In 2023, the UK government announced a Major Conditions Strategy, publishing ‘The case for change and our strategic framework’, which set out the focus on cancers, diabetes, dementia, mental ill health, musculoskeletal disorders, CVD and chronic respiratory diseases. Together, these conditions account for 60% of total disability-adjusted life years lost to early death or ill health in England, and one in four adults has at least two (multimorbidity). This review considers some of the key dietary risks for these major conditions and population policies that may improve diets and reduce risks. UK Government dietary recommendations, based on independent risk assessment and advice from the Scientific Advisory Committee on Nutrition, are encapsulated in the national food model, the Eatwell Guide. Based on key sources of dietary data – chiefly consumption data from the National Diet and Nutrition Survey and consumer purchase data from Kantar – most people do not meet dietary recommendations. This review considers how science and evidence inform health improvement policy. This includes policies that encourage healthier food choices, such as labelling and public procurement standards to those that minimise the impact of the less healthy choice such as sugar and salt reduction and reformulation. The review also considers nutritional approaches to managing some non-communicable diseases. Given the role nutrition and excess weight play in the onset, prognosis and quality of life for those living with one or more of the major conditions, there are huge potential gains from even small dietary improvements across population groups.

To investigate the associations between dietary patterns and biological aging, identify the most recommended dietary pattern for coping with biological aging and explore the potential mediating role of gut microbiota in less-developed ethnic minority regions (LEMRs). This prospective cohort study included 8288 participants aged 30-79 years from the China Multi-Ethnic Cohort study (CMEC). Anthropometric measurements and clinical biomarkers were utilized to construct biological age based on Klemera and Doubal’s method (KDM-BA) and KDM-BA acceleration (KDM-AA). Dietary information was obtained through the baseline food frequency questionnaire (FFQ). Six dietary patterns were constructed: plant-based diet index (PDI), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI), healthy diet score (HDS), Dietary Approaches to Stop Hypertension (DASH), and alternative Mediterranean diets (aMED). Follow-up adjusted for baseline analysis were employed to assess the associations between dietary patterns and KDM-AA. Additionally, quantile G-computation was utilized to evaluate the significant beneficial and harmful food groups. In the subsample of 764 participants with gut microbiota data obtained through 16S rRNA gene sequencing, we used causal mediation model to explore the mediating role of gut microbiota in the associations between dietary patterns and KDM-AA. The results showed that all dietary patterns were associated with KDM-AA. Transitioning from non-compliance to compliance, DASH exhibited the strongest negative association with KDM-AA [β = -0.91, 95%CI (-1.19, -0.63)]. The component analyses revealed that tea and soybean products were the significant beneficial food groups, while salt, preserved vegetables, red and processed meats were identified as the major harmful food groups. In mediation analysis, the decreased abundance of Synergistetes phylum and Pyramidobacter genus possibly mediated the negative associations between plant-based diets and KDM-AA (5.61%-9.19%). Overall, healthy dietary patterns, especially DASH, are negatively associated with biological aging in LEMRs. The Synergistetes and Pyramidobacter may mediate the associations between plant-based diets and biological aging. Developing appropriate strategies may promote healthy aging in LEMRs.

People living with mental illness report a broad spectrum of nutrition risks, beyond malnutrition, but appropriate and adequately validated nutrition risk screening tools for mental health settings are lacking. This study aimed to develop a nutrition-risk screening tool, the NutriMental Screener, and to perform preliminary feasibility and validity testing. In an international, stakeholder engaging approach, a multifaceted nutrition-risk screening tool for mental health services was developed by means of workshops with international stakeholders and two online surveys. Feasibility of the NutriMental screener was tested as part of a research study in Switzerland with 196 participants, evenly distributed across the three study groups (sixty-seven outpatients and sixty-five inpatients with psychotic or depressive disorders as well as sixty-four controls without mental illness). The NutriMental screener consists of ten items covering different nutritional issues that indicate the need for referral to a dietitian or clinical nutritionist. Almost all patients (94·7 %) reported at least one nutrition risk by means of the NutriMental screener. Prevalence for nutrition risks via NutriMental screener was higher in patients than in controls. Almost every second patient expressed a desire for nutritional support (44·7 %). After further validity testing is completed, there is the potential for the NutriMental Screener to replace malnutrition screening tools as routine screening in various mental health settings aiming to organise nutritional therapy prescriptions in a more targeted and efficient manner.

