Energy drinks are widely consumed for their caffeine content and related ergogenic effects. Many energy drinks also contain additional ingredients purported to enhance both physical and cognitive performance; however, it remains unclear whether these benefits are attributable solely to caffeine or the synergistic effect of other ingredients. The purpose of this study was to assess the effects of an energy drink vs. a caffeine-matched control on measures of sustained attention. Using a randomised, double-masked design (n = 116), subjects were assigned to an energy drink (C4 – Nutrabolt®) or a caffeine-matched control (200 mg caffeine). The following assessments were conducted before and approximately 45 min after consuming an energy drink or caffeine-matched control: psychomotor vigilance test (PVT), MemTrax (memory), handgrip strength, and wall-sit endurance. Both the energy drink and the caffeine-matched control improved pre vs. post for the PVT (i.e. reaction time improved); however, there were no differences in the delta score. The energy drink group showed a significant decrease in the MemTrax assessment (% correct), whereas reaction time increased, with no change in the control group. However, there were no differences in the delta score between groups for either the % correct score or reaction time. There were no significant differences in the handgrip or wall-sit assessments between the two groups. There are no significant differences between the effects of consuming an energy drink or caffeine. Both beverages improved sustained attention and alertness likely due to the effects of caffeine. There were no differences in memory, handgrip strength, or wall-sit endurance.

Prebiotics are selectively utilised dietary substrates that may influence depression through gut microbiota-related pathways, but population-level estimates of intake and associations with depression are limited. This repeated cross-sectional study estimated intake of International Scientific Association for Probiotics and Prebiotics (ISAPP)-recognised prebiotics and examined associations with depression among US adults using National Health and Nutrition Examination Survey (NHANES) 2015–2018 and NHANES August 2021–August 2023, analysed as independent survey periods. Estimated intakes of galactooligosaccharides and inulin-type fructans were assigned to foods using published source-food values, Food and Nutrient Database for Dietary Studies food codes, and ingredient-level information for mixed dishes. Depression was defined as Patient Health Questionnaire-9 score of 10 or greater. Survey-weighted analyses estimated intake distributions, and logistic regression models estimated ORs and 95% CIs for depression per 5 g/day higher estimated prebiotic intake in restricted adult samples. Mean estimated prebiotic intake was 6.44 g/day in NHANES 2015–2018 and 6.09 g/day in NHANES 2021–2023. In NHANES 2015–2018, higher estimated intake was associated with lower odds of depression overall (OR: 0.69; 95% CI: 0.49–0.98) and among females (OR: 0.65; 95% CI: 0.45–0.94), but not among males. In NHANES 2021–2023, estimated intake was not associated with depression overall (OR: 1.03; 95% CI: 0.74–1.43) or in sex-stratified models. These repeated cross-sectional findings provide nationally representative estimates of intake of ISAPP-recognised prebiotics and indicate that the inverse association observed in 2015–2018 was not replicated in 2021–2023. Prospective studies are needed to clarify whether prebiotic intake is associated with depression risk.

Coeliac disease (CD) is an autoimmune disease resulting in lifelong intolerance to gluten. Treatment of CD is a gluten-free diet (GFD). High gluten-free (GF) food costs contribute to GF-food insecurity (GF-FI) in households with children with CD. The study objective was to describe parental perceptions of the barriers/facilitators of GF-food security (GF-FS) and the health policies parents deem necessary to combat GF-FI. A subset analysis of a cross-sectional study examining household and child socio-demographic, child diet quality and GFD adherence, food environment, and GF-FI in parent–child dyads (n = 59) using validated questionnaires. Virtual interviews included 13 open-and-closed ended questions examining parent perceptions related to barriers/facilitators of GF-FS and health policies to address GF-FI. Questions were validated for face-and-content using an iterative process with parental responses deductively coded using the 5As of food insecurity theoretical framework. High GF-food costs (>90%) and the lack of effective GF-food specific health policies (∼94%) were the most commonly cited barriers to GF-FS, particularly in GF-FI households. Social media (>60%) was used to share information related to tax credits (15%) affordability, accessibility, and availability of GF-foods (75%). Parents deemed child tax credits (∼75%), development of food policies focused on education in schools (∼34%), dietary prescriptions (25%) and official recognition of CD as a disability (∼26%) as important to address GF-FI. In conclusion, parents perceive high GF-food costs and lack of effective GF-food health policies as important mediators of GF-FI. Social media platforms were widely used by the community to share information and solutions to address GF-FI.

