This review summarises evidence from cohort and intervention studies on the relationships between nutrition in early life, epigenetics and lifelong health. Established links include maternal diet quality with conception rates, micronutrient sufficiency before and during pregnancy with preterm birth prevention, gestational vitamin D intake with offspring bone health, preconception iodine status with child IQ, adiposity with offspring obesity and maternal stress with childhood atopic eczema. Animal studies demonstrate that early-life environmental exposures induce lasting phenotypic changes via epigenetic mechanisms, including DNA methylation, histone modifications and non-coding RNA, with DNA methylation of non-imprinted genes most extensively studied. Human data show that nutrition during pregnancy induces epigenetic changes associated with childhood obesity risk, such as Antisense long Non-coding RNA in the INK4 Locus (ANRIL, a long non-coding RNA) methylation variations linked to obesity and replicated across multiple populations. Emerging insights reveal that paternal nutrition and lifestyle also modify sperm epigenomics and influence offspring development. Although nutritional-randomised trials in pregnancy remain limited, findings from the NiPPeR trial showed widespread preconception micronutrient deficiencies and indicated that maternal preconception and pregnancy nutritional supplementation can reduce preterm birth and early childhood obesity. The randomised trials UPBEAT and MAVIDOS have shown that nutritional intervention can impact offspring epigenetics. Postnatal nutritional exposures further influence offspring epigenetic profiles, exemplified by ALSPAC cohort findings linking rapid infant weight gain to later methylation changes and increased obesity risk. Together, these studies support a persistent impact of maternal and early-life nutrition on child health and development, underpinned by modifiable epigenetic processes.

Body composition (BC) offers essential insights into the physical condition and performance capacity of athletes. Several factors can influence athletes’ BC, such as nutrition, which can improve lean mass (LM) and body fat percentage (%BF). This longitudinal observational study aimed to investigate the factors influencing BC in professional female football players, including hormones, dietary habits and physical activity, as these are relevant to their sport performance and health. Data related to dietary habits, dual-energy X-ray absorptiometry measurements, serum hormones, menstruation and global position system metrics were collected in November 2023 and late March 2024 from thirty-eight female football players from the Real Sociedad team. Of the thirty-eight players enrolled, thirty-five completed all assessments and were included in the final analyses. Spearman correlations and linear regression analyses were performed. Statistically significant models were executed for %BF and LM (adjusted R2 = 0·55 and 0·47, respectively). For %BF, total testosterone had a positive influence, while high-speed running per minute, follicle-stimulating hormone, distance covered per minute, prolactin and fat intake influenced negatively. In the LM model, positive associations were total testosterone, progesterone, age, adrenocorticotropic hormone and carbohydrate intake, while insulin, distance covered per minute and sex hormone binding globulin had negative associations. These results emphasise the complexity of the factors influencing BC in female football players. Personalising and periodising carbohydrate intake and monitoring training loads are crucial to prevent adverse effects such as higher %BF and muscle catabolism. Establishing healthy nutritional practices is essential for long-term health and performance.

The global syndemic of obesity, undernutrition and climate change – three interconnected challenges – threatens both human and planetary health. This review focuses on one critical intersection: older populations living with overweight and obesity in the context of sustainable nutrition. Obesity and sarcopenia, particularly the co-occurrence called sarcopenic obesity, are often overlooked until the onset or exacerbation of other diseases necessitates secondary care. Preventing sarcopenic obesity requires reducing excess fat mass while preserving muscle mass and function. This involves lowering total energy intake while ensuring adequate protein intake in terms of quantity, quality and distribution, combined with physical activity, particularly resistance exercise. Short-term studies show that both the source and dose of dietary protein significantly influence muscle protein synthesis rates. Longer-term studies examining the impact of plant-based diets on muscle health in older adults with or without overweight or obesity remain limited. Animal protein have shown a modest advantage over most plant-based protein in supporting muscle mass. Qualitative studies suggest that emphasising both the health benefits and palatability of plant-based protein sources is key to promoting dietary changes in older adults. In older adults with obesity, it is challenging to combine energy restriction with higher protein intake, especially when protein sources are plant-based. To prevent and treat sarcopenic obesity in older adults and support planetary health, a shift toward more plant-based protein sources is required, while ensuring sufficient protein quantity and quality to preserve muscle health during weight loss.

