The Mediterranean Diet (Med Diet) has long been shown to be associated with lower cardiovascular mortality in epidemiological studies. However, the direct effect of the dietary pattern on cardiovascular risk factors is less clear. Furthermore, the effect of Med Diet interventions in non-Mediterranean populations on cardiovascular and metabolic risk is variable. A Cochrane Review in 2019 concluded there was low to moderate evidence of a modest benefit but noted that there were still ongoing trials. Since 2019, there have been a number of published trials that have not shown a benefit of the Med Diet over other interventions or usual care. It is possible that dietary factors such as quality or quantity of carbohydrate and energy restriction are more important factors, along with the degree of weight loss, than the Med Diet itself. There are also many other factors that influence the uptake and effectiveness of the Med Diet in populations that have a different traditional or habitual diet. This review paper examines a selection of 20 Med Diet intervention trials specifically looking at clinical outcomes of glucose metabolism: fasting plasma glucose, HbA1c, development of type 2 diabetes or need for hypoglycaemic medications, with or without other cardiometabolic risk factors. These trials are a mix of randomised controlled trials, crossover studies and cohort studies of greater than 8 weeks duration with more than 25 participants. There is heterogeneity in study designs and outcomes, making comparison difficult, but there is no clear benefit of the Med Diet presented.

Nutritional status has been compromised by ongoing war and restrictions on food deliveries in the Gaza Strip. We developed a mathematical model that outputs retrospective estimates and scenario-based projections of acute malnutrition prevalence among children given caloric intake and other factors. We present here the model and its application to the crisis in Gaza. We extended an existing mechanistic model for weight change as a function of energy balance, calibrating it to represent variability in growth curves observed in pre-war Gaza. We simulated open cohorts of children exposed to time-varying caloric intake, infant exclusive breast-feeding prevalence, incidence of infectious disease and coverage of malnutrition treatment, while allowing for adult caloric sacrifice to supplement child intake in times of food scarcity. The model accurately replicates growth standards, pre-war growth patterns and expected parameter dependencies. It suggests that a considerable increase in acute malnutrition occurred in northern Gaza during early 2024. Projections for late 2024 include a serious nutritional emergency if relatively pessimistic assumptions are made about food availability. The model may hold considerable promise for informing decisions in humanitarian response but requires further validation and development.

This paper examines associations between maternal exposure to a radio programme, Bhanchhin Aama (Mother Knows Best), and the programme’s most promoted maternal and child nutrition-related practices, using the Nepal Demographic and Health Survey (NDHS) from 2022. We limited our sample to mothers of children less than 2 years (n = 1,933). The primary exposure variable was whether the mother listened to the Bhanchhin Aama radio programme. The five primary outcomes were: maternal dietary diversity, maternal use of modern family planning methods, exclusive breastfeeding (EBF) of children less than 6 months, dietary diversity among children 6 to 24 months, and participation in growth monitoring and promotion among children 0 to 24 months. Descriptive analyses followed by logistic regression models, adjusted for potentially confounding factors and clustering, were conducted. Maternal exposure to Bhanchhin Aama was associated with nearly 70% higher odds of meeting both maternal (OR: 1.67; p: <0.001; CI: 1.26–2.21) and child minimum dietary diversity (OR: 1.70; p: 0.005; CI: 1.18–2.45), as well as 83% higher odds of a child participating in growth monitoring and promotion (OR: 1.83; p: 0.001; CI: 1.28–2.63). No associations were found for use of modern family planning methods and EBF. These findings suggests that radio programmes may be an effective tool to improve some maternal and child nutrition-related practices. Further research is needed to understand why certain behaviours are modifiable from this type of intervention versus others that are not and for which population groups this intervention would be most effective.

Food insecurity is a global issue. The objective is to summarise the literature identifying the main outcomes related to out-of-school hours interventions that provide food for low-income families with school-aged children, how they impact school-aged children and their families, and to identify gaps in knowledge. This review covered the main types and dimensions proposed in the literature. One author independently selected the studies, and an independent reviewer randomly reviewed them. Any paper meeting the inclusion criteria was considered regardless of geographical location. Papers were predominantly from the US, UK and Australia, including school-aged children from low-income families. Ninety-four articles were included relating to holiday clubs (n = 38), breakfast clubs (n = 45) and after-school clubs (n = 11). Key outcomes were healthy eating, academic, social, physical activity, nutritional education and financial outcomes. Clubs were consistent regarding the positive social and financial outcomes. There was variation in the primary aim, either to improve healthy eating or to feed children, regardless of nutritional quality. None of the studies reported children’s health outcomes. This review identified the key outcomes of interventions for low-income families outside of school hours in the literature. It highlights the consistent positive social outcomes across the three intervention types and the discrepancy in the nutritional value of the food provided. Few studies examined the attainment impact of holiday clubs, with no evidence on how they could impact term-time attendance. This highlights the need to analyse secondary data to understand further the attainment and attendance impact on children attending these interventions over time.

