This review examines the relationship between diet and functional dyspepsia (FD), a prevalent disorder of gut–brain interaction affecting 8% of the global population and characterised by postprandial fullness, early satiety and epigastric pain or burning. Despite 40–70% of FD patients reporting symptom onset within minutes of eating, standardised dietary recommendations remain limited. The pathophysiological mechanisms underlying food-related symptoms in FD involve complex interactions between altered gastric accommodation and emptying, visceral hypersensitivity, duodenal immune activation and small intestinal microbial dysbiosis. Current evidence most strongly supports dietary lipids as potent triggers of dyspeptic symptoms, likely mediated through cholecystokinin pathways and heightened visceral sensitivity. Additionally, emerging research indicates potential benefits of fermentable carbohydrate restriction, with the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) diet showing promise particularly for patients with postprandial distress syndrome. Other dietary factors such as alcohol, coffee, food chemicals, bioactive compounds and meal patterns may also influence FD symptoms though current evidence remains insufficient to inform clinical practice. While existing evidence provides a foundation for understanding diet–symptom relationships in FD, significant gaps remain in translating mechanistic insights into personalised dietary recommendations. Future research should focus on developing evidence-based dietary strategies tailored to FD subtypes, ensuring nutritional adequacy while addressing the complex interplay between nutrient sensing, duodenal immune activation and gut microbiota in symptom generation.

The purpose of this study was to confirm reduced training metrics previously associated with a ketogenic low-carbohydrate (CHO) high-fat diet (LCHF) and investigate their attenuation with caffeine supplementation. At baseline, n 21 elite race-walkers followed a high CHO availability (HCHO) diet and performed a tempo hill session (14 km with a 450 m elevation gain). Athletes were then assigned to either the HCHO or LCHF in a parallel groups design for 3 weeks, where the 14 km tempo hill session was repeated each week. On weeks 2 and 3, in a randomised crossover allocation, all participants received 3 mg/kg caffeine or placebo (gum), 20 min before the session. Race-walking speed, heart rate, ratings of perceived exertion, blood metabolites and Stroop word-colour test metrics were collected. Although LCHF athletes walked faster at baseline compared with HCHO (P = 0·049), the HCHO group improved by week 2 (P = 0·009) and week 3 (P = 0·007), whereas the LCHF group was significantly slower in Week 1 (P < 0·001) and Week 2 (P = 0·026) compared with baseline. During the 14 km hill session, within-group analysis shows that athletes walked significantly faster (P = 0·010) and at a higher percentage of vVO2max (P = 0·007) when using caffeine compared with a placebo. Between-group differences remained present, with HCHO athletes walking at a higher percentage of vVO2max than those adhering to the LCHF diet (P = 0·035). No interaction between supplement treatment and dietary group occurred (P = 0·640). Caffeine supplementation partially reversed the performance impairment associated with an LCHF diet, but training quality remained lower than the combination of caffeine and high CHO availability.

This study examined the associations between cold and hot food and beverage consumption and various health outcomes among Asians and Whites in the USA. Data were drawn from 212 Asian and 203 White adults (aged 18–65 years) in the Healthy Ageing Survey. Participants reported their frequency of cold and hot drink and meal intake, along with symptoms of depression, anxiety, insomnia and gastrointestinal issues (e.g. gas, abdominal fullness). Multivariable analyses adjusted for confounders were used to assess these associations. Among Asians, higher cold consumption in summer was associated with increased anxiety (β = 0·24, 95 % CI: 0·05, 0·44) and abdominal fullness (β = 0·05, 95 % CI: 0·01, 0·86). In contrast, among Whites, higher winter hot drink intake was linked to lower insomnia (β = –0·23, 95 % CI: –0·42, –0·04) and gas symptoms (β = –0·05, 95 % CI: –0·09, –0·01). Tertile analyses showed that, compared with tertile 1, Asians in the highest tertile of summer cold drink intake had higher insomnia scores (β = 1·26, 95 % CI: 0·19, 2·33), while Whites in the highest tertile of winter hot drink intake had lower depression scores (β = –1·73, 95 % CI: –3·28, –0·18). These associations were stronger among individuals with cold hands but not observed in those without. Findings suggest that the temperature of foods and beverages may influence mental and gut health, underscoring the need to consider temperature-related dietary habits in public health and nutrition strategies, particularly across diverse populations.