This special issue of the JNS presents a selection of abstracts and outputs from the 23rd edition of the IUNS International Congress of Nutrition (IUNS-ICN Paris 2025), held in Paris from 24 to 29 August 2025. The Congress, themed ‘Sustainable Food for Global Health’, brought together students, researchers, academics, practitioners, and policy stakeholders from across the globe to share advances in nutritional science and address contemporary challenges in nutrition and health. A total of 3,805 delegates from 123 countries participated. This wide international participation reflected the global nature of the IUNS-ICN Paris 2025 and supported the exchange of perspectives across all areas of nutritional science.

Diabetic retinopathy (DR) is a leading cause of preventable blindness, particularly in regions with poor glycemic control and limited access to structured education. Theory-driven interventions such as the Theory of Planned Behaviour (TPB) may enhance self-care and improve clinical outcomes. To evaluate the effectiveness of a TPB-based self-care education programme on glycemic control, knowledge, self-care behaviours, and TPB constructs among patients with diabetic retinopathy. This quasi-experimental pretest–posttest-controlled study was conducted between September 2024 and August 2025 among 200 patients with diabetic retinopathy attending a tertiary diabetes centre in Erbil, Iraq. Participants were allocated to an intervention group (n = 100) receiving a structured three-session TPB-based education programme or a control group (n = 100) receiving standard care. Outcomes were assessed at baseline and 3 months. The primary outcome was HbA1c. Secondary outcomes included diabetes knowledge, self-care practices, and TPB constructs. Statistical analyses included paired and independent t-tests, chi-square tests, and effect size estimation. At 3 months, HbA1c significantly decreased in the intervention group (−0.50%) but increased in controls (+1.06%), yielding a significant between-group difference (−1.50%, 95% CI: −1.93 to −1.07; p < 0.001; d = 0.97). Significant improvements were observed in systolic blood pressure, total cholesterol, and LDL cholesterol. Diabetes knowledge improved markedly, with 56% achieving high knowledge versus 0% in controls (p < 0.001). Self-care behaviours and TPB constructs also improved significantly (all p < 0.001). A brief TPB-based education programme significantly improved glycemic control and self-management in patients with DR. This low-cost intervention offers a scalable strategy for reducing diabetes-related complications in resource-limited settings.

In the context of the rapidly evolving modern food environment, there is a need for dietary assessment tools to accurately assess current food intake. The objective of this research was to develop and validate a new food frequency questionnaire (FFQ). A 265 item web-based, self-administered FFQ (PREDICT-FFQ-v1) was developed using information from two FFQs and US and UK cohort level data. Over a 1-month period, 68 participants completed the PREDICT-FFQ-v1 and six 24-h recalls (reference tool; Intake24). Relative validity was assessed using Bland–Altman plots, cross-classification food group analysis, and Spearman’s rank correlation for food groups and nutrients. From the Bland–Altman plots, the median bias between the PREDICT-FFQ-v1 and Intake24 were energy (414 kcal (95%CI 289 to 609) (1734 kj (95% CI 1208 to 2549)), carbohydrate (2.3 %EI, 95%CI 0.08 to 3.68), fat (2.5 %EI, 95%CI 0.23 to 3.52), protein (−1.14 %EI, 95% CI −1.64 to −0.23), and fibre (1.86 g/1000 kcal, 95% CI 1.05 to 2.65). Cross-classification by quartiles of diet quality (plant-based diet index) categorised >76% of participants into the same or adjacent quartiles. Correlation coefficients for food groups assessed using both tools ranged from 0.38 (legumes) to 0.78 (meat), and for energy-adjusted nutrients ranged from 0.28 (total fat) to 0.82 (alcohol). The PREDICT-FFQ-v1 captures intakes of foods that are commonly consumed in modern diets, with greater resolution at the food level than previous tools. The PREDICT-FFQ-v1 has acceptable relative validity in comparison to 24-h dietary recall and provides a valuable alternative for assessing dietary intake in nutritional epidemiology.

