Greater consumption of red meat has been linked to a higher risk of mortality and chronic diseases, including diabetes. We aim to examine the associations between total, processed, and unprocessed red meat intake and diabetes, and to evaluate the substitution effects of other protein sources for red meat on diabetes. This population-based cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2003-2016. Diabetes was defined as being diagnosed by a physician or other health professional, having a fasting plasma glucose of 126 mg/dL or higher, an HbA1c level of 6.5% or higher, or the use of antidiabetic drugs. Multivariable logistic regression models were conducted. The study included 34,737 adult participants (mean (SD) age of 45.8 (17.5) years) from NHANES 2003-2016. After adjusting for major confounders, compared to the first quintile, higher intakes of total, processed, and unprocessed red meat were positively associated with higher odds of diabetes, with adjusted odds ratios of 1.49 (95% CI, 1.22-1.81), 1.47 (95% CI, 1.17-1.84), and 1.24 (95% CI, 1.06-1.44), respectively (P- trend for all < 0. 001). In this nationally representative sample of U.S. adults, participants in the highest quintiles of total, processed, and unprocessed red meat intake had higher odds of diabetes than those in the lowest quintile. Substituting 1 serving/day of dietary protein from foods of plant origin (including nuts, seeds, legumes, and soy) for total, processed, or unprocessed red meat was associated with 9% to 14% lower odds of diabetes.

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.

Iodine deficiency is now a significant public-health concern in the UK. Data from the National Diet and Nutrition Survey (NDNS; 2019–2023) shows that several population groups are now classified as mildly iodine deficient, including women of childbearing age. This is a change from previous NDNS data where these groups were iodine sufficient. As iodine is needed for thyroid-hormone production, which are essential for brain development, iodine deficiency prior to, and during, pregnancy may have implications for child cognition – including lower IQ. However, the evidence base for the health effects of mild deficiency is not as strong as in severe deficiency. The WHO recommends salt iodisation to control iodine deficiency in a population, but such a policy was never introduced in the UK and iodised salt is not widely available. While UK milk is rich in iodine and is the principal source, the rise in popularity of plant-based milk alternatives may increase the risk of iodine deficiency. It may be necessary to give personalised advice to those with low iodine intake, but identify those at risk is challenging owing to a lack of a biomarker for iodine in an individual. Population-wide approaches may be required in the UK – for example, fortification of bread with iodised salt or mandatory iodine fortification of plant-based dairy alternatives. This review will critically discuss (i) the data on iodine deficiency in the UK (ii) the evidence base for the health implications of mild deficiency and (iii) the potential public-health solutions.

In the UK, approximately 64,000 individuals are living with an ileostomy. This surgery creates an opening in the abdominal wall (stoma), allowing for diversion of egesta into a disposable pouch. This procedure impacts nutrient absorption meaning people living with an ileostomy may be subject to sub-optimal nutrition, often compounded by the low-fibre diet – which is frequently encouraged post-operatively. This review explores the restrictive dietary patterns of this population and their effects on nutrition and quality of life, alongside current approaches to improve dietary management and health outcomes. Dietary restriction beyond the post-operative period is frequently reported, with avoidance of high-fibre foods (e.g., fruits and vegetables) being most prevalent. These long-term dietary changes are presumed to impact nutritional status, with current evidence suggesting diminished bone mineral density and vitamin B12. High-output stoma (HOS) and dehydration are significant issues for people living with an ileostomy, and dietary management of stoma output and other ileostomy-related symptoms is a major contributor to food avoidance. The efficacy of oral rehydration solutions (ORS) in management of HOS is well-established; however, due to high concentrations of glucose and sodium, the palatability of such treatments is poor, impacting patient adherence. Encouragingly, personalised dietary advice has shown some positive effects on both quality of life and nutritional outcomes for people living with an ileostomy. However, a greater understanding of dietary management is needed, and there remains scope to improve current dietary advice and enable people living with an ileostomy to benefit from a more complete and unrestricted diet.

