Ultra-processed foods, as classified by NOVA, provide a substantial and rising share of dietary energy worldwide. Manufactured from cheap refined ingredients and cosmetic additives, they are engineered for hyper-palatability, long shelf life and profit and are widely perceived as convenient, low-cost options. This commentary argues that such perceptions of “cheapness” are misleading once health, equity and environmental impacts are considered.

Nutrition has long been investigated with respect to its influence on human health. With the availability of various omics data, such as metagenomics and metabolomics, novel insights have been obtained into the influence of nutrition, particularly concerning the gut microbiome. The gut microbiome plays an important role in the breakdown of food-derived compounds and in producing essential bioactive metabolites required for human health. However, this wealth of information made the interactions between nutrition and human health increasingly intricate, and unravelling these links is complex. This review covers the concepts of genome-scale metabolic modelling as a tool to understand the links between nutrition, the gut microbiome and human metabolism and its applications. Genome-scale metabolic modelling treats metabolism as a mathematical problem which was used to develop models of human metabolism that incorporate physiology and organ-specific metabolism, known as whole-body metabolic models (WBMs). WBMs can incorporate physiological data, such as sex, weight, and body fat percentage, as well as nutrition in the form of its metabolite constituents. Finally, the gut microbiome can also be incorporated through a mathematical representation of the species present, based on stool metagenomics. WBMs have already been applied to understand gut microbiome–host co-metabolism in various non-communicable diseases. However, challenges remain, as metabolites measured in food items in public databases typically cover only common metabolites, and engagement with end-users such as nutritionists and policymakers is limited. Nevertheless, WBMs represent a promising step towards digital metabolic twins and thus personalised nutrition and medicine.

Protein intake is essential for maintaining physiological functions, with standard recommendations suggesting ∼0.7 g/kg/day for healthy adults. In recent years, high-protein diets have gained popularity due to their potential metabolic benefits, including reduced visceral adiposity, improved hormonal regulation, and preservation of muscle mass. However, the effects of high-protein intake on gut microbiota and overall health remain controversial. Emerging evidence indicates that excessive protein consumption, particularly from animal sources, may negatively impact gut health by increasing intestinal permeability, promoting chronic low-grade inflammation, and impairing mucosal immunity. These effects appear to depend on protein source, intake level, duration, and host-specific factors such as age, metabolic status, and immune function. While moderate protein intake seems to have minimal effects on microbial diversity, chronic high intake may disrupt gut microbiota composition and favor pro-inflammatory profiles, potentially contributing to metabolic dysfunction. Additionally, co-ingested dietary factors, including fat content, processed meat compounds, and fiber intake, may confound these outcomes. Certain populations, such as athletes, older adults, and individuals with type 2 diabetes, may benefit from higher protein intake, although these effects are context-dependent. In contrast, high-protein diets may be detrimental for individuals at risk of chronic kidney disease. Overall, the gut microbiota plays a central role in mediating the health effects of dietary protein, highlighting the importance of balanced and personalized nutritional strategies.

Metabolic dysfunction-associated steatotic liver disease is the most prevalent liver condition worldwide, affecting approximately 30% of the population globally. MASLD often coexists with hypertension, central obesity, type 2 diabetes, and dyslipidaemia, yet globally, national treatment strategies are still being established. Pharmacological options are limited and lifestyle modification to achieve weight loss through combining diet, physical activity (PA) and structured exercise remains the cornerstone of MASLD management. The Mediterranean diet (MedDiet) is an evidence-based dietary approach for MASLD prevention and treatment; however, its application in culturally and linguistically diverse, non-Mediterranean populations requires adaptation. In fact, the need for cultural adaptation for all lifestyle interventions (diet, physical activity, sleep) needs better acknowledgement and implementation. There are limited interventions which combine all lifestyle behaviours and even fewer that consider cultural safety and appropriateness Furthermore, limited healthcare staffing resources, geographical location and health system pressures highlight the need for more accessible and cost-effective delivery methods. This review summarises evidence on MedDiet for MASLD in multicultural populations, explores the synergistic benefits of combining with PA and sleep interventions, and provides practical recommendations for culturally tailored approaches. Finally, we outline future directions for research and healthcare delivery, emphasising the urgent need for holistic, culturally safe, culturally responsive, efficient, and digitally-enabled strategies to address the growing global burden of MASLD.

