Sulforaphane (SFN), a bioactive compound derived from glucoraphanin in cruciferous vegetables such as broccoli, has been extensively studied for its therapeutic potential across diverse disease categories. SFN exerts its effects through well-characterised pathways, including the Keap1/Nrf2 axis, which regulates phase II detoxification enzymes, and epigenetic mechanisms such as histone deacetylase inhibition. This review evaluates clinical trials registered on ClinicalTrials.gov, focusing on those using SFN or broccoli-derived extracts.

As a result, we identified 84 trials, of which 39 have been published. Results suggest SFN’s potential in regulating redox and inflammatory pathways, improving metabolic and cardiovascular outcomes, and exerting anti-cancer and neuroprotective effects. For healthy subjects, SFN enhanced detoxification and reduced inflammation. In cancer patients, SFN showed promise in early-stage prostate and breast cancer, particularly in GSTM1-positive individuals, but had limited effects in advanced cases. For brain disorders, SFN demonstrated symptomatic improvements in autism spectrum disorder and cognitive benefits in schizophrenia but lacked robust biomarker integration. SFN had minimal impact on respiratory diseases but showed supportive roles in allergic rhinitis therapy. Metabolic disease studies revealed glycaemic control improvements in type 2 diabetes but no benefits for hypertension. Approximately 50% of completed trials remain unpublished, raising concerns about publication bias. While published results highlight SFN’s therapeutic potential, limited sample sizes and inconsistent outcomes underscore the need for more extensive, stratified trials. This review emphasises the importance of integrating mechanistic insights and precision medicine approaches to maximise SFN’s clinical utility.

Norway exhibits one of the highest rates of colorectal cancer (CRC) in the world, and several dietary factors have been associated with the risk of CRC. With higher consumption of ultra-processed foods (UPF), a better understanding of how food processing affects CRC might be a new approach for prevention. The current findings are contradictory, and new findings indicate that CRC risk factors might affect colorectal subsites differently. We wanted to study the association between intake of UPF and CRC risk in Norwegian women. In this prospective cohort analysis encompassing 77 100 women (1625 cases) from the Norwegian Women and Cancer study, dietary intakes were collected using validated semi-quantitative FFQ and categorised using the Nova classification system. Multivariable Cox proportional hazard models were used to assess the association between intake of UPF and CRC risk. The average follow-up time was 17·4 years. A high UPF intake (fourth quartile), compared with a low UPF intake (first quartile), was statistically significantly associated with increased total CRC risk after adjusting for all covariates and energy intake (hazard ratio (HR) = 1·24; 95 % CI 1·04, 1·49, Pfor trend = 0·02). Furthermore, a high UPF intake, compared with a low UPF intake, was statistically significantly associated with right-sided colon cancer (HR = 1·58; 95 % CI 1·19, 2·09, Pfor trend < 0·001). More research is needed to understand the associations between UPF, UPF subgroups and total CRC as well as cancer in colorectal subsites.

Consuming whole grains (processed cereal grains containing all the bran, germ and endosperm), and whole-grain foods such as bread, porridge and pasta made from them, is universally recognised as beneficial for health. This is consistently shown through reduced risk and incidence of chronic diseases such as CVD, type 2 diabetes and some cancers with higher whole grain and whole-grain food intakes. Despite this, and the promotion of whole-grain foods in many food-based dietary guidelines, their consumption by the majority of global populations remains below levels predicted to improve health, particularly in the UK and Ireland. This paper (a) describes how whole grains and whole-grain foods can be better identified by consumers and food manufacturers through adoption of standard definitions and food-labelling processes, (b) summarises predicted benefits associated with higher whole-grain consumption and (c) discusses how developing population-based strategies to increase whole-grain consumption can beneficially affect dietary fibre intake, using the Danish Whole-Grain Campaign as a model for success. We suggest that the forthcoming ISO definition of whole grains as a food ingredient together with conditions of use should be adopted as soon as possible in the UK and Ireland. The health benefits of consuming more whole grain are unequivocal and should be recognised by including whole grains in dietary guidance, preferably with a minimum intake level for improved health. Public Health Agencies in the UK and Ireland should work in partnership with academics, industry and retailers to raise the profile of whole grains and whole-grain foods to improve population health.