A review was carried out of studies on the diet of various Mediterranean teuthivorous predators (marine mammals, chondrichthyans, osteichthyans, seabirds, turtles, crustaceans, and cephalopods) and their cephalopod prey. Data extracted from the literature were analysed using multivariate statistical techniques. Three distinct groups of predators were identified according to the cephalopod species consumed. The most common prey of the predators are the ‘unidentified Cephalopoda’, followed by the sepiolid Heteroteuthis dispar and the ommastrephid squid Illex coindetii. The most important cephalopod predators are the striped dolphin, Stenella coeruleoalba, the chondrichthyans Scyliorhinus canicula and Galeus melastomus, the swordfish Xiphias gladius, and the ommastrephid squid Todarodes sagittatus. The dietary preferences of the different teutophages, their geographical distribution and some ecological implications are discussed.

Ensuring adequate food intake among older people is essential for maintaining health and preventing malnutrition. This review explores strategies to enhance dietary intake in this population group. Several key interventions are highlighted, including offering high-energy and protein-fortified meals and snacks, optimising the visual appeal and presentation of foods, enhancing flavours, and providing finger foods or modified textures to support consumption. Familiarity with fortified foods may encourage acceptance and increase intake, while improving food aesthetics and incorporating varied flavours can enhance enjoyment and promote consumption. Flavour enhancement may help compensate for decline in smell and taste sensitivity often experienced by older people, helping to sustain interest in food and promote greater intake. Finger foods present a practical solution for older adults with physical impairments, allowing for easier handling and self-feeding. Additionally, for individuals with dysphagia or chewing difficulties, texture-modified diets tailored to their needs support safe food intake. Research suggests that refining food presentation through techniques such as moulding and 3D printing may improve palatability and appeal, potentially boosting consumption among older adults. Addressing sensory preferences and physical challenges associated with eating is critical to ensuring adequate nutrition and promoting overall wellbeing in the elderly population. This review underscores the importance of multifaceted dietary strategies, advocating for personalised interventions that align with older individuals’ needs and preferences to enhance food intake and nutritional status.

Oxidative stress is an important pathomechanism in psoriasis, and the oxidative balance score (OBS) serves as a standardised metric for assessing systemic oxidative status, but its association with psoriasis is unclear. This study included 18 023 adults from the National Health and Nutrition Examination Survey to investigate the relationship between OBS and psoriasis. After using a complex sampling weighting method, we performed multi-model logistic regression and stratified analysis with OBS as the exposure and psoriasis as the outcome for the primary analysis. Restricted cubic spline (RCS) plots were used to evaluate potential non-linear associations between OBS and psoriasis. In addition, we performed replication analyses using two 24-h dietary records data as a sensitivity test to ensure robustness of the results. Multi-model logistic regression analyses revealed no statistically meaningful link between OBS and psoriasis prevalence when accounting for all confounders (P > 0·05), but in stratified analyses, OBS demonstrated a significant association with reduced risk of psoriasis in individuals aged 60–80 years (OR = 0·27–0·35, P < 0·05). As part of the overall OBS, moderate dietary OBS demonstrated an association with reduced psoriasis risk in 60- to 80-year-olds (OR = 0·39–0·43, P < 0·05). Lifestyle OBS (LOBS) indicates a significant negative correlation with psoriasis risk among the ‘Other Hispanic’ group. (Q3 OR = 0·23, P < 0·05). The RCS showed a non-linear relationship between LOBS and psoriasis (non-linear P = 0·013). This study provides the first systematic confirmation of an association between OBS and a reduced risk of psoriasis in elderly populations and specific ethnic groups. These findings offer new insights and directions for the prevention and treatment of psoriasis.

