Most food and nutrition-based programs for the school setting cease implementation within two years.(1, 2) This phenomenon is largely due to a lack of sustained external funding, and unsupportive socio-political contexts, thus highlighting the necessity to explore alternative models that promote financial sustainability.(1, 2) Therefore, this scoping review aimed to investigate what business models have been applied to educational settings that deliver on food and nutrition-based outcomes.

Scoping review methodology was used with cross-verification with online sources on Google in 2024 to review currency of information. Eight databases were searched (PubMed, Web of Science, Embase, Cinahl, Social Science Database, Sociological Abstracts, Business Source Complete, ABI/Inform Collection) in November 2023. The descriptive factors of the social enterprises’ business structure, target population, customer base and financial structure were extracted. A narrative synthesis, using a taxonomy, was conducted to determine the social enterprises’ operational model and key features.

Five food and nutrition-based social enterprises were identified through case studies. Three were based in the United States of America (Everytable(3), Rebel Ventures(4), and Revolution Foods(5)), one in New Zealand (Eat My Lunch(6)) and one in Israel (Al Sanabel(7)). Three operated a targeted customer service model, selling healthy meals or snacks within educational settings and to other institutions or food retailers. One used a social business model (using the funds generated from corporate catering for providing free school meals) and the other used a combined employment and social business model (employing women to create school meals). The average years of operation of included social enterprises was 11 years (not inclusive of Al Sanabel since its operation in 2024 could not be verified).

Targeted customer service, social business and employment models can help to deliver on food and nutrition-based outcomes for educational environments, whilst generating profit to enable self-sufficiency. However, more robust formal evaluations of education-based food and nutrition-based social enterprises are warranted that surpass case studies. Policy makers and program implementers are encouraged to consider social enterprises in public health agendas and to embed design thinking within program development.

Vitamin D and iron deficiencies are highly prevalent globally, with evidence of a complex interaction(1). However, the extent to which these micronutrients interact, and whether this changes according to age and sex, remains uncertain. Understanding the association between vitamin D and iron could help address these nutrient insufficiencies concurrently, rather than as two independent public health concerns. The aim of this study was to determine the association between vitamin D (serum 25-hydroxyvitamin D (25(OH)D)) and iron (haemoglobin and ferritin) status in men and women of reproductive age.

Secondary analysis of Years 9-11 (2016/17-2018/19) of the UK National Diet and Nutrition Survey (NDNS) Rolling Programme was conducted. Concentrations of blood biomarkers in adults aged 19-49 years were compared to UK Scientific Advisory Committee on Nutrition (SACN) guidance. Spearman’s bivariate correlations were performed to investigate associations between vitamin D and iron status using IBM SPSS Statistics (2024).

Descriptive analyses found the percentage of men and women with serum 25(OH)D concentrations below the SACN threshold for increased risk of deficiency (<25nmol/L)(2), were 18.4% and 17.9%, respectively. Moreover, 62.0% of men and 49.8% of women had insufficient 25(OH)D concentrations (<50nmol/L). For ferritin, 17.0% of women had concentrations below the 15µg/L deficiency threshold, compared to 0.0% of men(3). Similarly, for haemoglobin, 8.7% of women were below the 120g/L diagnostic deficiency threshold compared to 2.3% of men (<130g/L)(3). Haemoglobin (g/L) and 25(OH)D (nmol/L) concentrations were not associated in men (rs(172)=-0.019, p=0.802) or women (rs(244)=0.034, p=0.595). However, despite no association found between ferritin (µg/L) and 25(OH)D (nmol/L) in men (rs(175)=-0.022, p=0.766), a significant correlation was observed in women (rs(259)=0.184, p=0.003), albeit with a small effect size. Furthermore, a Kruskal-Wallis test showed a significant difference when comparing median ferritin concentrations by vitamin D status (deficient <25.00nmol/L; insufficient 25-49.99nmol/L; replete ≥50nmol/L) in women (H(2)=8.888, p=0.012). Post-hoc testing revealed no significant difference between ferritin concentrations in women classified as deficient or insufficient (p=0.687 – Bonferroni correction p=1.000), whereas, there was a significant difference between the ferritin concentrations of women who were vitamin D deficient and replete (p=0.015 – Bonferroni correction p=0.046), or insufficient and replete (p=0.015 – Bonferroni correction p=0.046).

