Food refusal behaviours in preschool children can significantly impact their nutritional status and overall quality of life. This study investigated the relationship between food refusal behaviours, compliance with the Mediterranean diet and quality of life in preschool children. Conducted as a cross-sectional study, it included 400 children aged 4–6 years and their parents. The Child Food Rejection Scale measured food refusal behaviours, The Children’s Mediterranean Diet Quality Scale (KIDMED) assessed compliance with the Mediterranean Diet and the Children Quality of Life-Questionnaire (Kiddy-KINDL) scale evaluated quality of life. The mean age of the children was 4·80 (sd 0·71) years. According to age-based BMI-Z scores, 71·0 % were normal, 15·5 % underweight, 9·0 % slightly overweight and 4·5 % obese. Parents’ average age was 34·65 (sd 5·35) years; 96·8 % were married, 88·8 % had a nuclear family structure, 58·0 % were university graduates and 69·8 % rated their income level as moderate. Girls had higher food refusal scores than boys (P < 0·05). Children who frequently fell ill also scored higher in food refusal (P < 0·05). Food refusal decreased with higher family income, larger family size and older parental age (P < 0·05). Parental nutrition education significantly reduced food refusal scores (P < 0·05). Higher KIDMED scores were associated with lower food refusal (P < 0·01), and children with low Kiddy-KINDL scores exhibited higher food refusal behaviours (P < 0·01). A positive correlation was found between KIDMED and Kiddy-KINDL scores (P < 0·01). No significant associations were detected between BMI Z scores and food rejection and its subscales. The findings suggest that compliance with the Mediterranean diet reduces food refusal behaviours in preschool children and increases quality of life, while low quality of life is associated with increased food refusal behaviours.

Increasing prevalence of diet-related non-communicable diseases in India is attributed to overconsumption of energy-dense, nutrient-poor diets and ultra processed foods (UPF) may potentially contribute to this consumption pattern. Applying standard UPF definition and developing appropriate tools can better capture its consumption among Indians. This cross-sectional study aimed to validate the ‘Nova-UPF Screener (for India)’ and explore its potential to objectively capture UPF consumption among Indian adults. The screener, adapted in prior formative research study from a tool for Brazilian population, was subjected to content, face and concurrent criterion validation. Subject matter experts (n 74) participated in online consultations to determine its content validity. Adults (18–60 years) from different geographical regions of India were included for face (n 70) and concurrent criterion (n 304) validations. The screener comprised twenty-four UPF categories specific to Indian food environment. Critical inputs from experts on screener’s appropriateness were incorporated to enhance its content. For face validation, overall percentage agreement of 99·4 % for all questions indicated a strong agreement for retaining screener attributes in each question. Half the participants (49·4 %) who were administered the finalised screener had Nova-UPF scores between 2 and 4 out of 24. There was almost perfect agreement (Pabak index = 0·85) between distribution of participants based on Nova-UPF scores and fifths of dietary share of UPF (as energy %) assessed by 24-h dietary recall. Nova-UPF Screener (for India) is a valid tool to capture UPF consumption in India that can be used for rapid assessment of UPF consumption and informing policies to improve Indian diets.

An integrative approach addressing diet and other lifestyle factors is warranted in studying obesity and its related diseases. The objective of this study is to examine the associations of lifestyle patterns with overweight/obesity among children in the United Arab Emirates. Data were derived from a cross-sectional survey of children aged 4–9 years living in Dubai, Sharjah and Abu Dhabi (n 426). Dietary intake was collected using a 24-h dietary recall and evaluated with the Healthy Eating Index. The Youth Physical Activity Questionnaire assessed physical activity, while other lifestyle factors included the presence of a live-in household helper, number of electronic devices in the child’s bedroom, eating while watching TV, family dinner frequency, fast-food and breakfast consumption and hours of sleep. Factor analysis was used to identify the lifestyle patterns. Two lifestyle patterns emerged: an unhealthy pattern marked by higher fast-food intake, eating while watching TV, having a live-in household helper and lower family dinners and a healthy pattern with higher physical activity, better Healthy Eating Index, more sleep, micronutrient supplements and breakfast consumption. The healthy lifestyle pattern was linked to a 30 % reduction in overweight/obesity odds (OR = 0·7, 95 % CI: 0·53, 0·93). A healthy lifestyle pattern, characterised by higher physical activity, better dietary quality, adequate sleep and breakfast consumption, is associated with lower odds of overweight/obesity among children in the United Arab Emirates. These findings highlight the importance of promoting comprehensive lifestyle interventions to effectively address childhood obesity in this population.

