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.

Patients with chronic liver disease (CLD) often experience hypozincemia. The clinical factors associated with hypozincemia have not been established. We investigated clinical factors that may be useful to predict hypozincemia in patients with CLD. The serum zinc levels CLD patients were measured; Study 1 investigated the predictive factors of hypozincemia, and Study 2 was performed to validate the factors identified in Study 1. Study 1 included 197 participants, of whom 28 and 106 had serum zinc levels <60 µg/dL and <80 µg/dL, respectively. A multivariate analysis revealed that serum zinc levels <60 µg/dL or <80 µg/dL were associated with the albumin–bilirubin (ALBI) score and serum albumin level. A receiver operating characteristic curve analysis revealed that the ALBI score ≥ −1.83 and the serum albumin level ≤3.3 g/dL were the cut-off values for a serum zinc level <60 µg/dL, whereas the ALBI score ≥ −2.44 and the serum albumin level ≤3.6 g/dL were the cut-off values for a serum zinc level <80 µg/dL. In Study 2 (n = 177), the diagnostic accuracy rates for serum zinc <60 µg/dL were 81.9% for the ALBI score and 75.1% for the serum albumin level, and those for serum zinc <80 µg/dL were 70.1% for both parameters. Together these findings indicate that the ALBI score may serve as a predictive factor of hypozincemia in CLD patients.

Adequate protein intake is crucial for preventing frailty and sarcopenia in older adults, but conventional dietary assessments are time-consuming. Developing a rapid screening tool for identifying those at risk of low protein intake is essential; however, no such tool exists for Asian populations. This study developed a prediction model to identify older adults in Japan at risk of low protein intake using a simple food intake questionnaire. The model was developed using data from 4,085 older adults aged ≥65 years from the 2013 and 2017 National Health and Nutrition Surveys. Protein intake was assessed using a one-day dietary record with a semi-weighted method. A multivariable logistic regression model was developed to predict low protein intake (<1.0 g/kg adjusted body weight/day), incorporating sex, age, adjusted body weight, and food intake frequency of nine food groups. Model performance was evaluated using the area under the receiver operator characteristic (ROC) curve and a calibration plot, both adjusted for optimism through bootstrap resampling. Participants had a mean age of 74.1 years (standard deviation = 6.6), and 55.5% of all participants were female. The prevalence of low protein intake was 21.8%. Internal validation showed a bootstrap optimism-corrected ROC area of 0.695 and a calibration slope of 0.921. We developed a 12-item prediction model for identifying older adults at risk of low protein intake. The model provides a practical tool to identify older adults at high risk of low protein intake and is expected to be used in public health settings.

Nutrient gaps are differences between recommended and actual intakes and are often based on the estimated average requirement (EAR), the average daily intake estimated to meet the requirement of 50% of healthy individuals. While nutrient gaps have been established in the general population, their presence in exercising adults has not been extensively investigated. In the present analyses, 681 dietary recalls were obtained from 226 healthy exercising adults (154 F, 72 M) using the Automated Self-Administered 24-h (ASA24®) Dietary Assessment Tool. Intakes of seventeen vitamins and minerals were compared to corresponding EAR values to determine if nutrient gaps were present. Additionally, the potential for sex differences in absolute and relative nutrient intakes was examined. Median intakes of vitamin D fell below the EAR in both female and male adults, with the median intake of vitamin E below the EAR in female adults only (p ≤ 0.003 for each). In female participants, >50% exhibited intakes below the EAR for calcium, folate, magnesium, vitamin A, vitamin C, vitamin D, and vitamin E. In male participants, >50% exhibited intakes below the EAR for vitamin C, vitamin D, and vitamin E. Sex differences were present for intakes in sixteen of seventeen micronutrients (p < 0.001 for each), with lower intakes observed in female adults. Collectively, the present analyses indicate underconsumption of some micronutrients, particularly in exercising female adults. The potential to improve vitamin and mineral intakes and attendant health and performance outcomes through targeted interventions in exercising adults should be explored in future research.