The Mediterranean diet has emerged as a promising dietary pattern for preventing non-alcoholic fatty liver disease (NAFLD). This study aimed to examine the role of the Mediterranean diet on the risk of NAFLD in Turkish adults. A total of 252 individuals (126 NAFLD and 126 age- and sex-matched controls) participated in this case-control study. Dietary intake was assessed with a 24-h recall, and adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Screener (MEDAS). Logistic regression models were applied to estimate odds ratios (ORs). The prevalence of NAFLD was higher in the lowest tertile (64.6%) and lower in the highest tertile (30.5%; p<0.001). Moderate adherence to the Mediterranean diet was associated with a 57.0% lower risk of NAFLD after adjusting for age, sex, BMI, and energy intake. High adherence conferred an 86.0% reduction after adjusting for age, sex, BMI, energy intake, and comorbidities. Frequent consumption of butter, margarine, cream, (OR=2.75; 95% CI: 1.72–6.43) and sugar-sweetened beverages (OR=2.87; 95% CI: 1.20–6.87) significantly increased the risk. However, consuming nuts three or more servings per week was protective (OR=0.46; 95% CI: 0.21–0.99). In individuals who did not consume ≥3 servings of fruit daily, the risk of NAFLD was significantly reduced (OR=0.28; 95% CI: 0.16–0.69). Adherence to the Mediterranean diet was strongly associated with a reduced risk of NAFLD, highlighting the importance of limiting saturated fats and sugar-sweetened beverages while promoting nuts as practical strategies for prevention.

Plant-based diets are favourable for both climate and health. However, not much is known about different barriers to adopting more plant-based diets across sociodemographic groups. This study examined the proportions of the population reporting a shift towards more plant-based diets and identified perceived barriers to these changes across different sociodemographic groups. The study was based on the Healthy Finland Survey 2022–2023, including 5390 participants aged 20–74 years. Participants responded to questions on plant-based diets using pre-defined response options. Results were presented as prevalences and 95% CIs. Women reported that they had changed their diets to more plant-based more often than men did (46% vs. 31%). Urban residents, higher educated participants, and those with higher income were more likely to have adopted more plant-based diets than others. Concerns about nutritional adequacy (women 20%; men 24%) and lacking skills to prepare tasty vegetarian foods (women 30%; men 28%) were common perceived barriers. In men, barriers included a dislike of vegetarian foods (23%) and a lack of interest (28%). In women, 17% cited the preferences of their close ones as a barrier. Barriers also differed between groups. Older participants were more concerned about the nutritional adequacy (29%), while younger participants struggled with cooking skills (35%). One third of men living in rural areas or with basic education reported a lack of interest in the topic. Tailored health promotion and food education strategies are critical to overcoming barriers to adopting plant-based diets in diverse sociodemographic groups.

To provide a scientific basis for establishing a portion size database for dietary assessment and nutritional education, we determined the portion sizes of commonly consumed food groups among Japanese children and adolescents aged 3–17 years. This study analysed 8-day weighed dietary record data from a nationwide survey conducted between November 2016 and August 2020. Participants were grouped into preschoolers (3–6 years, n=572), elementary school children (7–12 years, n=406) and middle/high school students (13–17 years, n=379). Age- and sex-specific portion sizes of 73 food groups were calculated as weighted averages of median portion sizes of the food items within each group, using the number of consumers for each item as weights. Overall, older participants had larger portion sizes than younger participants, but the magnitude of this difference varied between sexes and food groups. For most food groups, middle/high school students consumed 1.2–1.5 times (29 and 45 food groups for boys and girls, respectively) or 1.6–1.9 times (32 and 18 food groups for boys and girls, respectively) larger portion sizes than preschoolers. Portion sizes among middle/high school students were at least twice as large as those among preschoolers for ten food groups in boys, including staple foods, pork/beef, some vegetables, some beverages and salty snacks, but only for three food groups in girls. In conclusion, these differences in portion sizes according to age, sex and food group should be taken into account when assessing dietary intake and designing nutritional education for portion size control.