Cancer-related fatigue is a common problem among colorectal cancer (CRC) survivors even after completion of treatment. In a randomised trial, we assessed the effect of a person-centred lifestyle programme on cancer-related fatigue among CRC survivors who completed treatment. Survivors who completed treatment at least 6 months but no longer than 5 years ago and who were experiencing cancer-related fatigue were randomised to intervention or control group. The intervention group worked with a lifestyle coach for 6 months during twelve sessions to stepwise increase adherence to the World Cancer Research Fund/American Institute of Cancer Research cancer prevention guidelines on healthy diet and physical activity. The control group did not receive lifestyle coaching. Changes in cancer-related fatigue from baseline to 6 months were assessed with the FACIT (Functional Assessment of Chronic Illness Therapy) – Fatigue Scale. As a secondary outcome, we assessed changes in health-related quality of life (HRQoL). Higher scores indicate less fatigue and better HRQoL. Eighty participants were randomised to the intervention group; eighty-one to the control group. Baseline characteristics were similar: mean age 64·1 (sd 10·9) years; 55·3 % were women; and 72 % had colon cancer. There were favourable changes in dietary behaviours and physical activity in the intervention group; the control group did not show changes to the same extent. The programme did not result in statistically significant differential changes over time between intervention and control group in cancer-related fatigue (0·8; 95 % CI −1·6, 3·2) or HRQoL (1·3; 95 % CI −2·2, 4·8). A person-centred lifestyle programme improved the lifestyle of CRC survivors, but the programme was not effective in reducing cancer-related fatigue or in improving HRQoL.

Igbo-Ora, a town in southwestern Nigeria, is renowned for exceptionally high dizygotic twin birth rates, recording approximately 45 per 1000 live births. This article explores the factors behind this unique phenomenon by critiquing the community’s perceptions and narrative of the factors responsible for the high twinning rate and comparing these perceptions with biomedical hypotheses. Drawing on 6 months of ethnographic fieldwork — participant observation, 81 semistructured interviews, and FGDs — this study documents local narratives that highlight hereditary ‘twin threads’ —; specific foods, notably Ilasa (okra-leaf soup) and cassava meals; environmental qualities of ‘air’ and ‘water’; and divine sanction as factors responsible for the incidence of twin birth in Igbo-Ora. These local narratives are analyzed against certain biomedical perspectives on maternal age and parity effects, putative genetic variants influencing gonadotrophins, and dietary phytoestrogens. The study found that the community resist single-cause explanations for the incidence of twin birth and instead articulates a complementarity of genetic, ecological, dietary, and spiritual factors. This holistic framing contrasts with and complements prevailing genetic and nutritional theories surrounding the incidence of twin birth. The article argues that future genetic and epidemiological investigations in high-twinning populations must be culturally attuned to ensure accurate phenotype definition, ethical engagement, and translational relevance.

The dietary antioxidant quality score (DAQS) is a valid and reliable tool for assessing the overall antioxidant potency of a diet by considering the synergetic effects of dietary antioxidants. Non-alcoholic fatty liver disease (NAFLD) is linked to the imbalance of the body’s oxidant and antioxidant defense system. The objective of the present research was to investigate the possible associations between DAQS and odds of NAFLD in a large population of the Azar cohort study. The present propensity score–matched case–control study was applied to a population of 14 655 individuals. Demographic, anthropometric and dietary data were gathered, and biochemical markers were measured. The DAQS was evaluated based on the daily dietary intake of vitamin E, vitamin A, vitamin C, Se and Zn, compared with the daily recommended intake. The multivariable logistic regression analysis was employed to determine the association between DAQS with NAFLD-related outcomes. After propensity score matching based on age, gender and body mass index (BMI), participants were allocated into NAFLD (n 660) and non-NAFLD (n 1234) groups. Findings indicated significant differences in age, weight, BMI, waist:hip ratio, TAG, HDL-cholesterol and LDL-cholesterol and dietary intake between percentiles of DAQS in NAFLD patients. Nonetheless, no significant associations were observed between DAQS and NAFLD before and after propensity score matching. Comparing the results to prior research underlines the need for a comprehensive approach for exploring the association between dietary antioxidants, serum antioxidant level and biochemical indices in NAFLD, which is essential for the efficient clarification of the underlying mechanisms.