Thyroglobulin (Tg) has been considered a measure of iodine status, but there is no global guidance. This analysis examines the relationship between serum Tg and spot urinary iodine concentration (UIC) data to identify Tg concentrations that correspond to current WHO thresholds for population iodine status. We analysed data from 730 non-pregnant Guatemalan women aged 15–49 years who had both UIC and Tg measurements. Correlations were examined. Bootstrap stratified finite sampling with replacement was used to generate cluster k-medians of UIC (mUIC) and Tg (mTg) that served as the population unit of analyses. Non-linear restricted cubic spline regression dose–response curve functions and ordinary differential equations were then used to derive the Tg threshold corresponding to WHO definitions for UIC. Mean age was 30·2 (sd 9·3) years. mTg was 10·4 ng/ml (9·9, 10·8), and mUIC was 148·7 μg/l (139·1, 161·0). Correlations between spot UIC and Tg were NS at the individual level, but correlations based on population k-medians were significant (Spearman r = −0·21 to −0·06, each P < 0·0001) and demonstrated a U-shaped relationship according to WHO categories. Derived mTg cutoffs were 14·2 ng/ml predictive of UIC insufficiency, 10·2 ng/ml for UIC adequacy, 8·5 ng/ml for UIC above adequate and 10·8 ng/ml for UIC excess. The significant and graded mUIC–mTg correlations suggest that Tg concentrations predictive of UIC categories are obtainable for non-pregnant Guatemalan women aged 15–49 years. The newly derived mTg cutoff may be more discriminant at a lower spectrum of UIC in terms of identifying iodine-deficient women, more so than in the UIC excess category.

Pregnant women are exposed to various contaminants through foods, with environmental toxicants and aflatoxin (AF) being among the major food contaminants. Therefore, this review was conducted for a better perspective on the AF exposure during pregnancy or infancy, highlighting how exposure through the mother (via placenta and breast milk) and directly through infant foods ultimately affects infant health. The literature suggests that AF exposure during pregnancy may lead to maternal anaemia, premature delivery, pregnancy loss or decreased number of live births. AF crosses through the placenta and also passes through breast milk. AF exposure during pregnancy may also lead to deleterious effects on the fetus or infants such as reduced fetal growth, low birth weight, impairment of linear or long bone growth and developmental delay such as small head circumference and reduced brain size, stillbirth or fetal death. It may also have an adverse effect on some organs and organ systems, causing aberrations such as neonatal jaundice and disrupting hormone synthesis. In the Indian context, there are limited clinical studies to assess the health effects of AF exposure during pregnancy. For the first time, we have made an attempt to estimate the AF exposure by calculating the AF estimated daily intake using the empirical formulae based on several reported studies. However, more research needs to be undertaken to understand the AF exposure outcomes during pregnancy. The data presented in this review warrant more clinical studies in India on maternal AF exposure to elucidate the birth outcomes and associated infant health outcomes.

E-sports has become popular among young people in recent years. The online nature of esports might contribute to differences in the dietary habits and lifestyles of university students who engage in this activity. The study aimed to compare the dietary habits, adherence to the Mediterranean diet and sleep duration of esports players (ESp) and non-eSports players (nESp) university students in Türkiye. The study was designed as a cross-sectional analysis, and data were collected through an online form. The form consisted of questions on socio-demographic characteristics, dietary habits, food frequency, physical activity, sleep duration and the Mediterranean Diet Adherence Scale. The study included 115 ESp participants (mean age: 20·5 (sd 1·5) years) and 110 nESp participants (mean age: 21·0 (sd 1·5) years). The ESp group had significantly higher rates of alcohol (45·2 % v. 15·5 %) and energy drink (34·8 % v. 12·7 %) consumption compared with the nESp group (P < 0·001). A significantly higher proportion of ESp skipped breakfast compared with nESp (68·3 % v. 46·2 %) (P = 0·004). The adherence rates to the Mediterranean diet were comparable between the two groups, with 30·4 % of ESp and 36·4 % of nESp adhering to the dietary pattern. Although physical activity, sleep duration and Mediterranean diet adherence were similar between groups, esports players reported higher consumption of alcohol, energy drinks and processed foods, which might increase the risk of obesity and metabolic disorders. These findings highlight the need for targeted nutritional guidance and health promotion strategies to support healthier lifestyle behaviours among ESp.

