Polycystic ovary syndrome (PCOS) is a common endocrine disorder amongst reproductive-aged women associated with cardiometabolic, reproductive and psychological abnormalities. Lifestyle modification, including a healthy diet, is considered first-line treatment for management of clinical symptoms. However, there is limited high-quality evidence to support one superior therapeutic dietary intervention for PCOS management that is beyond general population-based dietary guidelines. Adherence to a Mediterranean diet (MedDiet) has been shown to decrease cardiometabolic disease risk and attenuate depressive symptoms, particularly in patients with metabolic perturbations. This narrative review summarises the proposed biological mechanisms underpinning the potential therapeutic benefits of a MedDiet for the management of cardiometabolic, reproductive and psychological features related to PCOS. Observational evidence suggests an inverse relationship between MedDiet adherence and PCOS features, particularly insulin resistance and hyperandrogenemia. Although the exact mechanisms are complex and multifaceted, they are likely related to the anti-inflammatory potential of the dietary pattern. These mechanisms are underpinned by anti-inflammatory bioactive constituents present in the MedDiet, including carotenoids, polyphenols, and n-3 polyunsaturated fatty acids (PUFAs). Synthesis of the available literature suggests the MedDiet could be a promising therapeutic dietary intervention to attenuate short and long-term symptoms associated with PCOS and may aid in reducing the longer-term risks associated with cardiometabolic diseases and reproductive and psychological dysfunction. Nevertheless, current evidence remains insufficient to inform clinical practice and well-designed clinical trials are needed. As such, we provide recommendations for the design and delivery of future MedDiet interventions in women with PCOS, including exploring the acceptability, and feasibility to enhance adherence.

Mediterranean diet (MDi) has demonstrated a powerful preventing effect on various medical conditions, therefore, a positive effect on oral health may also be speculated. Also, tooth loss, pain or tooth mobility may discourage the consumption of specific food types, with affectance to MDi adherence. The aim of this study was to investigate the association between adherence to MDi and oral health in adult populations. The study protocol was registered in Open Science Framework, https://osf.io/vxbnh/, and adhered to PRISMA-ScR guidelines. Principal research questions were: 1) Does better oral health enable adults to better adhere to MDi? and 2) Does better adherence to MDi enable adult individuals to have better oral health? The content of three databases, Clarivate Analytics' Web of Science, Scopus, and PubMed was searched without language, date, or any other restrictions. The search results were imported into the Rayyan environment and from the initial 1127 studies identified only 20 remained after exclusion process. Three articles comprised the first group, revealing significant associations between various oral health parameters and adherence to MDi, with large variations in methodology and no safe conclusions. The studies investigating the effect of the level of adherence to MDi on various oral parameters were more numerous and revealed negative associations with the prevalence of periodontal disease and upper aero-digestive tract cancer. Further studies to explore the existence and direction of the association between oral health and MDi are needed, with public health interventions encouraging MDi to reduce the burden of oral conditions and other non-communicable diseases.

Within the framework of an increasing water scarcity, fostered by the climate change, in this study we investigate the environmental impact associated with current food consumption by means of the Water footprint indicator focusing on the case of Italy. For the analysis of the real food consumption and its impact, we selected the Mediterranean diet as a benchmark, since previous evidence shows that Italians are shifting their dietary habits away from the traditional Mediterranean Diet in favor of dietary patterns rich in animal-based products, especially meat. To promote more sustainable food choices, we applied a Sustainable Diet Model to analyze alternative diets that can reduce the Water footprint associated with food consumption. The results of the analysis show that by adopting slight changes in the consumption of certain categories of foods, it is possible to reduce the Water footprint of diets. The findings of this research are useful for supporting policies for the promotion of sustainable food consumption that would lead to a reduction in the exploitation of a scarce resource such as water, improving the allocation of this resource and achieving the objectives of the 2030 Agenda.

