The gut microbiome is impacted by certain types of dietary fibre. However, the type, duration and dose needed to elicit gut microbial changes and whether these changes also influence microbial metabolites remain unclear. This study investigated the effects of supplementing healthy participants with two types of non-digestible carbohydrates (resistant starch (RS) and polydextrose (PD)) on the stool microbiota and microbial metabolite concentrations in plasma, stool and urine, as secondary outcomes in the Dietary Intervention Stem Cells and Colorectal Cancer (DISC) Study. The DISC study was a double-blind, randomised controlled trial that supplemented healthy participants with RS and/or PD or placebo for 50 d in a 2 × 2 factorial design. DNA was extracted from stool samples collected pre- and post-intervention, and V4 16S rRNA gene sequencing was used to profile the gut microbiota. Metabolite concentrations were measured in stool, plasma and urine by high-performance liquid chromatography. A total of fifty-eight participants with paired samples available were included. After 50 d, no effects of RS or PD were detected on composition of the gut microbiota diversity (alpha- and beta-diversity), on genus relative abundance or on metabolite concentrations. However, Drichlet’s multinomial mixture clustering-based approach suggests that some participants changed microbial enterotype post-intervention. The gut microbiota and fecal, plasma and urinary microbial metabolites were stable in response to a 50-d fibre intervention in middle-aged adults. Larger and longer studies, including those which explore the effects of specific fibre sub-types, may be required to determine the relationships between fibre intake, the gut microbiome and host health.

Campylobacter spp. are leading bacterial gastroenteritis pathogens. Infections are largely underreported, and the burden of outbreaks may be underestimated. Current strategies of testing as few as one isolate per sample can affect attribution of cases to epidemiologically important sources with high Campylobacter diversity, such as chicken meat. Multiple culture method combinations were utilized to recover and sequence Campylobacter from 45 retail chicken samples purchased across Norwich, UK, selecting up to 48 isolates per sample. Simulations based on resampling were used to assess the impact of Campylobacter sequence type (ST) diversity on outbreak detection. Campylobacter was recovered from 39 samples (87%), although only one sample was positive through all broth, temperature, and plate combinations. Three species were identified (Campylobacter jejuni, Campylobacter coli, and Campylobacter lari), and 33% of samples contained two species. Positive samples contained 1–8 STs. Simulation revealed that up to 87 isolates per sample would be required to detect 95% of the observed ST diversity, and 26 isolates would be required for the average probability of detecting a random theoretical outbreak ST to reach 95%. An optimized culture approach and selecting multiple isolates per sample are essential for more complete Campylobacter recovery to support outbreak investigation and source attribution.

Georgia lies to the northeast of Türkiye, having a western border on the Black Sea. With a population of some 3·73 million, Georgia has a tradition of gastronomic excellence dating back millennia. However, changing lifestyles and external influences have, as elsewhere, led to problems of suboptimal nutrition, and lifestyle-related diseases and disorders prevail. There is considerable scope for improving the focus on public health (PH) and nutrition in Georgia. With this in mind, the Georgian Nutrition Society teamed up with The Nutrition Society of the UK and Ireland and the Sabri Ülker Foundation, a PH charity based in Istanbul, Türkiye, to host a conference and workshops in Tbilisi, Georgia. The primary purpose was to review the current status of PH and nutrition in Georgia with reference to the situation elsewhere, to share examples of best practice and to identify opportunities for improvement. A particular highlight was the presentation of a programme of nutrition education for family physicians recently implemented in Türkiye. This summary of the proceedings is intended as a blueprint for action in Georgia and also to inspire others to consider how PH might be improved via a focus on balanced nutrition.

There is a dearth of data on Se status in very old adults. The aims of this study were to assess Se status and its determinants in 85-year-olds living in the Northeast of England by measuring serum Se and selenoprotein P (SELENOP) concentrations and glutathione peroxidase 3 (GPx3) activity. A secondary aim was to examine the interrelationships between each of the biomarkers. In total, 757 participants (463 women, 293 men) from the Newcastle 85+ Study were included. Biomarker concentrations were compared with selected cut-offs (serum Se: suboptimal 70 µg/l and deficient 45 µg/l; SELENOP: suboptimal 4·5 mg/l and deficient 2·6 mg/l). Determinants were assessed using linear regressions, and interrelationships were assessed using restricted cubic splines. Median (inter-quartile range) concentrations of serum Se, SELENOP and of GPx3 activity were 53·6 (23·6) µg/l, 2·9 (1·9) mg/l and 142·1 (50·7) U/l, respectively. Eighty-two percentage and 83 % of participants had suboptimal serum Se (< 70 µg/l) and SELENOP (< 4·5 mg/l), and 31 % and 40 % of participants had deficient serum Se (< 45 µg/l) and SELENOP (< 2·6 mg/l), respectively. Protein intake was a significant determinant of Se status. Additional determinants of serum Se were sex, waist:hip ratio, self-rated health and disease, while sex, BMI and physical activity were determinants of GPx3 activity. There was a linear association between serum Se and SELENOP, and nonlinear associations between serum Se and GPx3 activity and between SELENOP and GPx3 activity. These findings indicate that most participants had suboptimal Se status to saturate circulating SELENOP.

