We examined whether diet quality is associated with executive function (EF) in middle-aged women with a family history of Alzheimer’s disease (AD) and whether this is moderated by a genetic AD risk factor, APOE-ε4 allele carriage. Data from 102 low-physically active women (AgeMean = 56.9 ± 5.8 years) were analyzed cross-sectionally. Diet quality was quantified via the Healthy Eating Index-2020 (HEI-2020). Overall EF and sub-domains (working memory [WM], exogenous inhibitory control [ICex], endogenous inhibitory control [ICen], and cognitive flexibility) were measured using neurocognitive assessments. APOE-ε4 carriage was determined from saliva. Moderated regression models tested HEI-2020*APOE-ε4 interactions; significant (p < .05) and near-significant (p < .10) interactions were followed by simple slope analyses. Main effects of HEI-2020 predicted overall EF (p = .033) and WM (p = .003). Interaction effects of HEI-2020*APOE-ε4 for EF and WM (p’s = .056–.038) were such that diet quality was positively associated with overall EF (p = .003) and WM (p = .005) in noncarriers only. Main effects of select HEI-2020 sub-scores were observed for overall EF and sub-domains (p’s = .001–.047). Interaction effects of total vegetables*APOE-ε4 on overall EF and ICex, saturated fatty acids*APOE-ε4 on overall EF and WM, and added sugars*APOE-ε4 on ICen (p’s = .007–.074) were such that sub-scores were positively associated with cognition in noncarriers only (p’s < .05). Diet quality and select sub-scores were positively associated with EF in middle-aged women without APOE-ε4 only. Future work should explore if APOE-ε4 carriers require a threshold of diet quality to yield cognitive benefits.

Food insecurity (FI) has increased in recent years due to economic shifts and rising food prices, with 13.6% of UK households experiencing FI, 47% including children in 2024. Following PRISMA guidelines, this systematic review with narrative synthesis explored the impact of UK interventions addressing FI for children, families, and pregnant women. Seven databases and two clinical trial registers were systematically searched for articles published between 2008–November 2023 (rapid search November 2023–February 2026). Peer-reviewed intervention studies were eligible if they were conducted in the UK, had an experimental design, targeted at least one FI pillar (accessibility, utilisation, availability, and stability) and if most participants were children aged 0–11 years, families with at least one child 0–11 years, or pregnant women. 18,225 articles were identified (rapid search identified 5,514); 11 intervention studies were included (rapid search n = 2). Types of interventions included cooking interventions (n = 4), free school meals (n = 3), holiday clubs (n = 2), supermarket vouchers (n = 1), and food bags (n = 1). Food availability was targeted in seven studies, food accessibility and utilisation in five, and food stability in one, one study included FI as an outcome. The interventions demonstrated barriers and facilitators to inform future intervention development. Most studies were considered serious or critical risk of bias. A lack of high-quality interventions addressing FI were identified. The additional studies reflected the evidence from the original studies. Government policies and funding are needed to relieve FI. Research needs to co-develop acceptable interventions and evaluate their effectiveness to reduce FI among families.

Acute malnutrition (wasting) remains a global public health problem. Ready-to-use therapeutic foods (RUTF) and supplemental foods (RUSF) for treatment of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM), respectively, come in the form of macro- and micronutrient-dense pastes. These lipid-dense treatments provide the energy and nutrients needed to support growth but have significant rates of relapse. Their role in reversing pathophysiological contributors to malnutrition, such as intestinal barrier dysfunction, intestinal dysbiosis, and systemic inflammation have not been evaluated. Traditional lipid-dense RUTFs and RUSFs are rich in pro-inflammatory omega-6 polyunsaturated fatty acids (PUFAs) but low in anti-inflammatory omega-3 PUFAs, which could fuel malnutrition-related pathological inflammation. We reasoned that reduced dietary omega-6 (n-6) PUFAs and increased dietary long-chain omega-3 (n-3) PUFAs found in fish oil would reduce malnutrition-related pathological inflammation. In an established mouse model of MAM, we observed that altering the dietary n-3/n-6 PUFA ratio through replacing dietary corn oil with fish oil improved the diversity and composition of the caecal microbiota, improved intestinal mucosal barrier and immune defence, reduced translocation of bacteria and bacterial lipopolysaccharides (LPS), and dampened systemic inflammation. Furthermore, dietary fish oil protected against weight loss upon systemic challenge with bacterial LPS. The anti-inflammatory effects of dietary fish oil did not compromise host defence against challenge with the intestinal pathogen, Citrobacter rodentium. Collectively, these results suggest that dietary fish oil blunts inflammation that contributes to the pathogenesis of MAM. Inclusion of fish oil in dietary interventions may be beneficial in prevention or reduction of malnutrition-associated inflammation.