This review aims to (1) provide an overview of research investigating the relationship between body composition, specifically fat-free mass (FFM) and fat mass (FM), appetite and energy intake (EI) and (2) to investigate potential mechanisms underlying these relationships, with a focus on ageing. Appetite and EI are influenced by complex, multifactorial pathways involving physiological, psychological, environmental, social and cultural factors. Early research investigating the association of body composition with appetite and EI focused on FM; however, the role of FFM in appetite control is gaining increasing attention. Studies have shown that FFM is positively associated with EI in younger populations, including infants, adolescents and adults. In contrast, FM appears to have no association or a weak inverse association with appetite/EI. However, research in older adults is limited, and the underlying mechanisms are not fully understood. It has been suggested that one way in which FFM may influence appetite and EI is by impacting resting metabolic rate (RMR). FFM, which includes metabolically active tissues including skeletal muscle and organs, represents the largest determinant of RMR and therefore may influence appetite and EI by ensuring the energetic requirements of crucial tissue-organs and metabolic processes are reached. Given that declines in FFM and RMR are common with ageing, they may be possible targets for interventions aimed at improving appetite and EI. While current evidence in older adults supports a positive association between FFM and appetite, further longitudinal studies are needed to explore this relationship in different contexts, along with the underlying mechanisms.

Ultra-processed foods (UPF), defined using frameworks such as NOVA, are increasingly linked to adverse health outcomes, driving interest in ways to identify and monitor their consumption. Artificial intelligence (AI) offers potential, yet its application in classifying UPF remains underexamined. To address this gap, we conducted a scoping review mapping how AI has been used, focusing on techniques, input data, classification frameworks, accuracy and application. Studies were eligible if peer-reviewed, published in English (2015–2025), and they applied AI approaches to assess or classify UPF using recognised or study-specific frameworks. A systematic search in May 2025 across PubMed, Scopus, Medline and CINAHL identified 954 unique records with eight ultimately meeting the inclusion criteria; one additional study was added in October following an updated search after peer review. Records were independently screened and extracted by two reviewers. Extracted data covered AI methods, input types, frameworks, outputs, validation and context. Studies used diverse techniques, including random forest classifiers, large language models and rule-based systems, applied across various contexts. Four studies explored practical settings: two assessed consumption or purchasing behaviours, and two developed substitution tools for healthier options. All relied on NOVA or modified versions to categorise processing. Several studies reported predictive accuracy, with F1 scores from 0·86 to 0·98, while another showed alignment between clusters and NOVA categories. Findings highlight the potential of AI tools to improve dietary monitoring and the need for further development of real-time methods and validation to support public health.

Individuals with severe mental illness face a significantly reduced life expectancy compared to the general population. Addressing key modifiable risk factors is essential to reduce these alarming rates of mortality in this population. Nutritional psychiatry has emerged as an important field of research, highlighting the important role of nutrition on mental health outcomes. However, individuals with severe mental illness often encounter barriers to healthy eating, including poor diet quality, medication-related side effects such as increased appetite and weight gain, food insecurity and limited autonomy over food choices. While nutrition interventions play a key role in improving health outcomes and should be a standard part of care, their implementation remains challenging. Digital technology presents a promising alternative support model, with the potential to address many of the structural and attitudinal barriers experienced by this population. Nonetheless, issues such as digital exclusion and low digital literacy persist. Integrating public and patient involvement, along with behavioural science frameworks, into the design and delivery of digital nutrition interventions can improve their relevance, acceptability and impact. This review discusses the current and potential role of digital nutrition interventions for individuals with severe mental illness, examining insights, challenges and future directions to inform research and practice.

Sarcopenia, the age-related decline in muscle mass and strength, is a contributor to frailty and reduced quality of life. Emerging evidence suggests an emerging role of the gut microbiome in modulating skeletal muscle through microbial species and metabolites, such as short-chain fatty acids (SCFAs), potentially influencing inflammation, nutrient absorption, and glucose and protein metabolism. This review considers the potential of probiotics, prebiotics, and synbiotics as interventions to mitigate sarcopenia based on animal and human studies, while providing a critique of present barriers that need to be addressed. Preclinical models, including germ-free mice and faecal microbiota transplantation, demonstrate that gut microbiota from healthy or young donors may enhance overall muscle health via reductions in inflammatory and muscle atrophy markers. Limited human studies show that probiotics such as Lactobacillus and Bifidobacterium could improve branched-chain amino acid (BCAA) bioavailability and potentially sarcopenia indices, although findings have been inconsistent. Particularly, challenges including inconsistent microbial assessments, lack of dietary control and interindividual variability due to diet, age, genetics, comorbidities and medications may hinder progress in this field. Delivery methods (e.g. capsules, fermented foods or fortified products) could further complicate efficacy through probiotic stability and dietary restrictions in older adults. Standardised protocols [e.g. Strengthening The Organisation and Reporting of Microbiome Studies (STORMS) checklist] and multi-omics approaches may be critical to address these limitations and identify microbial signatures linked to sarcopenia outcomes. While preclinical evidence highlights mechanistic pathways pertinent to amino acid metabolism, translating findings to humans requires rigorous experimental trials.