Sulforaphane (SFN), a bioactive compound derived from glucoraphanin in cruciferous vegetables such as broccoli, has been extensively studied for its therapeutic potential across diverse disease categories. SFN exerts its effects through well-characterised pathways, including the Keap1/Nrf2 axis, which regulates phase II detoxification enzymes, and epigenetic mechanisms such as histone deacetylase inhibition. This review evaluates clinical trials registered on ClinicalTrials.gov, focusing on those using SFN or broccoli-derived extracts.

As a result, we identified 84 trials, of which 39 have been published. Results suggest SFN’s potential in regulating redox and inflammatory pathways, improving metabolic and cardiovascular outcomes, and exerting anti-cancer and neuroprotective effects. For healthy subjects, SFN enhanced detoxification and reduced inflammation. In cancer patients, SFN showed promise in early-stage prostate and breast cancer, particularly in GSTM1-positive individuals, but had limited effects in advanced cases. For brain disorders, SFN demonstrated symptomatic improvements in autism spectrum disorder and cognitive benefits in schizophrenia but lacked robust biomarker integration. SFN had minimal impact on respiratory diseases but showed supportive roles in allergic rhinitis therapy. Metabolic disease studies revealed glycaemic control improvements in type 2 diabetes but no benefits for hypertension. Approximately 50% of completed trials remain unpublished, raising concerns about publication bias. While published results highlight SFN’s therapeutic potential, limited sample sizes and inconsistent outcomes underscore the need for more extensive, stratified trials. This review emphasises the importance of integrating mechanistic insights and precision medicine approaches to maximise SFN’s clinical utility.

Norway exhibits one of the highest rates of colorectal cancer (CRC) in the world, and several dietary factors have been associated with the risk of CRC. With higher consumption of ultra-processed foods (UPF), a better understanding of how food processing affects CRC might be a new approach for prevention. The current findings are contradictory, and new findings indicate that CRC risk factors might affect colorectal subsites differently. We wanted to study the association between intake of UPF and CRC risk in Norwegian women. In this prospective cohort analysis encompassing 77 100 women (1625 cases) from the Norwegian Women and Cancer study, dietary intakes were collected using validated semi-quantitative FFQ and categorised using the Nova classification system. Multivariable Cox proportional hazard models were used to assess the association between intake of UPF and CRC risk. The average follow-up time was 17·4 years. A high UPF intake (fourth quartile), compared with a low UPF intake (first quartile), was statistically significantly associated with increased total CRC risk after adjusting for all covariates and energy intake (hazard ratio (HR) = 1·24; 95 % CI 1·04, 1·49, Pfor trend = 0·02). Furthermore, a high UPF intake, compared with a low UPF intake, was statistically significantly associated with right-sided colon cancer (HR = 1·58; 95 % CI 1·19, 2·09, Pfor trend < 0·001). More research is needed to understand the associations between UPF, UPF subgroups and total CRC as well as cancer in colorectal subsites.

