The early postpartum period is a time of intense metabolic and physiological stress as maternal recovery from pregnancy impacts immune, cardiometabolic and gastrointestinal health. Studies considering the effect of nutrition on key maternal health parameters at this critical period are lacking. A combined supplement of bovine casein hydrolysate and yeast β-glucan has been shown to improve growth, intestinal health and inflammation in animal models, but studies in humans, including early postpartum lactating women, are lacking. In this 4-week randomised controlled trial, breastfeeding women (n 58) at 4-weeks postpartum consumed a supplement containing either: 1) a combination of 250 mg casein hydrolysate (LFC16) and 250 mg yeast β-glucan (Wellmune®) or 2) a maltodextrin control. Gastrointestinal health was self-assessed using the Structured Assessment of Gastro-Intestinal Symptoms (SAGIS) tool. At baseline, mothers reported an issue with constipation (56.5%), difficulty with defaecation (58.7%), an urgency to defaecate (6.7%), or diarrhoea (6.7%). In response to intervention, cytokine expression in peripheral blood mononuclear cells (PBMCs) and cardiometabolic health were unchanged following supplementation. After 4-weeks the intervention improved constipation domain scores (P = 0.049) and was almost twice as likely to improve SAGIS total domain score (80.0%) compared to control (45.5%, P = 0.011). This work highlights the residual effects of pregnancy on maternal gastrointestinal health parameters in the early postpartum period, and the potential of a combined casein hydrolysate and yeast β-glucan to improve gastrointestinal health, although limited findings on inflammation were observed. Further studies in larger sample sizes are warranted.

Infant and young child feeding (IYCF) is essential for growth and cognitive development. In rural Eastern Cape (South Africa), many infants/young children consume maize from an early age, reducing food security and safety. This baseline report informed the development of a culturally-specific IYCF education program grounded in behaviour-change principles and the Health Belief Model. A cross-sectional study included 178 mother/caregiver and child pairs. A socio-demographic and 24-h dietary recall questionnaire was administered, and anthropometric measurements were taken. Most mothers/caregivers were unmarried, unemployed, and had not completed high school, relying on government grants. Household income was low, with limited access to safe water and sanitation. Stunting (20.9%) and overweight (14%) were prevalent. Exclusive breastfeeding was low (30%), early maize introduction was common (58%), and only 3.7% of children (6–24 months) achieved minimal dietary diversity. Findings indicated the need for culturally specific, behaviour-informed IYCF education to improve feeding practices, food safety, and security.

Vitamin D may help reduce the risk of colorectal cancer (CRC) by exerting an anti-inflammatory or modulatory effect on biomarkers associated with the disease. While previous studies have investigated individual biomarkers, our approach evaluates their combined effects. We investigated the association between 25-hydroxyvitamin D (25(OH)D) levels, measured using MS, and the expression of 92 inflammatory biomarkers assessed using the Olink Target 96 inflammation panel. This analysis was conducted in women from the Norwegian Women and Health Study (NOWAC), utilising plasma samples taken 1–6 years prior to CRC diagnosis (n = 163) and 163 matched cancer-free controls. Factor analysis was used to identify biomarker patterns, and linear regression examined the association of each factor with 25(OH)D levels. Women with 25(OH)D deficiency (≤30 nmol/L) had significantly higher Factor 1 scores compared to those with sufficient levels (≥50 nmol/L) (β = 0.72, 95% CI: 0.26–1.18). This association was specific to pre-diagnostic CRC cases (β = 0.97, 95% CI: 0.33–1.60) and was not observed in cancer-free controls (β = 0.22, 95% CI: −0.50–0.93). Factor 1 represents a cluster of biomarkers, many of which are pro-inflammatory (TNFSF14, S100-A12, IL-8, IL-18) and many that play key roles in processes such as cell growth, angiogenesis, and apoptosis (OSM, TGF-alpha, VEGF-A, CASP-8). Several of these biomarkers have been independently linked to CRC, exhibiting both unfavourable and favourable roles. The observed association between 25(OH)D deficiency and Factor 1 in pre-diagnostic CRC cases supports the hypothesis that sufficient levels of vitamin D could potentially contribute to prevention of CRC development.