Nutrient-stimulated hormone therapies (NuSH) therapies, a key class within obesity management medications, have reshaped obesity and type 2 diabetes care, producing substantial weight loss, improved glycaemic control, and significant cardiometabolic benefits in adults and adolescents. Yet outcomes vary widely, and NuSH therapy-induced changes in appetite, eating behaviour, and gastrointestinal function can compromise nutrient intake, lean mass preservation, and long-term adherence. This review synthesises evidence across nutrition, behavioural science, microbiota research, and metabolic–bariatric surgery (MBS) to outline supportive strategies that optimise clinical outcomes with NuSHs.

Preclinical studies consistently show that NuSH therapies shift gut microbiota toward “lean-associated” profiles, while emerging human findings suggest that baseline microbial signatures may contribute to variability in response and tolerability. However, evidence in humans remains limited, heterogeneous, and underpowered. Across age groups, structured nutritional and behavioural support remains essential to ensure nutrient adequacy, manage side effects, strengthen adherence, and guide sustainable lifestyle change.

Key research priorities include defining behavioural and microbial contributors of treatment response and adherence, evaluating microbiota-targeted adjuncts, and developing scalable, multidisciplinary care models for both adult and paediatric populations. NuSH therapies are powerful tools, but their long-term success depends on integrated, personalised nutrition and behavioural care, with growing opportunity for microbiome-informed approaches.

The UK food-based dietary guidelines (FBDG) are a key public health tool that provides evidence-based recommendations for a healthy diet. However, adherence is low, with less than 0.1% of the UK population meeting all nine recommendations set out in the Eatwell Guide. A population-level shift towards a diet aligned with the FBDG would lower rates of obesity and non-communicable diseases (1). Health professionals, who play a central role in translating dietary guidance into practice, have highlighted limitations in both the FBDG and its communication. This review highlights the views of health professionals in calling for a substantial “shake up” of the Eatwell Guide. It sets out considerations of updating the UK dietary recommendations to include the integration of sustainability alongside nutrition modelling, and a review of supporting tools, resources and communication strategies. Investment from the UK government together with engagement from health professionals and other unbiased stakeholders is needed to develop a government-created and funded central hub of practical and adaptable resources which pulls together efforts from individual health professionals and other organisations to provide practical advice that can be tailored and personalised for individuals and diverse communities. This review summarises the current views of health professionals on the Eatwell Guide, advocating for a comprehensive “shake-up” of the UK FBDG and its communication to improve population’s adherence to dietary patterns that support both human and environmental health.

Mobility limitations due to chronic musculoskeletal pain are a major contributor to disability in older adults, yet current pharmacological treatments often have limited efficacy and increase the risk of polypharmacy. Omega (ω)-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have demonstrated anti-inflammatory and analgesic properties, but are under-consumed among older U.S. adults. Krill oil, a marine-derived source of EPA and DHA with enhanced bioavailability compared to typical fish oils and additional bioactive compounds such as astaxanthin and choline, may offer a promising nutritional intervention. This pilot study will assess the feasibility and acceptability of a 3-month randomized, double-blind, placebo-controlled trial of krill oil supplementation (4 g/day: 1,288 mg EPA+DHA, 0.45 mg astaxanthin, 320 mg choline) versus placebo (mixed vegetable oils) in 40 community-dwelling adults aged ≥60 years with chronic musculoskeletal pain. Primary outcomes include feasibility (recruitment, retention, adherence) and acceptability (participant satisfaction). Secondary outcomes include changes in the omega-3 index, ω-6/ω-3 ratio, and inflammation (hs-CRP), as well as exploratory changes in pain intensity and functional interference, and physical function (Short Physical Performance Battery, 6-Minute Walk Test). Findings will inform the design of future fully powered trials that may ultimately contribute to the evidence for omega-3 supplementation as a non-pharmacological strategy to support healthy aging and functional independence in older adults.