Intestinal inflammation can lead to inflammation-related diseases such as IBD, so modulation of inflammatory responses is crucial for maintaining homeostasis in the gut and alleviating intestinal inflammation. Autophagy may play a functional role in inflammatory responses and inflammatory signalling pathways. In addition, probiotics can influence important signalling pathways that lead to inflammation. Thus, our objective was to investigate the impact of probiotics on autophagy gene expression to prevent or reduce inflammation by targeting the autophagy signalling pathway. A relative real-time PCR assay was performed to evaluate gene expression involved in the autophagy process after exposing the HT-29 cell line to sonicated pathogens and adding a native potent Lactobacillus/Bifidobacterium cocktail before, after, and simultaneously with inflammation. In general, the native potential Lactobacillus/Bifidobacterium mixture was able to significantly increase autophagy gene expression in all phases and our selected probiotics can influence all phases of the autophagy signalling pathway. Our native Lactobacillus/Bifidobacterium cocktail exhibited a significant impact on the expression of autophagy genes throughout all treatments, particularly during the pre-inflammatory phase. Consequently, our selected probiotics can potentially serve a preventive function in an in vitro model of inflammation.

Sarcopenia, the age-related decline in muscle mass and strength is a growing challenge for older adults. This study investigates whether meeting the WHO physical activity guidelines (150–300 min/week of moderate or 75 min/week of vigorous exercise) with higher protein intake, based on the RDA, is associated with appendicular lean soft tissue index (ALSTI) and handgrip strength (HGS) in adults living in the United States aged 40–59 years. Data from the National Health and Nutrition Examination Survey 2007–2020 included 2540 adults aged ≥40 years. Physical activity (moderate/vigorous) was self-reported, while higher protein intake was assessed via two 24-hour recalls (>0.8 g/kg/bodyweight). Linear regressions, adjusted for age, sex, BMI, race, education, comorbidities, and energy-adjusted protein intake were used to assess associations with ALSTI and HGS. In fully adjusted models, vigorous activity with higher protein intake (47.1 ± 5.6 years) was associated with ALSTI only after adjustments for age, sex, BMI, race, education (β = 0.37, SE 0.17, p = 0.047; mean baseline: 8.56 ± 1.67 kg/m2). No associations were found in the fully adjusted model for ALSTI (p = 0.31), and across all models for HGS (mean baseline: 43.6 ± 10.1 kg). Moderate activity with higher protein intake was not associated with HGS or ALSTI across adjusted models. Meeting vigorous or moderate-intensity activity guidelines with higher than the RDA protein intake was not associated with ALSTI or HGS in middle-aged US adults.

Launched in 1994, the European Nutrition Leadership Platform (ENLP) has evolved over three decades into a unique and internationally recognised initiative for the development of leadership skills in the field of nutrition and public health. Through its two training programmes, the ENLP Essentials programme, designed primarily for early-career professionals and emerging leaders in nutrition, food science, and health, and the ENLP Advanced programme, tailored to mid-career and senior professionals seeking to enhance their leadership capacity, equips participants with scientific communication and interpersonal skills while fostering resilience, authenticity, and cross-sector collaboration. With more than 1000 graduates, many of whom now hold leading positions in academia, industry, government, and non-governmental organisations, the programme has proven its impact on professional development and the nutrition landscape. At IUNS-ICN 2025 in Paris, the ENLP celebrated its 30th anniversary and emphasised that leadership in the nutrition sector is best defined by authenticity, caring, resilience, and shared values. In the coming decades, the programme will continue to focus on inclusivity, adaptability, and vision, demonstrating that investing in people is the most powerful lever for improving nutrition and public health.