The aim of this study is to estimate the minimum prevalence of intestinal parasites in the population of Roman London through analysis of pelvic sediment from 29 third- to fourth-century burials from the 1989 excavations of the western cemetery at 24–30 West Smithfield, 18–20 Cock Lane and 1–4 Giltspur Street (WES89). Microscopy was used to identify roundworm eggs in 10.3 per cent of burials. We integrate these results with past palaeoparasitological work in the province of Britannia to explore disease, hygiene and diet. The most commonly found parasites (whipworm and roundworm) were spread by poor sanitation, but other species caught from animals were also present (fish tapeworm, beef/pork tapeworm and liver flukes). Parasite diversity was highest in urban sites. The health impacts of these infections range from asymptomatic to severe.

This study aimed to assess hemoglobin concentration and its association with oral contraceptive (OC) use, food insecurity (FI) and dietary iron availability (DIA) in adult women of reproductive age (20–44 years). This is a population-based cross-sectional study that analysed 505 women living in favelas and urban communities in a capital city in northeastern Brazil. Hemoglobin concentration was determined using capillary blood samples. FI and DIA were assessed using the Brazilian Food Insecurity Scale and the 24-h food recall, respectively. Association analysis was carried out using logistic regression. A directed acyclic graph (DAG) was designed to illustrate the causal paths between hemoglobin concentration and DIA. A significance level of 5 % was adopted. Low hemoglobin concentrations (11·2 g/dl: (1·79)) and a high prevalence of anaemia (64·0 %) were observed; 28·7 % used OC (28·7 %) and 76·4 % were in FI. An average energetic intake of 1495 kcal/d (482·0) and 0·46 mg/d (0·27) of DIA were also observed. In the DAG-guided multivariable analysis, it was observed that hemoglobin concentrations ≥ 12 mg/dl were directly associated with higher DIA (OR: 1·67; 95 % CI (1. 08, 2·59)) and OC use (OR: 1·67; 95 % CI (1·10, 2·55)) and inversely associated with mild FI (OR: 0·60; 95 % CI (0·37, 0·96)) or severe FI (OR: 0·37; 95 % CI: (0·18, 0·76)). Women taking OC and with a higher DIA were less likely to have low hemoglobin concentrations, while those in the context of FI were in the opposite situation.

High dietary salt intake is a known risk factor for hypertension. However, Australians continue to consume excessive amounts of salt. The purpose of this study was to identify barriers, enablers and strategies to reduce salt in a sample of Australian adults with hypertension. This was a qualitative study. Participants were asked a set of open-ended questions during focus groups conducted between October 2020 and April 2021. Sessions were recorded and transcribed. Using an inductive approach, the transcript data from the focus groups were thematically analysed. This involved checking accuracy, becoming familiar with the data, coding responses based on questions, identifying themes through common patterns and validating themes by grouping similar questions that represented the data and study aim effectively. Thirty-one adults (55 % females) with high blood pressure participated in the focus group discussions. Participants demonstrated good knowledge of high blood pressure risk factors but lacked an understanding of recommended salt intake levels and sources of hidden salt. Challenges in reducing salt intake included the limited availability of low-salt commercial foods. Participants suggested improved food labelling and the use of technology-based interventions to promote healthier choices. Findings highlight the need for behavioural interventions, policy reforms and collaborations between the government, food industries and health organisations to address high salt intake in the population.

Maternal diet may modulate human milk microbiota, but the effects of nutritional supplements are unknown. We examined the associations of prenatal diet and supplement use with milk microbiota composition. Mothers reported prenatal diet intake and supplement use using self-administered food frequency and standardised questionnaires, respectively. The milk microbiota was profiled using 16S rRNA gene sequencing. Associations of prenatal diet quality, dietary patterns, and supplement use with milk microbiota diversity and taxonomic structure were examined using Wilcoxon signed-rank tests and multivariable models adjusting for relevant confounders. A subset of 645 mothers participating in the CHILD Cohort Study (originally known as the Canadian Healthy Infant Longitudinal Development Study) provided one milk sample between 2 and 6 months postpartum and used prenatal multivitamin supplements ≥4 times a week. After adjusting for confounders, vitamin C supplement use was positively associated with milk bacterial Shannon diversity (β = 0.18, 95% CI = 0.05, 0.31) and Veillonella and Granulicatella relative abundance (β = 0.54; 95% CI = 0.05, 1.03 and β = 0.44; 95% CI = 0.04, 0.84, respectively), and negatively associated with Finegoldia relative abundance (β = –0.31; 95% CI = –0.63, –0.01). Fish oil supplement use was positively associated with Streptococcus relative abundance (β = 0.26; 95% CI = 0.03, 0.50). Prenatal diet quality and dietary patterns were not associated with milk microbiota composition. Prenatal vitamin C and fish oil supplement use were associated with differences in the milk microbiota composition. Future studies are needed to confirm our findings and elucidate mechanisms linking maternal supplement use to milk microbiota and child health.

