Cross-cutting issues like nutrition have not been adequately addressed for children with severe visual impairment studying in integrated schools of Nepal. To support advocacy, this study aimed to determine the nutritional status of this vulnerable group, using a descriptive cross-sectional design involving 101 students aged 5–19 years from two integrated public schools near Kathmandu Valley and two in western Nepal. The weight-for-age z-score (WAZ), height-for-age z-score (HAZ), and body mass index-for-age z-score (BAZ) were computed and categorised using World Health Organization cut-off values (overnutrition: z-score > +2.0 standard deviations (SD), healthy weight: z-score −2.0SD to +2.0SD, moderate undernutrition: z-score ≥ −3.0SD to <−2.0SD, severe undernutrition: z-score < −3.0 SD) to assess nutritional status. A child was considered to have undernutrition for any z-scores <−2.0SD. Multivariate logistic regression was used to analyse variables linked to undernutrition. The mean age of participants was 11.86 ± 3.66 years, and the male-to-female ratio was nearly 2:1. Among the participants, 71.29% had blindness, and 28.71% had low vision. The mean BAZ and HAZ scores decreased with age. The WAZ, HAZ, and BAZ scores indicated that 6.46% were underweight, 20.79% were stunted, and 5.94% were thin, respectively. Overall, 23.76% of students had undernutrition and 7.92% had overnutrition. More than three in ten students had malnutrition and stunting was found to be prevalent. Older students and females were more likely to have undernutrition. These findings highlight the need for nutrition interventions within inclusive education settings, particularly targeting girls with visual impairments who may face compounded vulnerabilities.

The Nordic Nutrition Recommendations 2023 (NNR2023) serve as the scientific foundation for national dietary guidelines and nutrient recommendations across the Nordic and Baltic countries. We reviewed how NNR2023 was adapted into national food-based dietary guidelines (FBDG) in the Nordic countries and Estonia, focusing specifically on sustainability considerations and policy implications. National FBDG integrated both health and environmental aspects in all countries, except Norway, which addressed environmental aspects only in a separate report. Health impacts served as the primary principle in all countries. Additionally, national policy perspectives, such as domestic food security, were addressed in some countries, while the integration of social and economic sustainability remained very limited. In adopting NNR2023, all countries modelled how implementation would affect nutrient adequacy or health within their food environments, making minor adjustments based on these findings. Guidelines for animal source food groups showed the most variation between countries; Estonia and Denmark established the strictest recommended limits for red meat and total meat, respectively, while Norway was most liberal regarding milk products. Stakeholders participated in the consultation process. The agricultural sector and meat industry primarily maintained pro-meat discourse, which was particularly intense in Norway and Sweden. Transition towards healthy and sustainable diets demands multiple policy instruments – FBDG being just one – alongside a supportive environment and participation from all food system actors.

Infants born at high altitudes, such as in the Puno region, typically exhibit higher birthweights than those born at low altitudes; however, the influence of ethnicity on childhood anthropometric patterns in high-altitude settings remains poorly understood. This study aimed to characterise the nutritional status, body composition and indices, and somatotype of Quechua and Aymara children aged 6–10 years. A cross-sectional, descriptive, and comparative design was employed, with a simple random sampling of children from six provinces representative of the Puno region, including 1,289 children of both sexes. Twenty-nine anthropometric measurements were taken, and fat, muscle, and bone components were assessed using bioelectrical impedance analysis. Standardised equations were applied to determine body indices. Among the findings, most children presented normal nutritional status according to BMI-for-age and height-for-age Z-scores. However, high rates of overweight and obesity were observed in Aymara (39%) and Quechua (28.4%) children, with differences in fat content between ethnic groups at the 5th, 10th, 50th, and 75th percentiles. Both groups were characterised by brachytypy and brachybrachial proportions; Quechua children were mesoskelic and Aymara brachyskelic, with macrocormic proportions, rectangular trunks, and broad backs. The predominant somatotype was mesomorphic, with a stronger endomorphic tendency among Aymara. It is concluded that both groups exhibit normal nutritional status; however, Aymara children show a greater tendency towards fat accumulation and notable morphological differences. Differences were also observed in limb proportions, particularly a relatively shorter lower limb.

The adoption of the main text of the Pandemic Agreement at the 2025 World Health Assembly is a milestone in global health law. The adopted text makes several key contributions, but there were several missed opportunities in the negotiating process, and key roadblocks remain for the future of the Pandemic Agreement.

