Time-restricted eating (TRE) has emerged as a promising strategy for weight loss and supporting metabolic health (1), yet limiting opportunities to eat may compromise overall nutritional adequacy of the diet and pose a barrier to long-term adherence (2)(3). Allowing consumption of certain foods outside the eating window, while maintaining the benefits of TRE, may help overcome such issues. Protein intake promotes diet-induced thermogenesis and insulin and satiety hormones secretion, affecting postprandial energy expenditure (EE), appetite and glycaemia (4). The extent to which protein from different sources may disrupt fasting is unclear, as the existing literature focuses on comparing a limited range of proteins as part of mixed meals, resulting in a lack of insight into their metabolic effects when ingested on their own. The present study aims to compare the acute effects of 20g of a plant-based v animal-based protein supplement on postprandial metabolism, appetite and subsequent energy intake.

Fifteen healthy adults (mean ± SD age: 26±4.4y) completed three study visits in randomised single blind crossover study design. After an overnight fast, participants consumed one of three test drinks: 20g whey or plant protein supplement (mix of pea, brown rice and pumpkin seed protein) prepared with water only, or an equivalent volume of water (control). Blood metabolites, insulin and GLP -1 were measured at baseline and over three hours postprandial alongside EE, substrate utilisation, and subjective appetite. Intake from an ad libitum lunch meal was used to access the effect of each supplement on subsequent energy intake.

There was a significant main effect of condition and time on plasma ketones and NEFA (p<0.05). Postprandial ketones were significantly lower after whey compared to control at T90 (p=0.014) and T120 (p=0.025). There was no significant difference in ketone levels between plant protein and control or between the two proteins.

Postprandial NEFA were significantly lower after whey at T30 (p=0.003), T60 (p<0.0001), T90 (p<0.0001), and T120 (p=0.003), and after plant protein at T30 (p=0.049), T60 (p<0.0001) and T90 (p<0.0001) compared to control. NEFA levels were significantly higher after plant protein compared to whey at T30 (p=0.031) and T60 (p=0.008).

Subjective feelings of hunger were significantly lower at T60 after whey (p=0.002) and plant protein (p=0.018) compared to control, but there was no significant difference between the two proteins.

Consuming protein may disrupt fasting through eliciting a transient reduction in ketones and NEFA, and this was more pronounced after eating whey protein. However, both protein sources were effective in reducing feelings of hunger one hour after intake which may be helpful in the context of reducing hunger experienced during TRE. Analysis of postprandial glucose, insulin, GLP-1 and EE will further elucidate the effects of protein on fasted metabolism.

Cross-cutting issues like nutrition have not been adequately addressed for children with severe visual impairment studying in integrated schools of Nepal. To support advocacy, this study aimed to determine the nutritional status of this vulnerable group, using a descriptive cross-sectional design involving 101 students aged 5–19 years from two integrated public schools near Kathmandu Valley and two in western Nepal. The weight-for-age z-score (WAZ), height-for-age z-score (HAZ), and body mass index-for-age z-score (BAZ) were computed and categorised using World Health Organization cut-off values (overnutrition: z-score > +2.0 standard deviations (SD), healthy weight: z-score −2.0SD to +2.0SD, moderate undernutrition: z-score ≥ −3.0SD to <−2.0SD, severe undernutrition: z-score < −3.0 SD) to assess nutritional status. A child was considered to have undernutrition for any z-scores <−2.0SD. Multivariate logistic regression was used to analyse variables linked to undernutrition. The mean age of participants was 11.86 ± 3.66 years, and the male-to-female ratio was nearly 2:1. Among the participants, 71.29% had blindness, and 28.71% had low vision. The mean BAZ and HAZ scores decreased with age. The WAZ, HAZ, and BAZ scores indicated that 6.46% were underweight, 20.79% were stunted, and 5.94% were thin, respectively. Overall, 23.76% of students had undernutrition and 7.92% had overnutrition. More than three in ten students had malnutrition and stunting was found to be prevalent. Older students and females were more likely to have undernutrition. These findings highlight the need for nutrition interventions within inclusive education settings, particularly targeting girls with visual impairments who may face compounded vulnerabilities.