Recently, functional foods have been considered as an effective approach in management of type 2 diabetes mellitus. This trial aimed to evaluate the potential benefits of date seed powder (DSP) on inflammation anxiety- and depression-like behaviours, sleep quality and tryptophan (TRP)–kynurenine (KYN) metabolism in type 2 diabetes mellitus patients. In this trial, forty-three patients with type 2 diabetes were randomised to two groups: either 5 g/d of the DSP or placebo for 8 weeks. Depression, anxiety and stress scale, sleep quality, quality of life (QoL), levels of fasting blood glucose, endotoxin, anti-inflammatory/pro-inflammatory biomarkers, hypothalamus–pituitary–adrenal (HPA) axis-associated biomarkers (including brain-derived neurotrophic factor (BDNF)), KYN, TRP, cortisol and adrenocorticotropic hormone (ACTH) were assessed at baseline and after 8 weeks. An independent t test was used for baseline comparisons, while ANCOVA was used for post-intervention between-group comparisons. The results showed that supplementation with DSP significantly improved depression, anxiety and stress scale, sleep quality and QoL in comparison with placebo. In terms of biochemical parameters, the intervention group exhibited significantly reduced levels of endotoxin, and cortisol, KYN, KYN:TRP ratio as well as significantly elevated levels of IL-10, TRP concentrations and IL-10:IL-18 ratio compared to the placebo group. Changes in fasting sugar, C-reactive protein (hs-CRP), IL-18, ACTH, BDNF concentrations and cortisol:ACTH ratio were not different between groups. Supplementing with date seed may effectively improve anxiety- and depression-like behaviours, sleep quality and QoL by modulating metabolic endotoxemia, inflammation and HPA axis activity in patients with type 2 diabetes.

Dietary patterns are prerequisites for health and integral components of ecological systems. For over a century researchers have been building a body of evidence of associations between dietary patterns and health and sustainability outcomes while policymakers have been synthesising and translating this evidence into policies to promote public health. During this period, food systems have dramatically changed and driven the emergence of food supplies and dietary behaviours with no ecological or evolutionary precedent. Now, the relevance of conventional nutrition research and policymaking approaches for understanding food system transitions and protecting against unhealthy and unsustainable diets is being questioned. This review aims to examine how the ecological nutrition paradigm might guide a transformed approach to nutrition research and policymaking to promote healthy and sustainable diets. It shows the ecological nutrition paradigm is transdisciplinary integrating biological, social and environmental dimensions into nutrition research and policymaking. The paradigm operates to a ‘fit-for-purpose’ policymaking orientation. It draws on ecological and evolutionary theories to provide insights to conceptualise the causes of, and solutions to, nutrition problems and help design relevant decision-making processes. These research and policymaking features contrast with the ‘one-size-fits-all’ policymaking orientation and prescriptive decision-making processes of the conventional medical nutrition paradigm. Their attention to a relevance criterion engenders confidence in the likely effectiveness, and ability to avoid unintended consequences, of policies informed within an ecological nutrition paradigm. The review proposes a shift to the ecological nutrition paradigm to transform nutrition research and policymaking for promoting healthy and sustainable diets is overdue.

Male volleyball athletes may be at risk of inadequate energy and carbohydrate intake. This may increase their risk of relative energy deficiency in sport (REDs) and impair a variety of physiological and psychological systems involved with performance and health. This study explored the eating behaviours and diet quality of international elite volleyball male athletes and their association on hormones associated with acute energy deficit and primary serum REDs indicators outlined in the International Olympic Committee REDs Clinical Assessment Tool 2. Methods: Using a retrospective design, 30 male athletes from a national indoor volleyball programme were assessed using DXA bone mineral density, hematological analysis, anthropometry, restrained eating behaviour via the Three-Factor Eating Questionnaire-R18 and the Athlete Diet Index (ADI) questionnaire. Results: All participants met or exceeded dietary recommendations for health and sport with ADI mean score of 95.2/125 ± 10.5. Restraint eating was inversely associated with insulin (r = − 0.37; p  < 0.05). Both the ADI total and core nutrition sub-scores were inversely associated with free-triiodothyronine (r = − 0.58; p < 0.01) but not with total testosterone, insulin or leptin. Conclusion: Male volleyball athletes at risk of inadequate energy intake may not necessarily demonstrate signs of poor diet quality.