A significant correlation was found between 25(OH)D and ferritin concentrations in women; moreover, a significant difference was identified when comparing ferritin concentrations by vitamin D status. No associations were found between haemoglobin and 25(OH)D concentrations. In conclusion, these results suggest a potential association between vitamin D and iron status; and that vitamin D adequacy or deficiency/insufficiency may influence concentrations of ferritin, as a marker of iron, and/or vice versa. To further explore these associations between vitamin D and iron status, further analysis will adjust ferritin concentrations by C-reactive protein concentrations and investigate whether seasonality influences observed associations.

Leptin plays a central role in the regulation of feeding and energy metabolism, and its dysregulation has been associated with obesity, including in the Mapuche population(1,2). Urbanisation in Chile has increased rapidly over recent decades, reaching over 88% in 2024(3). Nevertheless, the impact of urbanisation on leptin levels in this ethnic group remains unclear. The objective of this study was to compare the leptin levels between Mapuche subjects residing in urban and rural areas.

This systematic review and meta-analysis was registered in PROSPERO (CRD42017069924). A comprehensive search was conducted in PubMed, Web of Science, Scopus, and SciELO until May 2025. Observational studies conducted in both rural and urban Mapuche populations with data on the mean and standard deviation of leptin levels were included in the analysis. Studies with pregnant participants or subjects affected by severe infectious or inflammatory diseases were excluded. The initial selection was made by consulting the title and abstract of each study identified. In the subsequent phase of the selection process, the preselected studies were thoroughly examined. The global mean difference (GMD) and 95% confidence interval (CI) were calculated using the generic inverse variance method with random effects models. The mean difference was calculated as the difference in leptin levels between rural and urban Mapuche subjects. Stratified analyses were utilised to assess the influence of BMI and year of data collection. The Cochran test and the I2 statistic were used to study the heterogeneity of the data. The analyses were performed using STATA 15. The financial resources were provided by DIUDA 22385.

A total of 4,615 manuscripts were identified, and two studies were included in the systematic review and meta-analysis. A stratified analysis based on BMI (<27kg/m2, >27kg/m2, or mixed) revealed significant differences in leptin levels between urban and rural Mapuche subjects with a BMI lower than 27kg/m2 (GMD = −3.01 ng/mL; 95% CI: −5.06, −0.96), but not between those with a BMI greater than 27kg/m2 (GMD = 0.81 ng/mL; 95% CI: -2.80, 4.42). The degree of heterogeneity was low in both analyses. The I2 values were found to be 0.0% (p = 0.687) and 28.7% (p = 0.236), respectively. When the data were stratified by year of data collection, significant differences were only identified in the initial decade of the 2000s (GMD = −10.59 ng/mL; 95% CI: −15.08, −6.10).

The findings of this systematic review and meta-analysis suggest that leptin levels are higher in urban Mapuche individuals compared to those residing in rural areas, particularly when BMI is low to moderate. These differences may have become more pronounced in recent decades. Further research is required to confirm these results and better understand the effect of urbanisation on health.

Multi-component food items (MCFI) are single food products with sensorially distinguishable components that are brought together via processing (e.g., chocolate chip cookies). Despite a considerable food science literature on the formulation of such products, there is a paucity of research on how multi-component food items impact eating behaviour(1). This may be due to methodological challenges, including difficulty identifying test foods alongside suitable control foods(1). We have previously developed isocaloric sweet and savoury test food sets (ice cream and crustless quiche) to enable comparisons between MCFI, single component (control with no components) and blended (control with components blended to no longer be sensorially distinguishable) versions of the same food. We hypothesised that ad libitum intake of MCFI would be greater than intake of control food items.

Here, we conducted a between-subjects (N = 162; 64 male and 98 female) study with participants randomised to one of six conditions (MCFI, single component and blended for both quiche and ice cream). In line with our previous validation study, our MCFI test foods had significantly higher ratings of perceived variety than the control foods (manipulation check). Within a bogus taste test procedure, participants rated the food and were able to consume as much or as little as they wanted during the task. Amount consumed was covertly measured.

A between subjects 2x3 factorial ANCOVA (with hunger and gender as covariates) was performed. No significant difference in the amount of food consumed was found between plain (M = 97.76g, SD = 59.08); blended (M = 109.55, SD = 66.88); or MCFI (M = 113.13g, SD = 65.75) conditions (p =.752, ηp2 <.01). There was also no significant interaction between MCFI condition and food type (p =.871, ηp2<.01).