Consuming whole grains (processed cereal grains containing all the bran, germ and endosperm), and whole-grain foods such as bread, porridge and pasta made from them, is universally recognised as beneficial for health. This is consistently shown through reduced risk and incidence of chronic diseases such as CVD, type 2 diabetes and some cancers with higher whole grain and whole-grain food intakes. Despite this, and the promotion of whole-grain foods in many food-based dietary guidelines, their consumption by the majority of global populations remains below levels predicted to improve health, particularly in the UK and Ireland. This paper (a) describes how whole grains and whole-grain foods can be better identified by consumers and food manufacturers through adoption of standard definitions and food-labelling processes, (b) summarises predicted benefits associated with higher whole-grain consumption and (c) discusses how developing population-based strategies to increase whole-grain consumption can beneficially affect dietary fibre intake, using the Danish Whole-Grain Campaign as a model for success. We suggest that the forthcoming ISO definition of whole grains as a food ingredient together with conditions of use should be adopted as soon as possible in the UK and Ireland. The health benefits of consuming more whole grain are unequivocal and should be recognised by including whole grains in dietary guidance, preferably with a minimum intake level for improved health. Public Health Agencies in the UK and Ireland should work in partnership with academics, industry and retailers to raise the profile of whole grains and whole-grain foods to improve population health.

The food system, particularly animal agriculture, is a major contributor to environmental degradation, impacting critical Earth system processes such as climate change, freshwater use and biodiversity loss. There is a growing consensus that a shift from animal-based to plant-based diets is essential for both human health and environmental sustainability. This review explores the integration of sustainability competences into nutrition education, emphasising how systems thinking, strategic thinking, values thinking, futures thinking and interpersonal competences can contribute to the production of improved dietary guidelines. By applying these competences to the criticisms of the Planetary Health Diet, the Nordic Nutrition Recommendations and the Mediterranean diet as examples, this review highlights the tactics used by specific stakeholders to undermine sustainable healthy dietary guidelines. The review paper concludes by advocating for future dietary guidelines that are free of financial conflicts of interest, decolonised and developed through participatory processes in order to ensure that they are equitable, sustainable and aligned with the needs of diverse populations.

The aim of this paper is to review several key aspects of undernutrition in later life, with a major focus on undernutrition in community-dwelling older adults. The prevalence of undernutrition in community-dwelling older adults is about 8.5%, but higher in vulnerable subgroups such as the oldest old (19.3%), those reporting poor appetite (22.4%), and those receiving home care (15.8%). Frequently reported risk factors for undernutrition in the community include poor appetite, functional limitations and previous hospitalisation. The Determinants of Malnutrition in Aged Persons (DoMAP) model provides a clear framework to structure the different direct and indirect potential determinants of undernutrition in old age. Low BMI as well as involuntary weight loss, both important phenotypic criteria of undernutrition, are associated with early mortality in older adults. Furthermore, undernutrition in community-dwelling older adults is associated with a subsequent increased risk of frailty, falls, functional decline and rehospitalisation. Qualitative studies indicate a poor undernutrition awareness among healthcare professionals working in community care as well as among older adults themselves. The Malnutrition Awareness Scale can be used to objectively measure an older persons’ undernutrition awareness. In conclusion, the prevalence of undernutrition among older adults living in the community is substantial and has several negative consequences for health and functioning. Strategies towards greater undernutrition awareness by primary care professionals as well as older adults themselves is therefore necessary.

Suicidal ideation not only indicates severe psychological distress but also significantly raises the risk of suicide, whereas food insecurity may further increase this risk. To examine the relationship between food insecurity and suicidal ideation, we used the NHANES (National Health and Nutrition Examination Survey) data from 2007 to 2016. The association between the risk of suicidal ideation and food security status was examined using multivariate logistic regression models. To ensure the robustness of our findings, we also conducted subgroup and sensitivity analyses, which were crucial for assessing the consistency and precision of the research findings. This study included 22 098 participants, of whom 50·30 % were female and 49·70 % were male. In the comprehensive analysis of the population, after full adjustment, the OR were 1·14 (95 % CI 0·89, 1·46) for marginal food security, 1·40 (95 % CI 1·12, 1·76) for low food security and 1·59 (95 % CI 1·27, 1·99) for very low food security. In the subgroup analysis, we identified a significant interaction between depression and food security (P = 0·004). Additionally, the results of the sensitivity analysis were consistent with previous findings. Our study revealed that food insecurity significantly increased the risk of suicidal ideation, emphasising the importance of addressing food security to improve mental health. These findings support the need for national food assistance programmes integrated with mental health services. More longitudinal studies are needed to validate the long-term impact of food insecurity on suicidal ideation to optimise intervention measures and policy adjustments.