The food system, particularly animal agriculture, is a major contributor to environmental degradation, impacting critical Earth system processes such as climate change, freshwater use and biodiversity loss. There is a growing consensus that a shift from animal-based to plant-based diets is essential for both human health and environmental sustainability. This review explores the integration of sustainability competences into nutrition education, emphasising how systems thinking, strategic thinking, values thinking, futures thinking and interpersonal competences can contribute to the production of improved dietary guidelines. By applying these competences to the criticisms of the Planetary Health Diet, the Nordic Nutrition Recommendations and the Mediterranean diet as examples, this review highlights the tactics used by specific stakeholders to undermine sustainable healthy dietary guidelines. The review paper concludes by advocating for future dietary guidelines that are free of financial conflicts of interest, decolonised and developed through participatory processes in order to ensure that they are equitable, sustainable and aligned with the needs of diverse populations.

The aim of this paper is to review several key aspects of undernutrition in later life, with a major focus on undernutrition in community-dwelling older adults. The prevalence of undernutrition in community-dwelling older adults is about 8.5%, but higher in vulnerable subgroups such as the oldest old (19.3%), those reporting poor appetite (22.4%), and those receiving home care (15.8%). Frequently reported risk factors for undernutrition in the community include poor appetite, functional limitations and previous hospitalisation. The Determinants of Malnutrition in Aged Persons (DoMAP) model provides a clear framework to structure the different direct and indirect potential determinants of undernutrition in old age. Low BMI as well as involuntary weight loss, both important phenotypic criteria of undernutrition, are associated with early mortality in older adults. Furthermore, undernutrition in community-dwelling older adults is associated with a subsequent increased risk of frailty, falls, functional decline and rehospitalisation. Qualitative studies indicate a poor undernutrition awareness among healthcare professionals working in community care as well as among older adults themselves. The Malnutrition Awareness Scale can be used to objectively measure an older persons’ undernutrition awareness. In conclusion, the prevalence of undernutrition among older adults living in the community is substantial and has several negative consequences for health and functioning. Strategies towards greater undernutrition awareness by primary care professionals as well as older adults themselves is therefore necessary.

Suicidal ideation not only indicates severe psychological distress but also significantly raises the risk of suicide, whereas food insecurity may further increase this risk. To examine the relationship between food insecurity and suicidal ideation, we used the NHANES (National Health and Nutrition Examination Survey) data from 2007 to 2016. The association between the risk of suicidal ideation and food security status was examined using multivariate logistic regression models. To ensure the robustness of our findings, we also conducted subgroup and sensitivity analyses, which were crucial for assessing the consistency and precision of the research findings. This study included 22 098 participants, of whom 50·30 % were female and 49·70 % were male. In the comprehensive analysis of the population, after full adjustment, the OR were 1·14 (95 % CI 0·89, 1·46) for marginal food security, 1·40 (95 % CI 1·12, 1·76) for low food security and 1·59 (95 % CI 1·27, 1·99) for very low food security. In the subgroup analysis, we identified a significant interaction between depression and food security (P = 0·004). Additionally, the results of the sensitivity analysis were consistent with previous findings. Our study revealed that food insecurity significantly increased the risk of suicidal ideation, emphasising the importance of addressing food security to improve mental health. These findings support the need for national food assistance programmes integrated with mental health services. More longitudinal studies are needed to validate the long-term impact of food insecurity on suicidal ideation to optimise intervention measures and policy adjustments.