Therefore, our hypothesis was not supported. One possibility is that the form of MCFI used within the current study was not potent enough to elicit differences. On the one hand the ability for participants to taste all components within a single mouthful aided a well-controlled experimental design with intake as an outcome. On the other hand, we may have failed to capture a key property of MCFI as they exist in the food environment, that each spoonful may be different to the last. A future study may consider an alternative methodology to consider different forms of MCFI and how they may be perceived and consumed.

Bread is a staple food consumed globally(1); yet, refined wheat bread has high glycaemic index values, which may contribute to postprandial hyperglycaemia and long-term metabolic diseases (e.g., diabetes)(2). Legume flours contain higher protein, fibre, and resistant starch levels, which are able to dampen glycaemic(1). This review aims to assess the effectiveness of legume wheat flour combinations in bread on glucose control within the postprandial setting, insulin responses, and related metabolic outcomes.

A systematic review was conducted according to PRISMA guidelines(3). Comprehensive searches were performed in PubMed, Web of Science, and the Cochrane databases (studies published 2000 - 2025). Eligible studies were randomised controlled trials (RCTs), involving healthy adults or adolescents consuming bread made from legume wheat flour blends compared with wheat-only bread. Outcomes included postprandial glucose, insulin responses, glycaemic index (GI), satiety, and sensory acceptability.

Sixteen RCTs conducted using crossover designs (n = 353 participants) were included. The level of legume flour substitution ranged from 15% to 100%, incorporating chickpea, pea, lentil, soy, lupin, fenugreek, and kidney bean flours. Data were synthesised and compared across studies, showing that partial substitution with legume flours (typically 15–60%) considerably lowered the postprandial glucose and insulin responses compared with wheat control breads. Substitution with 30% and 60% chickpea flour produced the most pronounced and highly significant reductions in postprandial glucose (p < 0.05). Incorporating chickpea flour into composite blends (e.g., with guar gum) further enhanced glycaemic control compared with wheat bread. 40% lupin, 15% chickpea, and 25%-50% mix of kidney bean and chickpea flour formulations were associated with marked reductions in postprandial insulin responses (p < 0.05). Several formulations achieved a “low glycaemic index” classification, those containing a 25%-50% mix of kidney bean and chickpea flour, 25–50% soybean flour and 10% fenugreek. Satiation was considerably enhanced with soybean, lupin, as well as pea breads. Sensory acceptability of most formulations proved to be good, regardless of slight compromises in texture with higher levels of substitution.

Evidence from studies indicates that partial replacement of wheat flour (15–60%) with legume flours improves postprandial glycaemic and insulinemic responses. Further long-term RCTs involving at-risk populations (e.g., people with diabetes) are warranted to confirm optimal substitution levels and assess metabolic sustainability, while considering the substitution levels that may affect consumer acceptability and bread texture.

Recent meta-analyses of randomized controlled trials (RCTs) have raised concerns that treatment with omega-3 fatty acids may increase risk of atrial fibrillation (AF)(1,2). However, these analyses included only up to eight RCTs(1,2). The aim of this current meta-analysis was to expand the evidence base by identifying additional RCTs reporting AF incidence, incorporating both published and unpublished data. We further examined whether AF risk is influenced by omega-3 dose and baseline cardiovascular disease (CVD) risk status, with the a priori hypothesis that these factors interact synergistically.

A systematic search across multiple databases, trial registries, and data-sharing platforms (including PubMed, GOED CSD and ClinicalTrials.gov) was conducted to identify eligible RCTs. RCTs investigating daily supplementation ≥500 mg/day of docosahexaenoic acid (DHA) and/or eicosapentaenoic acid (EPA), ≥12 months of EPA/DHA treatment, participants aged ≥50 years, and where possible, absence of known AF/atrial flutter at baseline, were included. Unpublished data were identified through trial registries and direct contact with principal investigators. The primary outcome was new-onset AF. Trials were stratified by dose (high: ≥1500 mg/day vs low: <1500 mg/day) and baseline CVD risk (high vs low). Logistic regression models with Firth’s correction estimated study-specific odds ratios (ORs), which were pooled using inverse-variance weighted random-effects meta-analysis (metafor, R).