Polycystic ovary syndrome (PCOS) is a common hormonal disorder in women of reproductive age, associated with increased risks of metabolic disorders, depression and reduced quality of life. This study examined the impact of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on mental health, PCOS-related quality of life (PCOSQ), anthropometric indices, hirsutism, and metabolic/hormonal parameters in women with PCOS. Total of 52 women with PCOS, aged between 18 and 45 years, were randomly assigned to either the low calorie MIND diet group or the control group. Anthropometric data, depression and anxiety scores, serum levels of gonadotropins (luteinizing hormone [LH], follicle-stimulating hormone [FSH]), PCOSQ, and Ferriman-Gallwey score were evaluated before and after the intervention. Outcomes were assessed at baseline and at the end of the 8-week follow-up period. After 8 weeks, the MIND diet significantly reduced depression (β –3·03; 95 % CI: [–5·36, –0·70]; P = 0·011) and anxiety (β –3·54; 95 % CI: [–6·60, –0·49]; P = 0·024) scores compared with the control group. The MIND diet group exhibited significant increases in the emotion (β 0·63; 95 % CI: [0·18, 1·08]; P = 0·007) and body hair (β 0·65; 95 % CI: [0·03, 1·28]; P = 0·04) domains of the PCOSQ compared to the control group. The changes in other parameters did not show significant differences between the two groups. Both the MIND diet and control groups showed improvements in weight and BMI, with a slight advantage for the MIND diet group. These findings suggest that the MIND diet may be beneficial for improving mental health and some aspects of PCOSQ in women with PCOS.

We recently showed that adherence to the Mediterranean diet increased the proportion of plasma n-3 PUFA, which was associated with an improved intestinal barrier integrity. In the present exploratory analysis, we assessed faecal fatty acids in the same cohort, aiming to investigate possible associations with intestinal barrier integrity. Women from the Lifestyle Intervention Study in Women with Hereditary Breast and Ovarian Cancer (LIBRE) randomised controlled trial, characterised by an impaired intestinal barrier integrity, followed either a Mediterranean diet (intervention group, n 33) or a standard diet (control group, n 35). At baseline (BL), month 3 (V1) and month 12 (V2), plasma lipopolysaccharide-binding protein, faecal zonulin and faecal fatty acids were measured. In the intervention group, faecal proportions of palmitoleic acid (16:1, n-7) and arachidonic acid (20:4, n-6) decreased, while the proportion of linoleic acid (18:2, n-6) and α linoleic acid (18:3, n-3) increased (BL-V1 and BL-V2, all P < 0·08). In the control group, faecal proportions of palmitic acid and arachidic acid increased, while the proportion of linoleic acid decreased (BL-V1, all P < 0·05). The decrease in the proportion of palmitoleic acid correlated with the decrease in plasma lipopolysaccharide-binding protein (ΔV1-BL r = 0·72, P < 0·001; ΔV2-BL r = 0·39, P < 0·05) and correlated inversely with adherence to the Mediterranean diet (Mediterranean diet score; ΔV1-BL r = –0·42, P = 0·03; ΔV2-BL r = -0·53, P = 0·005) in the intervention group. Our data show that adherence to the Mediterranean diet induces distinct changes in the faecal fatty acid composition. Furthermore, our data indicate that the faecal proportion of palmitoleic acid, but not faecal n-3 PUFA, is associated with intestinal barrier integrity in the intervention group.

An anti-inflammatory diet is characterised by incorporating foods with potential anti-inflammatory properties, including fruits, vegetables, whole grains, nuts, legumes, spices, herbs and plant-based protein. Concurrently, pro-inflammatory red and processed meat, refined carbohydrates and saturated fats are limited. This article explores the effects of an anti-inflammatory diet on non-communicable diseases (NCD), concentrating on the underlying mechanisms that connect systemic chronic inflammation, dietary choices and disease outcomes. Chronic inflammation is a pivotal contributor to the initiation and progression of NCD. This review provides an overview of the intricate pathways through which chronic inflammation influences the pathogenesis of conditions including obesity, type II diabetes mellitus, CVD, autoinflammatory diseases, cancer and cognitive disorders. Through a comprehensive synthesis of existing research, we aim to identify some bioactive compounds present in foods deemed anti-inflammatory, explore their capacity to modulate inflammatory pathways and, consequently, to prevent or manage NCD. The findings demonstrated herein contribute to an understanding of the interplay between nutrition, inflammation and chronic diseases, paving a way for future dietary recommendations and research regarding preventive or therapeutic strategies.