Climate change stands as the paramount challenge confronting humanity in the contemporary era. Attempting to address the problem, the main sectors responsible for it have been subject to domestic or international policies and laws aimed at reducing greenhouse gas (GHG) emissions, except one: livestock. Given that animal-sourced food production contributes a large portion of GHG emissions, this Article aims to analyze the impacts that the exclusion of the livestock sector, in efforts to tackle climate change, would have on compliance with international treaties on the subject, especially the Paris Agreement. One conclusion reveals that state parties, by ignoring the sector, will violate several articles of the Agreement, which will likely lead to the failure of its main purpose of holding the increase in the global average temperature to well below 2°C.

It is well documented that Andean bears (Tremarctos ornatus) feed extensively on plants and carrion, but their hunting habits remain understudied. Better understanding and documentation of Andean bear feeding ecology can improve conservation efforts for this vulnerable species. Here, we report an observation of an Andean bear hunting and capturing a wild guinea pig (Cavia aperea) in Chingaza National Natural Park, in Cundinamarca, Colombia. The sighting occurred in January 2023 by a team of conservationists, and we provided photographic evidence and details of the encounter. Our observation suggests that Andean bears are capable hunters of small rodents, indicating that hunting may play a more important role in the ecology of Andean bears than previously appreciated and highlighting the need for a better understanding of this feeding behaviour.

The dietary habits of Neanderthals are considered an issue of great interest in the literature and have opened an important number of fruitful debates. Indeed, understanding diets can provide important information regarding issues of palaeoenvironmental reconstructions and subsistence strategies. In this respect, dental remains can play a vital role in the conducted efforts to reconstruct the palaeoecological niches securely and accurately since dental microwear analyses have precisely detected dietary patterns of the populations in the past. In this context, the Iberian Peninsula forms an interesting model for examining Neanderthal populations, their subsistence strategies, and adaptive skills. This study aims the examination of already published data in order to provide a holistic approach regarding the dietary habits of H. neanderthalensis populations in the Iberian Peninsula, along with the importance of the utilization of dental microwear analysis in the archaeological record.

Optimal diet and nutrition is vital for military readiness, performance and recovery. Previous research on military diets has primarily focused on the nutritional composition of field/combat rations and dietary intake during deployment. There is accumulating research exploring the usual free-living dietary intake and nutritional status of defence members in garrison (i.e. military bases on which personnel are stationed). However, no comprehensive review has been conducted to assess the overall dietary quality of defence members internationally. Therefore, this review assessed the diets of military populations against national nutritional guidelines and Military Dietary Reference Intakes (MDRI). A systematic literature review of original research was conducted. CINAHL, Medline (EBSCO), Scopus (Elsevier), PubMed and AMED databases were searched up to the 20/02/2023. A total of thirty-six studies met the inclusion criteria. The overall quality of included studies was high, with a low risk of bias. The diet quality scores indicate poor to fair diet quality among defence members. Defence members display low intakes of fruits, vegetables, wholegrains, seafood, plant protein and nuts and high intakes of added sugars, trans fat and processed meat. Results also indicated suboptimal intake of fibre, essential fatty acids, vitamin A, vitamin E, folate, Mg, Zn and iodine. This may lead to reduced performance, increased risk of chronic diseases and mental health disorders. More research is needed to assess the long-term consequences of poor diet quality in defence members. These results require the attention of policymakers to ensure that military education and food environment is supportive of healthy eating.