By 2050, 1.31 billion people will be living with type 2 diabetes (T2DM). Those with social disadvantage experience greater diabetes prevalence, morbidity and mortality. Gestational diabetes (GDM) is an established factor for T2DM, with 3–4 times greater risks among women who are Black, Hispanic and South and South East Asians. Lifestyle interventions that include diet and physical activity reduce T2DM in at-risk populations, including women with prior GDM, regardless of ethnicity. However, migrant women from non-Western backgrounds are less likely to engage with the programme despite its efficacy. This review paper aims to describe the social disparities in GDM globally, with a focus on equity issues and interventions in Australia. It outlines a five-part approach to solutions that move us towards equity in reach and uptake for women from non-Western migrant backgrounds in Australia. Culturally inclusive solutions start with evaluating reach in underserved groups through equity audits or stratified analyses and identifying groups where reach is low. Community partnerships can then be formed with key actors across health and social sectors identified through stakeholder mapping. Effective reach strategies, including implementation and evaluation plans, will be co-developed through these partnerships, addressing risk factors, enablers and barriers to a healthy lifestyle. Solutions that integrate medical and social services, such as social prescribing, could facilitate healthy lifestyle choices through restructuring the social environment of the individual. These steps lead to interventions that promote social cohesion and resilience, enabling individuals to attain health and well-being in the face of external challenges.

To explore the longitudinal associations between a Chinese healthy diet and the progression of cardiometabolic multimorbidity (CMM) development among Chinese adults. A prospective analysis was conducted utilising data from 18 720 participants in the China Health and Nutrition Survey, spanning from 1997 to 2018. Dietary data were collected by three consecutive 24-h dietary recalls combined with the weighing method. A Chinese healthy diet score was developed by assigning scores to various food components. CMM was defined as the coexistence of two or more cardiometabolic diseases (CMD), including myocardial infarction, stroke and type 2 diabetes, diagnosed through blood indicators and clinical diagnosis. We employed a multistate model to examine the associations between the Chinese healthy diet and the longitudinal progression from being free of CMD to first CMD and then to CMM. Quantile G-computation was utilised to evaluate the relative contribution of each food component. Over a median follow-up period of 7·3 years, 2214 (11·8 %) participants developed first CMD, and 156 (0·83 %) progressed to CMM. Comparing participants in the highest quintile of dietary scores with those in the lowest, we observed a 55 % lower risk of transitioning from baseline to CMM (HR = 0·45, 95 % CI: 0·23, 0·87) and a 60 % lower risk of transition from first CMD to CMM (HR = 0·40, 95 % CI: 0·20, 0·81). Fresh fruits contributed to 42·8 and 43·0 % for delaying CMM and transition from first CMD to CMM, respectively. Our study revealed that greater adherence to the Chinese healthy diet is negatively associated with the risk of CMM.

Recent literature has shown that appetite loss during ageing can lead to negative health outcomes in older adults, particularly malnutrition and mortality. However, its association with functional decline and the mechanisms driving this relationship are not well explored. This review summarises the current evidence regarding the potential effects of appetite loss on frailty and functional outcomes. Despite the limitations due to heterogeneous methodologies, including study designs, population characteristics and appetite assessments, most studies indicate that older adults with poor appetite tended to exhibit poor physical performance and increased functional limitations. Furthermore, the simultaneous weight loss in individuals experiencing appetite loss was associated with a higher risk of functional impairments. Finally, emerging evidence connects reduced appetite to biomarkers of ageing, including epigenetic alterations, chronic inflammation and the upregulation of GDF-15. Therefore, loss of appetite is a potential earlier marker of loss of function that deserves further investigation. Adopting a geroscience perspective may enhance our understanding of appetite loss during ageing and foster the development of effective interventions.