Household food (HFI) and water insecurity (HWI) have each been linked to poorer child health but their joint relationship is understudied. We used 2023–2024 Ecuadorian National Infant Malnutrition Survey data to examine the independent and joint associations of HFI and HWI exposure with illness, anaemia, and malnutrition in 6–59 month olds. The Food Insecurity Experience Scale measured marginal and moderate–severe HFI. Water indicators (source, availability, accessibility, microbial safety) measured HWI. We used a 4-category indicator to classify HFI only, HWI only, joint HFI/HWI, and secure food and water. Child respiratory (RI) and diarrheal illness (DI) were assessed from caregiver reports, anaemia from blood haemoglobin, and nutrition indicators from anthropometric measurements. Modified Poisson regression models estimated adjusted prevalence ratios (aPR). Joint HFI/HWI was associated with a higher RI and DI prevalence, HFI only with higher RI, stunting and overweight/obesity, and HWI only with higher overweight/obesity but lower anaemia. The age-stratified analyses linked joint HFI/HWI and HFI only to higher RI and DI in 6–23 month olds and higher RI in 24–59 month olds. Joint HFI/HWI and HWI were linked to lower anaemia. In 24–59 month olds, HFI only was associated with higher stunting and HWI only with higher overweight/obesity. Exclusion of marginal HFI in the sensitivity analysis identified child-level double malnutrition as more prevalent in 24–59 month olds from HFI only or joint HFI/HWI households. These findings suggest HFI and HWI independently and jointly influence child health and nutrition, underscoring the need for effective multisectoral policies and interventions simultaneously targeting both.

The concept of ultra-processed food (UPF) has shifted nutritional epidemiology from single nutrients towards food processing. Higher UPF intake is associated with adverse health outcomes across a large and broadly consistent body of evidence, yet the magnitude and specificity of associations vary across major prospective cohorts: some report linear associations with all-cause mortality, whereas others find risk concentrated in particular subgroups. This critical narrative review synthesises evidence from seminal cohorts (NutriNet-Santé, Nurses’ Health Study (NHS)/Health Professionals Follow-up Study (HPFS), EPIC, UK Biobank) to examine methodological and contextual factors that may contribute to this heterogeneity. We propose three interacting, hypothesis-generating dimensions. (1) The proposed Metric Trap: weight-based metrics (g/day) capture non-nutritive items such as artificially sweetened beverages, whereas energy-based metrics (% kcal) may under-capture them – a proposed ‘Zero-Calorie Paradox’. (2) The proposed Geographic Paradox: identical food categories may exert divergent effects depending on baseline diet quality; for example, ultra-processed whole grains appear neutral – or are excluded from the exposure a priori – in some US analyses, while industrial breads show neutral-to-adverse associations in parts of Europe. (3) Mechanistic Hierarchy: UPF risk may be cumulative, potentially involving nutrient-poor profiles, food-matrix degradation, and neo-formed contaminants. We argue that UPF is not monolithic, while emphasising that this heterogeneity does not negate the broadly consistent overall associations. We propose a Risk-Stratified Typology that moves beyond binary ‘High vs. Low’ comparisons towards scenario-specific definitions (toxicological, nutritional, volumetric). These frameworks are interpretive hypotheses requiring formal empirical validation.

Food neophobia, characterised by children’s reluctance to try diverse food varieties, is observed in childhood and can limit dietary variety, nutrient intake and growth. Understanding maternal influences can inform feeding practices in low- and middle-income settings. This study examined food neophobia and its association with maternal knowledge, attitudes and practices (KAP) among children and explored its link with nutritional status in urban India. A cross-sectional study was conducted in Hyderabad, Telangana, India. Food neophobia was assessed using the Child Food Neophobia Scale (CFNS); maternal KAP and anthropometric indices (WHO standards) were assessed. Associations with CFNS scores were analysed using chi-square, t-tests and multivariable regression. 150 mother–child pairs aged 2–7 years participated in the study. The mean CFNS score was 27.4 ± 5.7, with higher scores indicating greater food neophobia. Food neophobia was classified as low (<mean − 1 SD), moderate (mean ±1 SD) or high (>mean + 1 SD). 12% showed low, 76.6% moderate and 11.3% high food neophobia. Males had significantly higher mean CFNS scores than females (28.4 ± 5.9 vs. 26.3 ± 5.7; p = 0.018) although the proportion of children in the low/moderate/high categories did not differ significantly by gender. Wasting was positively associated with higher food neophobia (β = 5.81; 95% CI: 2.01–9.63; p = 0.003), and maternal KAP was inversely associated with CFNS scores (β = –2.87; 95% CI: –5.13 to –0.61; p = 0.013). Food neophobia was common among preschoolers, highlighting need for caregiver-focused strategies to improve maternal KAP.