The obesogenic maternal environment can lead to cardiac hypertrophy in the offspring. The aim of this study was to investigate whether (-)-epicatechin (Epi) modify the expression of genes related to pathological cardiac hypertrophy (CH), and its physiological pathway, in offspring obese by programing. Four groups of eight male offspring Wistar rats of 110 days were randomly selected to control groups [C and offspring of maternal obesity (MO)] or to Epi groups (C + Epi or MO + Epi). In heart tissue, we evaluated the size of the ventricular walls and cavities, presence of fibrosis, mRNA and protein of Myh6, Myh7, Anp, Bnp, Acta 1, Col1a1, Akt, and Mtor. We observed an increase of the heart weight/body ratio in groups treated with Epi. Only in MO group, heart area and its perimeter were increased, as well as Myh7 and Anp mRNA. We found a significant decrease of fibrosis area in male offspring treatment with Epi. In Epi group Anp mRNA was decreased whilst Anp protein in MO group was increased; further, a decrease in Col1a1 protein was found in MO group. In conclusion, the maternal obesity activates pathological CH markers reactivating fetal cardiac genes involved in histological changes observed in cardiac tissue. Epi treatment decreased the content of collagen area and expression of some fetal cardiac genes participating in this pathway in offspring of maternal obesity.

Personalised nutrition (PN) has emerged as an approach to optimise individual health outcomes through more targeted and tailored dietary recommendations based on unique genetic, phenotypic, medical, lifestyle and contextual factors. The application of artificial intelligence (AI) presents an opportunity to achieve personalised nutrition advice at a scale that has population impact. This review introduces a nutrition audience to different AI applications and offers insights into the concepts of AI that might be relevant to the field of nutrition research. The current and future uses of AI in PN are discussed, as well as the potential benefits and challenges to their application. AI-driven solutions have the potential to improve health and reduce the risk of disease because they can consider more information about an individual in making recommendations. However, challenges such as data interoperability, ethical considerations, and model interpretability remain an issue limiting widespread use at this point. This review will provide a foundational understanding of the application of AI within PN and help to identify opportunities to leverage the potential of AI in transforming dietary guidance and enhancing health outcomes through innovative solutions.

Metabolic imprinting refers to lasting metabolic changes from early-life environmental exposures, especially nutritional, that impact adult health and chronic disease risk. We investigated whether metabolic imprinting by small litter size (SL) activates interscapular brown adipose tissue (iBAT) and affects glucose and lipid metabolism, oxidative damage, and insulin resistance (IR) in young rats exposed to a high-sucrose diet (HSD) over eight weeks. Male Wistar rats (n = 48) were assigned to control (eight pups/ dam; CL) and small litter (four pups/ dam; SL) groups. Post-weaning (21 days), they were divided into four dietary groups: (i) standard diet (STD, chow diet) from CL, or (ii) SL; (iii) HSD (30% sucrose) from CL, or (iv) SL, for eight weeks. Afterward, animals were euthanized for analysis of iBAT and serum samples. HSD caused hypertrophy, IR, and oxidative damage in iBAT. However, the SL model attenuated HSD-induced IR by up-regulating p-AKT (Ser 473) and activating iBAT thermogenesis, resulting in decreased PGC1-α expression and up-regulating UCP1 expression, which contributed to iBAT hyperplasia. Additionally, SL reduced PKA activation and free fatty acid (FFA) release, decreasing the lipid oxidative damage observed in HSD-fed iBAT. These findings suggest that SL-induced metabolic imprinting enhances iBAT thermogenesis through p-AKT (Ser 473) and PGC1-α signaling, increases UCP1 expression, and reduces PKA substrates phosphorylation, decreasing FFA levels and oxidative damage following HSD exposure. While our results challenge the existing literature, we propose that the metabolic plasticity from the SL model allows rats to adapt to dietary variations and may protect against HSD-induced IR in adulthood.