Depression is a common prenatal psychological complication. We aimed to investigate if maternal pre-pregnancy diet can impact prenatal depressive symptoms and the mediating role of pre-pregnancy BMI and inflammation. We used data (N 1141) from the Alberta Pregnancy Outcomes and Nutrition cohort study. We calculated Mediterranean diet adherence (MED) and dietary inflammatory index (DII) scores using data from pre-pregnancy FFQ. In the third-trimester, we assessed depressive symptoms using Edinburgh Postpartum Depression Scale (EPDS) and inflammation through serum C-reactive protein (CRP) levels. BMI was calculated from self-reported pre-pregnancy weight. Race-stratified analyses (white and people of colour) were run. We observed no association between MED or DII tertiles and depressive symptoms. However, white participants in the MED tertile-3 had lower risk of depression (EPDS < 10) compared with tertile-1 (OR = 0·56, 95 % CI, 0·33, 0·95). White individuals in MED tertile-3 had lower BMI (MD = –1·08; 95 % CI, −1·77, −0·39) and CRP (MD = –0·53; 95 % CI, −0·95, −0·11) than tertile-1, and those in DII tertile-2 (MD = 0·44; 95 % CI, 0·03, 0·84) and tertile-3 (MD = 0·42; 95 % CI, 0·01, 0·83) had higher CRP than tertile-1. Among people of colour, neither MED nor DII was associated with BMI or CRP, but BMI was negatively associated with depressive symptoms (β = –0·25, 95 % CI, −0·43, −0·06). We found no association between diet and depressive symptoms through BMI or CRP, in either race. Pre-pregnancy diet might affect the risk of prenatal depression in a race-specific way. Further research is required to explore the racial differences in the association between maternal diet and prenatal depressive symptoms/depression risk.

During the menopausal transition, women often encounter a range of physical and psychological symptoms which negatively impact on health-related quality of life (HRQoL)(1). Diet quality has previously been identified as a modifiable factor associated with mitigating the severity of these symptoms in peri-menopausal and menopausal women(2). We therefore explored the independent associations between adherence to a Mediterranean diet (MedDiet) and the severity of menopausal symptoms in peri-menopausal and menopausal women living in Australia. We also explored the association between MedDiet adherence and HRQoL in this same cohort of women. We conducted a cross-sectional study of Australian peri-menopausal or menopausal women aged between 40 to 60 years. An 86-item self-administered questionnaire was used to assess the relationship between adherence to a MedDiet and severity of symptoms. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS), the Menopause Rating Scale (MRS) was used to assess the severity of menopausal symptoms related to somatic, psychological and urinary-genital symptoms and the 36-item short form survey instrument (SF-36) was used to assess HRQoL. Multivariable linear regression analysis (and 95% CI) was used to investigate the independent association between adherence to a MedDiet, severity of menopausal symptoms and HRQoL subscales using one unadjusted and five adjusted predictor models. A total of n = 207 participants (50.7 ± 4.3 years; BMI: 28.0 ± 7.4 kg/m2) were included in the final analyses. Participants reported low-moderate adherence to a MedDiet (5.2 ± 1.8; range: 1-11). We showed that MedDiet adherence was not associated with severity of menopausal symptoms. However, when assessing individual dietary constituents of the MEDAS, we showed that low consumption of sugar-sweetened beverages (<250ml per day) was inversely associated with joint and muscle complaints, independent of all covariates (β = −0.149; CI: −0.118, −0.022; P = 0.042). Furthermore, adherence to a MedDiet was positively associated with the physical function subscale of HRQoL (β = 0.173, CI: 0.001, 0.029; P = 0.031) and a low intake of red and processed meats (≤ 1 serve per day) was positively associated with the general health subscale (β = 0.296, CI: 0.005, 0.014; P = <0.001), independent of all covariates used in the fully adjusted model. Our results suggest that diet quality may be related to severity of menopausal symptoms and HRQoL in peri-menopausal and menopausal women. However, exploration of these findings using longitudinal analyses and robust clinical trials are needed to better elucidate these findings.