The purpose of this qualitative study was to explore farmers’ attitudes and beliefs as members of local public health systems, using the socio-ecological model (SEM) as a guide for framing their identities. In-person, semi-structured interviews were conducted with 24 farmers between May and September of 2019. The interviews were recorded and averaged 40 min. The farms were located within a 100-mile radius of Dayton, Ohio. The interviews were completed on the farmers’ properties. Purposive and snowball sampling were used to select 24 farm owners and/or operators in Indiana and Ohio. The sample included eight farmers from each farming method: conventional, certified organic, and non-certified organic. Key themes discovered using the SEM included: farming and nutrition policy; community outreach and education; institutional healthcare partners; farmers’ knowledge, attitudes, and beliefs. Farmers shared how intrapersonal factors, including their own knowledge and attitudes, framed their perceptions of their ability to influence community food systems and nutrition education. Farmers defined their influence based on interactions in their community organizations and outreach programming. They also discussed how policies can affect their farming decisions. Farmers have innovative ideas about health, nutrition, and the future of community/public health. Healthcare professionals should consider farmers as part of the healthcare and food systems network. The ideas and suggestions gathered from farmers in the current study could be the beginning of partnerships and programs to help promote health in communities, especially rural locations.

Newborn infants are at increased risk of gastrointestinal dysfunction, inflammation, and feeding intolerance because their digestive and immune systems are not fully developed. BioLipids-fortified diets enriched with a blend of medium-chain triglycerides (MCTs), mono- and diglycerides (MDGs), and milk phospholipids (MPLs) have emerged as a promising strategy to enhance gut health and resilience in paediatric populations. In the present study, neonatal C57BL/6 mice were gavage-fed either a standard lipid (StdLipid) or composite BioLipids-fortified diets containing graded levels of MCT, together with MDGs and MPLs (BioLipids1 and BioLipids2) for up to 5 days. To assess gut inflammation, intestinal motility, epithelial barrier integrity, and enteric nervous system (ENS) integrity, models of LPS-induced endotoxemia and DSS-induced colitis were employed. BioLipids-fortified diets were well tolerated and did not induce feeding intolerance or baseline intestinal inflammation in neonatal mice. Compared with StdLipid-fed controls, mice receiving BioLipid diets exhibited reduced expression of pro-inflammatory cytokines (Il6 and Il1b) and Tlr4 following LPS exposure in both the ileum and colon. BioLipids diets also preserved intestinal motility, protected enteric neuronal and glial marker expression, and mitigated LPS- and DSS-induced oxidative damage and epithelial injury. Furthermore, BioLipids-fed mice demonstrated protection against hypomotility and ENS dysfunction in both ileal and colonic tissues following inflammatory injury. Collectively, these findings demonstrate that BioLipids-fortified liquid diets are safe and provide multifactorial protection against gut injury in neonatal mice, supporting further investigation of bioactive lipid-based enteral formulations as therapeutic nutritional strategies for newborn and high-risk neonatal populations.