Amino acids (AA) are essential nutrients in human milk (HM) and critical for infant growth and development. Several maternal lifestyle factors have been suggested to influence HM AA composition, with possible consequences for the breastfed infant. Whether maternal dietary protein and AA intake is associated with AA concentrations in HM is still largely unknown. Therefore, the aim of this study was to investigate the association between maternal dietary AA intake and AA concentrations in HM over the first month postpartum. Data from the observational longitudinal Amsterdam Mother’s Milk study were used, consisting of 123 lactating women in their first postpartum month. HM samples were collected three times, on day 10, 17 and 24 postpartum. Maternal dietary protein and AA intake on these collection days was assessed using three 24-h recalls. HM protein-bound and free AA (BAA and FAA, respectively) were analysed by liquid chromatography. Associations between maternal AA intake and AA concentrations in HM were assessed using linear mixed models. Maternal intake was negatively associated with milk concentrations of free arginine (–0·0003; P = 0·01) and free lysine (–0·0004; P = 0·03) and was positively associated with free glutamine (0·002; P = 0·03) and free threonine (0·0008; P = 0·03). However, these associations were attenuated after correction for multiple testing. Both the quality and quantity of dietary protein intake in lactating women do not seem to influence the amino composition of their breast milk when living in an affluent environment.

Early-life family meal participation has been associated with several aspects of nutritional health, but longitudinal associations with linear growth have not yet been investigated. The aim of this study was to investigate whether family meal participation at 12 months of age associates with anthropometric measures 3 years later. We used follow-up data from children born to mothers in the Norwegian Fit for Delivery trial (NFFD) and included 368 first-borns with dietary and anthropometric data at 12 months and 4 years of age. We treated the sample as a cohort and conducted subgroup analyses by randomization status. A family meal participation score was used as exposure, and weight, height, and body mass index (BMI) as outcomes in crude and multivariable linear regression models adjusted for maternal education, randomization status, and child sex.

Higher family meal participation score at 12 months was positively associated with length at 12 months (B = 0.198, 95% CI 0.028, 0.367, p = 0.022) and 4 years (B = 0.283, 95% CI 0.011, 0.555, p = 0.042) in multivariable models. After additional adjustment for maternal height the associations attenuated and were no longer significant. An inverse association with BMI at 4 years of age was observed in children born to mothers that had been exposed to the NFFD intervention (B = −0.144, 95% CI −0.275, −0.014, p = 0.030), but attenuated after adjustment for maternal BMI.

The longitudinal association observed between early family meal participation and child height was largely explained by maternal height. The relationship with BMI differed according to maternal participation in a lifestyle intervention trial during pregnancy.

Oral health is a critical component of overall health and well-being, not just the absence of disease. The objective of this review paper is to describe relationships among diet, nutrition and oral and systemic diseases that contribute to multimorbidity. Diet- and nutrient-related risk factors for oral diseases include high intakes of free sugars, low intakes of fruits and vegetables and nutrient-poor diets which are similar to diet- and nutrient-related risk factors for systemic diseases. Oral diseases are chronic diseases. Once the disease process is initiated, it persists throughout the lifespan. Pain and tissue loss from oral disease leads to oral dysfunction which contributes to impaired biting, chewing, oral motility and swallowing. Oral dysfunction makes it difficult to eat nutrient-dense whole grains, fruits and vegetables associated with a healthy diet. Early childhood caries (ECC) associated with frequent intake of free sugars is one of the first manifestations of oral disease. The presence of ECC is our ‘canary in the coal mine’ for diet-related chronic diseases. The dietary sugars causing ECC are not complementary to an Eatwell Guide compliant diet, but rather consistent with a diet high in energy-dense, nutrient-poor foods – typically ultra-processed in nature. This diet generally deteriorates throughout childhood, adolescence and adulthood increasing the risk of diet-related chronic diseases. Recognition of ECC is an opportunity to intervene and disrupt the pathway to multimorbidities. Disruption of this pathway will reduce the risk of multimorbidities and enable individuals to fully engage in society throughout the lifespan.