Childhood obesity is an increasing concern in Indonesia, yet little is known about the content and sources of foods offered in Indonesian school food environments. This study aimed to examine the composition and preparation of foods sold in primary school canteens, and to identify potential modifications to address diet-related obesity risk. A cross-sectional survey of canteen vendors (n = 10) and structured observations of prepared foods (n = 112) sold in canteens were conducted across eight private and public primary schools in Central Java, Indonesia. Foods were categorized by food group, preparation method, and meal type, and associations with factors such as cost, location of sale, and the individual responsible for preparation were analysed using chi-square and t-test analyses. Among all prepared foods observed, 73.2% were classified as main meals and 26.8% as desserts, with parents often playing a central role in food preparation. Nearly half (47.3%) of non-beverage items were deep-fried, and the majority of dishes did not align with Indonesian Balanced Nutrition Guidelines. A compositional analysis of each main meal’s ingredients revealed that 29.3% lacked protein and 90.2% did not contain vegetables. Foods that were not deep-fried were priced significantly higher than deep-fried foods (x̄ = Rp.1846 ($0.11) vs Rp.1406 ($0.09); p < 0.001). Overall, the majority of prepared foods available to schoolchildren were low in nutritional quality, with limited fruits and vegetables and heavy reliance on frying. These findings highlight the need for strategies that combine parent education on healthy food preparation with economic incentives to increase the accessibility of healthier food options within Indonesian school canteens.

Household food insecurity has previously been associated with psychological distress, and subsequently, poorer diet quality. Further understanding of this relationship is required to improve nutritional outcomes, with food-related concerns suggested as one potential mechanism. Therefore, the current pre-registered (https://osf.io/zd3ak) study conducted cross-sectional secondary analyses of Wave 6 (October 2022–January 2023) of the Food and You 2 survey administered in adults aged 16 years and over across England, Wales, and Northern Ireland (N = 2315), to explore the differential prevalence of food-related concerns in people experiencing food insecurity. Exploratory analyses also identified characteristics of food support users (food bank or social supermarket; N = 467) and quantified associations between food support use and the same food-related concerns. People experiencing marginal (OR = 1.43, p = 0.02) and low food security (OR = 1.51, p = 0.02) (relative to high food security) were significantly more concerned about food prices, but this association was not seen in people experiencing very low food security. Both food bank and social supermarket use were predicted by very low food security (food bank OR = 6.05, p < 0.001; social supermarket OR = 2.40, p = 0.02) and having a long-term health condition (food bank OR = 3.91, p = 0.00; social supermarket OR = 3.17, p = 0.00). Food bank users were less concerned about healthy eating (OR = 0.33, p = 0.00) whereas social supermarket users were less concerned about food prices (relative to non-users) (OR = 0.40, p = 0.01). Food-related concerns, particularly regarding food prices, are differentially associated with food security status and food support use. Findings could support specific interventions to promote better diet quality and improve health and wellbeing in populations experiencing food insecurity.

This study investigates the associations between social determinants of health (SDOH) and hypertension prevalence across Wisconsin communities, with particular attention to food environments, economic factors, and transportation patterns. Using data from the 2019–2020 Wisconsin State Inpatient Database (387,047 patients) and the 2020 AHRQ SDOH database, we employed spatial analysis and logistic regression models to examine relationships between hypertension prevalence and neighbourhood characteristics across 597 ZIP codes. Lower-income areas exhibited significantly higher hypertension prevalence (EE = 1.233, 95% CI: 1.128–1.347 for incomes under $14,999), neighbourhoods with greater food resource density showed protective associations (EE = 0.549, 95% CI: 0.474–0.636 for supermarket access). Active transportation patterns were associated with lower hypertension rates (EE = 0.879, 95% CI: 0.829–0.933 for walking). We observed a ‘Hispanic paradox’ in Milwaukee County, where Hispanic populations demonstrated lower hypertension prevalence despite socioeconomic disadvantages, whereas African American populations with similar disadvantages exhibited higher prevalence. Our proposed ‘Food Environment Synergy Model’ helps frame these findings by conceptualising food environments through three interacting dimensions: physical access, economic accessibility, and cultural dietary patterns. This integrated approach highlights how these dimensions collectively relate to unique risk and resilience profiles within communities, challenging conventional binary classifications of ‘food deserts’ versus ‘food secure’ areas. These findings indicate that addressing food access disparities, promoting walkable neighbourhoods, and preserving beneficial cultural dietary traditions may be related to lower hypertension prevalence and advance health equity in diverse communities. However, the analysis is cross-sectional, causality cannot be inferred; further longitudinal studies are needed to establish causal relationships.