The study aimed to evaluate ultra-processed foods (UPFs) consumption among school-aged children and adolescents in Lebanon and examine factors associated with its intake. A cross-sectional national survey was conducted in 2014–2015 on a nationally representative sample of households with children and adolescents aged 5–18 years in Lebanon (n = 1111). Dietary assessment was performed using 24-h recall method and UPF were identified based on the NOVA classification. Information pertinent to sociodemographic characteristics and physical activity levels was also collected. Percent of energy intake (%E) from UPF ranged between 48.3% and 51.4% amongst children in our study sample with pizzas, dough-based dishes, sweets, and fast food as main energy contributors. Overall, UPFs were the largest contributors to carbohydrates, total sugar, total fat, saturated fat, sodium, and iron intakes. Unprocessed or minimally processed foods contributed most to protein, fibre, calcium, zinc, and vitamins A and C intakes, while being the lowest contributors to sodium intakes. Age and sex-based differences in UPF intakes were also noted. Adjusted regression models showed that girls and children of working fathers had significantly lower %E from UPF compared to boys and children of unemployed fathers (β: −0.18, 95% CI: −0.22, −0.14 and β: −0.27, 95% CI: −0.34, −0.20, respectively). In addition, higher household income was associated with increased %E from UPF. Public health action is needed to reduce the high UPF intake observed amongst children and adolescents in Lebanon and promote minimally processed, culturally appropriate diets to improve nutrition and protect the health of this vulnerable population.

In Switzerland, as in many other countries, national guidelines recommend individualized rather than systematic vitamin D supplementation in children beyond the age of three, making routine assessment challenging. This study aimed to examine paediatricians’ reported practices and opinions regarding vitamin D management in children aged 3–17 years in Geneva, Switzerland. A cross-sectional online survey was distributed to 193 paediatricians, of whom 59 completed the questionnaire (85% women). The questionnaire covered assessment frequency and methods, deficiency management, and views on systematic supplementation. Fewer than half reported assessing vitamin D adequacy at every check-up, with 49% (n = 29) for children aged 3–10 years and 44% (n = 26) for adolescents. Among children with clinical signs of deficiency, 76% (n = 45) reported assessment at every check-up, compared with 63% (n = 37) for children with dark skin or chronic digestive disorders and 58% (n = 34) for those with overweight or obesity. Assessments relied mainly on reported supplementation, followed by diet and sun exposure. Regarding prophylactic supplementation, 61% of paediatricians were in favour for children aged 3–10 years and 76% for those aged 11–17 years. Among those opposed, the main reason cited was the absence of clear national guidelines. Overall, this survey highlights marked variability in paediatricians’ approaches to vitamin D, with routine assessment remaining infrequent, even among children with clinical signs of deficiency. This gap may leave vulnerable children and adolescents with undetected deficiency, underscoring the need for harmonized national guidance and targeted educational initiatives to support preventive paediatric care.

This study aimed to conduct the first known systematic review concerning the evidence on probiotic-fermented food consumption among the young population across multiple countries and its dietary outcomes, including diet quality and nutrient intakes. Five databases were searched through December 8, 2025: Web of Science, Scopus, OVID Medline, EBSCO CINAHL, and ProQuest. English-language quantitative studies from 2004 to 2025 were included. Eligible studies reported probiotic-fermented food consumption patterns in youth aged 2–24 years and examined associations with dietary quality and nutrient intakes. Initial searches identified 11,844 records, of which twelve studies met the inclusion criteria. Included studies originated predominantly from high-income countries in North America and Europe, with limited representation from Africa and Asia. Consumption patterns varied widely, with both children and adolescents consuming probiotic-fermented foods at least once a week and having fewer daily servings, particularly for yogurt. Of the seven studies that examined dietary outcomes, six reported positive associations between consumption of probiotic-fermented foods and improved dietary quality scores, and six studies reported associations with higher nutrient intakes. The review underscored the need to increase the consumption of probiotic-fermented foods among the younger population to improve nutrient intake in the early stages. Further research is needed in under-represented regions, including Southeast Asia, Latin America, Africa, and the Middle East, where fermented food traditions are culturally significant but population-level consumption data among youth remain scarce.