We aimed to compare the mean sodium content of New Zealand (NZ) packaged breads in 2013 and 2023 and assess compliance with the NZ Heart Foundation (HF) and World Health Organization (WHO) sodium reduction benchmarks. Sodium data were obtained from a supermarket food composition database. Mean differences between years were assessed using independent samples t-tests and chi-square tests. There was a significant reduction in the sodium content of all bread from 2013 (n=345) to 2023 (n=309) of 46 mg/100g (p<0.001). In 2013, 20% (n=70/345) of breads met the HF benchmarks, and 10% (33/345) met the WHO benchmarks; corresponding values for 2023 were 45% (n=138/309) and 18% (n=57/309) (p<0.001 for both). If continued, the modest reduction in sodium content and increase in the percentage of NZ breads meeting relevant sodium reduction benchmarks could positively affect public health, particularly if extended across the packaged food supply.

Women and children are priority populations in Cambodia, however no dietary intake information exists on breastfeeding women for informing nutritional intervention. The aim was to assess nutritional adequacy of dietary intakes of Cambodian women, by breastfeeding status and locality. A cross-sectional assessment of dietary intake was conducted with non-pregnant women ≥18 years of age with at least one child under 5 years in rural, semi-rural and urban locations in Siem Reap province, Cambodia. Women used a bespoke smartphone application to capture three-day image-voice records on two occasions. Data were analysed using a semi-automated web platform incorporating a tailored Cambodian food composition database. Estimated Average Requirements were used to assess adequacy of nutrient intakes. Of 119 women included in the analysis, 58% were breastfeeding, and 63% were rural or semi-rural. Protein, carbohydrate, vitamin B12, iron, and sodium were adequate for over 65% of women. Less than 10% of women had adequate vitamin A, vitamin C, thiamine, calcium, and zinc intakes, in contrast to low deficiency rates reported for Cambodian women. Despite breastfeeding women recording higher dietary intakes, adequate intakes of protein, carbohydrate, vitamin A, thiamine, and zinc were lower than non-breastfeeding women due to higher requirements. Rural women generally had higher nutrient intakes, and urban women had inadequate folate intake. This study indicates dietary intakes of Cambodian women in Siem Reap province, particularly breastfeeding women, are not nutritionally adequate. Data collected using image-voice dietary assessment could inform nutrition interventions and policies in Cambodia to improve dietary intakes and nutrition-related health outcomes.

This cross-sectional study aimed to investigate the correlation between magnesium consumption and periodontitis in different body mass index (BMI) and waist circumference (WC) groups. 8385 adults who participated in the National Health and Nutrition Examination Survey during 2009–2014 were included. The correlation between dietary magnesium intake and periodontitis was first tested for statistical significance by descriptive statistics and weighted binary logistic regression. Subgroup analysis and interaction tests were performed to investigate whether the association was stable in different BMI and WC groups. There was a statistical difference in magnesium intake between periodontitis and non-periodontitis populations. In model 3, participants with the highest magnesium consumption had an odds ratio of 0.72 (0.57-0.92) for periodontitis compared to those with the lowest magnesium consumption. However, in subgroup analysis, the relationship between magnesium intake and periodontitis remained significant only in the non-general obese (BMI ≤ 30 kg/m2) and non-abdominal obese populations (WC ≤ 102 cm in men and ≤ 88 cm in women). Dietary magnesium intake might decrease the periodontitis prevalence in the American population, and this beneficial periodontal health role of magnesium consumption might only be evident in non-general obese and non-abdominal obese populations.

This study aimed to assess the extent to which first-morning void (FMV) urine samples can estimate sodium and potassium excretion compared with 24-hour (24-h) urine samples at the population level. We conducted a cross-sectional study collecting urine samples (FMV and 24-h) and two non-consecutive 24-h dietary recalls in a sub-sample from the Portuguese IAN-AF sampling frame. Six predictive equations were used to estimate 24-h sodium and potassium excretion from FMV urine samples. Pearson correlation coefficients were calculated to compare the association between FMV and 24-h urine collections. Cross-classifications into tertiles were computed to calculate the agreement between measured and estimated excretion with and without calibration. Pearson correlation coefficients were calculated to compare the excretion estimation from FMV and reported intake from 24-h dietary recalls. Bland–Altman plots assessed the agreement between two-day dietary recall and the best-performing calibrated equation. Data from eighty-six subjects aged 18–84 were analysed. Estimated sodium and potassium concentrations from the predictive equations moderate or strongly correlated with the measured 24-h urine samples. The Toft equation was the most predictive and reliable, displaying a moderate correlation (r=0.655) with no risk of over or underestimation of sodium excretion (p=0.096). Tanaka and Kawasaki equations showed a similar moderate correlation (r=0.54 and r=0.58, respectively) but tended to underestimate the 24-h urine excretion of potassium (p<0.001). Calibrated predictive equations using FMV urine samples provide a moderately accurate alternative and resource-efficient option for large-scale nutritional epidemiology studies when 24-h urine collection is impractical.