Malnutrition remains a major public health issue in Sub-Saharan Africa, with one-third of all malnourished children residing in the region. In Malawi, 37.1% of children under five are stunted, and 63% are anaemic. Poor diets and poverty contribute significantly. Legumes, being rich in protein, fibre, and micronutrients, offer a sustainable food-based approach to improve child nutrition and support local agriculture. This study aimed at assessing the association between legume consumption and nutritional status in children aged 6–59 months in rural Malawi. A community-based cross-sectional study was conducted in Mzimba, Mchinji, and Mangochi districts, involving 1275 children. Data were collected on dietary intake, socioeconomic status, and anthropometry using semi-structured questionnaires. Nutritional status was determined using WHO Anthro, and associations were analysed using logistic regression in Stata. Prevalence of stunting was 42.8%, underweight 17.4%, and wasting 8.4%. Over half of the children did not consume legumes. Pigeon pea consumption significantly reduced odds of wasting (AOR = 0.14), and common beans were associated with lower odds of both wasting and stunting. Conversely, groundnut consumption was linked to increased underweight (AOR = 1.68). Animal food consumption was associated with lower underweight but higher odds of wasting. Legume consumption showed both protective and adverse associations with child malnutrition. In conclusion, this study has shown that promoting dietary diversity and appropriate legume use could enhance nutrition outcomes. Findings highlight the potential of legumes in addressing undernutrition but also the need for targeted nutrition education and interventions in rural Malawi.

In the USA and Japan, body mass index (BMI) has increased over the last several decades, whereas energy intake (EI) has decreased. However, self-reported EI data may show systematic errors. Using the calibration approach for attenuating the systematic error of self-reported EI, we aimed to compare trends in BMI and EI with and without calibration in adults from the USA and Japan. This cross-sectional study included 38,370 Americans evaluated in the National Health and Nutrition Examination Survey 2003–2018, and 200,629 Japanese evaluated in national nutrition surveys in Japan 1995–2019. EI was estimated using at least 1 day of 24-h diet recalls for Americans and 1 day of household-based dietary records for Japanese. The calibrated EI was calculated using a previously developed equation based on total energy expenditure (TEE) measured by doubly labelled water method. Using data from a review, uncalibrated EI was −20.2% and calibrated EI was −4.1% compared to the TEE; the calibration approach attenuated EI underestimation. In the USA, uncalibrated EI decreased (annual percentage change [APC]: −0.24%), but calibrated EI and BMI increased (calibrated EI, APC: 0.04%; BMI, APC: 0.32%). In Japan, the decrease was smaller for the calibrated EI than for the uncalibrated EI (uncalibrated EI, APC: −0.23%; calibrated EI, APC: −0.04%). Uncalibrated EI decreased and BMI increased in the USA and Japan, and calibrated EI increased in the USA and decreased slowly in Japan. Calibration may attenuate systematic bias in dietary assessments and facilitate the effective use of dietary data.

Dietary magnesium (Mg) is a potentially modifiable factor in preventing dementia, but current evidence supporting this remains insufficient and inconclusive. This study aimed to determine whether dietary Mg is associated with the risk of dementia among middle-aged and older people. Participants of this 8-year cohort study were 13,032 community-dwelling individuals aged 40–74 years. Dietary data were collected using a validated food frequency questionnaire in 2011–2013. Mg intake was adjusted for energy intake using the residual method. The outcome was newly diagnosed dementia determined using Japan’s long-term care insurance database. Covariates included demographic characteristics, body size, lifestyles, and disease histories. Cox proportional hazard models were used to determine adjusted hazard ratios (HRs). The mean age of participants was 59.0 years. Dementia occurred in 148 males and 138 females. Lower quartiles of energy-adjusted Mg intake were associated with a higher risk of dementia (P for trend = 0.0410) in males, with the lowest quartile (Q1) having an elevated risk of dementia (HR = 1.73, 95% CI:1.07–2.83) compared to the highest quartile (Q4, reference); however, this association was not found in females. In a subgroup analysis by disease history in males, the HR of Q1 was attenuated in both subgroups; HR was 1.52 (95% CI:0.74–3.11) in those with a disease history and 1.40 (95% CI:0.73–2.69) in those without. In conclusion, low dietary Mg intake is associated with increased dementia risk in middle-aged and older Japanese males. However, this association may be partly attributable to underlying disease history.