Positive attitudes toward healthy nutrition and food literacy have been associated with healthy eating habits in previous research. However, evidence regarding the relationships among food literacy, attitudes toward healthy nutrition, and BMI among school teachers remains limited. This study examined the associations among self-perceived food literacy, attitudes toward healthy nutrition, and BMI among school teachers. This cross-sectional study was conducted with 294 primary, secondary, and high school teachers. An online questionnaire including demographic characteristics, eating habits, anthropometric measurements, the Self-Perceived Food Literacy Scale (SPFLS), and the Attitude Scale for Healthy Nutrition (ASHN) was used to collect data. A total of 294 school teachers aged 20–59 years completed the study, of whom 73.5% were female. Obese participants had lower food literacy (p < 0.001) and healthy nutrition attitude scores (p < 0.05) than normal-weight participants. Food literacy and attitudes toward healthy nutrition were positively correlated with age and years of experience, and negatively correlated with BMI (p < 0.05). Multiple linear regression analysis indicated that attitudes toward healthy nutrition and BMI were associated with self-perceived food literacy (R2adj = 0.501, p < 0.001). These findings contribute to the limited evidence regarding the relationships among food literacy, attitudes toward healthy nutrition, and BMI among school teachers.

Food insecurity is a significant public health concern associated with adverse mental health outcomes, including depression and anxiety symptoms, yet the role of resilience in this relationship remains unclear. This cross-sectional study investigated the relationship between food insecurity, resilience, and depression and anxiety symptoms and explored whether resilience moderates or mediates this association. Data were collected using a self-administered online survey distributed from April to May 2022 to a quota-based sample of California adults (n = 1,177). Food security was measured using the United States Department of Agriculture 6-Item Food Security Module, depression and anxiety symptoms using the Patient Health Questionnaire-4, and resilience using the Brief Resilience Scale. Food insecurity was reported by 39.5% of participants and 31.2% reported moderate-to-severe depression and anxiety symptoms. Regression analysis showed an inverse association between resilience and symptoms (beta = −2.01, 95% CI −2.22, −1.79), while food insecurity was positively associated with symptoms (beta = 0.46, 95% CI 0.38, 0.54). Moderation analysis was not significant, while mediation analysis revealed that resilience partially mediated the association between food insecurity and depression and anxiety symptoms (beta = 0.135; 95% CI: 0.095, 0.176). In conclusion, food insecurity and low resilience were independently associated with psychological distress. Resilience showed a partial indirect association in this relationship. These findings suggest that resilience may be a modifiable factor to consider alongside broader efforts to address food insecurity and support mental health. However, longitudinal studies are needed to confirm the directionality of these associations.

Lithium is a mainstay treatment in bipolar disorder and is used in various psychiatric conditions. Micro or trace doses have also been suggested to have potential neuropsychiatric effects. Dietary supplements containing lithium are available in the US, but no studies have evaluated their labelling regarding dosing, health claims, or precautionary practices. Products from the Dietary Supplement Label Database (DSLD) marketed between 2011 and 2025 were reviewed, with composition and dosing derived from declared labelling. Lithium amounts, mood-, cognitive-, and suicide-related claims, and precautions for pregnancy/breastfeeding, kidney, and antidepressant use were assessed, and associations with dosing were analysed using Mann–Whitney U tests with correction for multiple comparisons. Of 439 products, 99 met inclusion criteria. Forty-one percent were lithium-only, with reported elemental lithium ranging from trace amounts to 25 mg (median, 1.5 mg). Some elemental lithium amounts were comparable to the lowest manufactured doses of lithium carbonate. Lithium-only products contained higher elemental lithium than combination products (p < 0.05), and lithium orotate was the predominant salt (52.5%). Products with mood-related claims had higher reported elemental lithium than those without (5 vs. 1 mg; p < 0.05), whereas no association was observed for cognitive claims. No products made suicide-related claims. Kidney- and antidepressant-related precautions were not associated with elemental lithium amounts, while products with pregnancy/breastfeeding precautions had higher reported content than those without (3.25 vs. 0.5 mg; p < 0.05). These findings highlight variability in dosing and labelling, with certain labelling features correlated with declared lithium amounts, possibly reflecting conventions in lithium use.