A significant association between tomato consumption and a lower risk of developing hypertension has been reported. In this study, we aimed to investigate the relationship between tomato intake and prehypertension risk among Korean adults. Hypertension was defined according to the criteria established by the Korean Society of Hypertension. The study participants were selected from the Health Examinees cohort study. Tomato consumption was measured using an FFQ and categorised into quintiles based on the amount consumed. Higher tomato consumption was associated with a lower risk of prehypertension in men (hazard ratio (HR) 0·86, 95 % CI 0·80, 0·92, Pfor trend 0·0005). Women in the highest quintile also showed a similar trend (HR 0·94, 95 % CI 0·90, 0·99, Pfor trend 0·0091). Stratified analyses revealed a reduced risk of prehypertension across all subgroups, except underweight individuals and those with a history of alcohol consumption (all Pfor interaction < 0·05). These findings indicate that higher tomato intake may offer potential advantages for managing blood pressure levels.

Accurate assessment of an individual’s diet is vital to study the effect of diet on health. Image-based methods, which use images as input, may improve the reliability of dietary assessment. We developed an iOS application that uses computer vision to identify food from images. This study aimed to assess the accuracy of energy intake (EIapp) estimates from the application by comparing them to estimated energy expenditure (EE) and to the EI estimates from a validated dietary assessment tool, the 24-h recall (EIrecall). Participants were recruited from a randomised controlled trial called He Rourou Whai Painga. Participants recorded all intake over 7 d using the application, which provided a mean daily EI; this was compared to the EI estimated by two 24-h recalls. The EI from the application and the recalls were compared to EE, estimated using indirect calorimetry and wrist-worn accelerometry. EI estimates from the application and the 24-h recalls were lower than EE, with a mean bias of -1814 kJ (95% CI -3012 to -615, p = 0.005) and -1715 kJ (95% CI -3237 to -193, p = 0.029), respectively. The mean bias between EI from the application and the 24-h recall was 783 kJ (95% CI -875 to 2441, p = 0.33). This suggests that the EI estimates from the application are comparable to the 24-h recall method, a validated and widely used tool in nutritional research.

Healthy ageing and longevity have emerged as urgent public health priorities amid global population ageing and declining birth rates. This review synthesises empirical evidence highlighting the essential role of diet and nutrition in preventing chronic diseases and supporting functional independence in later life. The review was organised using a problem-solving approach to address three core questions: ‘What’ evidence links food and nutrition with positive health outcomes; ‘Why’ do specific dietary components affect biological ageing – via mechanisms such as nutrient sensing, inflammation modulation and caloric restriction; and ‘How’ culturally tailored, person-centred dietary interventions should be developed for better adoption. Findings from centenarian populations suggest that low-energy (i.e. foods with low energy density, such as fruit and vegetables, whole grains), nutrient-rich and diverse diets may help prevent or delay age-related diseases, supporting the notion that food could be used as medicine. Moreover, addressing barriers such as food insecurity and limited access to culturally appropriate healthy food options, particularly in low-income and rural communities, is crucial for achieving equitable health outcomes. Finally, the review calls for integrating personalised nutrition strategies into clinical care and public health initiatives. These efforts can enhance healthspan, improve quality of life and reduce the broader social and economic burdens associated with ageing populations.

This review comprehensively examines the current evidence on the dietary management of chronic constipation, and the dietary recommendations presented in clinical guidelines for chronic constipation. Several randomised controlled trials (RCT) have investigated the effect of dietary supplements, foods and drinks in chronic constipation. Systematic reviews and meta-analyses of these RCTs have demonstrated that psyllium supplements, specific probiotic supplements, magnesium oxide supplements, kiwifruits, prunes, rye bread and high mineral water content may be effective in the management of constipation. However, despite the plethora of evidence, current clinical guidelines only offer a limited number of dietary recommendations. The most commonly recommended dietary strategy in clinical guidelines is dietary fibre, followed by senna supplements and psyllium supplements. The least commonly recommended dietary strategies are magnesium oxide, Chinese herbal supplements, prunes and high mineral-content water. Several evidence-based dietary strategies are omitted by current clinical guidelines (e.g. kiwifruits), while some strategies that are recommended are not always supported by evidence (e.g. insoluble fibre supplement). Dietary recommendations in clinical guidelines can also be ambiguous, lacking outcome-specific recommendations and information for appropriate implementation. Future RCTs are needed to assess currently under-investigated dietary approaches that are nevertheless commonly recommended, and future clinical guidelines should include dietary recommendations supported by available evidence.