Healthy ageing and longevity have emerged as urgent public health priorities amid global population ageing and declining birth rates. This review synthesises empirical evidence highlighting the essential role of diet and nutrition in preventing chronic diseases and supporting functional independence in later life. The review was organised using a problem-solving approach to address three core questions: ‘What’ evidence links food and nutrition with positive health outcomes; ‘Why’ do specific dietary components affect biological ageing – via mechanisms such as nutrient sensing, inflammation modulation and caloric restriction; and ‘How’ culturally tailored, person-centred dietary interventions should be developed for better adoption. Findings from centenarian populations suggest that low-energy (i.e. foods with low energy density, such as fruit and vegetables, whole grains), nutrient-rich and diverse diets may help prevent or delay age-related diseases, supporting the notion that food could be used as medicine. Moreover, addressing barriers such as food insecurity and limited access to culturally appropriate healthy food options, particularly in low-income and rural communities, is crucial for achieving equitable health outcomes. Finally, the review calls for integrating personalised nutrition strategies into clinical care and public health initiatives. These efforts can enhance healthspan, improve quality of life and reduce the broader social and economic burdens associated with ageing populations.

Mandatory calorie labelling was introduced in out-of-home (OOH) food sector outlets during 2022 in England. Previous research in North America has found that labelled energy content can be underestimated for packaged and quick-serve foods, but no study has evaluated the accuracy of OOH food sector menu calorie labelling in response to the mandatory policy introduced in England. N 295 menu items from a range of outlet types (e.g. cafes, pubs, restaurants) and menu categories (e.g. starters and sides, main, dessert) were sampled. Bomb calorimetry was used to quantify energy content, and the reported energy content on menus was recorded. Consistency of measured energy was assessed by sampling the same items across outlets of the same business (n 50 menu items). Differences between reported and measured energy content were tested through Wilcoxon signed rank tests, and a linear model examined correlates of the difference. Mean measured kilocalories (kcal) were significantly lower than reported kcal (–16·70 kcal (±149·19), V = 16 920, P < 0·01 and r = 0·182). However, both over- (23 % of menu items) and under-estimation (11 %) by > 20 % of measured energy content were common, and the averaged absolute percentage difference between reported and measured values was 21 % (±29 %). Discrepancy between measured and reported energy content was more common in some outlet types (pubs), and reported energy content was substantially different (> 20 %) to measured energy content for 35 % of sampled menu items. There may be significant inaccuracies in reported energy content of calorie labelled menu items in English food outlets subject to mandatory calorie labelling.

Vitamin D deficiency is common in the UK, especially in certain ethnic minority populations. There is limited information on childhood vitamin D status in the UK, or factors associated with vitamin D deficiency. Using a cross-sectional study of 4650 children of South Asian, Black African and Caribbean and White European origins (9–10 years old) surveyed between 2004 and 2007, we investigated measurements of circulating 25(OH)D concentrations (a measure of vitamin D status) and anthropometric measurements. Overall, 68 % of children had 25(OH)D concentrations ≤ 50 nmol/L and were either insufficient (25–50 nmol/L) (45 %) or deficient (< 25 nmol/L) (23 %). Mean 25(OH)D concentrations were lowest in South Asian (especially Bangladeshi) children, intermediate in Black African and Caribbean and highest in White European children. Mean values were ≤ 50 nmol/L for all children during the winter months and ≤ 50 nmol/L throughout the year for South Asian, Black African and Caribbean children. In analyses adjusted for season, age, sex, ethnicity, socio-economic status and fat mass index, girls had a higher risk of being vitamin D deficient or insufficient (OR 1·49, 95 % CI 1·32, 1·68) compared with boys. South Asian children (OR 25·49, 95 % CI 19·95, 32·57) and Black African and Caribbean children (OR 10·31, 95 % CI 10·31, 17·52) had the highest risks of being deficient or insufficient compared with White European children. Childhood vitamin D deficiency was common in this study population. In the UK, targeted and novel interventions are needed to increase 25(OH)D concentrations, particularly South Asian and Black African and Caribbean children and reduce the health risks associated with low vitamin D status.