Although many online-based dietary surveys have been developed in recent years, systems that easily survey the dietary balance based on the Japanese diet are insufficient. This study aimed to evaluate the relationship between dietary balance scores from an online survey system based on the Japanese Food Guide Spinning Top, and nutrient/food intake calculated using the weighing method from dietary records (DRs), as well as to assess the system’s utility and applicability. An online dietary balance survey and semi-weighted DR assessment with food photographs were conducted in Japanese participants (n = 34). Registered dietitians entered the balance scores into the system based on the participants’ food photographs, and the scores were calculated using the system. Significant positive correlations (p < 0.001) were found between the online dietary balance scores and nutrient/food intake from DRs; especially for ‘grain dishes’ and carbohydrates (r = 0.704); ‘vegetable dishes’ and the vegetable dish group (sum of potatoes, vegetables, mushrooms, and algae) (r = 0.774); ‘main dishes’ and protein (r = 0.661); ‘milk’ and the milk and milk products group (r = 0.744); and ‘fruits’ and the fruits group (r = 0.748). Bland–Altman analysis showed that the dietary balance scores obtained by this system tended to underestimate the intake compared with the weighing method. Although there are limitations to the accurate estimation of nutrient and food intake, the online dietary balance scores obtained from the online dietary balance survey system were useful for understanding the dietary balance in the Japanese diet.

Kids SIPsmartER is a school-based behavioural intervention for rural Appalachia middle school students with an integrated two-way short message service (SMS) strategy for caregivers. When tested in a cluster randomized controlled trial, the intervention led to significant improvements in sugar-sweetened beverage (SSB) consumption among students and caregivers. This study explores changes in secondary caregiver outcomes, including changes in caregiver SSB-related theory of planned behaviour constructs (affective attitudes, instrumental attitudes, subjective norms, perceived behavioural control, and intentions), parenting practices, and the home environment. Participants included 220 caregivers (93% female, 88% White, 95% non-Hispanic, mean age 40.6) in Virginia and West Virginia at baseline and 7 months post-intervention. Relative to control caregivers (n = 102), intervention caregivers (n = 118) showed statistically significant improvements in instrumental attitudes (Coef.= 0.53, 95% CI [0.04, 1.01], p = 0.033), behavioural intentions (Coef.=0.46, 95% CI [0.05, 0.88], p = 0.027), parenting practices (Coef. = 0.22, 95% CI [0.11, 0.33], p < 0.001), and total home SSB availability (Coef. = –0.25, 95% CI [–0.39, –0.11], p < 0.001), with specific improvements for sweetened juice drinks (Coef. = –0.18, 95% CI [–0.35, –0.01], p = 0.043) and regular soda/soft drinks (Coef. = –0.31, 95% CI [–0.55, –0.07], p = 0.010). In contrast, there were no significant between group changes for affective attitudes, subjective norms, or perceived behavioural control. Our findings highlight future research areas and fill gaps in intervention literature. This study is among the few to develop and evaluate a scalable, theory-based caregiver SMS component in a rural, school-based intervention. Combined with evidence that Kids SIPsmartER improved SSB behaviours, our results emphasize the potential of theory-guided SMS interventions to impact SSB-related outcomes.

Trial registration: Clincialtrials.gov: NCT03740113.

Despite the multiple advantages of 25-hydroxyvitamin D (calcifediol or 25(OH)D) compared to cholecalciferol, it is used sparingly. This study was planned to assess the safety and efficacy of supplementing daily 25 µg of calcifediol capsules vis-a-vis 100 µg (4000 IU) of cholecalciferol sachets in apparently healthy individuals with vitamin D deficiency in Chandigarh, India (latitude 30.7° North, 76.8° East). It was a prospective, interventional study to evaluate the effects of calcifediol vis-a-vis cholecalciferol. Following initial screening of 70 subjects in each group, 62 were included in the calcifediol and 41 in the cholecalciferol group. Forty-six from calcifediol and 37 from cholecalciferol group completed the 6-month follow up. There was a significant increase in serum 25(OH)D (355% in cholecalciferol & 574% in calcifediol groups, respectively, p < 0.001) and 1,25 (OH)2D (p < 0.001) with a marked decrease in iPTH (p < 0.001) and ALP (p = 0.016) in both groups. Though serum ALP decreased significantly more in the calcifediol group than the cholecalciferol group, no appreciable difference in other biochemical parameters was noted between the groups. No episodes of hypercalcaemia or incidence of new renal stone disease were observed during follow-up. However, hypercalciuria (spot urine calcium creatinine > 0.2 mg/mg) was noted in 8/46 individuals in the calcifediol group and 5/37 individuals in the cholecalciferol group at final visit with no significant difference between two groups. This study establishes the efficacy and safety of correcting vitamin D deficiency with daily 25 µg calcifediol capsules as an alternative to 4000 IU (100 µg) cholecalciferol sachets.