Plant-based diets (PBD) have been found to be environmentally sustainable and beneficial for health. Observational research showed that higher plant-based diet quality improves health-related quality of life (HRQoL) in adult women, however this is unclear for older adults. This association may be due to anti-inflammatory properties of PBD. Older adults, prone to chronic inflammation, may therefore profit from PBD. We investigated the relation between PBD and HRQoL in older adults of both sexes and tested whether the effects are associated with circulating high-sensitivity C-reactive protein (hsCRP) levels. We used data of the population-based Lifelines Cohort Study (n = 6,635, mean age = 65.2 years) and a subsample in which hsCRP was measured (n = 2,251, mean age = 65.2 years). We applied a plant-based diet index measuring adherence to a healthful (hPDI) and an unhealthful (uPDI) plant-based diet based on food frequency questionnaires. The RAND-36 questionnaire was applied as measure of HRQoL, from which we derived physical and mental HRQoL. Older adults with the highest adherence to a hPDI had respectively 15% and 12% greater odds for high physical quality of life and mental quality of life. Meanwhile, higher adherence to uPDI was associated with respectively 16% and 13% lower odds for high physical and mental quality of life. An additive but no interactive effect of hsCRP on the association between PBD and HRQoL has been observed. Adherence to a healthful plant-based diet and circulating levels of inflammation are independently associated with physical and mental HRQoL. Mechanisms other than inflammation through which PBD could influence HRQoL may be explored in further research.

The NOVA food classification system and its categorisation of ultra-processed foods (UPFs) have significantly influenced dietary guidelines worldwide, yet the assumption that all UPFs are uniformly harmful warrants critical examination. Here, a review of evidence revealed substantial heterogeneity in health outcomes across UPF subtypes, with products like sugar-sweetened beverages consistently associated with adverse outcomes while fortified cereals and certain dairy products demonstrate neutral or protective effects. The binary nature of NOVA’s classification fails to account for nutritional composition, fortification benefits, and cultural food traditions, creating inconsistencies in categorisation across different contexts. Methodological limitations in UPF research include inadequate dietary assessment tools, selective reporting of negative findings, and experimental design flaws that conflate processing with other dietary factors. Implementation challenges extend to socioeconomic accessibility, as UPFs often provide cost-effective nutrients for disadvantaged populations and environmental sustainability, where wholesale reduction could increase resource demands. Future directions should develop more nuanced classification systems that integrate processing methods with nutritional quality to better inform public health strategies rather than categorically rejecting all UPFs.

The Nordic Nutrition Recommendations 2023 (NNR2023) serve as the scientific foundation for national dietary guidelines and nutrient recommendations across the Nordic and Baltic countries. We reviewed how NNR2023 was adapted into national food-based dietary guidelines (FBDG) in the Nordic countries and Estonia, focusing specifically on sustainability considerations and policy implications. National FBDG integrated both health and environmental aspects in all countries, except Norway, which addressed environmental aspects only in a separate report. Health impacts served as the primary principle in all countries. Additionally, national policy perspectives, such as domestic food security, were addressed in some countries, while the integration of social and economic sustainability remained very limited. In adopting NNR2023, all countries modelled how implementation would affect nutrient adequacy or health within their food environments, making minor adjustments based on these findings. Guidelines for animal source food groups showed the most variation between countries; Estonia and Denmark established the strictest recommended limits for red meat and total meat, respectively, while Norway was most liberal regarding milk products. Stakeholders participated in the consultation process. The agricultural sector and meat industry primarily maintained pro-meat discourse, which was particularly intense in Norway and Sweden. Transition towards healthy and sustainable diets demands multiple policy instruments – FBDG being just one – alongside a supportive environment and participation from all food system actors.