Diet and diet quality have been linked to improvements to psychosocial health and wellbeing(1). However, data from national health surveys indicate that most Australian’s have poor diet quality and consume a Western style diet high in saturated fat, discretionary foods and added sugars and salt(2). The Mediterranean Diet (MedDiet), a predominantly plant-based diet rich in bioactive foods and nutrients, has been shown to improve mood and wellbeing. However, long-term effects beyond 6-months have not been thoroughly explored in older adults. MedWalk compares a 12-month MedDiet and Walking intervention with habitual lifestyle (HabDiet) in 160 older adults residing in retirement villages across South Australia and Victoria. Data from the South Australian cohort at baseline (n = 83) and 6-months (n = 74) are presented in this preliminary analysis.

To determine dietary compliance, participants completed the 14-point MedDiet Adherence (MEDAS) questionnaire which assesses the intake of key MedDiet foods such as legumes, fish, and extra virgin olive oil; higher scores reflect higher adherence. Wellbeing was assessed using the Flourishing Index, which assesses life satisfaction, relationship satisfaction, happiness, mental and physical health. The total flourishing score includes 10 questions with a maximum of 100 points reflecting highest flourishing, while the secure flourishing score includes two additional questions related to safety, housing, and access to food with a maximum of 120 points to indicate highest flourishing. Group and time interactions for MEDAS and flourishing scores were analysed using linear mixed effects modelling. There were no significant differences between groups for MEDAS score at baseline (MedDiet 5.78 ± 0.34 vs HabDiet 5.74 ± 0.32). At 6 months, the MedDiet group had significantly increased their MEDAS by 4.16 points (P<0.001), (MedDiet 10.0 ± 0.42 vs HabDiet (5.85 ± 0.39). At baseline there were no significant differences between groups for the total 10-point flourishing score (MedDiet 83.5 ± 2.01 vs HabDiet 82.1 ± 2.0) or 12-point secure flourishing score (MedDiet 100.6 ± 2.2 vs HabDiet 100.4 ± 2.2). At 6 months there was a significant between-group difference in total flourishing index scores with a mean difference of 6.97 points in the MedDiet group (MedDiet 85.8 ± 1.9 vs HabDiet 78.8 ± 1.8, P = 0.010). Similarly, the secure flourishing index score was 6.18 points higher in the MedDiet group compared to the HabDiet at 6-months (MedDiet 102.9 ± 2.2 vs HabDiet 96.8 ± 2.07, P = 0.046). Adhering to a MedDiet and walking intervention may lead to positive improvements to wellbeing in an older population. The flourishing index may need to be compared with other wellbeing questionnaires and instruments to better understand the relationship between wellbeing and MedDiet adherence as there was a cross-sectional association but no positive correlation at 6-months.

Preconception diet is a proposed modifiable risk factor for infertility(1). However, there is no official guidance for women in the preconception period as to which dietary approaches may improve fertility. A comprehensive synthesis of the relevant evidence is key to determine the potentially effective dietary patterns and components as well as evidence gaps, and to provide information for nutritional recommendations for couples planning a pregnancy. In this systematic scoping review, four electronic databases (Medline and EMBASE via Ovid processing, CAB Direct, and CINAHL via EBSCO) were searched for observational studies (prospective and retrospective cohort, cross-sectional, and case–control studies) from inception to 27 September 2021. Eligible studies included women of reproductive age during the preconception period, and evaluated exposures related to preconception diet and outcomes related to fertility. Results were synthesised using a descriptive approach. A total of 36 studies were eligible for inclusion (31 prospective, 3 cross-sectional, and 2 case–control studies) and were published between 2007 and 2022. Of the assessed dietary exposures, increased adherence to the Mediterranean diet displayed the strongest and most consistent association with improved clinical pregnancy rates. Reducing trans fatty acids (TFAs), saturated fatty acids, and discretionary food intake (fast food and sugar-sweetened beverages) were associated with improvements in live birth, clinical pregnancy rates, and related ART outcomes. The dietary components of seafood, dairy, and soy demonstrated inconsistent findings across the few included studies. Due to heterogeneity and the limited available literature on most exposures, there is insufficient evidence to support any specific dietary approach for improving fertility. However, following some of the dietary approaches outlined in this review (anti-inflammatory diets, reducing TFA, and discretionary food intake) are consistent with broad healthy eating guidelines, have little to no associated risk, and offer a plausible set of possible benefits. This warrants further exploration in randomised controlled trials.