The effects of high plant-based proteins (PP) used as alternative protein sources in aquafeeds on muscle cellularity and myogenic factors of rainbow trout, Oncorhynchus mykiss, remain unclear. This study explored muscle fibre growth phases and the impact of two additive mixtures (A) in high-PP diets on muscle physiology. Over a seven-month trial, 2000 fish (2·22 g) were divided into four groups (five replicates each) and fed isonitrogenous (fry, 46 %; fingerling, 44 %; and grow-out, 42 % crude protein) and isolipidic (20 % lipid) diets: control (30 % fishmeal), PP, PP + A1 (krill meal, taurine, selenium) and PP + A2 (proline, hydroxyproline, vitamin C). Sampling for muscle histology and myogenic gene expression was conducted at ten sampling points from Day 0 to Day 214. Muscle histology (fibre distribution: small, 0–20 μm; small-medium, 20–60 μm; large-medium, 60–100 μm and large, ≥ 100 μm diameter) revealed four growth phases: hyperplasia (2·2–15 g), hypertrophy (15–50 g), hyperplasia (50–150 g) and hypertrophy (150–350 g). MyoD2 and myogenic regulatory factor 4 (MRF4) were upregulated during hyperplasia, while myostatin 1 (MSTN1)/myostatin 2 (2) and reduced Paired box 7 indicating growth inhibition and fewer satellite cells. The PP diet without additives altered fibre recruitment, while PP + A2 enhanced hypertrophy, increasing large (> 100 μm) fibres. Additive mixtures modulated myogenic gene expression, with PP + A2 promoting MyoD2, myogenin and MRF4 and reducing MEF2A/C, contrary to known hypertrophy markers. PP + A1 and PP + A2 diets reduced MSTN1 expression, potentially mitigating growth inhibition. Additive supplementation in PP diets alleviates negative impacts on muscle cellularity and myogenic regulation. The identified growth phases provide insights for precision nutrition, supporting improved feeding strategies for sustainable aquaculture.

Previous studies highlighted the health benefits of coffee and tea, but they only focused on the comparisons between different consumptions. Consequently, the association estimate lacked a clear interpretation, as the substitution of beverages and distribution of doses were not explicitly prescribed. We focused on the ‘relative association’ to ascertain the optimal consumption strategy (including total intake and optimal allocation strategy) for coffee, tea and plain water associated with decreased mortality. Self-reported coffee, tea and plain water intake were used from the UK Biobank. Within a compositional data analysis framework, a multivariate Cox model was used to assess the relative associations after adjusting for a range of potential confounders. The lower mortality risk was observed with at least approximately 7–8 drinks/d of total consumption. When the total intake > 4 drinks/d, substituting plain water with coffee or tea was linked to reduced mortality; nevertheless, the benefit was not seen for ≤ 4 drinks/d. Besides, a balanced consumption of coffee and tea (roughly a ratio of 2:3) associated with the lowest hazard ratios of 0·55 (95 % CI 0·47, 0·64) for all-cause mortality, 0·59 (95 % CI 0·48, 0·72) for cancer mortality, 0·69 (95 % CI 0·49, 0·99) for CVD mortality, 0·28 (95 % CI 0·15, 0·52) for respiratory disease mortality and 0·35 (95 % CI 0·15, 0·82) for digestive disease mortality than other combinations. These results highlight the importance of the rational combination of coffee, tea and plain water, with particular emphasis on ensuring adequate total intake, offering more comprehensive and explicit guidance for individuals.

Personalised nutrition aims to deliver targeted advice to promote dietary behaviours that are beneficial to health based on individual characteristics. Given the financial implications (for providers and participants) of characterising, developing, implementing, communicating and supporting individual behaviour change there remains potential for personalised nutrition to widen health inequalities within populations. Some commentators promote a universal approach to achieve wider population-level benefit. Universal approaches attempt to provide a whole systems perspective with individual outcomes, potentially smaller in scale, impacting at the population level. In the UK the national food-based guidance, the Eatwell Guide, is used to communicate advice on diet consistent with UK government dietary recommendations based on robust, independent assessment of the best available evidence by the Scientific Advisory Committee on Nutrition. Effort was taken in ensuring all UK government recommendations in 2016 (when the UK’s national food-based guidance was last reviewed following changes in dietary recommendations on carbohydrates and sugars) could be achieved at a population level based on available and recognised foods. There is evidence that moving towards a diet consistent with national food-based guidelines has positive benefits for health and the environment. There is debate about the cost of a healthy diet and the impact of including elements of sustainability elements. This commentary considers how developments in healthy eating indices may be beneficial as a universal approach could provide opportunities to support individuals move towards healthier diets. It also raises questions about the evidence requirements and timing of any future amendments to the UK’s Eatwell Guide.