Clinical and preclinical data about perinatal inflammation show its implication in brain injuries leading to autism spectrum disorder (ASD). For instance, Group B Streptococcus (GBS) chorioamnionitis generates autistic manifestations in the progeny. However, the precise way(s) how chorioamnionitis exerts its noxious effect on the central nervous system remains to be define. The pathogen-induced inflammatory response effects on the permeability of the blood brain barrier (BBB) have been documented in the mature brain. No study deals with the effect of GBS-induced chorioamnionitis, on the fetal BBB, even though it is one of the most common infection affecting the fetal environment. Given that dysfunctions of several key cells and molecules from the BBB seem to be involved in the pathogenesis of ASD from genetic and/or environmental origins, we hypothesized that pathogen-induced chorioamnionitis affects structurally and functionally the BBB. We used a well-established preclinical model of GBS chorioamnionitis leading to ASD phenotype in male offspring. We document a significant decrease of albumin permeability of the BBB in the white and gray matters of fetuses exposed versus unexposed to GBS chorioamnionitis. In line with this result, a significant increase in the expression of claudin-5 – component of tight junctions of the BBB – is detected in endothelial cells from BBB exposed to chorioamnionitis. Altogether, our results show that beyond genetic determinants, environmental factors such as bacterial infections affect the integrity of the BBB and might be involved in the fetal programming of ASD.

An adverse in utero experience negatively impacts perinatal growth in livestock. Maternal heat stress (HS) during gestation reduces placental growth and function. This progressive placental insufficiency ultimately leads to fetal growth restriction (FGR). Studies in chronically catheterized fetal sheep have shown that FGR fetuses exhibit hypoxemia, hypoglycemia, and lower anabolic hormone concentrations. Under hypoxic stress and nutrient deficiency, fetuses prioritize basal metabolic requirements over tissue accretion to support survival. Skeletal muscle is particularly vulnerable to HS-induced placental insufficiency due to its high energy demands and large contribution to total body mass. In FGR fetuses, skeletal muscle growth is reduced, evidenced by smaller myofiber size and mass, reduced satellite cell proliferation, and slower rate of protein synthesis. Disruptions in skeletal muscle growth are associated with mitochondrial dysfunction, including reduced pyruvate flux into the mitochondrial matrix and lower complex I activity in the mitochondrial electron transport chain. This review summarizes current research on the mechanisms by which HS-induced placental insufficiency affects skeletal muscle growth in the fetus, with an emphasis on myogenesis, hypertrophy, protein synthesis, and energy metabolism. The evidence presented is primarily drawn from experiments using chronically catheterized fetal sheep exposed to maternal HS during mid-gestation. Additionally, we explore emerging nutritional strategies aimed at enhancing skeletal muscle growth in animals with FGR. These strategies hold promise not only for improving reproductive efficiency in livestock affected by prenatal stress but also for their translational relevance to human pregnancies complicated by placental insufficiency.

Maternal diabetes, a common pregnancy complication, has long-term implications for both mother and offspring. While the developmental origins of metabolic health from prenatal diabetes exposure are well known, cognitive consequences in offspring are still being explored. The timing of hyperglycemia during pregnancy that most affects cognitive development and whether these effects persist into adulthood remains unclear. This study aimed to determine the association between trimester-specific hyperglycemia exposure and adult cognition in the offspring of women with pregestational diabetes. The Transgenerational Effect on Adult Morbidity (TEAM) Study evaluated health outcomes in young adult offspring of mothers with pregestational diabetes who participated in a Diabetes in Pregnancy Program Project Grant (PPG) at the University of Cincinnati (1978–1995). The TEAM Study visit (March 2018 - August 2022) included a comprehensive clinical examination and cognitive assessment (Wechsler Abbreviated Scale of Intelligence – II). Linear regression estimated the association between prenatal hyperglycemia and offspring’s perceptual reasoning and verbal comprehension. The mean age at follow-up was 32.1 years. Hyperglycemia during pregnancy was inversely associated with cognitive measures, controlling for confounders including maternal education and pre-pregnancy obesity. Higher glycohemoglobin in the second and third trimesters was significantly linked to lower IQ scores, matrix reasoning, and vocabulary subtest scores. Third-trimester hyperglycemia was also associated with lower block design subtest scores. In summary, hyperglycemia, particularly in the latter half of pregnancy, was associated with lower cognitive ability in adult offspring of women with pre-pregnancy pregestational diabetes.