Food cravings are one of several important complexities between psychological and physiological triggers for food consumption. Cravings are commonly cited as contributing to over-consumption of hyperpalatable foods (sugary, salty, and fatty foods) and may be causal in obesity(1). The Mediterranean dietary pattern (MedDiet) is linked to reduced disease risk and improved health and wellbeing(2). Despite a lower intake of sugary and salty foods compared to a Western diet, free-living adults switching to the MedDiet find it satiating and achieve high adherence in Western countries. The MedDiet is known to improve mood and wellbeing, is high in fibre, monounsaturated fat and low in added sugar, and has a low glycaemic load, which could separately and synergistically reduce food cravings. The relationship between adherence to the MedDiet and food cravings has never been investigated. In the MedLey randomised controlled trial, we investigated the effects of a MedDiet on food cravings, compared with a habitual Australian diet (HabDiet)(3). Adherence to the MedDiet was scored out of 15 (maximum adherence). Participants completed three food cravings questionnaires at baseline and 6-months. The State questionnaire measures momentary cravings and has a maximum score of 75, indicating maximum food cravings. The Trait-reduced questionnaire measures general cravings and has a maximum score of score of 126, indicating more frequent and intense cravings for foods. The Food Cravings Inventory (FCI) measures cravings for four food domains: fatty foods, fast foods, sugary foods, and high carbohydrate (CHO) foods. MedDiet group (n = 58) responses were compared with the HabDiet group (n = 53) across visits using linear mixed effects modelling. Predicted differences were obtained for adherence scores of ≤8 (median adherence) and ≥9. Means ± SD or CIs are presented. Mean adherence increased from 7.1 ± 1.8 to 10.7 ± 1.48 in the MedDiet group (P<0.01), with no change in the HabDiet group (P = 1.00). Trait-reduced scores were not significantly different between groups at 6-months (P = 0.11), although there was a 5.57-point reduction within the MedDiet group (CI −12.56, −1.96, P = 0.04). State score was significantly lower in the MedDiet group than the HabDiet at 6-months (−4.4 (CI −7.53, −0.39), P = 0.03), and was significantly lower than at baseline (−5.9 (CI −9.33, −0.24,) P = 0.04). There were no differences between groups for the four domains of the FCI (P>0.05). Cravings for sugary foods was significantly reduced within the MedDiet group (−0.26 (CI −0.46, −0.05) P = 0.01). The predictive modelling suggested moving from an adherence score of 8 to 9 was associated with lower cravings for sugar (−0.03 ± 0.01, P = 0.03), fast food (−0.04 ± 0.02, P = 0.02) and CHO foods (−0.05 ± 0.02, P = 0.02). These results are suggestive that higher adherence to a MedDiet could reduce cravings compared to the Australian diet and suggest that the MedDiet may specifically reduce sugar cravings. Further investigation is warranted, through observational and intervention trials.