Ready-to-use therapeutic foods (RUTFs) are widely used to treat severe acute malnutrition (SAM) by improving key anthropometric outcomes; however, optimisation of RUTF formulations remains important to support sustained recovery. Rice bran, a novel nutrient-dense, prebiotic food ingredient, can support healthy growth. This two-arm, double-blinded, randomised controlled trial, compared the effectiveness of a locally produced RUTF with rice bran to the same RUTF without rice bran for the treatment of uncomplicated acute malnutrition in Jember, Indonesia. 200 children aged 6–59 months with SAM (WHZ < −3.0 and/or mid-upper arm circumference (MUAC) < 115 mm or having bilateral pitting oedema +/++) or approaching SAM (WHZ < −2.5) were enrolled in the study. Primary outcomes were weight, MUAC, and anthropometric z-scores. Linear mixed models were applied across all ages, and split by age groups (6–23 months and 24–59 months) at weeks 0, 4, 8, 12, and 16 for intention-to-treat (ITT) and per protocol analysis (PP). Children in two age groups were expected to respond differently to treatment based on their microbiome maturity. At week 4, the PP analysis revealed RUTF+rice bran treatment had significantly greater weight gain velocity (p = 0.02; p = 0.008) and MUAC velocity (p = 0.004, p = 0.03) when compared to RUTF at all ages and in the 24–59 months age group, respectively. There were no significant differences between treatment groups at time points in the other anthropometric outcomes. This investigation shows promising impact of stabilised rice bran as a prebiotic and nutrient-dense ingredient for inclusion into RUTFs that can improve child growth outcomes.

The objective of this study was to develop and validate an educational comic book designed to promote healthy eating among caregivers of young children. The study was conducted in four phases: (1) literature review and script development; (2) creation of the initial version of the comic book, including illustrations, layout and design, and calculation of the Flesch Readability Index (FI); (3) expert validation of the initial version and calculation of the Content Validity Index (CVI); and (4) adaptation of the comic book based on expert suggestions, recalculation of the FI, and pilot testing (CVI) with a lay population. A total of 64 volunteers participated in the validation process, including 14 expert judges and 50 caregivers responsible for feeding children aged 0 to 5 years. Statistical analysis included descriptive measures and inferential testing using the Wilcoxon signed-rank test. The FI score for the initial version was 85.0%, indicating a reading level classified as “easy to understand.” After expert evaluation, the CVI reached 94%, reflecting high agreement among participants. In the revised version, the FI remained high at 84.7%, reinforcing the “easy to understand” reading level, while the CVI increased to 98% following the pilot test, demonstrating strong consensus among participants. A significant improvement in knowledge regarding healthy eating was observed after reading the comic book (p < 0.05). The comic book was validated for appearance, content and readability, showing a positive impact on caregivers’ knowledge about healthy eating practices. It represents an accessible and effective resource that can be integrated into community-based nutrition education programmes.

