Precision nutrition aims to optimise health by tailoring dietary interventions to individual biological characteristics. In ageing populations, gut microbiome composition and intestinal barrier integrity are key modulators of immune and metabolic function, yet both decline with age, contributing to chronic low-grade inflammation and disease risk. Nutritional interventions such as omega-3 fatty acids, plant bioactives, and postbiotics can improve these parameters, but inter-individual variability limits consistent benefit. Metabotyping—classifying individuals by metabolic phenotype—offers a strategy to personalise interventions based on metabolomic fingerprints reflecting diet–microbiome–host interactions(1). This study applied a metabotyping framework to integrate urinary metabolomics, gut microbiome sequencing, and gut barrier biomarkers in older adults, to identify metabolic phenotypes predictive of response to nutritional supplementation.

A randomised, double-blind, placebo-controlled trial (ISRCTN75484092) was conducted in healthy adults aged ≥60 years (n = 60). Participants received 12 weeks of either Cerbella™ (EPA, DHA, ginseng, green tea extract, phospholipids) or PoZibio™ (heat-inactivated Lactobacillus paracasei D3.5) or placebo. Biological samples collected at baseline and post-intervention included stool (whole-genome microbiome sequencing), plasma (short-chain fatty acids; SCFAs), and urine (untargeted metabolomics by FIE-MS). Metabolomic data underwent preprocessing, normalisation, and unsupervised clustering using k-means and principal component analysis to define metabotypes. Associations between metabotypes, microbiome α-diversity, and gut barrier biomarkers (zonulin, sCD14, mucin, calprotectin) were assessed using ANOVA and multivariate regression. Machine-learning models (random forest) were trained to predict intervention response based on baseline metabolic signatures.

Preliminary analyses identified distinct metabolic clusters among participants, each defined by unique metabolomic fingerprints linked to diet and microbiome activity. Early integration with microbiome data indicates that these metabotypes differ in bacterial diversity and in taxa associated with SCFA and polyphenol metabolism. Participants with plant- and fibre-associated metabolic profiles appear to show more favourable gut barrier biomarker patterns (e.g., lower zonulin and sCD14), though validation is ongoing. Initial modelling suggests that baseline metabotypes may predict responsiveness to Cerbella™ and PoZibio™ supplementation, particularly in relation to microbiome composition and gut integrity. These interim findings support the feasibility of metabotyping as a stratification tool for personalised nutrition in older adults.

This study provides preliminary evidence that metabotyping can stratify older adults according to gut microbiome composition, barrier integrity, and response to nutritional supplementation. Integration of untargeted metabolomics, microbiome sequencing, and biomarker data identified reproducible metabolic phenotypes predictive of intervention outcomes. By incorporating metabotyping into nutrition research, personalised dietary strategies can be developed to enhance efficacy, reduce non-responder rates, and support healthy ageing. These results advance the translation of multi-omics science into actionable tools for precision nutrition(1,2).

To develop an international template to support patient submissions in Health Technology Assessments (HTAs). This was to be based on the experience and feedback from the implementation and use of the Scottish Medicines Consortium's (SMC) Summary Information for Patient Groups (SIP).

To gather feedback on the SMC experience, web-based surveys were conducted with pharmaceutical companies and patient groups familiar with the SMC SIP. Semistructured interviews with representatives from HTA bodies were undertaken, along with patient group discussions with those less familiar with the SIP, to explore issues around the approach. These qualitative data informed the development of an international SIP template.

Survey data indicated that 82 percent (18 of 22 respondents) of pharmaceutical company representatives felt that the SIP was worthwhile; 88 percent (15/17) of patient group respondents found the SIP helpful. Both groups highlighted the need for additional support and guidance around plain language summaries. Further suggestions included provision of a glossary of terms and cost-effectiveness information. Patient group interviews supported the survey findings and led to the development of a new template. HTA bodies raised potential challenges around buy-in, timing, and bias connected to the SIP approach.

The international SIP template is another approach to support deliberative processes in HTA. Although challenges remain around writing summaries for lay audiences, along with feasibility considerations for HTA bodies, the SIP approach should support more meaningful patient involvement in HTAs.

Globally, over 1.97 billion adults and 338 million children and adolescents are living with overweight and obesity, increasing the risk of numerous co-morbidities, including at least 12 cancers(1). WCRF/AICR conducted a literature review of diet and physical activity as determinants of weight gain, overweight and obesity in adults and children. We also introduce a novel evidence-based policy framework for promoting physical activity, and linked database, currently in development as part of the EU-funded CO-CREATE project on child and adolescent obesity prevention.

Evidence on diet and physical activity as determinants and risk of weight gain, overweight and obesity was systematically extracted from existing reviews and a systematic search for recent meta-analyses, then collated and analysed. The WCRF Continuous Update Project Expert Panel drew conclusions about which exposures influence risk of weight gain, overweight and obesity, using pre-defined criteria that included evidence of biological plausibility.

The Panel identified strong evidence that several diet and physical activity related exposures influence the risk of weight gain, overweight and obesity in adults and children (see table 1). Separate conclusions were drawn for adults and children in relation to screen time, considered a marker of sedentary time.

However, the Panel noted that as exposures tend to cluster, physiologically interact and share common biological mechanisms, they should not be regarded as absolutely ‘singular'but an integrated concept of interrelated exposures within a pattern of lifestyle.Table 1.

Risk of weight gain, overweight and obesity

For full list of footnotes, see Energy Balance and Body Fatness report(1).

Healthy dietary patterns help prevent excess weight gain. Achieving such patterns requires attention to the broader economic, environmental and social factors that influence and constrain people's behaviour. The findings of this report support the need for evidence-based public health policy to help create health-enabling environments, particularly for children and adolescents. The WCRF International MOVING framework(2) presents a package of policies to promote physical activity, which alongside wider public health policy can help address the multiple drivers of overweight and obesity.