Currently, market demand indicates a trend towards the use of milk proteins in food products. Technological innovations in milk protein production have facilitated the development of new products that can be adapted to various food systems. Despite the growing use of milk protein concentrates (MPCs), much remains to be understood regarding how the interactions between these proteins can lead to a more cost-effective ratio and better utilization of their properties. Although a variety of MPCs are available in the market, the industry may face difficulties replacing one brand's product with another. This is because although the products have the same protein content, their production history can interfere with their technological properties. Therefore, the objective of this study was (a) to create a protocol for analyses that allows the segregation of MPCs based on their key characteristics and, using these results and statistical treatments, (b) to develop a diagram to guide the industry, research and development sectors, and/or procurement departments on the potential application of these products and even the possible substitution of one MPC for another. To this end, nine MPC brands were classified based on their rehydration capacity, browning potential, foaming ability and thermal stability. The results of each analysis were scored to generate a rating that classified the samples and enabled the creation of a technological application diagram.

This review aimed to summarise the nutrition education programs and interventions that have sought to improve maternal health outcomes. Pregnancy is often considered a “teachable moment” when mothers may be motivated to adopt positive behavioural changes, including improving their nutrition habits. Pregnancy nutrition education is the provision of information and guidance on optimal nutritional practices that aim to support a healthy pregnancy. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic databases were searched (Medline, Embase, CINAHL, Global Health, Scopus, PsycARTICLES, SocINDEX, Academic Search Complete) for studies reporting on nutrition education programs and interventions with pregnant women. Studies were included based on PICOS criteria, with no limitations on time and study design. Data were extracted and thematically analysed to identify the scope of diet, nutrition knowledge, and maternal outcomes included. This review includes 169 studies, which included various maternal outcomes, gestational weight gain; gestational diabetes mellitus, hypertensive disorders of pregnancy, and anaemia; dietary outcomes; nutritional status; and nutritional knowledge, attitudes, and/or behaviours. Significant positive results were observed for many health and dietary outcomes, with the exception of prevention of gestational diabetes and hypertensive disorders of pregnancy. A range of strategies have been used to deliver nutrition education. This inconsistency makes it challenging to summarize the key components of effective nutrition education and highlights the need for targeted approaches tailored to specific maternal outcomes.

We examined differences in characteristics between dietary supplement (DS) users and non-users in three age groups of Japanese women, including younger women (dietetic students), middle-aged women (their mothers), and older women (their grandmothers). In total, 3952 younger women (aged 18 years), 3780 middle-aged women (aged 34–60 years), and 2192 older women (aged 61–94 years) participated in this cross-sectional study in 2011 and 2012. DS use and other characteristics were self-reported using a questionnaire, and dietary intake from foods was assessed using a validated, self-administered diet history questionnaire. DS users were defined as participants who reported using DS at least once in the past month. We calculated the percentage of participants with nutrient intakes below the Estimated Average Requirement (EAR) from the Japanese Dietary Reference Intakes. The proportion of DS users was 5.7% in younger women, 24.3% in middle-aged women, and 27.7% in older women. In younger and older women, DS users were more likely to live in a city with a population of ≥ 1 million. In middle-aged women, DS users were more likely to have an education level more than high school or to be former smokers. In older women, DS users tended to have shorter sleep duration. Among the 15 nutrients examined, DS users were less likely to have intake levels below the EAR for 10 nutrients in younger women, 9 nutrients in middle-aged women, and 4 nutrients in older women. Some characteristics of Japanese female DS users differed from non-users depending on the age group.