An increasing body of evidence has emerged suggesting that lifestyle behaviours, including diet quality, may be an important modifiable risk factor for mental health disorders. The Mediterranean diet (MedDiet), which is often heralded as an anti-inflammatory diet, has been widely investigated and promoted as one of the ‘healthiest’ dietary patterns for reducing chronic disease risk and promoting healthy ageing(1). Greater adherence to a MedDiet and/or anti-inflammatory diet is inversely associated with the risk of depression or depressive symptoms in younger and middle-aged adults(2). However, these findings have been inconsistent, particularly in older adults. We therefore explored the independent associations between adherence to a MedDiet and severity of symptoms related to depression, anxiety and stress in community-dwelling older adults from Australia. We conducted a cross-sectional study of older Australians aged ≥ 60 years. Older adults who were permanent residents of Australia, free from dementia or cognitive decline and could independently complete an anonymous online survey in English were invited to participate. A 75-item self-administered questionnaire was used to assess the relationship between adherence to a MedDiet and severity of symptoms related to depression, anxiety, and stress. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS)(3) and the Depression, Anxiety and Stress Scale (DASS-21)(4) was used to assess the severity of negative emotional symptoms. Multivariable linear regression analysis (and 95% CI) was used to investigate the independent association between adherence to a MedDiet and severity of symptoms related depression, anxiety and stress using one unadjusted and six adjusted predictor models. A total of n = 294 participants were included in the final analyses (70.4 ± 6.2 years; Females, n = 201; Males, n = 91; n = 2 unspecified). Adherence to a MedDiet was inversely associated with severity of anxiety symptoms (β = −0.118; CI: −0.761, −0.012; P = 0.043) independent of age, gender, BMI, physical activity, sleep, cognitive risk and ability to perform activities of daily living. Furthermore, MedDiet adherence was inversely associated with symptoms of stress (β = −0.151; CI: −0.680, −0.073; P = 0.015) independent of age, gender, BMI, physical activity and sleep. However, no relationship between MedDiet adherence and depressive symptoms was observed. We showed that adherence to a MedDiet is inversely associated with severity of symptoms related to anxiety and stress but not for depression. Exploration of these findings using longitudinal analyses and robust clinical trials are needed to better elucidate these findings in older adults.

As the global population continues to age, strategies that promote health and wellbeing among older adults are urgently required. This demographic faces an increasing burden of chronic diseases linked to inflammation(1), often associated with diets that are energy dense and nutrient poor(2). Importantly, the impact of these conditions can be minimised by adopting an anti-inflammatory dietary pattern, such as the Mediterranean diet(3). While there are numerous predictors of behaviour and an individual’s capacity for behaviour change, nutrition knowledge is a fundamental influencer of eating behaviours(4). However, knowledge of anti-inflammatory diets generally and the Mediterranean diet specifically is lacking among older adults(5), highlighting the need for effective educational programs targeting this group. Digital health technologies have the potential to provide cost-effective and accessible nutrition education, however, few technologies have been developed to meet older adults unique needs and preferences. To address this gap, this study aimed to explore the specific needs and design preferences of older adults for an online nutrition education resource. A total of 20 adults aged 55 years and older participated in one of four 2-hour participatory design workshops, where prompted discussion questions were used to explore their use of technology and scope their needs and preferences for an online nutrition education resource. All participants were regularly using a range of different devices (e.g., smartphones, tablets, and computers) and reported being comfortable doing so. Participants wanted a website that could be accessed across devices (i.e., desktop and mobile friendly) that provided practical nutrition advice, recipes, and information on the link between diet and disease. A number of design principles were identified as essential to optimise the user experience, including large and simple fonts, use of dark type on a light background, and clear categories for easy navigation. To enhance engagement, participants sought a personalised resource that could be adjusted to suit their needs, provided up-to-date information, and allowed for easy content sharing with others, such as by exporting information as a PDF. Participatory design methods offer new knowledge for developing and refining existing and future digital health technologies that are appropriate and useful for the target audience. Specifically, the older adult participants were motivated to access a user-friendly web-based nutrition resource provided it was able to be personalised to their health and nutrition needs, offered practical solutions such as adaptations to portion size or in relation to cost, and was easily shareable with others. Given the limited availability of online, self-directed and evidence-based nutrition education resources for older adults, these findings provide valuable insights to shape digital health resources that cater to the needs and preferences of this population and have the potential to support healthy eating habits and contribute to reducing diet-related chronic disease burden.