Centenarians represent a phenomenon of successful aging, yet little is known about their lifestyle and health practices, including diet/nutrition, medication use, and health conditions. A protocol for this systematic review was registered previously(1). We systematically searched Medline, CINAHL, Scopus, and grey literature from 2000 to 2022, limited to quantitative studies published in English among adults aged 95 years or above. Two reviewers independently screened 3,392 records and identified and extracted data from 34 eligible studies. Additionally, they independently assessed the study quality using the Modified Newcastle-Ottawa Scale (mNOS)(2). Any disagreement was discussed and resolved with a third reviewer. In analysis, pooled prevalence was provided for categorical variables on demographics, lifestyles, medications, and diseases using % (95%CI); mean or median was provided for continuous variables. Due to study heterogeneity, we conducted a narrative synthesis for the associations between the exposures and outcomes. Over 70% of the included studies met 6/8 criteria based on the mNOS; nearly half did not mention or control for confounders in statistical analyses. The age ranged from 95-118y (32 studies: 100y+; 2 studies: mean age 97-98 y); the majority were females (75%; 95%CI: 71%,78%). Most centenarians did not smoke or drink [current smokers: 7% (5%, 9%); former smokers:16% (12%, 19%); daily drinkers: 27% (20%, 34%); former drinkers:21% (13%, 30%)]. Most centenarians were physically inactive (23%; 20%, 26%). Over 50% had normal weight (52%; 42%, 61%), 33% (14%, 52%) underweight, and 14% (8%, 20%) overweight. Regarding nutrition, the narrative synthesis suggests that centenarians had normal levels of albumin (3.8g/dL), total triglycerides (111mg/dL), total (188mg/dL), and HDL cholesterol (54mg/dL) but high levels of LDL cholesterol (109mg/dL). Regarding medications, nearly 50% took antihypertensive medications (49%; 14%, 84%) or other cardiovascular drugs (48%; 24%, 71%); they took a median of 5 (range: 2-7) drugs. Common conditions included impairment of basic activities of daily living (ADL) (54%; 33%, 74%), hypertension (43%; 21%, 65%), and diabetes (22%; 9%, 52%). In regression analyses among centenarians, high dietary diversity, lower salt preference, and weight status were significant factors for more independence in basic ADL, lower mortality, and greater longevity. For example, a high dietary diversity score was associated with a low mortality risk [0.93 (0.92, 0.94) per unit increase]; those who preferred salty food versus those who did not had a 3.6-fold risk of impaired ADL [adj.OR: 3.59 (1.14, 11.25)]. Being overweight vs. normal weight reduced the risk of ADL impairment [adj.OR: 0.84 (0.78, 0.91] while underweight increased this risk [adj.OR:1.34 (1.28, 1.41)]. Also, overweight [adj.OR: 0.92 (0.90, 0.94)] or abdominal obesity [adj.OR: 0.72 (0.52, 0.996)] reduced the likelihood of longevity per kg increase. This systematic review suggests a healthy lifestyle, good nutrition, and normal body weight may contribute to extreme longevity. Interpreting these summary findings should be cautious due to potential recall bias and heterogeneity of the included studies.

TikTok is a global social media platform popular with young people, encouraging viewers to engage with user-generated video content (through likes, shares and comments) and mimic displayed behaviours (by creating similar videos or content). It is therefore a powerful and engaging tool that has potential for the widespread dissemination of information (or misinformation) and to influence behaviours. Social media is saturated with the promotion of ‘diet culture’ and has a strong influence on the eating behaviours of young people (1,2). This is concerning as childhood and adolescence are critical periods of growth requiring optimal nutrition (3). This study aimed to investigate how dieting is portrayed on TikTok and consider the potential implications for public health. A cross-sectional descriptive content analysis was undertaken of 50 videos from each of the five most popular diet-related hashtags (#diet, #whatieatinaday, #wieiad, #dietitian, #diettips). A codebook was developed to analyse the body-related content referenced (weight measurement, calories, body image, body checking, body comparisons over time) and collect the engagement for each video (likes, comments and shares). Overall, the 250 videos contributed to a total of 197.2 million likes (M = 789,051.0, SD = 923,335.0), 126,7251 comments (M = 5,069.0, SD = 9,315.3), and 3.8 million shares (M = 15,423.2, SD = 41,271.3). Most videos featured adults (n = 205, 82%), and only a small number of videos featured identifiable children or adolescents (n = 16, 6.4%). The information and advice regarding diets and eating behaviours came from two types of sources: 'experts’ and regular creators sharing their personal experience. Almost half of the videos were educational or instructional (n = 116, 46.4%), of which 74 (63.8%) were posted by users who claimed expert status. The most common titles by those claiming to be experts were “dietitian” (n = 43, 58.1%), “health and wellness coach” (n = 7, 9.5%), “doctor” (MD; n = 6, 8.1%), “fitness trainer” (n = 6, 8.1%), and “nutritionist” (n = 3, 4.1%). Of the videos that specifically mentioned a certain diet, the most common diets were low calorie (n = 32, 12.8%), vegan (n = 14, 5.6%), self-reported healthy eating (n = 12, 4.8%), and fasting (n = 10, 4.0%). The use of humour was the only feature significantly associated with engagement. Health professionals are presented with a unique opportunity to widely and positively influence the public by utilising the popularity of TikTok amongst young people to disseminate evidence-based information and promote healthy eating behaviours. Our findings suggest that experts using authentic, humorous, and engaging personas would be more likely to be popular on this platform.