Responsive feeding characterised by recognising and appropriately addressing children’s hunger and satiety signals, plays a key role in health. Despite children’s innate ability to self-regulate food intake, caregivers can override these cues, especially in child care settings. The study determined the effects of a 6-month coaching intervention on the responsive feeding environments of child care centres. CELEBRATE Feeding was a 6-month, coaching, pre-post intervention design conducted in eight child care centres across Nova Scotia and Prince Edward Island, Canada. Child care centres’ feeding environments and educator practices were observed using a modified Environment and Policy Assessment and Observation tool at baseline and follow-up in two rooms per centre (n = 16). Twenty-one responsive feeding components were scored from 0–3 (3 as best practice). The average centre scores were summed for an overall score ranging from 0–63 at each time point. Paired samples t-tests and Wilcoxon signed rank tests were conducted to assess the impact of the intervention on overall rooms’ and individual responsive feeding components’ scores. There was an increase in scores from baseline (M = 38.16, SD = 6.55) to follow-up (M = 45.75, SD = 5.87), t (15) = 4.91, P < 0.001. All but one score improved, where 3 of the 21 scores were significantly more responsive after the intervention after applying a Bonferroni correction (P < 0.002). The score with the greatest positive change was ‘Educators provide gentle comments or nudges towards feeding’, with a mean difference of 1.33, P < 0.001. The CELEBRATE Feeding coaching intervention was successful in improving responsive feeding practices and environments in child care settings.

Monocrotaline (MCT) induces lung injury and pulmonary hypertension (PH) by a mechanism that is in part due to oxidative stress. The purpose of this study was to determine how MCT affected nutrient antioxidants retinol and alpha-tocopherol in a rat lung and liver. Rats were fed a purified diet (AIN-93G) one-week prior to a subcutaneous injection of MCT (60 mg/kg) and remained on the diet throughout the study. Three weeks after injection, the animals were euthanized, and the lungs and livers were analyzed for retinol, alpha-tocopherol, phospholipid (PL), and cholesterol content. Lung retinol concentrations were significantly lower in MCT-treated rats, 2.0 ± 1.2 (nmol/g lung) vs. vehicle control (VEH), 5.8 ± 1.4 (P < 0.01). However, liver retinol concentrations were not significantly different, 3.3 ± 1.3 vs. 2.5 ± 0.9 nmol/g liver. Alpha-tocopherol was significantly greater in MCT-treated rats in the lung, 145 ± 24 vs. 99 ± 13 nmol/g lung (P < 0.001), and liver, 107 ± 30 vs. 47.7 ± 4.8 nmol/g liver (P < 0.001). Phospholipid and cholesterol were significantly lower in the lung of the MCT-treated group, but not significantly different in the liver. In conclusion, retinol along with phospholipid, and cholesterol were decreased in the lungs whereas alpha-tocopherol was elevated in the lungs and liver in response to MCT. These findings along with others suggest a novel mechanistic link between MCT-induced oxidative stress, lung vitamin A depletion, inflammation and the impairment of alveolar cell proliferation and repair. Pulmonary retinol is important in the pathogenesis of MCT-induced lung injury.

Maternal nutrition is critical for foetal brain development, and dietary polyphenolic compounds play an important role in mitigating oxidative stress, inflammation, and neurotoxic damage. This narrative review explored the potential promotion of brain development by polyphenols such as resveratrol, curcumin, quercetin, naringin, ferulic acid, genistein, and fisetin through their antioxidant, anti-inflammatory, and neurotrophic effects. The key molecular mechanisms are central to the advantageous actions of these polyphenols in the neurogenesis process. These compounds protect against neurodevelopmental challenges induced by maternal high-fat diet, immune activation, environmental toxins, and psychological stressors. However, their efficacy may depend on dosage, timing of administration, and maternal-foetal metabolic interactions, emphasising the need for personalised maternal nutrition strategies. Further research is needed to investigate the long-term effects and interactions of these compounds with other nutrients toward personalised maternal nutrition strategies. This narrative review presents the potential of polyphenols to support foetal brain health with an emphasis on their possible incorporation into maternal dietary interventions.