The Healthy Eating Index (HEI) is widely used to assess diet quality, but certain contexts (e.g., pregnancy) may benefit from tailored versions. We evaluated whether the HEI’s current approach of assigning approximately equal weights to all components to compute the total score is appropriate when studying diet quality around conception. Data were from a U.S. prospective cohort of individuals who had not delivered a previous pregnancy past 20 weeks’ gestation (2010–2013, n=7882). Usual dietary intake around conception was estimated from food frequency questionnaires. Select adverse pregnancy outcomes (gestational diabetes, preeclampsia, preterm delivery, and small-for-gestational age birth) were abstracted from the medical record. We regressed each outcome on the 13 HEI-2015 component scores using SuperLearner, an ensemble machine learning method that combines predictions from multiple algorithms and avoids relying on parametric assumptions that characterize standard regression. We assessed the relative importance of each component using two permutation-based metrics: change in negative log likelihood (global influence) and absolute difference in the predicted probabilities (individual-level influence). Six of the 13 components (Greens and Beans, Saturated Fats, Total Protein Foods, Seafood and Plant Proteins, Fatty Acids, and Added Sugars) were important according to at least one metric for at least two of the four outcomes. In contrast, the Refined Grains component was not appreciably important for any outcome. These findings suggest that equal weighting of the HEI components may not be appropriate when evaluating diet quality for studies of pregnancy.

This study investigated the hypothesis that milk quality traits and milk proteolytic activity vary with lactation number in dairy cows. Milk was collected from 109 individual cows, 20 Swedish Holstein and 89 Swedish Red, from 12 commercial Swedish farms. Samples were analysed individually and grouped into three lactation categories: lactations 1–2 (N = 56), lactations 3–4 (N = 32) and lactations ≥5 (N = 21). The principal finding was that plasmin (PL) activity increased markedly with advancing lactation number, with significantly higher activity observed in cows in lactations 3–4 and ≥5 compared with those in lactations 1–2 (P < 0.001). Although plasminogen (PG) concentrations tended to decrease with increasing lactation number, this trend did not reach statistical significance (P = 0.298). As a result, the PG-to-PL ratio decreased progressively with advancing lactation (P < 0.001), indicating increased proteolytic potential in milk from older cows. Lactation number also had a clear influence on milk protein composition. The proportion of total casein decreased steadily across lactation groups, while the proportion of whey proteins increased (P ≤ 0.004). Within the casein fractions, total β-casein declined significantly from lactations 1–2 to ≥5 (P < 0.001), whereas the relative amount of β-casein B increased with lactation number (P = 0.003). The proportions of αs2-casein and κ-casein were highest in cows with lactations ≥5 (P ≤ 0.019). Among whey proteins, α-lactalbumin increased markedly with lactation number (P < 0.001), and β-lactoglobulin showed an increasing, although statistically non-significant, tendency (P = 0.071). Gross milk composition was unaffected by lactation number; however, somatic cell count (SCC) increased significantly in cows in lactations 3–4 and ≥5 compared with lactations 1–2 (P = 0.002). Overall, advancing stage of lactation was associated with enhanced PL-mediated proteolysis, shifts in milk protein profile and higher SCCs, whereas the basic milk composition remained stable.

In the early history of vitamin D research most of the studies on its chemistry and function were performed with vitamin D2 which was readily obtained by UV irradiation of ergosterol from yeast. Yet, in the physiological economy of vitamin D for most vertebrates, including humans, fish and especially for birds, vitamin D3 produced in skin by solar irradiation of 7-dehydrocholesterol, is the natural form of vitamin D. Vitamin D2, as a dietary supplement, while of comparable potency to vitamin D3 in most mammals, has been found in nature only when ergosterol in fungi is inadvertently exposed to solar UV radiation. Nevertheless, some herbivorous animals, horses and elephants, seem to maintain adequate vitamin D status with vitamin D2 rather than vitamin D3. The source of that vitamin D2 has been assumed to be the traces derived from ergosterol in endophytic fungi exposed to the sun on grass being consumed. However, outdoor grazing sheep in winter maintained adequate vitamin D status with vitamin D2, yet no vitamin D2 could be detected on the grass they were consuming. Bovine rumen contents, fermenting in an artificial rumen, had an increase in vitamin D2 concentration, particularly when cellulose fibre was added as a fermentation substrate. Furthermore, mice being raised from weaning on a vitamin D-free diet had vitamin D2 in their colon contents. This review examines anaerobic microbial production of vitamin D2 in the alimentary tract, in the dark, and describes a natural function for vitamin D2 in microorganisms and potentially for gut health.