesting a potential metabolically protective effect. The positive effects of higher DF intake may be associated with microbiota diversity, as higher BF% was associated with reduced alpha diversity and an increased Firmicutes:Bacteroidetes ratio. Further analysis will explore which foods contributed to the higher DF intake, and associations with body composition, microbiota and biomarkers of metabolic health.

Aims: This study aimed to explore the experiences of Māori dietitians and students in Aotearoa New Zealand, with a focus on how racism, marginalism and tokenism affect their training, workplaces and wellbeing. Methods: A kaupapa Māori community research approach was undertaken in partnership with Te Kāhui Manukura o Kai Ora (Māori Dietitians Association). A focus group was held with Māori dietitians and students in March 2024. Data were analysed using reflexive thematic analysis, guided by kaupapa Māori research principles. Candidate themes were then shared with participants in March 2025, and a dissemination strategy was co‐designed to protect anonymity. Composite narratives were then developed to illustrate how individual experiences connect to systemic issues. Results: Three composite narratives were developed to highlight shared experiences of racism, tokenism and marginalism across the dietetic journey. Participants described culturally unsafe training environments where deficit stereotypes and staff silence placed additional burdens on Māori students. In workplaces, participants observed Māori patients being subject to inequitable care shaped by racialised assumptions, while Māori dietitians often carried the cultural load of being positioned as ‘the Māori voice’ without adequate support. These pressures contributed to isolation, burnout and challenges to professional identity, belonging and wellbeing. Conclusion: Systemic racism underpins these experiences, creating culturally unsafe environments and unsustainable cultural loading for Māori dietitians and students. Addressing these issues requires profession‐wide action to strengthen cultural safety, support the retention and wellbeing of Māori within dietetics.