High intake of processed foods, especially those with high sodium content, is a contributor to hypertension and cardiovascular disease. This study aimed to compare the sodium content of packaged foods and beverages in Nigeria to WHO Global Sodium Benchmarks and similar products in Kenya and South Africa. The study examined packaged foods from major retail stores in the capital cities of the Federal Capital Territory, Kano, and Ogun states in Nigeria from November 2020 to March 2021. Benchmark values were based on the 2021 WHO Global Sodium Benchmarks. We used secondary data from packaged food surveys conducted in South Africa (2015, 2016 and Kenya 2019). Approximately 40.0% (n = 36) of subcategories of packaged foods were captured in the WHO global sodium benchmark. Of these, 64.0% (n = 23) exceeded the benchmarks, including ‘processed meat’ (912.0 vs. 250.0 mg/100 g), cheese (776.0 vs. 190 mg/100 g), and ‘wholegrain chips’ (930.0 vs. 470 mg/100 g). Exactly 36.0% (n = 13) had lower sodium content, such as ‘rice-based snacks’ (113.0 vs. 520 mg/100 g) and ‘dried seafood’ (400 vs. 800 mg/100 g). In seven out of eleven main food categories (64%), Nigeria had a higher sodium content compared to Kenya. Similarly, Nigeria exhibited higher sodium content than South Africa in six out of eleven food categories (55.0%). With 64.0% of Nigerian subcategories exceeding WHO benchmarks and higher sodium levels than South Africa and Kenya in most categories. These findings highlight the urgent need for targeted sodium reduction and product reformulation to align Nigeria’s packaged foods with international benchmarks.

The effect of dietary intake on body weight may vary based on individual genetic differences. However, children are rarely used in such investigations. The aim was to identify possible genetic moderation through polygenic scores (PGS) for BMI, of the association between dietary intakes and BMI in children. The study sample included children who were part of a French-Canadian birth-cohort study. BMI data was available on seven occasions between ages 4 and 13 years. FFQ (juice and fruit drinks, sweets and snack foods, meats, and fruits and vegetables) and 24-h dietary recall (proteins, lipids, carbohydrates, total energy) data were available up to 4 years. Linear mixed models were used to account for repeated BMI measurements. The consumption of juice and fruit drinks (in girls), sweets and snack foods, fruits and vegetables, proteins, lipids, carbohydrates and total energy were associated with BMI. Associations with BMI increased with age (kg/m2 per year) for fruits and vegetables (β: −0.03, 95%CI: −0.06;−0.01), lipids (β: 0.11, 95%CI: 0.01;0.22), carbohydrates (β: 0.05, 95%CI: 0.01;0.08), and total energy (β: 0.07, 95%CI: 0.02;0.12), and with higher values of a PGS (kg/m2 per SD) for proteins (β: 0.54, 95%CI: 0.03;1.06), lipids (β: 0.63, 95%CI: 0.12;1.13), and total energy (β: 0.32, 95%CI: 0.06;0.58). Using longitudinal data, we showed that the associations between specific dietary intakes and BMI may vary depending on age and genetic susceptibility in childhood.

Consumer enthusiasm in plant-based eating has resulted in the rapid expansion of plant-based meat (PBM) products. The extensive processing required to simulate meat warrants further investigation regarding PBMs nutritional quality and healthiness, particularly considering the health halo that has surrounded these products. An online audit of dominant UK supermarkets evaluated PBM (n = 209) against ‘standard’ (n = 2143) and ‘reduced’ (e.g. low fat) meat equivalents (n = 100), across eight product categories. This evaluation included NOVA categorisation, Nutritional Profiling Model (NPM) classification, on-pack claims, micronutrient content and product affordability. PBM products were typically more favourable than ‘standard’ meat equivalents for energy density, dietary fibre, total and saturated fat content. However, they contained significantly higher salt in most product categories. Differences between PBM and ‘reduced’ meat comparators were more nuanced. PBM products were significantly more expensive than ‘standard’ meat equivalents in four of the eight product categories (p < .05). Few PBM and zero meat-based products reported micronutrient information. While all PBM and most meat-based products were characterised as ultra-processed, PBM products demonstrated a lower (‘healthier’) NPM score compared to ‘standard’ meat equivalents across all product categories (p ≤ .001). Although no significant differences were detected between PBM and ‘reduced’ meat-based products, a greater proportion of PBM products were classified as ‘healthier’ according to NPM compared to ‘standard’ and ‘reduced’ meat equivalents. Thus PBM products may offer healthier alternatives with the potential to synergistically support public and planetary health. Future manufacturing practices should consider cost-effective fortification and reformulation strategies to improve nutritional quality and affordability of PBMs.