Cardiometabolic diseases are highly prevalent in Aotearoa New Zealand(1). Dietary intake is a modifiable risk factor for such diseases and certain dietary patterns, specifically the Mediterranean diet (MedDiet), are associated with improved metabolic health(2). This study aims to test whether an intervention of a Mediterranean dietary pattern incorporating high quality New Zealand foods (NZMedDiet pattern) using behaviour change science can improve the metabolic health of participants and their household/whānau. This is a multi-centre, three-stage trial, with two randomised controlled trials (RCTs), both parallel groups, superiority trials, and a longitudinal cohort study. The first RCT (RCT1) is a comparison of the NZMedDiet pattern implemented using behaviour science compared to usual diet for 12 weeks, and the second (RCT2) is a behaviour-change intervention compared to no intervention for 12 weeks, administered after participants have been exposed to the intervention in RCT1. The third stage is a longitudinal cohort study where all participants are followed for up to a year. The primary outcome measure for each stage is the metabolic syndrome severity score (MetSSS). Two hundred index participants and their household/whānau have been recruited and randomised into the trial. Participants are from four centres, two of which are University research units (University of Auckland (n = 57) and University of Otago, Christchurch (n = 60)), one a community-based traditional meeting place (Tu¯ Kotahi Māori Asthma and Research Trust at Ko¯kiri Marae in Lower Hutt, Wellington (n = 19)), and the other based at a hospital-based research unit (the Centre for Endocrine Diabetes and Obesity Research (CEDOR) in Wellington (n = 64). The trial will test whether the NZMedDiet pattern and behaviour change support improves the cardiometabolic health of people in New Zealand.

Data on the association of the Mediterranean diet (MD) with depressive symptoms in older people at high risk of depression are scarce. This study aimed to investigate the cross-sectional association of the adherence to the MD and its components with depressive symptoms in an Italian cohort of older men and women. A total of 325 men and 473 women aged 65–97 years (2019–2023) answered a 102-item semi-quantitative FFQ, which was used to calculate the Mediterranean diet score (MDS). Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale; subjects with a score of 16 or more were considered to have depression. Multivariable logistic regression was used for statistical analysis. The occurrence of depressive symptoms was 19·8 % (8·0 % men, 27·9 % women). High adherence to MDS (highest tertile) significantly reduced the odds of having depressive symptoms by 54·6 % (OR 0·454, 95 % CI 0·266, 0·776). In sex-stratified analysis, the reduction was evident in women (OR 0·385, 95 % CI 0·206, 0·719) but not in men (OR 0·828, 95 % CI 0·254, 2·705). Looking at the association of MDS components with depressive symptoms, we found an inverse significant association with fish consumption and the MUFA:SFA ratio above the median only in women (OR 0·444, 95 % CI 0·283, 0·697 and OR 0·579, 95 % CI 0·345, 0·971, respectively). High adherence to the MDS, and a high fish intake and MUFA:SFA ratio were associated with lower depressive symptoms in women only. Future longitudinal studies are needed to confirm these findings and to explore the underlying biological mechanisms.

Healthy dietary patterns such as the Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) have been evaluated for their potential association with health outcomes. However, the lack of standardisation in scoring methodologies can hinder reproducibility and meaningful cross-study comparisons. Here we provide a reproducible workflow for generating the MeDi, DASH and MIND dietary pattern scores from frequently used dietary assessment tools including the 24-h recall tool and two variations of FFQ. Subjective aspects of the scoring process are highlighted and have led to a recommended reporting checklist. This checklist enables standardised reporting with sufficient detail to enhance the reproducibility and comparability of their outcomes. In addition to these aims, valuable insights in the strengths and limitations of each assessment tool for scoring the MeDi, DASH and MIND diet can be utilised by researchers and clinicians to determine which dietary assessment tool best meets their needs.

Age-related macular degeneration (AMD) is one of the most prevalent eye diseases among the ageing population worldwide. It is a leading cause of blindness in individuals over 55, particularly in industrialised Western countries. The prevalence of AMD increases with age, and genetic factors and environmental influences are believed to contribute to its development. Among the environmental factors, diet plays a significant role in AMD. This review explores the association between dietary components, dietary patterns and AMD. Various nutrients, non-nutrient substances and dietary models that have the potential to counteract oxidative stress and inflammation, which are underlying mechanisms of AMD, are discussed. Consuming fruits, vegetables, fish and seafood, whole grains, olive oil, nuts and low-glycaemic-index foods has been highlighted as beneficial for reducing the risk of AMD. Adhering to the Mediterranean diet, which encompasses these elements, can be recommended as a dietary pattern for AMD. Furthermore, the modulation of the gut microbiota through dietary interventions and probiotics has shown promise in managing AMD.