Research highlights school meals as a powerful mechanism to impact population health. As 4.7 million English primary school children consume around 30.0% of their daily food at school, the school lunch caterer can influence child dietary health. Despite this, and considerable public sector spend on school food, no public record of school food provision exists. This study aimed to understand who provides school food and whether school characteristics differed by provider type. School food provision in 1,771 state funded Yorkshire primary schools was mapped by provider and provider type, along with key school characteristics (school size, geography, deprivation, cultural diversity and school type). Descriptive statistics and ANOVA analysed differences in characteristics between provider types. Three provider types were identified; local government caterer, commercial caterer, and in-house caterer. School size varied widely from 5 to 789 children and 21.0% of schools had fewer than 150 pupils necessary for meal provision to financially breakeven. Local government caterers served most schools (49.3%), with smaller (F3-479 = 7.132, P < 0.001), less deprived (F3-470 = 8.813, P < 0.001) schools, and a higher rural proportion, than other catering types. Commercial caterers served 30.2% of schools, with the largest (F3-479 = 7.132, P < 0.001), and proportionally more urban, schools. In-house catering was less prevalent at 8.9%. Data were unavailable for 11.6% of schools. The data demonstrated fragmentation and complexity of school food provision which may hinder effective policy and practice. Significant differences in school characteristics by provider type, facilitating unequal profitability potential and issues with financial viability, likely affect school food quality.

Many dietary interventions have been conducted in rheumatoid arthritis (RA) with quantitative outcomes the key focus; qualitative research exploring participant experiences remains limited. The autoimmune protocol (AIP) diet is an elimination reintroduction approach designed for autoimmune conditions. This study explored the experiences of nine adults with RA who completed an eight-week AIP dietary intervention, with semi-structured interviews conducted immediately post-intervention and again one year later. Interviews explored participants’ motivations, challenges, enablers, and perceived effects of the intervention, their experiences with food reintroduction, and the degree to which dietary changes were sustained. Thematic analysis identified three themes related to initial intervention experiences. Open to change, captured initial motivations, trust in the protocol and willingness to attempt substantial dietary change. Navigating dietary transition described the mental, practical, and social strategies used to manage challenges and support adherence. Reflections on benefits and looking ahead, captured perceived health changes and intentions for future dietary practices. At one-year follow-up, three further themes were identified. Personalised reintroductions and responses highlighted how participants observed the effects of foods on RA and health. Finding and sustaining balance reflected the ongoing process of negotiating dietary structure with flexibility, particularly in social contexts. Reflections on wellbeing and future intentions encompassed perceived benefits, persistent challenges, and plans for ongoing dietary management. High initial adherence was facilitated by participant motivation and structured study support. The reintroduction protocol was perceived as burdensome, however, most participants sustained meaningful dietary change, even without ongoing formal guidance.

In Japan, a version of the Japanese Food Guide, specifically developed for pregnancy and lactation (JFGST-P/L), promotes healthy dietary habits. In the mid- to-late stages of pregnancy, it is especially important to consume the recommended additional calories and nutrients. Adherence to these guidelines also plays a key role in achieving appropriate gestational weight gain (GWG). This study investigated the relationship between adherence to these guidelines and GWG among women in the mid- to late stages of pregnancy. Data were obtained from the Maternal and Child Cohort Study, conducted at the National Center for Child Health and Development (Setagaya-ku, Tokyo, Japan). The degree of adherence to the JFGST-P/L was evaluated using scores calculated from responses to a semi-quantitative food frequency questionnaire. The participants were classified into quartiles (Q1–Q4) based on their adherence scores. GWG was classified as inadequate, adequate, or excessive according to the Ministry of Health, Labour and Welfare guidelines. The degree of JFGST-P/L adherence was divided into quartiles, and a multinomial logistic regression analysis was performed. Furthermore, the Q1 group was compared with the Q2–Q4 groups to examine the association with the risk of insufficient GWG. In the quartile analysis, no clear dose–response relationship was observed between JFGST-P/L adherence and GWG. Conversely, among Q1, an increased risk of insufficient GWG was noted compared to the Q2–Q4 group (Unadjusted OR 1.389, 95%CI 1.008–1.913). In this study, the lowest degree of adherence to the JFGST-P/L among pregnant women was associated with inadequate GWG.