This cross-sectional study evaluated the nutritional composition and labelling of commercial foods in Canada targeted to infants up to 18 months of age. Front-of-package labelling requirements were assessed based on daily values identified by Health Canada for saturated fatty acids, sugars, and sodium for children aged one year and older. Infant commercial food products were identified from online and in-person records of retailers across Canada. A total of 1,010 products were identified. Products aimed at older infants (12–18 months) contained significantly more calories, macronutrients, sugars, saturated fat, and trans fat compared to those targeted at younger infants (<12 months). In addition, 40% of products for children aged 12–18 months required a ‘high in sugar’ front-of-package label, while less required a ‘high in saturated fats’ (13%) and ‘high in sodium’ (5%) label. Organic products had higher added sugar and fibre, while they were lower in calories, total fat, saturated fat, and protein. Plant-based products, including vegetarian/vegan products, contained fewer calories, fat, saturated fat, trans fat, and protein, but more fibre. Gluten-containing products had more calories, macronutrients, sugar, fibre, and saturated fat. Non-GMO labelled products had more calories, carbohydrates, and sugar, but less saturated fat. Significant differences were observed for vitamins and minerals across food categories (p < 0.05). Our findings offer valuable guidance for parents, caregivers, and healthcare professionals on infant nutrition, highlighting the importance of selecting foods that align with infants’ specific dietary needs.

Although numerous clinical studies suggest that ginseng supplementation may benefit CVD risk factors, results remain inconclusive. This systematic review and meta-analysis evaluated the effects of ginseng supplementation on CVD-related risk factors. Relevant studies were identified through electronic searches in Embase, Web of Science, Scopus, PubMed and CENTRAL up to August 2024. Statistical analyses, including a random effects model, meta-regression and non-linear modelling, were used to assess heterogeneity, dose–response relationships and the overall effects of ginseng supplementation. A total of 70 studies, published between 1998 and 2024 and involving 4506 participants, were included. Ginseng supplementation significantly affected several biochemical markers, including high-sensitivity C-reactive protein (standardised mean difference (SMD): −0·23; 95 % CI: −0·38, −0·08; P = 0·002), gamma-glutamyl transferase (SMD: −0·20; 95 % CI: −0·36, −0·04; P = 0·015), glutathione reductase (SMD: 0·90; 95 % CI: 0·38, 1·42; P = 0·001), reactive oxygen species (SMD: −0·94; 95 % CI: −1·27, −0·60; P < 0·001) and superoxide dismutase (SMD: 0·48; 95 % CI: 0·10, 0·87; P = 0·014). Meta-regression analysis showed significant linear associations between ginseng dosage and Homeostatic Model Assessment for Insulin Resistance (P = 0·044) and between supplementation duration and malondialdehyde (P = 0·007). Dose–response analysis revealed significant associations between ginseng dose and fasting blood glucose (P < 0·001), high-sensitivity C-reactive protein (P = 0·043), IL-6 (P = 0·041), diastolic blood pressure (P = 0·022), IL-10 (P = 0·048), fasting insulin (P = 0·012) and total protein (P = 0·010). Supplementation duration was positively associated with malondialdehyde levels (P = 0·008). Ginseng supplementation was associated with improvements in inflammatory markers, liver function and oxidative stress parameters. No significant effects were observed on anthropometric indices, blood pressure, glycaemic profile, lipid profile, adipokines or heart rate.

A national food guide for the UK, providing food based dietary guidelines was first issued in 1995. It was last revised and published as the Eatwell Guide in 2016. The Guide is a pie chart indicating the proportions of foods from different food groups that should make up the ideal diet from a health perspective. The number of segments for the pie chart, the names of the food groups that comprise those segments and the list of individual foods that fit into the wider food groups was in essence decided in around 1995 and have remained essentially unchanged since then. The 2016 edition of the guide – the Eatwell Guide – was the first to employ optimisation modelling to calculate the angles of the segments of the pie chart. This was a significant improvement to the scientific basis to the guide. But still the Eatwell Guide leaves much to be desired and it is time for its revision. This review paper outlines the aims of the guide, provides a brief history of the Eatwell Guide, outlines its strengths and weaknesses and suggests some ways by which the Eatwell Guide might be improved.