Maternal health and nutrition in early pregnancy play a vital role in the growth and development of the foetus. During this time, macro and micronutrients contribute to nutritional programming, which helps form the foundations of the foetus’s life course health outcomes. This study aimed to investigate dietary habits, macro and micronutrient intake, micronutrient status, and folic acid supplement adherence among Emirati pregnant women in their first trimester. Data were collected according to the UAE-BCS study protocol, which was set up to investigate maternal nutrition, health, child growth, and developmental outcomes within the first 1000 days. Pregnant Emirati women with singleton pregnancies within their first trimester of pregnancy (between 8 and 12 weeks of gestation) were enrolled. The 24-hour food recall method was administered to collect dietary intake. The maternal mean average age was 29 years. Participants had high adherence to supplementation during pregnancy compared to preconception. The mean energy intake was 1345kcal, and 56% of participants consumed saturated fats above the acceptable macronutrient distribution ranges (AMDR), while 94% consumed below AMDR for total fibre. The consumption of micronutrients was below the recommended dietary allowance (RDA). Biochemical results show a high prevalence of low haemoglobin (74%) and deficiencies in vitamin D (39%) and vitamin E (96%). There is a need for research into dietary patterns and influences in pregnant women in the UAE. Furthermore, investigations of knowledge practices and attitudes towards supplementation and the factors contributing to folic acid supplement use are needed to inform government strategies and interventions.

Prior studies have shown that plant-based diets are associated with lower cardiovascular risk. However, these diets encompass a large diversity of foods with contrasted nutritional quality that may differentially impact health. We aimed to investigate the pooled cross-sectional association between metabolic syndrome (MetS), its components and healthy and unhealthy plant-based diet indices (hPDI and uPDI), using data from two French cohorts and one representative study from the French population. This study included 16 358 participants from the NutriNet-Santé study, 1769 participants from the Esteban study and 1565 participants from the STANISLAS study who underwent a clinical visit. The MetS was defined according to the International Diabetes Federation definition. The associations between these plant-based diet indices and MetS were estimated by multivariable Poisson and logistic regression models, stratified by gender. Meta-analysis enabled the computation of a pooled prevalence ratio. A higher contribution of healthy plant foods (higher hPDI) was associated with a lower probability of having MetS (PRmen: 0·85; 95 % CI: 0·75, 0·94, PRwomen: 0·72; 95 % CI: 0·67, 0·77), elevated waist circumferences and elevated blood pressure. In women, a higher hPDI was associated with a lower probability of having elevated triacylglyceride (TAG), low HDL-cholesterolaemia and hyperglycaemia; and a higher contribution of unhealthy plant foods was associated with a higher prevalence of MetS (PRwomen: 1·13; 95 % CI: 1·01, 1·26) and elevated TAG. A greater contribution of healthy plant floods was associated with protective effects on metabolic syndrome, especially in women. Gender differences should be further investigated in relation to the current sustainable nutrition transition.

I write in tribute to my friend Larry Gostin, who has long emphasized that accountability and governance are central to global health policy.

This article discusses the prospects and pitfalls of a legally binding pandemic agreement under the auspices of the World Health Organization, currently under negotiation in Geneva. Such an agreement could foster a rules-based pandemic prevention, preparedness and response as a reaction to the failures by states during the COVID-19 pandemic, including a lack of effective coordination for sharing all kinds of data and the global inequity in the distribution of medical goods fueled by vaccine nationalism. Achieving these goals, however, will depend upon a meaningful engagement by delegations negotiating the agreement, a legally sound formulation of its provisions, and overcoming the currently pervasive emergency-bias in this field of global health law. Thus, as advocated by Lawrence Gostin in his seminal treatise on Global Health Law ten years ago, the pandemic agreement could help realize the transformative potential of law for facing one of the greatest health threats to humanity.

The field of global health law has evolved over the past decade to describe new legal and policy instruments that apply to a changing set of public health threats, non-state actors, and regulatory norms that structure the global response to public health challenges. This special issue—bringing together the O’Neill Institute for National & Global Health Law and the Global Health Law Consortium—examines the expansive evolution of the field of global health law and its continuing development to face new health threats.

The field of global health law encompasses both “hard” law treaties and “soft” law policies that shape global health norms. Transitioning from “international health law” to “global health law and policy,” global health policymakers have increasingly looked to soft law instruments to address public health needs in a rapidly globalizing world – within the World Health Organization and across global health governance. Yet, as policymakers have expanded the landscape of soft law policy instruments to advance global health across state and non-state actors, the COVID-19 response revealed the limitations of this soft law approach to global health threats, with states now seeking hard law reforms to strengthen global health governance. As hard and soft law can provide complementary approaches to preventing disease and promoting health, future research must conceptualize how these normative frameworks interact in advancing global health.