A total of 34 RCTs (36 datasets: 12 high-risk high-dose [HR-HD], 6 high-risk low-dose [HR-LD], 11 low-risk high-dose [LR-HD], and 7 low-risk low-dose [LR-LD]) were included in the meta-analysis. When stratified by baseline CVD risk and omega-3 dose, only participants at high CVD risk receiving high-doses (≥1500 mg/day; HR-HD) showed a statistically significant increase in AF risk (pooled OR 1.48, 95% CI 1.21-1.81; absolute risk difference 0.8% [0.40–1.10%]). The other strata HR-LD, LR-HD, and LR-LD; did not show significant risk (ORs 1.07, 1.06, and 0.95, respectively). Post-hoc comparisons versus the HR-HD group indicated significantly lower AF risk for the HR-LD and LR-LD strata (pooled OR 0.71 in both, p<0.001), while the LR-HD group demonstrated the lowest but non-significant risk (OR 0.63). Between-study heterogeneity was minimal (I2<7%, p>0.45).

This meta-analysis indicates that EPA/DHA supplementation may increase AF risk primarily in individuals with high CVD risk receiving high doses (≥1500 mg/day) typically from pharmacological products. No significant increase in AF risk was observed with lower doses or in lower-risk populations. These findings suggest that while high-dose therapy may warrant caution in high-risk patients, AF risk should be balanced against the established cardiovascular benefits of omega-3 fatty acids.

Food waste poses a significant challenge to sustainable food systems and carries far-reaching economic, environmental, and public health consequences(1). ‘Root-to-tip’ dining, which incorporates edible parts of the plant which are typically discarded (e.g., fruit and vegetable peels and stalks), provides a promising solution to reduce waste, reduce environmental impact and further support better health and nutrition(2,3). Following the launch of ‘Root-to-tip’ menu items in a UK higher education food service setting, this study aimed to investigate consumer attitudes and perceptions of ‘root-to-tip’ dining.

A cross-sectional study was conducted using data collected via an anonymous online survey, amongst a convenience sample of current students and employees who had purchased both ‘root-to-tip’ and non-‘root-to-tip’ meals at campus dining outlets between 28 April and 27 June 2025. The survey captured meal selection and factors influencing meal choice; awareness, post-consumption perceptions of and satisfaction with dishes; plate waste generation; and demographic data. Descriptive statistics and Pearson’s Chi-squared test were performed to identify associations between meal selection and, food characteristics, demographic and psychographic factors. The research protocol was approved by the King’s College London Research Ethics Committee (Ref: LRS/DP-24/25-47050).

A total of 727 participants (60.2% female) provided complete responses, primarily aged 26-45 years (47.2%). Among the respondents that selected ’root-to-tip’ menu items (38.1%) (61.9% selected non-’root-to-tip’ menu items), taste (89.5%) and health (70.8%) were rated the most important, while visual appearance (64.6%) and affordability (54.5%) were rated the second most important. Taste (93.4%), visual appeal (92.1%), smell (91.4%) and healthiness (93.8%) received the highest satisfaction scores post-consumption, while sustainability (91.7%) received the second highest satisfaction scores. Most respondents that chose ‘root-to-tip’ dishes (75.8%) reported that they would be highly likely to eat their meal again. A total of 110 participants provided responses for plate waste analysis and 58.2% reported between 76-100% of food to be consumed. Meal selection was significantly influenced by taste (ꭓ2=10.63, p=0.031), visual appearance (ꭓ2=10.63, p=0.037), affordability (ꭓ2=16.45, p=0.002), familiarity (ꭓ2=35.52, p<0.001, 23.8% importance rating), health (ꭓ2=15.11, p=0.004, 70.8% importance rating), novelty (ꭓ2=24.70, p<0.001, 34.7% importance rating) and profession (ꭓ2=17.99, p=0.006). Satisfaction was significantly associated with sustainability (X2 =10.18, p=0.037), visual appeal (ꭓ2=29.49, p=0.004), and value for money (ꭓ2=21.01, p<0.001, 57.0% satisfaction rating). Repeat consumption was significantly associated with satisfaction (ꭓ2=22.43, p<0.001).

This study advances research on consumer responses to food waste ingredients, in particular peels and stalks, highlighting taste, health, affordability, and sustainability as key acceptance drivers. Findings provide practical insights for institutional catering and public health initiatives to reduce food waste through consumer engagement and behaviour change.