Workplaces offer a key setting for health improvement interventions, given their reach and potential to promote lasting behaviour change. While diet and physical activity (PA) are common targets, sleep remains an underexplored yet influential factor in employee health. This randomised feasibility trial evaluated the practicality and acceptability of a 14-week, remotely delivered sleep-enhanced intervention (SEI) integrating sleep, PA, and diet, compared with a standard intervention (SI) focusing on PA and diet only, with exploratory assessment of behavioural and health-related outcomes. Staff from a UK higher education institution (n = 28) with short sleep duration (<7 h) and elevated cardiometabolic risk were randomised to SEI or SI. Quantitative data included self-reported and objective measures of PA, sleep, diet, and anthropometry over 14 weeks. Feasibility outcomes (recruitment, retention, compliance) and acceptability were assessed through qualitative interviews informed by the Theoretical Framework of Acceptability (TFA). Recruitment targets were achieved with 82% retention and 84% adherence. The SEI group showed indications of improvement in PA, dietary behaviours, anxiety symptoms, and sleep hygiene, while both groups showed reductions in BMI and waist circumference. Qualitative data highlighted the value of personalised guidance, peer support, and accountability, but also noted that the SEI’s complexity sometimes hindered adherence. The WHOLE trial demonstrates the feasibility and acceptability of a remotely delivered, holistic lifestyle intervention for UK employees. A phased or extended approach may enhance sustainability and engagement in future large-scale evaluations.

Accurately assessing dietary intake in children and adolescents is essential for understanding dietary patterns and informing public health strategies. In Latin America, rapid nutrition transitions and increasing childhood obesity highlight the need for culturally appropriate, validated dietary assessment tools (DATs). However, methodological challenges and limited regional data hinder effective dietary surveillance. This scoping review identified and characterised DATs used among children and adolescents (5–18 years) in Latin America, examining tool types, features, validation and regional coverage. Following Joanna Briggs Institute and PRISMA-ScR guidelines, comprehensive searches were conducted in EMBASE, Web of Science, PubMed, and LILACS (April 2024) in English, Spanish, and Portuguese. Eligible studies included original research developing, validating, or applying DATs in Latin American populations. Of 13,946 records screened, 105 reports met the inclusion criteria. Brazil and Mexico contributed the most studies, while six countries (Paraguay, El Salvador, Nicaragua, Panama, Honduras, and Belize) had none. Forty-three DATs were identified, 77% of which were food frequency questionnaires (FFQs). Half targeted adolescents, 39% children, and 11% both groups. Most were interviewer-administered (58%) and applied in person (49%), with only 19% conducted online, reflecting regional digital limitations. Validation was reported for 70% of tools, primarily against 24 HR. The DAT landscape in Latin America remains dominated by FFQs and traditional administration methods, with limited use of digital platforms. Developing age-appropriate, validated and culturally adapted digital DATs is essential to strengthen dietary surveillance and guide effective nutrition policies across the region.

This study aimed to identify barriers and facilitators to reducing free sugar intakes while participants were in the process of attempting to do this. Sixty-two adults with free sugar intakes >5% total energy intake; participants in a randomised controlled trial examining the effects of three different dietary recommendations versus control for reducing free sugar intakes were interviewed at either 1, 2, 4, 8, or 12 weeks after receiving their recommendation. Data were analysed using thematic analysis and framework analysis based on recommendation received, time for change, and success in reducing free sugar intakes at 12 weeks. Thematic analysis revealed seven interactive themes leading to dietary change: ‘Is it possible?’; ‘Power of knowledge’; ‘Personal balance and empowerment’; ‘Habitual approach’; ‘Realities of life’; ‘Extensive awareness and viewpoint’; and ‘Proof and impact’. Framework analysis revealed greater knowledge, including knowledge related to practical solutions, in intervention groups compared to control; greater intentions and expectations at the start of the process, followed by increasing or decreasing engagement and satisfaction over time, with noticeable physical and subjective proof occurring from 4 weeks; and active engagement, with growing confidence and motivation in those who ended the trial having reduced their free sugar intakes compared to more passive attitudes in those less successful. Our findings demonstrate clear variation in barriers and facilitators to reducing free sugar intakes throughout the process, dependent also on recommendation received and individual orientation. Suggestions for improving free sugar intake reduction can be offered based on these differences.

Food habits vary across ethnic groups and geographical regions. However, validated dietary assessment tools accounting for such diversity remain limited. A semi-quantitative food frequency questionnaire (FFQ) was developed and validated to assess the habitual food intake of adolescents and adults across Malaysia. The 147-item FFQ was constructed using commonly consumed foods from five main ethnicities (Malay, Chinese, Indian, and Sabah and Sarawak indigenous groups) identified from national surveys. A cross-sectional validation study was conducted among purposively sampled healthy individuals aged 10–59 years from 16 administrative regions. Trained community nutritionists administered the FFQ to assess monthly intake, alongside a three-day dietary record and recall (3DRR) covering two weekdays and one weekend. Spearman’s correlation, Bland–Altman plots, and quartile cross-classification evaluated the agreement between the FFQ and 3DRR for energy, macronutrients, and selected micronutrients (Vitamin C, thiamine, calcium, and iron). Respondents (n = 361; 50.3% adults, 49.7% adolescents) were 50.4% female and represented five main ethnicities (range: 15.8–25.2%), with 60.4% from Peninsular Malaysia. Energy intake estimated by the FFQ (median: 2285 kcal) was significantly higher than by the 3DRR (median: 1785 kcal; Wilcoxon p < 0.001). Spearman’s correlation coefficients observed for energy (crude r = 0.31), and selected nutrients (energy-adjusted r range: 0.19–0.38), along with <10% of extreme quartile misclassification indicated acceptable ranking ability and agreement for most nutrients. Bland–Altman plots indicated no proportional bias for energy and macronutrients. In conclusion, the FFQ is a valid tool for assessing dietary intake within the multi-ethnic Malaysian population nationwide.

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.

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 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.

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.

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.

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.