By 2050, 1.31 billion people will be living with type 2 diabetes (T2DM). Those with social disadvantage experience greater diabetes prevalence, morbidity and mortality. Gestational diabetes (GDM) is an established factor for T2DM, with 3–4 times greater risks among women who are Black, Hispanic and South and South East Asians. Lifestyle interventions that include diet and physical activity reduce T2DM in at-risk populations, including women with prior GDM, regardless of ethnicity. However, migrant women from non-Western backgrounds are less likely to engage with the programme despite its efficacy. This review paper aims to describe the social disparities in GDM globally, with a focus on equity issues and interventions in Australia. It outlines a five-part approach to solutions that move us towards equity in reach and uptake for women from non-Western migrant backgrounds in Australia. Culturally inclusive solutions start with evaluating reach in underserved groups through equity audits or stratified analyses and identifying groups where reach is low. Community partnerships can then be formed with key actors across health and social sectors identified through stakeholder mapping. Effective reach strategies, including implementation and evaluation plans, will be co-developed through these partnerships, addressing risk factors, enablers and barriers to a healthy lifestyle. Solutions that integrate medical and social services, such as social prescribing, could facilitate healthy lifestyle choices through restructuring the social environment of the individual. These steps lead to interventions that promote social cohesion and resilience, enabling individuals to attain health and well-being in the face of external challenges.

To explore the longitudinal associations between a Chinese healthy diet and the progression of cardiometabolic multimorbidity (CMM) development among Chinese adults. A prospective analysis was conducted utilising data from 18 720 participants in the China Health and Nutrition Survey, spanning from 1997 to 2018. Dietary data were collected by three consecutive 24-h dietary recalls combined with the weighing method. A Chinese healthy diet score was developed by assigning scores to various food components. CMM was defined as the coexistence of two or more cardiometabolic diseases (CMD), including myocardial infarction, stroke and type 2 diabetes, diagnosed through blood indicators and clinical diagnosis. We employed a multistate model to examine the associations between the Chinese healthy diet and the longitudinal progression from being free of CMD to first CMD and then to CMM. Quantile G-computation was utilised to evaluate the relative contribution of each food component. Over a median follow-up period of 7·3 years, 2214 (11·8 %) participants developed first CMD, and 156 (0·83 %) progressed to CMM. Comparing participants in the highest quintile of dietary scores with those in the lowest, we observed a 55 % lower risk of transitioning from baseline to CMM (HR = 0·45, 95 % CI: 0·23, 0·87) and a 60 % lower risk of transition from first CMD to CMM (HR = 0·40, 95 % CI: 0·20, 0·81). Fresh fruits contributed to 42·8 and 43·0 % for delaying CMM and transition from first CMD to CMM, respectively. Our study revealed that greater adherence to the Chinese healthy diet is negatively associated with the risk of CMM.

Recent literature has shown that appetite loss during ageing can lead to negative health outcomes in older adults, particularly malnutrition and mortality. However, its association with functional decline and the mechanisms driving this relationship are not well explored. This review summarises the current evidence regarding the potential effects of appetite loss on frailty and functional outcomes. Despite the limitations due to heterogeneous methodologies, including study designs, population characteristics and appetite assessments, most studies indicate that older adults with poor appetite tended to exhibit poor physical performance and increased functional limitations. Furthermore, the simultaneous weight loss in individuals experiencing appetite loss was associated with a higher risk of functional impairments. Finally, emerging evidence connects reduced appetite to biomarkers of ageing, including epigenetic alterations, chronic inflammation and the upregulation of GDF-15. Therefore, loss of appetite is a potential earlier marker of loss of function that deserves further investigation. Adopting a geroscience perspective may enhance our understanding of appetite loss during ageing and foster the development of effective interventions.