Indigenous peoples and ethnic minority groups often experience poor diet quality and poor health outcomes. Such inequities may be partially due to nutrition interventions not meeting the unique cultural and linguistic needs of these population groups, which could be achieved using co-creation and/or personalised approaches. Cultural adaptation or tailoring of nutrition interventions has shown promise in improving some aspects of dietary intake, but this requires careful consideration to ensure it does not inadvertently exacerbate dietary inequities. The aim of this narrative review was to examine examples of cultural adaptations and/or tailoring of public health nutrition interventions that improved the dietary intake and to consider implications for the optimal design and implementation of personalised and precision nutrition interventions. This review identified six examples of cultural adaptation and/or tailoring of public health nutrition intervention in Indigenous peoples and ethnic minority groups across Australia, Canada and the US. All studies used deep socio-cultural adaptations, such as the use of Indigenous storytelling, and many included surface-level adaptations, such as the use of culturally appropriate imagery in intervention materials. However, it was not possible to attribute any improvements in dietary intake to cultural adaptation and/or tailoring per se, and the minimal reporting on the nature of adaptations limited our ability to determine whether the interventions used true co-creation to design content or were adapted from existing interventions. Findings from this review outline opportunities for personalised nutrition interventions to use co-creation practices to design, deliver and implement interventions in collaboration with Indigenous and ethnic minority groups.

The present paper reviews progress in research on dietary fibre and human health over the past five decades. There is now convincing evidence from prospective cohort studies that diets low in dietary fibre are associated with increased risk of common non-communicable diseases including CVD, type 2 diabetes and colorectal cancer. These findings provide strong support for hypotheses proposed by Denis Burkitt 50 years ago, based on very limited evidence but with considerable imagination and insight. For the first two to three decades of this period, research on dietary fibre was hampered by the lack of consensus about the definition, and measurement, of this complex and diverse dietary component and by the lack of appropriate tools for investigating the gut microbiome that is central to understanding mechanisms of action. Recent technical and scientific advances in microbiome research (based on fast, low-cost, DNA sequencing) are facilitating investigation of the associations between dietary fibre, the gut microbiome and human health. Current challenges include the need for agreement about the characteristics of a healthy gut microbiome. Although the health benefits attributed to higher dietary fibre intake are likely to be shared with most types of dietary fibre, one should anticipate that different sources of dietary fibre and the other components (resistant starch and non-digestible oligosaccharides) that make up dietary fibre will have characteristically different effects on human physiology and disease risk. In conclusion, population-level intakes of dietary fibre are low and there is a public health priority to develop and implement more effective interventions to increase intake.

Optimum nutrition plays a major role in the achievement and maintenance of good health. The Nutrition Society of the UK and Ireland and the Sabri Ülker Foundation, a charity based in Türkiye and focused on improving public health, combined forces to highlight this important subject. A hybrid conference was held in Istanbul, with over 4000 delegates from sixty-two countries joining the proceedings live online in addition to those attending in person. The primary purpose was to inspire healthcare professionals and nutrition policy makers to better consider the role of nutrition in their interactions with patients and the public at large to reduce the prevalence of non-communicable diseases such as obesity and type 2 diabetes. The event provided an opportunity to share and learn from different approaches in the UK, Türkiye and Finland, highlighting initiatives to strengthen research in the nutritional sciences and translation of that research into nutrition policy. The presenters provided evidence of the links between nutrition and disease risk and emphasised the importance of minimising risk and implementing early treatment of diet-related disease. Suggestions were made including improving health literacy and strengthening policies to improve the quality of food production and dietary behaviour. A multidisciplinary approach is needed whereby Governments, the food industry, non-governmental groups and consumer groups collaborate to develop evidence-based recommendations and appropriate joined-up policies that do not widen inequalities. This summary of the proceedings will serve as a gateway for those seeking to access additional information on nutrition and health across the globe.