Children’s growth extends beyond gains in height and weight: it includes non-physical achievements. This paper reviews the research conducted by the International Union for Nutritional Sciences Task Force ‘Towards a Multidimensional Approach to Child Growth’, which developed a Multidimensional Index of Child Growth (MICG) framed within a capability- and human-rights- based conceptualisation of child growth across interconnected dimensions, including physical health, love and care, mental wellbeing, participation, autonomy, mobility, and safety. Qualitative research in Bangladesh and southeastern Tanzania informed the operationalisation of the MICG, showing that caregivers understand child growth as a multidimensional capability set distributed across children, caregivers, and households. Quantitatively, we prototyped the MICG using Young Lives Survey data from Ethiopia, India, Peru, and Vietnam. The MICG reveals patterns of deprivation not captured by anthropometric indicators alone, such as compounded shortfalls in education, mobility, and mental wellbeing among rural girls in Peru, despite similar physical growth profiles. Regression and quantile analyses indicate that community participation in the design of WASH programmes is associated with higher multidimensional achievements, particularly among the most deprived children. To bridge observed achievements and unrealised potential, we extend the MICG using a Bayesian stochastic-frontier approach to estimate context-specific capability distributions and identify children at risk of being left behind. Finally, we propose a spiderweb growth chart for monitoring multidimensional child growth, complementing WHO anthropometric charts. Overall, the MICG offers an equity-sensitive tool for evaluating nutrition interventions, strengthening child growth surveillance, and advancing the Sustainable Development Goal commitment to leave no child behind.

This document presents some advances in personalised and precision nutrition that were addressed in the IUNS-ICN 2025 Congress at August 2025 including the role of biomarkers in personalised and precision nutrition research, personalised and precision nutrition approaches to routine health care services, implications for public health, personalised and precision nutrition around the world, machine learning and precision nutrition, and personalised dietary guidelines alongside population-based policies.

Throughout the Mediterranean region, adherence to the Mediterranean diet is decreasing especially among young people. The Mediterranean diet is the most studied dietary pattern with proven health benefits, especially regarding the prevention of non-communicable diseases at a time when their incidence is increasing worldwide. It has also been recognized as a sustainable diet model with multiple interdependent benefits on social, cultural, environmental, and economic dimensions. Faced with the challenge of promoting adherence to the Mediterranean diet, a Joint Med Diet Task Force of CIHEAM, FENS, and IUNS was formed to set the path for reversing the erosion of the Mediterranean diet heritage, by promoting its benefits, as a way of living, as defined by UNESCO. In this paper, the rationale and propositions of the Joint Task Force are described for the development of a voluntary code of conduct for promoting the adherence of the Mediterranean diet, and sustainable diets per se, addressed to all interested stakeholders and rights holders, linking food consumption and production, toward sustainable food systems transformation in the Mediterranean and beyond.

This study aimed to determine if habitual intake of key dietary antioxidants, both individually and collectively, is associated with all-cause and cause-specific mortality among U.S. adults, given that oxidative stress heightens cardiovascular and cancer mortality risk. This prospective cohort study analysed 34,955 participants from the National Health and Nutrition Examination Survey (NHANES) 2003–2018. Intakes of vitamins A, C, E, zinc, selenium, and carotenoids were assessed, and a composite dietary antioxidant index (CDAI) was calculated. The principal results, from 347,580 person-years of follow-up where 4,456 deaths occurred (1,368 CVD; 1,038 cancer), showed significant associations. Compared with the lowest intake quintile, the highest quintile of vitamin E was associated with lower all-cause mortality (HR: 0.69, 95% CI: 0.58–0.83) and CVD mortality (HR: 0.67, 0.48–0.92). High carotenoid intake was inversely associated with all-cause mortality (HR: 0.77, 0.67–0.88). Participants in the highest CDAI quintile experienced an 18% lower risk of all-cause mortality (HR: 0.82, 0.70–0.97) and a 39% lower risk of cancer mortality (HR: 0.61, 0.45–0.84). Dose–response relationships for vitamins A, C, selenium, and zinc were U-or L-shaped, and WQS analyses assigned the greatest weights to vitamin A or C. In conclusion, while individual antioxidants like vitamin E show strong protective associations, the evidence collectively suggests that greater overall antioxidant exposure from a varied diet is linked to materially lower risks of death. This reinforces that focusing on diets rich in diverse antioxidant sources is superior to single-nutrient strategies.