Antenatal corticosteroids are given to pregnant people at risk of preterm birth to reduce newborn morbidity, including respiratory distress syndrome. However, there has been concern surrounding potential adverse effects on subsequent generations. Animal studies have demonstrated endocrine and metabolic changes in those exposed to corticosteroids in utero (F1) and in the second generation (F2). We aimed to assess the effects of parental antenatal corticosteroid exposure on health of the second generation (F2) of Auckland Steroid Trial (AST) participants. In the AST, women (F0) expected to birth between 24 and 36 weeks’ gestation were randomised to betamethasone or placebo. When their children (F1) were 50 years old, they and their children (F2) were followed up with a self-report questionnaire and data linkage. The primary outcome for this analysis was body mass index (BMI) z-score in the F2 generation. Secondary outcomes included respiratory, cardiovascular, neurodevelopmental, mental and general health, and social outcomes. Of the 213 F2 participants, 144 had BMI data available. There was no difference in BMI z-score between participants whose parent was exposed to betamethasone versus placebo (mean (SD) 0.63 (1.45), N = 77 vs 0.41 (1.28), N = 67, adjusted mean difference (95% confidence interval) = 0.16 (-0.37, 0.69)). There was no evidence of a difference in rates of overweight, diabetes, respiratory disease, cardiometabolic risk factors, neurodevelopmental difficulties, mental health difficulties and social outcomes between parental betamethasone versus placebo exposure groups, but confidence intervals were wide. These findings are reassuring regarding the intergenerational safety of antenatal corticosteroids.

Maternal mental health represents a significant global health burden, not only in terms of maternal wellbeing, but also for the impact it has on child development. The relationship between maternal mental health and deleterious environmental exposures to the fetus is one mechanism of risk transmission. This study utilizes network analysis to a) explore how maternal mental health is associated with a wide array of fetal exposures, and b) examine how these exposures cluster together. A total of 485 pregnant women were recruited from the Mercy Hospital for Women in Melbourne, Australia between 2011–2017, as part of the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). The MPEWS includes measures of mental health diagnosis and symptoms, psychotropic medication, smoking, alcohol, substance use, and a wide range of lifestyle factors in the first and third trimesters of pregnancy. Regularized Partial Correlation Modelling was used to examine the network of relationships between maternal mental health and fetal exposures due to environmental factors, lifestyle and medications. For women diagnosed with mental health disorders there are relatively higher rates of exposure to smoking, anxiety and depression symptoms, psychotropic medications, pregnancy health conditions and less than optimal lifestyle factors. Factors such as physical exercise and folate supplementation show strong patterns of partial correlation. Trait anxiety emerged as the central variable in the network with the highest strength of relationship to all other exposure variables. The current study shows the value of approaching fetal exposures as a complex network of associated aspects of maternal lifestyle, mental health and environment. Viewing exposures together may assist clinical and public health interventions to target multiple associated risk factors, rather than the current focus on individual exposures. The preconception and perinatal periods offer important opportunities for the prevention of teratogenic fetal exposures and the promotion of a healthy start to life.

The Scientific Advisory Committee on Nutrition (SACN) provides independent advice on nutrition and related health matters to UK government organisations. In keeping with its commitment to openness and transparency, SACN follows a set ‘Framework’ to ensure a prescribed and consistent approach is taken in all its evidence evaluations. Following an update of the SACN Framework in 2020, which addressed some straightforward issues, the SACN Framework subgroup was established in 2021 to consider more complex matters that were not addressed in the 2020 update. The SACN Framework subgroup considered four main topics for update: (1) the different types of evidence evaluations produced by SACN, (2) interpretation of statistical data, (3) tools for assessment of study quality and (4) tools to assess the certainty of a body of evidence for exposure–outcome relationships. The Framework subgroup agreed clear definitions and processes for the different types of evidence evaluations produced by SACN and agreed that interpretation of P values should be informed by consideration of study size, power and methodological quality. The subgroup recommended use of the AMSTAR 2 tool for quality assessment of evidence from systematic reviews and use of the Grading of recommendations, assessment, development and evaluation approach to assess the certainty of evidence. The updated Framework was published in January 2023. This was followed by publication of a further update in October 2024. As a ‘living’ document, the Framework will be subject to regular review by the Framework subgroup and continue to evolve in line with best practice.