A Palaeolithic diet is an efficacious dietary approach for glycaemic control in type 2 diabetes. Causal mechanisms are body weight loss and glucometabolic effects from differences in included food groups, macronutrient composition, fibre content, and glycaemic load. The aim was to test the hypothesis that characteristic food group differences between a Palaeolithic and a diabetes diet would cause an effect on glycaemic control when weight was kept stable and diets were matched for macronutrient composition, fibre content and glycaemic load. Adult participants with type 2 diabetes and increased waist circumference were instructed to follow two diets, with or without the food groups cereal grain, dairy products, and legumes, during two periods of 4 weeks separated by a 6-week washout period in a random-order crossover design. The Palaeolithic diet included fruit, vegetables, tubers, fish, shellfish, lean meat, nuts, eggs and olive oil, and excluded cereal grains, dairy products and legumes. The diabetes diet included fruit, vegetables, fish, shellfish, lean meat, nuts, eggs, olive oil, and substantial amounts of whole grains, low-fat dairy products and legumes. Dietary energy content was adjusted throughout the study to maintain stable body weight. There were no differences between diets on HbA1c or fructosamine among the 14 participants. Body weight was kept stable, and the two diets were successfully matched for macronutrient composition and glycaemic load but not for fibre content. Characteristic food group differences and the accompanying differences in fibre content between a Palaeolithic and a diabetes diet do not cause an effect on glycaemic control.

Parkinson’s disease (PD) is the fastest-growing neurological condition in the world, affecting 11·8 million people worldwide in 2021. Due to the globally expanding and ageing population, as well as growing industrialisation, this number is likely to increase. Given the absence of disease-modifying pharmacological therapies, this review aimed to examine the effect of dietary interventions on PD progression, motor symptoms, non-motor symptoms, specifically those affecting the gastrointestinal (GI) tract, and severity. To do so, this review synthesised the current evidence from randomised controlled trials (RCTs) on dietary patterns, individual foods and beverages, and nutritional supplements including nutrients, bioactive compounds, and biotics.

Results from the included RCTs failed to demonstrate conclusive evidence for the use of a dietary intervention as a therapy for improving PD progression, symptoms and severity. However, this is likely a reflection of the current scarcity of RCTs in the literature, rather than an outright demonstration of the ineffectiveness of such dietary approaches. In contrast, several trials have demonstrated a beneficial effect of biotic supplementation in managing GI symptoms, particularly constipation syndrome, which may be a promising avenue for improving GI-related issues that affect up to 80 % of PD patients. In conclusion, further RCTs are required to decipher the role that diet may play in mitigating PD progression and severity and improving overall patient care by reducing both motor and non-motor symptoms.

During the global recession of 2020 food insecurity increased substantially in many countries around the world. Fortunately, the surge in food insecurity quickly came to a halt as the world economy returned to its positive growth path, despite double-digit domestic food inflation in most countries. To shed light on the relative importance of income growth and food inflation in driving food insecurity, we employ a heterogeneous-agent model with income inequality, complemented by novel cross-country data for the period 2001–2021. We use external instruments (changes in commodity terms-of-trade, external economic growth, and harvest shocks) to isolate exogenous variation in domestic income growth and food inflation. Our findings suggest that income growth is the dominant driver of annual variations in food insecurity, while food price inflation plays a somewhat smaller role, aligning with our model predictions.