A multi-disciplinary expert group met to discuss vitamin D deficiency in the UK and strategies for improving population intakes and status. Changes to UK Government advice since the 1st Rank Forum on Vitamin D (2009) were discussed, including rationale for setting a reference nutrient intake (10 µg/d; 400 IU/d) for adults and children (4+ years). Current UK data show inadequate intakes among all age groups and high prevalence of low vitamin D status among specific groups (e.g. pregnant women and adolescent males/females). Evidence of widespread deficiency within some minority ethnic groups, resulting in nutritional rickets (particularly among Black and South Asian infants), raised particular concern. Latest data indicate that UK population vitamin D intakes and status reamain relatively unchanged since Government recommendations changed in 2016. Vitamin D food fortification was discussed as a potential strategy to increase population intakes. Data from dose–response and dietary modelling studies indicate dairy products, bread, hens’ eggs and some meats as potential fortification vehicles. Vitamin D3 appears more effective than vitamin D2 for raising serum 25-hydroxyvitamin D concentration, which has implications for choice of fortificant. Other considerations for successful fortification strategies include: (i) need for ‘real-world’ cost information for use in modelling work; (ii) supportive food legislation; (iii) improved consumer and health professional understanding of vitamin D’s importance; (iv) clinical consequences of inadequate vitamin D status and (v) consistent communication of Government advice across health/social care professions, and via the food industry. These areas urgently require further research to enable universal improvement in vitamin D intakes and status in the UK population.

Across the globe, there has been a marked increase in longevity, but significant inequalities remain. These are exacerbated by inadequate access to proper nutrition and health care services and to reliable information to make the decisions related to nutrition and health care. Many in economically developing as well as developed societies are plagued with the double-burden of energy excess and undernutrition. This has resulted in mental and physical deterioration, increased non-communicable disease rates, lost productivity, increased medical costs and reduced quality of life. While adequate nutrition is fundamental to good health at all stages of the life course, the impact of diet on prolonging good quality of life during ageing remains unclear. For progress to continue, there is need for new and/or innovative approaches to promoting health as individuals age, as well as qualitative and quantitative biomarkers and other accepted tools that can measure improvements in physiological integrity throughout life. A framework for progress has been proposed by the World Health Organization in their Global Strategy and Action Plan on Ageing and Health. Here, we focused on the impact of nutrition within this framework, which takes a broad, person-centred emphasis on healthy ageing, stressing the need to better understand each individual's intrinsic capacity, their functional abilities at various life stages, and the impact of their mental, and physical health, as well as the environments they inhabit.

Selenium is an essential micronutrient with biochemical and cellular effects through activities of 25 selenocysteine-containing selenoproteins. Selenoproteins are anti-inflammatory and have antioxidant properties. Severe selenium deficiency causes muscle weakness and atrophy in humans however the effects of moderate selenium deficiency are unclear. The aims of this study are twofold: 1) to determine dietary selenium intakes and contributing food sources in very old adults and; 2) to determine whether dietary selenium intakes are associated with 5-year trajectories of muscle function: hand-grip strength (HGS) and Timed-Up-and-Go (TUG).

Cross-sectional (baseline) and prospective (1.5, 3 and 5-year follow-up) analyses of 845 participants aged 85 years from the Newcastle 85 + study were assessed for HGS and TUG performance using standardized protocols (Antoneta et al. 2016). Baseline dietary intakes were assessed using 24-hour multiple pass recall methods on two separate days (Mendonça et al. 2016). The top selenium food contributors (~90%) and the adequacy of intakes were determined i.e. those with intakes < LRNI, between the LRNI and RNI and > RNI. Linear mixed models explored the associations between selenium intake categories and time on the prospective, 5-year change in HGS and TUG in all participants, males and females.

Median intakes of selenium were 39, 48 and 35μg for all participants, males and females, respectively. Selenium intakes were below the LRNI in 51% of participants (median 27μg) whilst 15% had intakes ≥ the RNI (median 85μg). Only 13.3% of females and 16.9 % of males met the RNI. The top selenium contributors were cereals (46%), meat (22%), fish (10%), milk (6%), eggs (4%) and potatoes (3%) making up 91% of selenium intakes. Those with the lowest intakes had 2.72 kg lower HGS and 2.36s slower TUG compared to those with higher intakes (P < 0.005). There was no association between selenium intake in HGS or TUG, but time had a significant effect on the rate of change over 5-years in both parameters (P < 0.001).

Overall these results show that poor dietary selenium intakes are common in very old adults and that cereal and cereal products are major sources of selenium in this population. Whilst low selenium intakes are associated with worse HGS and TUG performance in the cross-sectional analysis, no significant associations were observed in the prospective analyses.